Headache triggers can be a variety of factors, including: food reactions, allergies, nutrient deficiencies, hormone imbalances, stress, poor sleep, and dehydration.
Identifying potential food triggers and avoiding those foods may significantly reduce migraine episodes. If you do not find relief after completing a general elimination diet, you may be suffering from food sensitivities. Food sensitivities are an immune-mediated reaction, meaning your immune cells are responding with a large amount of chemical mediators that trigger inflammation and symptoms - in this case, pain. Continue reading to learn more.
In this article we will focus on food and food triggers, but keep in mind the other factors that can trigger headaches and migraines. This list includes nutrient deficiencies, hormone imbalances, stress, poor sleep, and dehydration.
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Can Food Trigger Migraines?
The short answer is yes; in some cases certain foods, or more specifically food chemicals, can trigger a migraine attack. The trouble is that the list of solid, clinical evidence related to food triggering migraines is short. This is because each person differs in their ability to metabolize or detoxify natural chemicals and nutrients. One research theory proposes some people might develop migraines due to the way the body processes natural chemicals such as tyramine, nitrate, caffeine, and sodium (1). The good news is that once food triggers are identified and avoided the risk of migraine attacks can be significantly reduced.
The Most Common Food Triggers
There are food additives, meaning chemicals added to food products, that are commonly linked to headaches and migraines. The list of food chemicals include:
Artificial sweeteners, like aspartame
Monosodium glutamate (MSG)
Nitrates and Nitrites, found in cured and processed meats
Sulfites, found in wine and beer
Aged or Fermented Dairy products (aged cheeses, yogurts, sour cream and buttermilk)
Aged, Smoked, Fermented, Pickled or Salted meats and fish
Certain Fruits, especially when ripened (dried fruits, banana, avocado, citrus)
Nuts and Legumes (soy, tofu, nut butters, etc.)
Confused about caffeine? You're not alone.
When it comes to caffeine, some people are highly sensitive to the chemical and are unable to metabolize well. Caffeine can therefore be a migraine trigger. For others, caffeine can actually help alleviate some of the pain because it widens the blood vessels (pain can be due to blood vessel constriction).
Where it becomes tricky is caffeine withdrawal. In this case, caffeine might have helped alleviate headaches or migraines when you were consuming it regularly. With elimination of caffeine, the withdrawal symptom is often a headache.
If you consume caffeine regularly and metabolize it efficiently (you do not become anxious, jittery, shaky, etc.) then continue with the same amount around the same time of day. If you consume caffeine occasionally, stick to three times per week or less to prevent caffeine withdrawal. (1)
Foods that contain caffeine:
Gum and Candy
Medications, including pain relievers, cold medicines, and diuretics
If you are trying to cut back on caffeine, you will want to gradually reduce your caffeine intake until you no longer feel the negative effects to avoid triggering a headache or migraine.
So let's delve into why some of these other foods made their way onto the most common trigger list.
Some individuals may be unable to process tyramine in the body and therefore suffer from chronic migraines. A low tyramine diet is one of the most common migraine elimination diets and is a good place to start if you are trying to identify food triggers.
Tyramine is a naturally occurring chemical found in all foods. Tyramine levels in food increases s the food ages. For example, a green banana has less tyramine than a brown banana. (2) A good rule of thumb if you are trying to avoid tyramine is to eat or freeze your meals within 48 hours. Purchasing the freshest meats, vegetables, and fruits available will also help to keep tyramine levels low. Freezing stops tyramine production, which is why frozen fruits and vegetables may be another way to ensure lower tyramine in your diet since most produce is flash-frozen soon after harvest.
Foods with high levels of tyramine include:
Aged cheese, cheddar cheese, blue cheese, parmesan
Cured meats, pepperoni, salami, and other
Fermented or pickled foods, sauerkraut, kimchi, pickles
Beers on tap or home brews
Fava beans, broad beans, snow peas
Histamine is another naturally occurring food chemical that can trigger pain.
Histamine is most commonly known for its role in allergic reactions, including those annoying seasonal allergies. Histamine is a neurotransmitter, meaning a chemical signal in the nervous system that tells blood vessels to widen (vasodilation). During a migraine attack, the widening of these blood vessels in the brain causes head pain.
Histamine can be a migraine trigger in individuals who have an intolerance to histamine. Intolerance means the body is unable to properly break down the molecule which lead to the molecules building up in the body. Diamine oxidase (DAO) is the main enzyme responsible for metabolizing (breaking down) ingested histamine. A lack of this enzyme leads to a histamine intolerance. (3)
Histamine is found in many of the same foods as tyramine. Here are the foods that have higher levels of histamine:
Nuts (especially walnuts and cashews)
Chocolates and cocoa
Foods containing preservatives and artificial colors
DAO supplements are available which can help increase levels of diamine oxidase in the digestive tract. Supplementation should be in addition to a low-histamine diet. You should always talk with your health care provider before starting new supplements.
So what should you eat to help prevent a migraine attack?
I always recommend an low-inflammatory diet to my clients suffering with chronic pain and migraines. An low-inflammatory diet is plant-based, meaning it has a larger amount of vegetables and smaller amount of animal protein compared to the typical Western diet. Below are some key points to help you implement a low inflammatory diet.
Plenty of vegetables, aim for at least five servings per day
Fresh or frozen fruits, aim for 2-3 servings per day
Lean, grass-fed animal protein
Healthy plant fats - olive, coconut, avocado, nuts, and seeds
Low, natural sugars - stick to 25 grams per day
Low sodium - avoid processed foods and use salt after cooking to avoid using too much
Limit alcohol, caffeine, aged or fermented foods
Limit eating out - if you notice migraine attacks occur more often on the weekend, be mindful of your habits. Are you eating out more, drinking alcohol on weekends, increased stress?
Drink plenty of water - aim for half your body weight in ounces (ex: weigh 160, drink 80 oz)
Manage stress - breathing techniques, exercise, and meditation
Sleep at least 7 hours per night
Eat regular meals and snacks. Avoid skipping meals, blood sugar can drop and trigger a migraine
Track your symptoms - keep track of your symptoms, stress, sleep, food, and water to find a pattern of what might be triggering your attacks
What about options to decrease pain during a migraine attack?
Aside from medications and implementing the diet and lifestyle changes above to prevent migraines, there are some foods and nutrients found to help alleviate pain and nausea that can develop.
Ginger - can help with pain relief and nausea
Turmeric - can help with pain relief
Peppermint - can help with nausea
Magnesium - can help with pain relief
Water - add 1/8 tsp of salt if you think dehydration may be present
If you are suffering with headaches or migraines and would like additional guidance on identifying triggers and healing the body, please reach out to me at firstname.lastname@example.org. As a registered dietitian, I am trained with the skills to identify potential food triggers and can recommend successful dietary and lifestyle interventions.
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Liz Riesen, RD