Starve a Headache

Can cleaning up your diet help clear your head?
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ask the doc starve a headache

Q: I get a lot of headaches. Could they be caused by something I'm eating?

A: Yes, they certainly could be. A common example is MSG (monosodium glutamate), a flavor enhancer often used in Chinese restaurants and also found in processed foods. People who are sensitive to it get a feeling like a tight band around the head that kicks in about 20 minutes after MSG touches their lips. Sinus headaches strike in the forehead or under your eyes, and feel like a constant ache, as opposed to a pulsing pain. Environmental allergies often are responsible, but sometimes foods—even innocuous-seeming ones such as wheat, dairy products, citrus fruits, or eggs—can contribute.

More common are caffeine-withdrawal headaches, which cause a dull, continuous ache that disappears as soon as you have your daily dose. You can eliminate these headaches permanently by gradually eliminating caffeine from your diet.

Among the most miserable of all headaches are migraines. A migraine is not just a bad headache; it's usually a throbbing pain, often on one side of the head. And it does not pass quickly. It can last for hours—sometimes days. Along with the pain, you are likely to feel sick to your stomach and may even vomit. Sometimes a migraine is preceded by an aura—flashing lights or other sensory phenomena. Foods can trigger these headaches, but so can stress, sleep deprivation, hunger, an approaching menstrual period, or weather changes.

Q: Which foods have been linked to migraine headaches?

A: Migraine sufferers have long known that red wine, chocolate, and aged cheeses can lead to migraines. But by putting migraine patients on very restricted diets, and then adding foods back into the diet, one at a time, researchers have been able to identify several common food triggers, which I call the "migraine dirty dozen": apples, bananas, chocolate, citrus fruits, corn, dairy products, eggs, meat, nuts, onions, tomatoes, and wheat.

I should point out that there is nothing unhealthful about an apple, banana, or several other common migraine triggers. But just as some people are allergic to strawberries and have to avoid them, the same is true for foods that trigger migraine headaches.

Like the aforementioned red wine, some beverages have been implicated too: alcohol (any kind), caffeinated beverages, and drinks that are artificially flavored and/or sweetened. On the other hand, some foods almost never cause migraines: brown rice, cooked vegetables, and cooked or dried fruit.

Q: How can I determine what my trigger foods are?

A: To identify your diet sensitivities, eliminate all the potential triggers (the "dirty dozen" plus the problem beverages) for 10 days or so. Once you are migraine-free, bring these foods back into your diet one at a time, every two days. Have a generous amount of each new food to see if it triggers a headache. If it does, eliminate it again. If not, you can keep eating it.

If an elimination diet does not prevent all your migraines, you might consider butterbur or feverfew. These herbal supplements are sold at health food stores and are used as preventives, rather than treatments. Studies that examined each herb individually found that participants experienced fewer migraines and reduced migraine pain with no significant side effects.

Q: Could anything else besides food be causing my headaches?

A: The most common headaches of all are stress headaches. They are dull and constant (not throbbing) and are on both sides of your head. The best treatment is relaxation. Slow your breathing, and intentionally relax the muscles of your head and neck. Visualize tension leaving these muscles every time you breathe out. If stress headaches are frequent, be sure to get adequate rest and exercise.

One final point: Sometimes headaches can spell danger. If you have a headache that is severe or persistent, be sure to have a doctor evaluate it. That is especially true if you also have fever, neck or back pain, or any neurological or mental symptoms.