It gets worse for the additional 50 million Americans who endure migraines, which pulse and throb relentlessly on one side of the brain. Accompanied by nausea, dizziness, numbness, neck pain and a host of other physical symptoms — even hallucinations — migraines can be mild or can grind life to a halt for hours or days at a time. The most severe migraines keep people home, in darkened bedrooms, and unable to drive, withstand the light of day, work or care for their kids. About 6 million people suffer migraines every day of their lives.
A perfect cure for headaches may not be within our grasp anytime soon. But by embracing the wide range of treatments available now — from avoiding triggers and taking supplements to trying medical interventions when warranted — all but the most intractable headaches can be controlled.
Dietary Triggers: Top 10 List
David Buchholz, MD, of Johns Hopkins University, points to the top 10 migraine triggers found in food:
Caffeine. Found in coffee, tea, colas and certain other sodas. Going off caffeine suddenly can also trigger headaches.
Chocolate. Anything with cocoa. Chocolate contains phenylethylamine, which may cause blood vessels to expand and contract.
Nuts. From almonds to pistachios, they can all be culprits, as can nut butters.
Monosodium glutamate. Famously found in Chinese food, but also in seasoned salt, salty snacks, prepared soups, many low-fat and low-cal foods, and even veggie burgers. Steer clear of hydrolyzed vegetable, soy or plant proteins, which can contain similar compounds.
Deli meats and fish. If it has been aged, canned, cured, fermented, marinated, smoked or tenderized, it may trigger headaches, says Buchholz. Preservation with nitrites or nitrates is a no-no. Avoid beef livers and chicken livers, as well.
Dairy products, especially cheese. This includes all kinds of hard cheeses and foods prepared with cheese. The more aged the cheese, the worse the trigger. White cheeses, including cottage cheese, ricotta and cream cheese, have not been implicated, but yogurt has.
Red wine. Too much red wine or any dark alcohol can stack the decks against you. Of all drinking alcohols, vodka is tolerated best. Also avoid vinegar; balsamic is the most problematic, but white should be OK.
Certain fruits and vegetables. In his book Heal Your Headache, Buchholz lists the fruits and vegetables most implicated in triggering headaches. Among the problematic fruits: citrus fruits and fruit juices, bananas, raisins and other dried fruits preserved with sulfites, raspberries, red plums, papayas, passion fruit, figs, dates, and avocados. Vegetable culprits include sauerkraut, pea pods and beans (from fava to navy to lentils). The worst vegetable offender may be onions, though baby onions are OK.
Freshly baked breads risen with yeast. Especially problematic is sourdough. Also look out for bagels, doughnuts, pizza dough and soft pretzels less than 24 hours out of the oven.
Aspartame. Found in many diet soft drinks and artificial sweeteners, aspartame contains excitotoxins known to affect nerve cells.
Eager to prevent your headaches before they start? These are the top five most effective and scientifically validated supplements:
Riboflavin, otherwise known as vitamin B2. Two hundred milligrams of B2 twice a day has been shown to help a significant subset of patients with migraines, says neurologist Richard Lipton, MD, of the Albert Einstein College of Medicine in New York City. The key to success, experts say, is taking the vitamin every day, whether you have a headache or not.
Butterbur, a root extract from the plant Petasites hybridus. Researchers compared butterbur with a placebo in 245 headache patients. Over the course of four months, migraine attack frequency was reduced by 68 percent for those receiving 75 milligrams of the supplement twice a day.
Magnesium. Crucial for many cellular processes. When magnesium is deficient, a headache may result. Numerous studies show that patients taking magnesium supplements have significantly fewer migraine attacks, lose fewer days to pain, and can greatly reduce the amount of medication they take for migraines. Neurologist Alexander Mauskop, MD, director of the New York Headache Center, recommends daily doses of up to 600 milligrams.
Coenzyme Q10. European researchers compared migraine sufferers treated with this antioxidant with a placebo group. After three months of treatment, half of the migraine patients had fewer attacks and less nausea than the control group. The recommended dose is 300 milligrams, three times a day.
Feverfew, made from the plant Tanacetum parthenium, has long been used for headaches. The active ingredient, parthenolide, prevents blood vessel constriction, a leading cause of headaches. At the same time, parthenolide inhibits two headache triggers implicated in the inflammatory process: arachidonic acid and prostaglandins. Mauskop recommends a dose of 100 milligrams, taken up to four times a day.
Not every supplement will work for every patient, notes Mauskop. He recommends mixing these preventives for the best effect. Though the formula varies by patient, his favorite supplement cocktail tends to include 50 milligrams of feverfew, 200 milligrams of riboflavin, 150 milligrams of coenzyme Q10 and 200 milligrams of magnesium, taken twice a day with food. As with any treatment regimen, you should consult with your healthcare provider before proceeding.
Easy Fixes Worth Trying
- Avoid caffeine drinks and chocolate.
- Eliminate diet soda and other products with aspartame.
- See an acupuncturist.
- Try biofeedback.
- Eat breakfast and schedule regular meals.
- Stop wearing perfume and avoid scented products.
- Don’t oversleep or undersleep.
- Stay away from MSG (monosodium glutamate) and remember that many diet products are loaded with it.
- Get regular aerobic exercise.
- Check your home for fumes.
- Embrace stress-management techniques like yoga, meditation or deep breathing.
- Identify and eliminate food to which you have intolerances or sensitivities.