Caffeine and headaches

February 26, 2024

A new study by Harvard researchers suggests that there is no connection between caffeine consumption and migraine headaches. I am not convinced. This study was small and had only 12 out of 97 participants consume 3-4 cups a day, while 65 consumed 1-2 cups and 20 consumed no caffeine. Statistics based on such small numbers are unreliable.

Most headache sufferers who drink large amounts of caffeine develop a caffeine-withdrawal headache when they don’t get their usual dose of caffeine on time.  My most dramatic case was that of a man who drank about 10 cups of coffee a day. He also set an alarm for 3 AM to have a cup of coffee. If he skipped that 3 AM cup, he would wake up with a debilitating migraine.

A double-blind caffeine withdrawal study published in the New England Journal of Medicine. It showed that 52% of people consuming an average of 2.5 cups of coffee developed a moderate or severe headache when caffeine was stopped.

Caffeine can play positive role in the treatment of migraine and tension-type headaches. It is considered to be an adjuvant analgesic and is included in over-the-counter and prescription drugs along with pain medications. It enhances pain relief produced by acetaminophen, aspirin, and other pain drugs.

The problem arises from excessive intake of caffeine. Two cups of coffee at breakfast, a cup of caffeinated soda at lunch, and a couple of Excedrin do not appear excessive until you consider the total amount of caffeine in these products. If you are prone to headaches, this amount may be sufficient to cause a headache, typically upon awakening in the morning.

Written by
Alexander Mauskop, MD
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Insights from Dr. Alexander Mauskop on headaches and migraines
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