Nutritional factors in migraine and other headaches

October 29, 2013

A study of 13,573 people by a Harvard physician Catherine Beuttner examined the role of nutrition in patients with migraines and severe headaches. Among these participants of the National Health and Nutrition Examination Survey who were 20 years old or older, 22% or 2,880 suffered from migraines or severe headaches. A large variety of factors that could influence headaches were examined, including age, sex, race/ethnicity, education, smoking, alcohol intake, physical activity, health status, body mass index, diabetes, and number of prescription medications used. Sophisticated statistical analysis established that carbohydrate intake as a percentage of energy consumption and caffeine use were associated with higher prevalence of migraine and severe headaches. On the other hand, fiber intake appeared to reduce the prevalence of migraines and severe headaches. Dr. Beuttner also discovered that intake of foods rich in folate (folic acid, or vitamin B9), thiamine (vitamin B1), and vitamin C was also associated with lower prevalence of migraines and severe headaches.

This large study confirms some of the previous reports about the role of carbohydrates and caffeine in the development of headaches. According to one small study, three out of four migraine sufferers have reactive hypoglycemia. Reactive hypoglycemia is a condition that causes blood sugar to drop too low after eating a carbohydrate-rich meal. This drop of sugar seems to trigger headaches. Many migraine sufferers figure this out on their own and reduce their carbohydrate intake, but some fail to make this connection. So, if you suffer from severe headaches try eating small frequent meals that are low in carbs.

Caffeine is a well-known and proven trigger of migraine headaches. Caffeine can sometimes cause headaches directly, but more often headaches occur due to caffeine withdrawal. This is why many people wake up in the morning with a headache – they’ve gone all night without caffeine. Since caffeine is a short-acting drug withdrawal can occur throughout the day leading people to consume more and more caffeine. Eventually the headache become constant with some improvement after each dose of caffeine, whether it is from coffee, soda, strong tea or medications, such as Excedrin, Anacin, Fioricet, and Fiorinal. Getting off caffeine is the only way to stop these headaches. It can be done gradually or “cold turkey”. Your doctor can prescribe medications to make this process less painful because headaches will get worse before they get better. These medications may include triptans (Imitrex, Maxalt, and other), Migralex, or naproxen (Aleve). Botox injections can also help. Many of my patients argue that caffeine is not the cause of their headaches since headaches started long before they were consuming any caffeine. It is true that caffeine does not cause headaches, but if you suffer from migraines and other headaches, caffeine can make them worse. And getting off caffeine may not eliminate all headaches, but will make them much more amenable to treatment.

As far as folic acid and vitamin B1, there have been some studies proving that B vitamins (including B12) can prevent migrianes, but fiber and vitamin C have not been reported to help headaches in the past.

In summary, if you suffer from migraines or severe headaches try to keep your carbohydrate intake low, eliminate caffeine, increase your intake of foods rich in fiber, B vitamins, and vitamin C. You may also want to consider taking a supplement of these vitamins, along with B12, magnesium, CoQ10, and possibly some herbal products mentioned earlier in my blog or on our main site, nyheadache.com.

Written by
Alexander Mauskop, MD
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