Migraine Treatments: Headache Clinic Doctors Support Migraine Diet Power
Doctors at migraine clinics agree that no single migraine treatment works for everyone. So too, with migraine diet treatments. Headache doctors agree: migraine diet treatments work for many— but not for all. At our New Jersey (NJ) Migraine Clinic, we have found that migraine diets often brings help when other methods have not.
Food and Diet Triggers That All Migraineurs Should Avoid:
- Nitrites, a preservative added to hot dogs, bacon, lox, salami, bologna and other luncheon meats. Look for nitrite and nitrate free processed meats.
- Salt – High sodium diets tend to provoke migraine.
- Alcohol, of any kind but especially red wine.
- MSG or monosodium glutamate, a commonly used preservative especially in soups, and in Chinese food.
- Migraine clinic doctors often report migraine diet problems from citrus fruits, dried fruit (including raisins), nuts, peanuts, high yeast foods such as sourdough or home–made breads, cheeses (especially hard or stinky cheeses; ricotta and cream cheese are okay), sauerkraut and other aged foods, ripe avocado, ripe banana, yogurt and buttermilk, raspberries, plums, onions, Worcestershire or Teriyaki sauce.
A double blind study found that a special immune test called IgG RAST helped spot migraine food triggers. Avoiding these foods reduced migraine attacks by 30%. IgG RAST is more effective for migraine than either standard allergy blood tests (called IgE RAST). It's also more effective than allergy skin tests.
Source: Cephalgia, vol 30, p 829, 2010.
Most migraine doctors and Headache Clinics recommend avoiding migraine diet triggers which are rich in the amino acid Tyramine. For many headache clinics this is a standard migraine treatment. Other headache doctors and migraine clinics are less concerned. Foods high in Tyramine include: aged or blue cheese, yogurt, smoked, cured or pickled meat or fish, red wine or beer, soy sauce, miso, and tempeh.
Most headache clinics prefer migraine diets that also avoid foods high in the amino acid, phenylethylamine. These migraine diet triggers include: cheesecake, yellow cheeses, chocolate, citrus fruit, cocoa, berry pie filling or canned berries, and red wine.
Other migraine treatments avoid foods that are high in histamine. These migraine diet treatments avoid most prominently banana as well as beef, pork, beer, cheese (especially yellow ripened cheese), chicken, liver, eggplant, fish, shellfish, processed meat such as salami, sauerkraut, tempeh, tofu, miso, tamari, spinach, strawberry, tomato, tomato sauce, tomato paste, wine, yeast and foods containing yeast, pineapple, citrus fruit and chocolate.
Caffeine: A Migraine Treatment, a Migraine Diet Trigger or Both?
Migraine and Caffeine: All Migraine Clinics have mixed feelings about caffeine. Caffeine is a useful acute headache treatment when used occasionally along with aspirin or Tylenol. BUT, drinking caffeine regularly can cause a kind of addiction to caffeine, so that not getting quite enough coffee, can be a major migraine trigger. Headache Clinic doctors recommend tapering off caffeine for a trial of 3 or 4 weeks. This is especially important for people who drink 3 or more cups of coffee or tea a day or who often take migraine treatment medicines, such as Excedrin, which contain caffeine. Persons who drink less coffee are not at high risk, but our migraine clinic has observed caffeine withdrawal headaches among persons who drink as little as one cup of coffee daily.
Suspect caffeine might contribute to your headaches if skipping caffeine for one or two days causes fatigue, muscle aches, migraine or other headache. If caffeine withdrawal headaches are severe, the best migraine treatment is to taper off caffeine under medical supervision. A brief course of anti-headache treatment with a preventive medicine such as amitryptiline can block “withdrawal” headaches.
Other Treatments: Migraine and Nutrition
Migraine and Gluten: Headache doctors and Migraine Clinics find that a small but significant proportion of migraineurs are sensitive to gluten. Gluten is a protein found in wheat, oat, barley and rye. Ask your doctor to do a gluten blood antibody test. If gluten antibodies are high, consider eliminating all gluten for a three month period since it takes that long to judge a gluten-migraine treatment. Eliminating gluten is not an effective migraine treatment for all, even if gluten antibodies are high. However, for many who are gluten sensitive, gluten headache treatment results can be dramatic.
Migraine and Food “Allergies” or Sensitivities: Some, but not all headache doctors and migraine clinics believe that allergy-like sensitivities to milk, wheat, egg, yeast, soy, food additives can be migraine triggers. A full scale elimination diet for these might best be done under medical supervision.
Migraine and Hypoglycemia: Headache doctors argue about whether hypoglycemia or low blood sugar is “real”. But, at our headache clinic we are convinced that treating the hypoglycemia migraine connection is often an effective migraine treatment. If you often become achy or tired or develop other symptoms if your next meal is late, consider low blood sugar to be likely. Change your diet to small, frequent meals with fewer simple sugars and carbohydrates at each meal. Please note: measuring the level of blood sugar and/or a glucose tolerance test is usually NOT an accurate way to diagnose migraine-low blood sugar problems. Contact our NJ headache clinic for more information on migraine diets.
Diet Recommendations From Our Migraine Clinic
Most headache doctors recommend eating a well balanced diet with plenty of fresh, non–processed foods. Emphasize whole grains, fruits and vegetables. Read all food labels to spot migraine food triggers.
Migraine Doctor Diet Treatments
|Food Type||Foods Allowed||Foods to Avoid|
|Beverages||Decaffeinated coffee, fruit juices, club soda, non-cola sodas (7Up, ginger ale)||Coffee, tea, cola type sodas in excess of 2 cups per day—sensitive persons should be even more limited |
No chocolate or cocoaAlcoholic beverages NONE!
|Meat, Fish, Poultry||Fresh or frozen turkey, chicken, fish, lamb, veal, pork, egg, tuna||Aged, canned, cured or processed meats, canned or aged ham, pickled herring, salted dried fish, chicken liver, aged game, hot dogs, fermented sausage (no nitrates or nitrites), bologna, salami, pepperoni, summer sausage, peanut butter, any meal prepared with meat tenderizer, soy sauce or yeast extracts|
|Dairy||Milk: Homogenized, 2% or skim
Cheese: American, cottage, farmer, ricotta, cream cheese, VelveetaYogurt: limit to 1/2 cup
|Cultured dairy such as buttermilk, sour cream, chocolate milk Cheese: blue, boursault, brick, brie types, camembert types, cheddar, swiss, gouda, roquefort, stilton, mozzarella, parmesan, provolone, romano, emmentaler|
|Breads And Cereals||Commercial breads: white, whole wheat, rye, french, italian, english muffins, melba toast, crackers, rye crisp, bagel
|Homemade yeast breads, bread and crackers with cheese|
|Potato or Substitute||White potato, sweet potato, rice, macaroni, spaghetti, noodles|
|Vegetables||Asparagus, string beans, beets, carrots, spinach, pumpkin, tomatoes, squash, corn, zucchini, broccoli, green lettuce, etc. all except those to avoid||Pole or broad beans, lima beans, Italian beans, lentils, snow peas, fava beans, navy beans, pinto beans, pea pods, sauerkraut, garbanzo beans, onions, except for flavoring, olives, pickles|
|Fruits||Any fruit juice such as prune, apple, applesauce, cherries, apricots, peach, pears, fruit cocktail
Limit intake to ½ cup orange, grapefruit, tangerine, pineapple, lemon, lime
|Avocados, banana (½ allowed per day), figs, raisins, papaya, passion fruit, red plums
Nuts and seeds: peanut butter, sunflower, sesame and pumpkin seed, peanuts
|Soups||Cream soups made from foods allowed, homemade broths||Canned soups: soup cubes, bouillon cubes, soup bases with yeast or MSG (read labels)|
|Desserts||Fruits listed, sherbets, ice cream, cakes, and cookies made without chocolate or yeast, jello||Chocolate type: ice cream pudding, cookie and cake|
|Sweet||Sugar, jelly, jam, honey, hard candy||Chocolate candies, chocolate syrup|
|Miscellaneous||Salt in moderation, lemon juices, butter or margarine, cooking oil, whipped cream
White vinegar and commercial salad dressing in small amounts
| Pizza, cheese sauces, soy sauce, monosodium glutamate (MSG) in excessive amounts, yeast, yeast extracts, brewer's yeast, meat tenderizers, accent and seasonal salt
Mixed dishes: Macaroni and cheese, beef stroganoff, cheese blintzes, lasagna, frozen TV dinners
Some snack items to be avoided. Read all labelsAny pickled, preserved or marinated foods
Find out more about the migraine treatments offered at our NJ migraine clinic.