Food allergies in migraine

Many migraine sufferers feel that food allergies cause their headaches.  There is little dispute that certain foods can trigger migraines.  Some of these foods include chocolate, wine, cheese, citrus fruit, onions, smoked, cured, and pickled foods.  However, migraine that results from eating these foods is not due to an allergic reaction, but rather is due to a chemical reaction.  An allergic reaction occurs when the body’s immune defense mechanisms try to isolate and attack an offending substance, called an allergen.  It is possible to evaluate this immune response by measuring blood levels of immune globuline (IgG) which is specific to to a particular food or substance.  Since there are so many different foods that we eat, literally hundreds of tests are required.  Doing such extensive testing has been controversial, in part because of its high cost.  This testing has been advocated for patients with irritable bowel syndrome.  People who are found to have high levels of of IgG to certain foods can improve their condition by eliminating those foods.  Another way to detect food allergies is by scratch test, where an extract of different foods is placed into skin scratches and then the skin reaction is measured.

A sophisticated study recently published in Cephalalgia by Dr. Ertas and his colleagues looked at food allergies in migraine patients.  They tested IgG levels to 266 foods in the blood of 30 migraine sufferers.  The number of foods these 30 patients were allergic to ranged from 13 to 35.  After testing, for six weeks each patient ate a diet which included or excluded foods they were allergic to. After that, they had two weeks of unrestricted diet, followed by another 6 weeks of the opposite diet (if they first had a diet free of allergen, then they were switched to a diet with allergens, and vice versa).  Neither the doctor, nor the patient knew what foods the patient was allergic to or which diet was given in each 6-week period.  The results of the study showed that significantly fewer migraines occurred when the diet excluded foods patients were allergic to.  This is the first rigorous study which suggests that food allergy testing may find a place in the management of patients with migraine headaches.

13 comments
  1. Quail says: 10/13/20124:40 pm

    I disagree very strongly with Spencer. I have had too many incidents in which I get a delayed reaction from eating something. I have even gotten sick after eating something that I did not know was in it that I know I was sensitive to (soy). I use topical vs. oral administration of estrogens because the oral gives me migraines, but not topical. I have worked on getting migraines under control for over 10 years (I’ve suffered for about 40 years) and the only thing that ever helped me reduce the severity and frequency of migraine was learning which foods triggered them and to rotate the rest to reduce the possibility of their recurrence. I went from almost constantly aching to some degree or another to the reverse. I get only a few migraines now and almost all of those are more controllable than before. My concern now is developing new sensitivities such as has been happening lately (the plant family Roasaceae – almonds, apples, stonefruit and strawberries, etc). Is there any help for older people under stress?

  2. Barry Spencer says: 01/13/20121:29 am

    Dr. Mauskop writes: “There is little dispute that certain foods can trigger migraines.”

    I would like to dispute it. Dr. Mauskop, I did an exhaustive search of the medical literature and found no demonstrated evidence any food has ever triggered a migraine.

    The exceptions include foods containing caffeine or alcohol. Red wine, more than other alcoholic drinks, seems to promote migraine episodes. Chocolate contains lots of theobromine and some theophylline, substances similar to caffeine, a demonstrated cause of headache accompanied by nausea/vomiting, so it stands to reason chocolate could cause migraine-like headaches. It also stands to reason that nitrites and nitrates in preserved foods could promote migraine episodes.

    But there’s no demonstrated evidence cheese, citrus fruit, onions, smoked foods, or pickled foods have ever triggered a migraine.

    The results of the Ertas study you summarized don’t support the conclusion that any particular food triggers migraine. Every subject was treated differently. That’s no way to run a trial study.

    Eating and migraine are both highly prevalent, which means inevitably many people will notice unreal or real but coincidental associations between eating a food and getting a migraine, and mistake them for causal associations.

    Physicians and authors should stop telling migraine patients that foods can trigger migraine, or that dietary restriction is helpful beyond a placebo effect.

  3. Dr. Mauskop says: 10/17/20111:14 pm

    Pamelor (nortriptyline) is an effective drug for pain of almost any kind, including for the prevention of migraines and tension-type headaches. However, it is not proven at all to help other neurological symptoms associated with migraines, such as vertigo, dizziness, visual symptoms, etc. There are no drugs that are proven to help these symptoms, although it is not unusual for all symptoms to subside when migraine headaches improve. For example, with Botox injections headache goes away first and with time other neurological symptoms, including migraine aura, also disappear. When vertigo, dizziness and other neurological symptoms occur without a headache pain medications, such as nortriptyline and Botox injections are less likely to be effective. When pain is present it usually causes an increase in the excitability of brain cortex, which in turn makes the patient more likely to have the next attack and other neurological symptoms. We speculate that by reducing pain the brain becomes less excitable and both headaches and other neurological symptoms improve. If there is no pain, the treatments directed at pain will be less effective in reducing other symptoms. The drugs that can be tried are gabapentin (Neurontin) and other epilepsy drugs, as well as memantine (Namenda), a drug for Alzheimers. Before trying drugs, magnesium and CoQ10 can be tried.

  4. tina says: 10/12/20117:43 am

    I’ve recently been told I have migraine associated vertigo. I’ve had these symptoms for 17 yrs. I don’t get the headaches, but i’m always lightheaded and tired. They started me on pamelor. Has anyone else taken this and does it help?

  5. Rob says: 07/29/20115:03 pm

    I suffered from migraines as a kid until I was 15. I never knew what caused them then. They started recurring more than 10 years ago. Using a log, I have determined that tree nuts and items made in machinery that has processed tree nuts are major triggers, among other foods. I can now control the migraines through prophylactic medication, monitoring my diet very carefully, and taking acute medication as needed. I am now 63 years old and anticipate that the condition will continue indefinitely. My physician wants to reduce my headache frequency to “zero.” However, unless I restrict all my meals to home, I don’t think this will be possible. Restaurants sneak too many trace foods into their recipes for someone like me to completely avoid my particular triggers, no matter how careful I am.

  6. Dr. Mauskop says: 02/25/20116:53 pm

    Yes, seeing an allergist may help discover additional allergies. It is also possible that he is no longer allergic to dairy or peanuts – allergies can come and go. Botox injections are now FDA-approved for frequent migraines in adults, but I have been using it in children older than 10 for the past 15 years with good results. Botox is much safer than prescription drugs – asked your son’s doctor. Of course, first make sure he gets enough sleep, exercise, eats regularly, etc. Magnesium and CoQ10 have been shown to help nto only adults, but also children.

  7. Debbie Pollack says: 02/25/20114:04 pm

    Ny 14 year old son has multiple food allergies (severe) and has not ever eaten any of the foods that he is allergic to (dairy, peanuts, treenuts). He suffers from migraine headaces as well. Over the last few years the headaches have gotten more frequent. We see a neurologist and he is on medications (not much help). He has had workups with allergists but not in the last 4 years or so. Do you think we should see a allergist about other foods possibly causing his migraines?

  8. Murat says: 11/01/201012:52 pm

    I have had migraines last 25 years. 6 weeks ago, I found out I have a reactions to gluten, dairy and eggs. really high levels of IgG and IgA..
    Started gluten, dairy and egg free diet and since then I got only two migraines. top of that I am more energetic then 20 years ago..
    If you have a migraine, get the food panel (IgA, IgG and IgE) test done.. and start special diet, you will see the differences in first week of the diet..

  9. Dr. Mauskop says: 08/14/201011:31 am

    You may want to check with your local allergist to see if some of these tests are covered by insurance. If you live near a major medical center you may want to call them and see if they have an allergy/immunology division and if they do, ask them about research studies.

  10. Sara says: 08/14/201010:27 am

    I have been suffering from chronic migraines without aura for 15 years. I was recently diagnosed with IBS (chornic constipation.) I think I would be a good candidate for food allergen testing. Where can I get this done? Are there research centers conducting studies where I may participate? I know it is expensive.

  11. Bill says: 08/09/20102:25 am

    I am 72, I have had migraines since 1954, I just recently, and by accident, found that sugar is responsible for my migraines. No sugar = no migraines.

  12. Monica says: 08/07/20103:01 pm

    As someone who has suffered with multiple food allergies since an infant; plus, many yrs of food untolerances associated with Migraine disease for many yrs, I find this article interesting. I was just diagnosed w/Eosinophilic Esophagitis almost 2 yrs ago, rare autoimmune disorder associated with food allergen exposure (IgE mast cells found in biopsies during upper/lower Endoscopy procedures. They used to believe it occurred mainly in the esophagus; but, has since been found through out the GI tract & is no longer just a children’s condition. With EE, I have to eliminate wheat, dairy, soy, eggs, shellfish/fish, peanut/tree nuts, in addition to what I was already allergic to for many years. I’ve believed a link existed between my food allergies & Migraines & seem to get one with eating wheat products after having eliminated it from diet & reintroduced it. Just an observation by me.
    Thanks for the info! ~ Monica

  13. Monica says: 08/07/20102:44 pm

    As someone who has suffered with multiple food allergies since an infant; plus, many yrs of food untolerances associated with Migraine disease for many yrs, I find this article interesting. I was just diagnosed w/Eosinophilic Esophagitis almost 2 yrs ago, rare autoimmune disorder associated with food allergen exposure (IgE mast cells found in biopsies during upper/lower Endoscopy procedures. They used to believe it occurred mainly in the easphagus;but, but has since been found through out the GI tract & is no longer just a children’s condition. With EE, I have to eliminate wheat, dairy, soy, eggs, shellfish/fish, peanut/tree nuts, in addition to what I Walser already allergic to For many years. I’ve believed a link existed

Submit comment