the headache series
It is very rare for a food allergy or sensitivity to be the sole cause of frequent headaches or migraines. Unfortunately, for most people who suffer from frequent head pain, the causes are almost always multifactorial. Tracking down a food trigger can sometimes seem a bit overwhelming at first, but taking stock of how food may be playing a part in the stimulation of your headaches can be an invaluable step in your journey to identify the pain factors that are within your control.
It would be nice if we could say that there is a specific list of foods that will always trigger a headache, but the truth is that body chemistry is so individual that it’s possible for a person to be sensitive to almost any type of food. Some people are even triggered by the odor of certain foods.
But within the food-sensitivity spectrum, there are still several individual foods and food categories that tend to trigger more head pain than others. Paying particular attention to the following categories as you begin your food tracking journey is often the simplest way to start understanding how the things you eat and drink may be affecting your head pain.
Most of us have experienced the aching head pain that can follow a night of drinking more than your body can handle. But a hangover headache can be triggered by very different amounts of alcohol depending upon the individual.
For some very sensitive people, even a single drink or part of a drink can trigger a hangover headache. While some of these headaches are induced by an actual allergy to the alcohol itself, most are related to the way the alcohol affects the body as a whole.
Whenever a toxin is present in the bloodstream, the body works overtime to cleanse the system. That means that primary functions are often set aside in order to deal with the immediate need, which is to get the toxin out of the bloodstream. In the case of alcohol, the liver takes on the primary task of detoxifying the blood, and is then unable to regulate blood sugar effectively. The kidneys are also working overtime by increasing urination substantially in order to flush those toxins from the body once the liver has removed them from the bloodstream. Dehydration and strong fluctuations in blood sugar are the result – and both of these conditions can trigger headaches even when alcohol is not present.
Additionally, the sulfites found in red wine are a very common headache trigger for people who are sensitive to them. Beer can also be a problem for people with with wheat or gluten allergies. Hard alcohol and mixed drinks are also no exception. Many popular mixed drinks are laden with sugar, which is the next common food-related trigger we will discuss.
Sugar is much like alcohol in its relationship to headaches; there are some people who are allergic to the sugar itself, but most people experience sugar-related headaches because of the way it affects primary body functions. There are certainly liver and kidney issues related to the overconsumption of refined sugar, and dehydration definitely plays a part in many sugar-related headaches. But there is another functional component related to sugar-triggered headaches that may often come into play before dehydration can set in. We’re talking about brain function.
Brain function is reliant on two very important sources of energy: blood sugar and oxygen. Constrict or cut off either of these two things, and the brain will do anything it can to regain those levels. Many of those reactions will cause headaches at the very least. But when it comes to sugar, the brain doesn’t just react to a lack of blood sugar – it also reacts to large swings in blood sugar levels. And this is how dietary sugar often triggers headaches first.
Refined sugar and other simple carbohydrates translate almost immediately into blood glucose. Candy, cookies, sodas, and other sweets are obvious sources of simple carbohydrates, but breads, pastas, and cereals made from refined white flour can have the same effects on blood sugar. Depending upon how many simple carbohydrates you eat in a given sitting, your blood sugar level will increase both dramatically and quickly. But it’s not the increase in blood glucose levels that triggers the brain’s reaction and consequent headache so much as it is the inevitable fall or “crash” that happens afterwards. This creates a condition called relative hypoglycemia.
Hypoglycemia is the condition in which the blood cells don’t have enough glucose to function properly. And we already know that the brain needs glucose to function. When blood sugar drops too low, the arteries in the brain constrict and cramp up in order to force more blood flow. This causes a headache. In relative hypoglycemia, the brain also experiences a sudden drop in blood glucose levels. But even though the brain may still have enough blood glucose to function, the sudden drop triggers a stop-gap reaction that causes the arteries to constrict and cramp up in order to keep the levels from dropping any further.
Hypoglycemia and relative hypoglycemia can trigger more headaches than people think. Fasting, skipping meals, and eating or drinking too many simple carbohydrates in a given sitting can all trigger episodes of hypoglycemia or relative hypoglycemia. These episodes will naturally come with headaches, lightheadedness, weakness, and even sweating or fainting. Eliminating as many simple carbs as you can from your diet, making sure you are getting enough protein and good fats, as well as eating multiple small meals throughout the day rather than two or three larger ones are changes that can make a significant difference for people who experience blood-sugar related headaches.
Here are some common sources of sugar and other simple carbohydrates to avoid consuming regularly:
- Candy, baked goods, ice cream and other sweets
- Soda, sweetened tea and coffee drinks, and other soft drinks or energy drinks
- Pasta, bread, crackers, and cereals made from refined white flour
- Fruit juice
- Most processed and pre-prepared foods
- Most mixed drinks and cocktails
Caffeine intake and its relationship to head pain is always a tricky subject because caffeine can function as both a cause and a cure for headache pain. In fact most headache medications contain caffeine because it has been shown to make the pain relieving ingredients up to 40% more effective.
The occasional use of a headache medication, and a cup or two of coffee or tea in the morning is generally a safe amount of caffeine for most people. More than that, and headaches caused by caffeine excess, caffeine withdrawal, and/or medication overuse (rebound headaches) are often the result.
For people who suffer from frequent headaches or other types of chronic pain, caffeine can also act as a kind of pain amplifier, turning up the volume of pain associated with relatively minor muscle strain or tension headaches. For these people in particular, reducing and/or eliminating dietary sources of caffeine, including regularly used headache medication, can be an important step in unraveling the ultimate sources of head pain. When eliminating caffeine sources from your diet, remember to always reduce it gradually over several weeks in order to avoid a withdrawal headache. Headache medication elimination should always be done under the supervision of your doctor.
Common sources of caffeine to consider reducing or avoiding altogether:
- Coffee, tea, and yerba mate
- Chocolate and cocoa
- Soft drinks and sodas (both diet and regular)
- Most energy drinks, supplements, and snacks
- Guarana powders and extracts
- Many types of pain relievers including over-the-counter and prescription medications
For patients who have Celiac disease, dietary gluten can trigger a number of uncomfortable symptoms, including headaches and migraines. But many people who do not have Celiac disease may still have gluten sensitivities, and for those people who suffer from frequent or migraine headaches, reducing or eliminating gluten for a period of time, in addition to tracking your headaches in relation to what you eat, may provide significant relief.
Gluten sensitivities can sometimes be tricky to understand at first. Some people are specifically sensitive only to wheat gluten, which includes bulgar, bran, farina, semolina, spelt, and even couscous. But barley, rye, and oats also contain gluten and could be another source of digestive distress and head pain if you have gluten sensitivities. If you suspect that gluten may be a problem for you, a good list of gluten-containing ingredients to start with can be found here.
Other Food Triggers to Consider
We’ve already covered the most common food triggers reported by many headache sufferers, but here are a few more to consider as you begin exploring how food affects your headaches:
- Cultured or fermented dairy products, especially aged cheeses
- Citrus fruit
- Processed meat
- Pickles, olives, and onions
- Any excessively cold foods or drinks
Starting a Food Diary
Food diaries don’t have to be complicated, but they should include the following details in order to be fully informative:
- The exact time of each meal or snack, and a list of everything you ate and drank.
- Notes about headaches you had throughout the day, including pain location and a list of any additional symptoms (dizziness, nausea, light sensitivity, etc).
- Specific notes on the time head pain began, how long it lasted, and a rating of your pain level on a scale of 1-10.
- Additional notes on any medication you took, what time you took it, and what the dosage was.
Dr. Rich has created a Headache Diary Form that makes it easy for you track your headaches in relation to the food you eat and other lifestyle habits that could be affecting your head pain. A printable version of that form is provided at the bottom of this page.
Unraveling the way food and other factors affect your headaches can take time, and you may need some help from your primary care physician, a qualified dentist, a naturopath, an allergist, or other practitioner in order to fully understand and control all the triggers for your head pain. For many people who have struggled with the pain of frequent headaches for a long time, looking at how food – or the lack of food – is related to their pain episodes can be quite revealing. We encourage you to take a look at your dietary habits and to consult with your providers about how some simple changes might help you reduce or perhaps even eliminate the majority of your headaches.
Mayo Clinic: Migraine Causes
National Headache Foundation: Headache Triggers and Food
The Migraine Trust: Hypoglycemia and Migraines
National Library of Medicine: Association Between Migraine and Celiac Disease
Web MD: Migraines, Headaches, and Caffeine and Fighting Food Related Headaches
Food Triggers (information on this page only)
The Full Headache Series (entire series including Daily Headache Diary)
Daily Headache Diary (with instructions)
Daily Headache Diary Form (form only, no instructions)