Migraine headaches - are there foods to avoid?

I often have patients who suffer from migraine headaches because it is an extremely common problem. But the majority of this vast population has finally caught on to the extremely effective, almost miraculous, medications that can save the day more often than not.

Unfortunately there are exceptions, patients on whom the newer meds do not work, and these headache sufferers are the ones we now see in medical practice most often. Since the quick and easy treatments don’t work, they focus on what things might trigger a headache, in the hope that avoiding as many of them as possible will spare them lost and painful days. And the question of which foods to avoid is often first in line. Here’s what I tell my patients about food triggers for migraine:

1) They represent one of many triggers and can be somewhat unpredictable as well as dependent on other factors at the time. For example, a prime trigger for women is the immediate pre-menstrual state of "falling estrogen levels." Should an offending food be introduced at this time, it may be more likely to trigger a headache (the final straw if you will) than at other times of the month. Besides premenstrual status, some of the other common triggers include peri-menopause status, hunger, lack of sleep, genetic tendency, stress and especially chronic use of pain medications such as ibuprofen, acetaminophen, and aspirin.

2) Foods most commonly associated with triggering headache include wine, chocolate, nuts, cheese, citrus, MSG (monosodium glutamate – the “Chinese Restaurant Syndrome”), aspartame/Nutrasweet® - my personal nemesis – and caffeine withdrawal. Others food triggers are known but less common and tend to be more specific to isolated individuals. I have one or two patients who only get headache with yeast exposure, for instance.

3) Almost all headaches, including those thought to be “tension” or “sinus” headache have now been convincingly proven to be migraine in origin. The term “migraine” refers to the etiology of the headache, not the severity, as so many people think. Interestingly, like so many medical conditions, migraine was originally defined by the most severe and dramatic cases – picture the patient in a dark quite room, cold wet towel over light-sensitive eyes, nauseous and miserable. But most true migraines are much more mild, yet caused by the same triggers and treated effectively with the same treatments.