A Review of the Relationship between Chocolate and Migraines

Abstract

Migraine is a chronic disorder with episodic attacks, and patients with a migraine often report that certain factors can trigger their headache, with chocolate being the most popular type of food-based trigger. Many studies have suggested a link between chocolate and headaches; however, the underlying physiological mechanisms are unclear. As premonitory symptoms may herald migraine attacks, a question arises regarding whether eating chocolate before a headache is a consequence of a food craving or indeed a real trigger. Here, we aim to summarize the available evidence on the relationship between chocolate and migraines. All articles concerning this topic published up to January 2020 were retrieved by searching clinical databases, including EMBASE, MEDLINE, PubMed, and Google Scholar. All types of studies have been included. Here, we identify 25 studies investigating the prevalence of chocolate as a trigger factor in migraineurs. Three provocative studies have also evaluated if chocolate can trigger migraine attacks, comparing it to a placebo. Among them, in 23 studies, chocolate was found to be a migraine trigger in a small percentage of participants (ranging from 1.3 to 33), while all provocative studies have failed to find significant differences between migraine attacks induced by eating chocolate and a placebo. Overall, based on our review of the current literature, there is insufficient evidence that chocolate is a migraine trigger; thus, doctors should not make implicit recommendations to migraine patients to avoid it.

Keywords: chocolate, cocoa, headache, migraine, trigger factor, polyphenols, flavonoid, flavonol, theobromine, magnesium

1. Introduction

Headaches have emerged as a great public health concern, with almost three billion people estimated to suffer from them worldwide, and, among them, 1.04 billion people suffer from migraines [1]. A migraine is a type of primary headache with recurrent attacks, typically with unilateral, pulsating, severe headaches that last from 4 to 72 h, with accompanying nausea, photophobia, phonophobia, and sometimes even transient neurological symptoms [2]. Individuals with migraines commonly report that certain factors can trigger a migraine attack [3,4,5,6,7]. Trigger factors are defined as measurable endogenous or exogenous exposures which increase the probability of an attack over a short period of time [8]. The most frequent migraine precipitating factors are stress, fatigue, fasting, lack of sleep, and weather. Foods are reported as a migraine trigger by approximately 20% of individuals with migraines, and chocolate is thought to be one of the most popular food-based triggers of a migraine [9]. Migraine sufferers are often recommended to avoid triggers, which can lead to restrictive changes in lifestyle, with further unhappiness and frustration [8,10]. However, the evidence to support these recommendations is insufficient [10,11]. The aim of this review is to examine the relationship between chocolate and migraines, and to check whether chocolate avoidance may be of benefit to certain patients.

1.1. Chocolate Composition

Chocolate consists of cocoa powder, cocoa butter, sugar, and milk powder (in the case of milk chocolate). The two first ingredients are found naturally in the cocoa bean, and the combination of both makes cocoa mass (also known as cocoa liquor) [12]. Cocoa, the raw material for chocolate, is a dry, powdered product made from the beans of the Theobroma cacao plant. It contains various polyphenols (more than most foods, even tea and red wine), particularly flavonoids, with a subclass called flavanols (epicatechin and oligomeric procyanidins), which are biologically active and may thus affect human health [13,14]. The beneficial effect of polyphenols on health is thought to be associated with its high content of antioxidants. Other active components of cocoa are methylxanthines (caffeine and theobromine, with a 1:5 ratio), as well as serotonin, its precursor, tryptophan, and β-phenylethylamine (PGA) [15,16,17]. Moreover, cocoa is a significant source of many vitamins and minerals important in the human diet, mostly magnesium, zinc, selenium, copper, potassium, riboflavin, and iron [18,19]. We distinguish dark chocolate, milk chocolate, and white chocolate [19]. It is worth noting that the highest concentration of flavonoids and minerals is found in dark chocolate, particularly in 90% cocoa-containing chocolate [13,18,20]. That is why dark chocolate is preferred over milk and white chocolate [14]. It should also be emphasized that cocoa is a rich source of fibre (26%–40%), proteins (15%–20%), carbohydrates (about 15%), and lipids (10%–24%) [19,21].

1.2. Chocolate and Health

A great amount of data suggests that cocoa has several important biological effects, mostly antioxidant, cardiovascular, anti-inflammatory, and metabolic effects [14]. It should be emphasized that most of the health benefits attributable to chocolate are associated with consuming the dark chocolate [19]. The available data indicate that chocolate consumption is connected with a reduced risk of acute myocardial infarction, death via cardiovascular disease, diabetes, and stroke; however, the evidence is weak [22]. Some research suggests a dose-response connection between chocolate consumption and the risk of all-cause mortality, heart failure, coronary heart disease, type 2 diabetes, hypertension, and colorectal cancer [23]. Another review shows that moderate consumption of chocolate is beneficial for a variety of conditions including hypertension, coronary heart disease, cholesterol, cerebrovascular accidents, heart failure, and peripheral vascular disease [24]. The cardioprotective effect of chocolate is probably associated with nitric oxide (NO). Flavanols stimulate endothelial NO synthase (eNOS) activity, leading to increased NO generation. This increase may be responsible for vasodilation and blood pressure reduction [13]. Another effect of NO enhancement is the prevention of leukocyte adhesion and migration, as well as smooth muscle cell proliferation, platelet adhesion, and aggregation [25].

A number of human and animal studies have documented the beneficial effects of polyphenols on the central nervous system (CNS), which is possibly connected to their anti-inflammatory activity [20]. Studies have demonstrated that catechin and epicatechin are able to cross the blood–brain barrier (BBB), with greater efficacy for epicatechin [26]. Both, as well as other flavonoids, can accumulate in the brain, and their action on the central nervous system is potentially sanogenetic for cognition, vision, and neuroprotection [27]. Traditionally, products containing xanthines, such as those derived from tea leaves, coffee, or cocoa beans, are known to stimulate the functioning of nervous systems. Another mechanism is associated with NO generation, with further vasodilatation and increased cerebral blood flow (CBF) and blood perfusion, not only in the CNS, but also in the peripheral nervous system. This CBF increase enhances the oxygen and glucose supply to neurons, helping to get rid of waste metabolites in the brain and sensory organs, but also stimulating angiogenesis in the hippocampus [13,20]. Increased blood flow in the middle cerebral artery may also account for protective effects in the course of stroke. Moreover, evidence exists that cocoa flavanols have beneficial effects on the progression of Parkinson’s and Alzheimer’s disease [20]. Chocolate also contains PGA, which is produced during the thermal processing of cocoa [17]. This neurotransmitter may be associated with specific psychological disorders, like attention deficit hyperactivity disorder, depression, and schizophrenia [17]. Cocoa polyphenols not only behave as powerful free-radical scavengers, but also modulate the microbial population of the human gut. It has been demonstrated that a diet containing 10% cocoa is able to modify the intestinal immune status as well as the composition of microbiota [28]. Moreover, evidence exists of the antinociceptive effects of polyphenolic compounds, particularly in animal models, where neuropathic, inflammatory, and nociceptive pains are reduced and alleviated by polyphenols [29]. Similarly, Costa de Miranda et al. demonstrated that the intake of polyphenol-rich foods is associated with a lower number of tender points and a better quality of life for people with fibromyalgia [30]. Another study has revealed, in a laboratory setting, that individuals who habitually consume greater amounts of caffeine as part of their daily diet demonstrate diminished sensitivity to painful stimuli [31]. As caffeine is naturally found in cocoa beans, it may also be one of the mechanisms of chocolate and pain association. In a very interesting study, Bastian et al. showed that participants enjoyed chocolate more after an experience of pain compared to completing a similar but non-painful task, meaning that physical pain increases the pleasantness derived from chocolate consumption [32].

Although much evidence about the health benefits of chocolate exists, one should remember that it is a high calorie food, and, if overused, may lead to weight gain and obesity, especially when more than 30 g/day is consumed [13,21,25,33]. One-hundred grams of cocoa, dark chocolate, and milk chocolate contains 355, 515, and 545 kcal, respectively [19]. However, a recent review has shown that cocoa or dark chocolate supplementation for at least 4 weeks at 30 g/day has a favorable effect on body mass index (BMI) and weight [33].

1.3. Chocolate and Migraines as a Potential Mechanism of Action

Migraine patients frequently describe that certain foods may induce or even exaggerate the severity of a headache attack [3,4,5,7,34,35,36,37]. Chocolate is the most popular food trigger of a migraine, and it has been epidemiologically implicated in triggering migraine attacks, and the classic advice given by doctors to patients with migraines is to avoid it [11]. Martin et al., in a review of the role of diet in the prevention of headaches, found that chocolate has been self-reported to be a precipitant for migraine headaches in 2%–22% of migraine sufferers [38]. Possible geographic variations in this matter may exist, as none of the patients among the Japanese and India survey groups reported chocolate consumption as a potential trigger of migraines [39,40].

The question arises: Why does chocolate induce a migraine attack? One possible explanation is that flavanols stimulate eNOS activity, leading to increased NO generation, which may lead to vasodilatation [13]. However, the role of vasodilation in migraines is unclear, and recent findings challenge its necessity [41]. There are also some ambiguities regarding the influence of chocolate on NO production. On the one hand, a great number of studies indicate that cocoa flavanols increase NO levels, while other studies have surprisingly found that cocoa reduces NO production by inhibiting the expression of NO synthase [20,42,43,44]. Another possible link between chocolate and migraine attack is serotonin. The concentrations of this neurotransmitter increase during a migraine attack. Cocoa is also suggested to play a role in the release of serotonin, which is proposed to be involved in the pathogenesis of migraines. Serotonin and its precursor tryptophan were found in chocolate, with the highest serotonin level in chocolate found with a cocoa content of 85% [15]. Theoretically, it is possible that by increasing the serotonin level, chocolate consumption may induce a migraine attack. Nevertheless, existing studies have not confirmed this theory [45]. Phenylethylamine is also reported as a neurotransmitter that can initiate migraine-type headaches in susceptible individuals. In an animal study, PGA produced significant increases in CBF and cerebral oxygen consumption during the first 40 min of infusion. In contrast, a further increased phenylethylamine concentration constricted the cerebral bed (cerebral blood flow reduced by 28%), producing a pattern of vascular events similar to those seen in migraines [46].

Although there is a lack of data showing the beneficial effect of chocolate on migraines, theoretically such a link is possible. First of all, chocolate contains many vitamins and minerals, among them magnesium and riboflavin, which are recommended in migraine prevention [47]. Magnesium plays an important role in neuromuscular conduction and nerve transmission and also acts as a protective agent against excessive excitation, which causes neuronal cell death. There is strong evidence regarding the beneficial effect of magnesium for chronic pain conditions and migraines [48,49]. One should remember that chocolate is a great source of Mg (with up to 252.2 mg of Mg per 100 g of chocolate). Another vitamin found in chocolate, riboflavin, was also reported to be efficient in the reduction of the frequency of migraines in adult patients [50]. It is known that migraine sufferers have chronically decreased serotonin levels, while the concentration increases during an attack [51]. Tryptophan is an essential serotonin precursor; thus, its depletion, which can occur with decreased dietary tryptophan intake, may increase the susceptibility to migraine-associated symptoms. One study showed that subjects who had a greater intake of tryptophan per day had reduced odds of developing migraine by approximately 54%–60% [45]. This means that chocolate, which contains both tryptophan and serotonin, by increasing serotonin levels, may also decrease the migraine frequency. Another study has shown that a cocoa-enriched diet suppresses stimulated levels of the inducible form of nitric oxide synthase (iNOS) [43]. NO is an important biological regulator and key mediator in migraines, where it regulates neurotransmission and vasodilation. NO levels increase in jugular venous plasma during a migraine attack, and additionally, iNOS inhibitors are effective in migraine treatment [52]. Therefore, it is possible that chocolate contains biologically active compounds that may reduce the incidence of migraine attacks by inhibiting NO synthase production.

CGRP (calcitonin gene-related peptide) is a neuropeptide that is released from the peripheral nerve, central nerve endings, and within the trigeminal ganglion. The release of CGRP starts a cascade of events, including the increased synthesis of nitric oxide, vasodilation, and causing mast cells to release inflammatory mediators and the sensitization of the trigeminal nerves, thus playing an essential role in the pathophysiology of migraines. The concentration of CGRP is elevated in the plasma of people with episodic and chronic migraines between and during migraine attacks; moreover, the administration of CGRP elicits a headache and sometimes a delayed migraine in migraineurs [53,54]. It should be emphasized that CGRP receptor antagonists are effective in migraine treatment. Cady et al. demonstrated that a cocoa-enriched diet prevents inflammatory responses in trigeminal ganglion neurons by inhibiting the expression of CGRP [43]. Abbey et al. showed that Theobroma cacao extract can repress the stimulated CGRP release by a mechanism that likely involves the blockage of calcium channel activity [42].

Depression and other mood diseases often coexist with migraines and can exaggerate their course. Chocolate is known to have mood-enhancing properties, mostly due to its orosensory properties, psychoactive ingredients, and the activation of neural reward pathways [55]. The consumption of chocolate may be associated with an improvement in the mood state, the attenuation of negative moods, or reduced odds of clinically relevant depressive symptoms [55,56].

Another mechanism by which chocolate may have a beneficial effect on migraines is the influence on the microbial population of the human gut [19]. Martami et al. demonstrated that a probiotic mixture could be an effective and beneficial supplement to treat migraine headaches in both chronic and episodic migraine sufferers [57]. As cocoa polyphenols may modulate the microbial population of the human gut, they may be another mechanism for treating migraines.

All of this evidence shows that chocolate may act not only as a migraine trigger, but also as a protective factor, possibly decreasing the probability of an attack over a period of time ().

Possible mechanisms by which chocolate may trigger or prevent migraine attacks (based on our literature review).

1.4. Migraine Triggers

Trigger factors are events or exposures (endogenous or exogenous) that are linked to an increased probability of an attack over a relatively brief period of time [8]. According to a review based on 25 publications, the “top 10” migraine triggers are stress, auditory triggers, fatigue, fasting, hormonal triggers, sleep, weather, visual triggers, olfactory triggers, and alcohol [9]. Dietary factors are less common, but their role in precipitating migraine episodes is of increasing interest. The classical and most frequently cited migraine dietary triggers are chocolate, cheese, citrus fruits, nuts, processed meats, monosodium glutamate, aspartame, red wine, and coffee [7,58,59,60]. It is believed that when these foods are avoided headaches improve [61]. However, in the case of exposure, attacks appear usually within 12–24 h after ingestion [3]. Kelman found that migraine patients with triggers have more family members with migraines, but also a longer lifelong duration of migraines, a higher frequency and duration of attacks, a better response to acute medications, more premonitory symptoms, more comorbidity, and more sleep difficulties than individuals without triggers [6]. There are several hypotheses about the causative connections between trigger factors and migraine initiation. The mechanism by which dietary triggers affect migraines may be connected with the release of serotonin and norepinephrine, vasoconstriction or vasodilatation, or by direct stimulation of the brainstem, cortical neuronal pathways, and trigeminal ganglia [62]. Trigger factors may diminish the migraine threshold, making it easier to initiate attacks. Alternatively, some migraine triggers may induce events that lead to a migraine attack. Some triggers may induce cortical spreading depression in the hyperexcitable migraine brain. Others may activate trigeminal nociceptors in the meninges or the neurons in the trigeminal nuclear complex. Headaches with trigger factors have greater severity or migraine features [63]. Many patients recognize multiple dietary triggers; thus, it is possible that most dietary precipitants in isolation are insufficient to trigger an attack [10]. Besides, it is not always easy to identify triggers. One study revealed that migraine patients show poor awareness of their headache triggers and hardly recognize a trigger unless asked specifically [64]. Hougaard et al. experimentally provoked 27 migraine patients, reporting that light or exercise would trigger their attacks, giving them different types of photo stimulation and exercise, or a combination of both. Only 3 (11%) individuals reported attacks following provocation, meaning that patients’ beliefs about triggers may be misleading [65]. Furthermore, many authors highlight the methodological difficulties of investigating the link between trigger factors and migraines [10]. According to Lipton et al., many different designs for studying trigger factors exist, such as surveys of beliefs, paper diary studies, electronic diary studies, case cross-over studies, repeated measurement retrospective cohort studies, and clinical trials [8]. Unfortunately, the majority of studies simply ask patients to retrospectively recall their usual headache triggers, which measures beliefs about triggers but not the link between exposure and headache occurrence. Using electronic diaries seems to be one of the best study designs, because the data are time-stamped so that the sequence of datum entry is known [8]. Besides, prospective diary studies better elucidate the causal association between potential triggers and migraine development, given that retrospective trigger reporting is subject to both recall and confirmation bias [66].

Many doctors, scientists, medical staff, and internet resources recommend avoiding triggers (including chocolate) to migraine patients [5,67,68]. Nevertheless, the common advice to identify and avoid triggers may be wrong. First of all, strict avoidance may lead to frustration, which in turn eliminates a potentially beneficial effect or even aggravates the situation. Besides, if a migraine is a disorder of the habituation of the CNS to sensory signals, the brain should be trained to habituate rather than avoid the triggers [51]. It is possible that avoiding triggers results in increased sensitivity to triggers. Moreover, studies have demonstrated that short exposure to a headache trigger results in increased sensitivity, and prolonged exposure results in decreased sensitivity (leading to desensitization). According to Martin et al., patients with migraines should cope with triggers rather than avoiding them [69]. Besides, there is no scientific evidence to recommend the so-called “migraine elimination diet” to patients.

3. Results and Discussion

Studies investigating the prevalence of chocolate as a trigger factor in patients with migraines are summarized in , and studies including provocative studies evaluating the effect of chocolate on migraine attacks are summarized in .

Table 1

Overview of studies investigating the prevalence of chocolate as a trigger factor in migraineurs. Abbreviations: TTH–tension-type headache, MWA–migraine without aura, MA–migraine with aura, EM–episodic migraine, CM–chronic migraine, TF–trigger factor.

Table 2

Overview of provocative studies evaluating the effect of chocolate on migraine attacks. Abbreviations: TTH–tension type headache.

3.1. The Prevalence of Chocolate as a Migraine Trigger Factor

Twenty-five studies have evaluated the prevalence of chocolate as a migraine trigger. Among them, two studies failed to find any participant that reported chocolate as a trigger. In other studies, chocolate was found to be a migraine trigger in a small percentage of participants (ranging from 1.3 to 33). Nevertheless, it is worth noting that the majority of studies asked patients to retrospectively recall their usual headache triggers using a predetermined list of triggers, thus mostly assessing beliefs about triggers rather than facts. Only one study used an electronic diary (supposed to be one of the best trigger factor study designs) and found chocolate as a trigger in a very small percentage of migraineurs (<1.5%) [63]. This study also showed that headaches with triggers were significantly related to a greater pain intensity, headache-related disability, and the use of abortive treatment. Tai et al. found that chocolate and coffee significantly triggered migraines when compared to tension type headaches (TTHs) [61]. Besides, chocolate was the second most frequently implicated trigger factor among the migraine patients in the study [61]. Similarly, other studies have also confirmed the connection between chocolate and migraines when compared to TTH and have shown no association between TTH and chocolate intake [36,76,78,79]. A study evaluating TTH in migraine and non-migraine populations found that only migraine patients had episodes of tension-type headaches precipitated by alcohol, over-matured cheese, chocolate, and physical activity [79]. Neut et al. found that chocolate was a trigger in more migraine-with-aura individuals as compared to those with migraines without aura [74]. One study found no differences between episodic and chronic migraine patients in reporting triggers [34]. Taheri et al. examined the effect of the exclusion of certain frequently consumed dietary triggers in a population of children with headaches. Cocoa was identified as a trigger in 22% of children. After exclusion of the identified food triggers (1 to 3) for 3 months, 87% of patients achieved a complete resolution of headaches [71]. Rist et al. evaluated the association between the headache status and the low intake of foods commonly reported to trigger migraines. They discovered that those who experience non-migraine headaches were less likely to have a low intake of chocolate, which suggests that they consume more of those items than participants with no history of headaches. In addition they showed that migraine patients who experience auras were more likely to have a low intake of chocolate [73]. In a very interesting study, Wober et al. aimed to assess whether a certain factor precipitates headaches consistently or only occasionally and compared patients’ personal experiences to their theoretical knowledge about trigger factors. They revealed that the number of patients having heard or read that a certain factor might precipitate a headache was larger than the number of patients who actually experienced this factor as a trigger. The largest difference between the theoretical knowledge and personal experience was found for oral contraceptives (65.0% vs. 14.7%, p < 0.001) and chocolate (61.7% vs. 14.3%, p < 0.001) [76]. One study discovered that patients who had relatives with migraines were more likely to report the initiation of an attack by chocolate [81]. Dalton et al. recorded the food intake of 1883 women during the 24 h before a migraine attack, examining 2313 attacks. Chocolate was consumed prior to an attack by 33% of patients, and among them only 14% mentioned food when asked “what do you think caused this attack?” [37]. Another diary study found that migraines were more common on days with exposure to chocolate consumption, but only in 2.5% of patients [72]. Peris et al. found individual trigger profiles, with an average of four trigger factors linked to an increased risk of attack. They concluded that it is likely that a combination of triggers are associated with the occurrence of migraine attacks in individuals when a ‘threshold’ is reached [72]. One study revealed that having relatives with migraines was linked with chocolate being a trigger factor, which may suggest a genetic origin of response to triggers [81]. It was also shown that individuals who reported that alcohol, cheese, or citrus fruit provoked their headache were more likely to have migraines also triggered by chocolate, with the strongest correlation between sensitivity to alcohol and to these three food stuffs [81]. Dalton demonstrated that chocolate was a more prevalent migraine trigger in younger women, as compared to those over 50, and also in women who had a hysterectomy [37]. Besides, chocolate was reported as a trigger more frequently between 1–4 days into a menstrual cycle as compared with other days [37].

3.2. Double Blind Provocative Studies

Only three double blind studies have evaluated if chocolate can provoke migraine attacks. Two of them used carob as a placebo, while in the other the placebo consisted of synthetic fat. Marcus et al., in a study using chocolate or carob to induce headaches, found no difference between chocolate and the placebo in provoking headaches, regardless of personal beliefs about the possibility that chocolate provokes headaches. Before the study, a double-blind taste test of the chocolate and carob products was performed, in order to determine if it is possible to identify which sample contained the actual chocolate product. The results demonstrated that subjects could not accurately determine what they were eating, indicating that carob was an appropriate placebo for chocolate. Before the study, eleven subjects (17.5%) reported that chocolate was a trigger for their headaches. It is worth noting that all subjects initially followed a diet with the restriction of vasoactive amine-rich foods. The authors concluded that eating chocolate is not likely to be a trigger, but cited sweet food cravings as a part of prodrome phase of headaches [78]. Contrary to these results, Gib et al., in similar study, found that 41.7% of patients experienced migraine headaches after eating chocolate, while none developed headaches after eating a placebo [83]. However, the sample was small, and this difference did not reach a statistical significance. It is worth noting that the median time from eating chocolate to the onset of the attack was 22 h [83]. In the last study, Moffett et al. found no significant difference in the responses to chocolate or a placebo in a group of 25 migraine patients who reported chocolate as a headache trigger. In this study, 25 headaches were reported in 80 subject sessions, but only 13 of these occurred after eating chocolate alone [82].

Here’s Why Chocolate And Wine Give Some People Migraines

Scientists think they’ve figured out why chocolates and wine can trigger migraines in some unlucky people: it’s down to gut microbes and the way they interact with chemicals in food.

This unfortunate bacteria-powered chain of events turns chemicals called nitrates – found in chocolate, wine, processed meat, and other foods – into nitric oxide byproducts. And it’s these byproducts, which have been linked to migraines in previous research, that can cause a splitting headache.

To find the link between the two, researchers from the University of California, San Diego (UCSD) analysed 172 oral samples and 1,996 stool samples from their American Gut Project database.

The results showed that people who experienced migraines also had higher levels of the gut microbes that can modify nitrates.

“There is this idea out there that certain foods trigger migraines – chocolate, wine, and especially foods containing nitrates,” says one of the researchers, Antonio Gonzalez. “We thought that perhaps there are connections between what people are eating, their microbiomes, and their experiences with migraines.”

When nitrates enter the body via food and drink, bacteria access them and use them as fuel. But it doesn’t end there, because the bacteria’s own waste products, called nitrites, eventually become nitric oxide in our blood.

Nitric oxide isn’t all bad, because it dilates our blood vessels and can aid cardiovascular health by boosting blood circulation. But it’s thought that sometimes this dilation and inflammation can increase a person’s risk of migraines.

In fact, patients experiencing chest pains or heart problems often take drugs containing nitrates – but the problem is that more than 80 percent of them report headaches as an unwanted side effect. The question is whether their bacterial microbiomes are to blame.

After sequencing the bacteria from the samples in the study, the UCSD team used a bioinformatics software program called PICRUSt – pronounced “pie crust” – to identify which genes were likely to be present in the microbes of each individual.

Genes that encoded nitrate, nitrite, and nitric oxide-related enzymes were all shown to be more abundant in the mouths and guts of migraineurs – the term for people who regularly experience migraines.

While that lends weight to the argument that the bacteria living in our guts and mouths might be the link between nitrates in food and migraines, the researchers admit more work is needed to prove this hypothesis.

“It remains to be seen whether these bacteria are a cause or result of migraines, or are indirectly linked in some other way,” said American Gut Project manager Embriette Hyde, who also worked on the study.

To team intends to run follow-up studies looking at people with particular types of migraines to further investigate the association. If it really does exist, one day there could be a range of treatments to alleviate migraines, like a “magical probiotic mouthwash”, Gonzalez suggests.

Until then, the best advice scientists have is that you might want to take a pass on the red wine and chocolate. Sheesh… sorry, guys.

“If you suspect that nitrates are causing you migraines,” Gonzalez says, “you should try to avoid them in your diet.” 

The findings are published in mSystems.

Common triggers – The Migraine Trust

Common triggers

Changes in routine

Some people find that changes in their routine can contribute to a migraine. For example changing sleep patterns or changes caused by long journeys can precede an attack. Even pleasant changes such as a holiday can be implicated.

Weekend headaches

Many people complain that they get migraines at the weekend. At the weekend you may have a change in many of your daily routines such as eating times, reduced caffeine consumption which is particularly noticeable if you have a ‘lie in’ after a busy week. See also stress, sleep, and caffeine below.

Stress

Migraine and stress are strongly linked. Indeed, anxiety, excitement and any form of tension and shock may all lead to a migraine attack. However, some people report that their migraine attacks start when the stress reduces. This is sometimes experienced as “weekend headaches” when, after a busy and stressful week at work, an individual might experience a migraine at the weekend when they are more relaxed.

Sleep

The complex nature of trigger factors is illustrated by sleep. Both too much and too little sleep can be implicated in a migraine starting. Some people find that sleepless nights, a number of late nights and being over tired can trigger a migraine. Other people find that sleeping in or dozing in the mornings has the same effect.

Caffeine

Excessive consumption of caffeine may contribute to the onset of a migraine attack. You could try not having more than 4 or 5 cups of tea, coffee or cola in a day. Some people find that suddenly stopping caffeine altogether can also be a trigger factor. If you suspect this, you may wish to cut down on caffeine more gradually. Some people find that consuming less caffeine at the weekend can have an impact on migraine attacks, but you should also note that caffeine can be found in many products including chocolate and over the counter painkillers.

Hormonal changes in women

Migraine is closely associated with female hormones. Some women find their migraines start at puberty, and are linked to their menstrual cycle. The additional hormonal trigger for women may explain why more women than men experience migraine during their reproductive years. The menopause is often the most difficult time for women with migraine.

The environment

There are certain trigger factors which can be related to environmental issues such as high altitude, weather changes, high humidity, loud noises, exposure to glare or flickering lights. It is unclear if light and sound are themselves triggers, or if heightened sensitivity to them are early features in the attack.

Computer screens/VDUs

Sitting in front of a computer at home or work for long periods of time can cause problems if you experience migraine. Following common sense precautions such as taking regular breaks, using anti glare screens and good lighting can help prevent this sort of difficulty.

Sitting comfortably is very important when you use a computer to avoid muscle tension building up in the head, neck and shoulders. This muscle tension is implicated in the onset of migraine.

Food

Food related triggers occur in about 10% of people with migraine. Many people will crave sweet food such as chocolate before the pain of the migraine is experienced which leads them to conclude that eating sweet food is a cause. However, sometimes the craving for particular food is a symptom of the beginning of the migraine.

Lack of food

Missing meals or eating sugary snacks instead of a balanced meal can all contribute to a migraine attack. Insufficient food is probably one of the most important dietary triggers. You may find that eating small nutritious snacks at regular intervals can help to control your attacks.

Additives

Some food products contain chemicals or additives which may also be implicated in an attack. Ones which are frequently mentioned by people with migraine are monosodium glutamate, nitrates and aspartame.

Alcohol and cheese

There is some evidence that red wine may trigger a migraine because it contains tyramine which has been linked to migraine. Certainly many people with migraine avoid red wine. Tyramine is also found in other food products such as soft cheeses like camembert and brie.

Mild dehydration

Mild dehydration can have an impact on people who have migraine. It is recommended that you should drink at least 8 glasses of water per day. This is in addition to any other drinks you may have. Fizzy drinks can contain the sweetener aspartame which some people link to their migraine.

Is chocolate really a migraine trigger?

It’s common wisdom that chocolate is a migraine trigger—yet
the common wisdom might not be correct. Studies have failed to establish a
clear link between chocolate consumption and migraine attacks.

Research

In one well-designed study of 63 women with migraine,
tension-type headache, or both found that chocolate was no likely to trigger a
migraine than carob was. The study’s abstract concludes, “Thus, contrary to the
commonly held belief of patients and physicians, chocolate does not appear to
play a significant role in triggering headaches in typical migraine,
tension-type, or combined headache sufferers.”

An article that reviewed the research on chocolate and
migraine, published last December, found that chocolate was far less likely to
trigger migraine attacks than stress, fasting, lack of sleep, or alcoholic
beverages. Researchers found that chocolate was as likely to be a migraine
trigger as a placebo was (read: unlikely) and say that “the widespread belief
that chocolate and cocoa containing foods should be absolutely
avoided by migraine patients lacks of a reliable scientific basis.”

Why is chocolate so often considered a migraine trigger?

There are several factors at work here. One is that people
tend to crave sweets before a migraine attack. It could be that you were
craving chocolate in the first place because you already had an attack coming
on. Or you could be more likely to consume chocolate at times when you have
other trigger factors at play, like ties of high stress or when you’re wrung out
from lack of sleep. And, unfortunately, chocolate is a migraine trigger for
some people. The research shows that there’s no reason for everyone with
migraine to absolutely avoid chocolate, but it doesn’t rule it out as a trigger
for everyone.

Does this mean you’re safe to finish off the bowl of
leftover Halloween candy in one sitting? Maybe… but probably not. Like with
so many migraine triggers, it’s not that straightforward.

Tips for eating chocolate when you’re not sure if it is a
trigger

Take notes. Make
a note of when you eat chocolate and what kind and how much of it you eat. Then
make note of when you get migraine attacks. After a while (it depends on your
migraine frequency), you should be able to establish whether chocolate is a
trigger for you. Your notes don’t need to be detailed or complicated. Just jot
the basic information down on a calendar, send yourself an email with a searchable
phrase that will let you pull up all your relevant notes at once, or keep a
tally on a sticky note inside a cabinet. It’s important to have notes across
multiple attacks because something can be a trigger one day, but not another.

Watch out for other
ingredients that could be the culprit
. Nuts, gluten, caffeine, sugar, and
corn (and it’s derivatives) are all cited as migraine triggers for some people.
If you’re sensitive to any of these ingredients, their presence may overrule
that of cocoa.

Quantity matters.
You might be fine with three pieces of Halloween candy, but not four. The
threshold varies from one person to the next.

Consider the context.
If you eat candy as a meal or scarf it down after not eating all day, you’re
probably not going to feel great. There’s not a clear scientific explanation
for this, but the anecdotal evidence is strong that eating junk food can make a
person feel ill. If you’re prone to migraine, that ill feeling might be a
migraine attack. (I write this after a few days of eating lots of carbs and
sugar and I’m feeling it. It’s back to fruits, veggies, and lean protein
today.)

Concluding thoughts

Food sensitivities
are weird
. As much as food is implicated in migraine and other health
conditions, there’s very little research on the topic. And, according to my
dietician, it’s unlikely that there will ever be much research, since there’s
little funding for it. That’s why it’s so important to determine your unique
triggers. You can only really know if chocolate, or any other food, is a
migraine trigger for you once you know your own body, migraine patterns, and
trigger thresholds.

Maybe it’s worth it.
If you love, love, love chocolate or can’t imagine Halloween without your
favorite treat, you may decide that the ensuing migraine attack is worth it for
you. I’m an advocate for occasional indulgences, just be sure you have your meds
close by.

REFERENCES

Marcus, D. A., Scharff, L., Turk, D., & Gourley, L. M. (1997). A double-blind provocative study of chocolate as a trigger of headache. Cephalalgia, 17(8), 855-862.

Lippi, G., Mattiuzzi, C., & Cervellin, G. (2014). Chocolate and migraine: the history of an ambiguous association. Acta Bio Medica Atenei Parmensis, 85(3), 216-221.

Can Eating Chocolate Give You a Headache?

Chocolate can create a sensation of well-being and alertness, but it can also cause migraine headaches in some people.

Chocolate is an indigenous South American food. Traditionally, the bean of the cacao tree was brewed with hot water, producing a bitter drink often mixed with dried chili peppers. Adding sugar to create the hot chocolate that is drunk today, and adding fats to create chocolate candy, occurred in Europe in the 16th and 17th centuries. Chocolate can create a sensation of well-being and alertness, but it can also cause migraine headaches in some people.

Tyramine and Phenylalanine

Dark chocolate contains the chemical tyramine, which has been found to trigger migraine headaches in the majority of migraine-prone subjects tested in some studies, according to the Clemson University Extension. Phenylalanine, another component of chocolate, has been shown to trigger migraines in about half the migraine-prone subjects in another field study, according to the University of California Nutrition Bytes. Additional studies on both of these chemicals have yielded variant, inconclusive results. Keeping a food diary to determine personal migraine triggers may be a more effective strategy than simply eliminating foods like chocolate from consumption, according to Harvard Health Publications editor Christine Junge, as triggers seem to vary considerably from person to person.

Caffeine

Over-consumption of caffeine may trigger migraine headaches in some individuals, according to MedlinePlus. Chocolate does contain caffeine, as well as the stimulant thobromine, but only in very small amounts. One ounce of milk chocolate has approximately the same quantity of caffeine as a single cup of decaffeinated coffee, according to the California Academy of Sciences. A person would have to eat more than 12 chocolate bars to consume the same quantity of caffeine as in a single cup of coffee, according to the University of Washington Neuroscience for Kids project. For caffeine sensitive individuals, this small amount of caffeine might trigger a headache, while regular consumers of caffeine might experience a headache if they miss their regular doses of coffee or chocolate.

Opiates

Eating chocolate triggers the brain to release natural opiates that dull pain and produce a happy feeling of well being, according to the Washington State University Neuroscience for Kids project. Anandamide, also a chemical component of chocolate, encourages the release of dopamine, another naturally occurring substance in the body that creates feelings of happiness. Chocolate also increases the brain’s serotonin and endorphin levels. Although these chemicals are only present in very small amounts in an ordinary serving of chocolate, the positive sensations caused by dopamine and opiates released from eating chocolate may actually bring relief from minor headaches, especially those caused by tension and anxiety.

Health Benefits

Chocolate is one of the richest food sources of antioxidants, nutritional compounds that help the body fight off free radicals that damage cells. Cocoa powder and dark chocolate contain more antioxidants per serving that fruit, green tea or red wine, according to the Clemson University Extension. Eating small amounts of dark chocolate can lower high blood pressure, increase blood vessel elasticity, and help to regulate blood sugar. While most chocolate candy contains high amounts of fat and sugar, which are detrimental to consume in large quantities, consuming dark chocolate, which is lower in fat and sugar, in modest amounts can be beneficial to cardiovascular disorders that may also contribute to headaches.

Migraine Cravings & Triggers Explained: Chocolate

What’s the Story with Chocolate and Migraines?

Is wanting to eat chocolate just a craving we have because of chocolate’s incredible flavor, or is there a deeper reason that our body cries out for it? Why do you crave chocolate more right before your period? And how do you reconcile the paradox of wanting to eat something that gives you so much joy and pleasure with the probability that doing so may land you back in bed with a migraine? Finally, how can you get to a place where you can once again partake of this nourishing and sacred ancient plant – theobroma cacao?

We’ll explore these questions today.

Perhaps you already have a handle on your chocolate cravings because you’ve paid the price too many times. Or perhaps your short-term need for gratification in eating chocolate continuously trumps your knowledge that it doesn’t support you. It could be that, having read many of the health benefits of chocolate, you’ve convinced yourself it’s not a trigger. Or perhaps, if you’re lucky, you actually are someone who isn’t stuck in chronic migraines and chocolate is not even an issue for you or a major contributor to the few migraines you do get. In that case, this article might still explain why you crave chocolate so much.

The Sacred

Theobroma Cacao

Throughout this article, we will refer to the properties of cacao as being distinct from that of chocolate, which contains cacao as its main ingredient. Because chocolate contains sugar and other ingredients that can also trigger migraine, it’s important to make this distinction between the raw substance taken from the cacao plant and the processed end-product we know as chocolate:

Cocoa, or cacao, is the dried and fully fermented fatty seed of the fruit of the cocoa tree, Theobroma cacao. Cocoa liquor is the paste made from ground, roasted, shelled, and fermented cocoa beans, called nibs. It contains both nonfat cocoa solids and cocoa butter. Cocoa liquor is what is referred to as “percent cacao” on food packaging. Cocoa powder is made by removing some of the cocoa butter from the liquor. Chocolate is a solid food made by combining cocoa liquor with cocoa butter and sugar. (Source)

In my own circle of friends, cacao is going through a renaissance – honored not just as an indulgence or aphrodisiac, but as a sacred plant medicine. A lady friend of mine who does not get migraines and who has travelled extensively in Mesoamerica runs monthly Goddess gatherings involving a cacao ceremony. She has a beautiful cacao pod on her altar that she also uses as a rattle to sing with.

Among its many qualities, cacao is recognized as a plant useful in healing the heart. The medicinal properties of cacao are amplified through the intentions and songs of those using cacao for healing work. These cacao ceremonies, utilizing cacao as a bitter drink mixed with other herbs and spices, originated thousands of years ago.

Foods and beverages made from beans from the Theobroma cacao tree (cocoa, cacao) have been consumed by humans since at least as early as 460 AD. The medicinal uses of cacao or chocolate either as a primary remedy or as a vehicle to deliver other medicines originated in Mesoamerica, where it was consumed by indigenous peoples, and diffused to Europe in the mid-1500s. Between the 16th and 20th centuries, well over 100 uses for cacao or chocolate, as a medical treatment, have been documented. Among these, three applications are most common: (i) to induce weight gain in emaciated patients; (ii) to stimulate the nervous system; and (iii) to improve digestion and elimination. (Source)

While I can now partake of large quantities of cacao and chocolate without consequences, I have to be alert in attending these local cacao ceremonies, because the cacao is brewed in the traditional Meso-american way, with very little sugar, no milk, and a dash of cayenne pepper. If you are familiar with my approach to healing migraine or my earlier writings, you will know cayenne is the Queen of all migraine triggers, due to its capsaicin content. But happily, as long as it does not contain chilli, I can now freely partake of all other forms of cacao.

Cacao: the “Mountain of Sustenance”

In the Popal Vu, the Mayan creation story, cacao is considered one of the principle foodstuffs of the “Mountain of Sustenance”, where humankind was also first created from maize and water.

The nutritional components that make cacao (and chocolate) so nourishing and sustaining are also what make it medicinal. Cacao has long been recognized to be supportive in protecting nerves from injury and inflammation, protecting the body’s tissues from oxidative damage, and supportive of cognitive function and mood. All of these properties of cacao benefit those with migraine.

Cacao is impressive in its content of many health-promoting substances, especially procyanidins, and flavonoids/antioxidants. The polyphenols, flavanoids and catechins in chocolate even trump the levels found in high-antioxidant fruits like blueberries and acai. Cacao contains beneficial lipids and saturated fatty acids as well.

Many of these beneficial effects (especially antioxidant effects) vary by cultivar type and roasting method. As is usually the case with all foods, the extent to which a raw food is processed affects its nutrient content and overall health benefits. The same goes with cacao:

The extent to which cocoa beans are roasted also has a substantial impact on the antioxidant capacity of the cocoa’s phenolic compounds; longer roasting time is associated with reduced antioxidant activity. . . Variation in antioxidant capacity can also be seen in cocoa powder. Cocoa powder is often treated with alkali to neutralize the natural acetic acid in cocoa in a process called “Dutching.” This process substantially reduces the flavanol content of the cocoa. In one study of commercially available cocoa powders, the flavanol content of heavily alkalized cocoas was 78.5% lower than that of natural cocoas. (Source)

So, quality and processing methods DO matter when it comes to how beneficial the cacao is as a medicine.

Finally, looking at the mineral constituents in cacao, it is easy to see why and how it is truly sustaining, and has been treasured for so long. It is also easy to see why chocolate would be craved by migraineurs, since it contains significant levels of some of the most important minerals for healing migraine, notably manganese, magnesium, copper, and zinc.

Here’s a snapshot of the stellar mineral profile of 1 cup of cacao nibs:

• Manganese: 1.9mg (96%)
• Copper: 1.8mg (89%)
• Magnesium: 229mg (57%)
• Zinc: 3.2 mg (21%)
• Phosphorous: 321mg (32%)
• Potassium: 750 mg (21%)
• Iron: 3.9mg (21%)
• Calcium: 71.4mg. (7% DV)
• Selenium: 7.5mcg (11%)

Chocolate, Migraine & Biogenic Amines

Chocolate used to be one of my more formidable migraine triggers – not because it is as strong of a trigger as some other foods like hard cheese, chilli, or wine, but because it’s so much more difficult to avoid consuming due to how delicious it is.

Before understanding the role that biogenic amines play in migraine, I was confused by the mixed information I read online about whether chocolate was truly a migraine trigger or not, which helped me to justify eating it.

In the course of doing research for this article I found one study that concluded that cacao is not actually a migraine trigger. However, the study was done on migraineurs who had abstained from all amine-rich foods for two weeks. This factor alone would mean that the migraineurs had lower than usual “buckets” of histamine upon eating the small sample of cacao at the end of the study.

The study’s conclusion that chocolate may not be a trigger when consumed in small quantities alongside a low-amine diet would hold true for most migraine-triggering foods (with the exception of chili). It is indeed the total load of histamine and biogenic amines present already in the body (most of which originate in imbalanced gut flora), exacerbated by mineral deficiencies, that determines the extent to which a food acts as a trigger – or not. Therefore, the way to heal this issue is to address the gut flora and mineral imbalances and abstain from amine-rich foods while doing so. These approaches to healing are covered in detail in my coursework and coaching.

But why are biogenic amines so triggering? Biogenic amines are nitrogenous compounds that can raise nitric oxide levels in the body, leading to blood vessel dilation and inflammation. Biogenic amines are found in many foods, most notably aged or fermented foods, and are the most widely recognized group of food triggers for migraines.

The main biogenic amines found in cocoa and chocolate are 2-phenylethylamine, tyramine, tryptamine, serotonin, dopamine, spermidine, putrescine, and histamine. Tyramine is the most common biogenic amine in chocolate. Cultivar type, level of fermentation, and level of roasting of cacao pods all affect amine content. The good news is that organic and fair trade chocolates generally tend to contain lower amounts of biogenic amines.

Other Reasons Why Chocolate Can Trigger Migraine

There are additional factors aside from biogenic amine content that contribute to chocolate being a migraine trigger.

If the chocolate quality is poor, the sugar content is too high, or the chocolate contains dairy, nuts, oxidized oils, wheat, glutamate, soy, or corn syrup, chocolate can act as a trigger for reasons that have nothing to do with the biogenic amine content of the cacao itself.

Waxes in cacao butter may also be hard for those with a sluggish gallbladder to break down. The caffeine content of chocolate is also a consideration, though the levels of caffeine in chocolate are relatively low and should not pose a problem for most people unless they happen to be highly sensitive to caffeine.

Chocolate Cravings

So we can truly appreciate cacao for the amazing substance, food, and medicine that it is. Personally, I think that the nutritional profile of cacao alone could explain the reason why our body craves it. But researchers have concluded that it is not actually the nutrition in cacao that causes the cravings, but rather that chocolate cravings are associated with negative mood.

The findings of Rozin and colleagues provide strong evidence that it is not the bioactive compounds in cocoa solids, but rather the particular taste and mouth-feel of solid chocolate products that satisfy chocolate cravings. . . In a cross-sectional study, chocolate consumption was associated with higher depression scores (indicating more depressive symptoms), but whether the relationship is a causal one is still unclear. Further, individuals classified as “emotional eaters” have reported greater craving for and consumption of chocolate. (Source)

Many women can likely relate to the intensity of chocolate cravings increasing right before or during their moonstruation (menses), when they are also more “moody”. But why are certain times of the moonth more “moody” for women, and why would these times of the moonth lead us to eat “emotionally”? Is this just a natural biochemical aspect of being a woman – or are the mood swings and emotions that women experience right before or during their periods a signal from their inner self to slow down and soothe themselves in a world gone haywire with speed, overwhelm, and obligation?

Emotional Eating as a Prompt for Self-care

Perhaps if we learned to honor our body’s natural rhythms better we would not need to resort to emotional eating. Lisa Hendrixson Jack, author of “The Fifth Vital Sign” points out that when women have moonstrual problems, we need to see it as an intelligent signal by the body – not a dysfunction.

“As women, we’ve been programmed with a monthly reset feature.  It’s as though there’s a force within you that knew you would be such an amazing light for everyone else that you’d forget to shine it on yourself.  Your period ensures that you pay attention to your own needs once in awhile.  Oh, and if you try to ignore it, it just keeps banging on your door until you start paying attention.”

I think that the moon-time is a perfectly good time to eat for pleasure, stock up on minerals, soothe ourselves, and generally feel our feelings that have been swept under the rug the rest of the moonth. But if you want to be truly nurturing to yourself during this time, triggering a migraine by overeating chocolate could very well place you in a torture chamber rather than the restful Goddess retreat you desire.

Therefore, if you find yourself craving chocolate at this time, use it as a prompt to ask yourself:

• “Where can I get the minerals present in cacao in another food that is not high in biogenic amines?” or
• “How else can I soothe myself and give myself some enjoyment and pleasure in a way that is not likely to trigger a migraine?” or
• “How can I honor my feelings and cope with what’s going on in my life in a way that is truly supportive to my body?” or
• “In what other way can I honor my sensual and sensitive self as a way to reduce stress?” or
• “Is there a way that I can check out for a moment that will support my nervous system right now?”

Because eating chocolate is a very QUICK way to soothe, find a bit of pleasure and sensuality, and reduce stress, it is an easy go-to – especially if you don’t give yourself permission to take more time to do those things that lie beneath the chocolate craving. When you ask yourselves the questions above, be sure to make an extra emphasis on giving yourself permission to take the time to meet the needs underlying the food cravings, as most of them will require a bit more time than inhaling a chocolate bar.

Permission is key. The sad truth is that so many women (especially mothers) are so over-extended in their lives that a migraine is the only thing that will allow them to have the permission to check out for a bit. Let’s examine – and CHANGE – this tragic story.

Instead, consider living your life in such a way that you are able to give yourself permission to slow down, be more internal and less obliged in the second half of your cycle, all the while reducing your intake of foods high in biogenic amines as you get closer and closer to your moonstruation time – so that when this time comes around you can rest, pamper yourself, hydrate, and generally be exquisitely sensitive to honoring yourself. If this sounds like a long shot, recognize that any and all shifts in that direction can make a big difference in your overall resilience. Healing is a learning process, after all.

You may even find that the more you learn to listen to and respect the natural ebb and flow of your womanly physiology, you will be able to eat small amounts of cacao without being triggered. Eating foods fully aware of their properties, choosing top quality ingredients and consuming them in the proper quantity can make the difference between a migraine and the truly pleasurable, conscious and slow savoring of a special treat.

If you are post-menopausal, you can still use food cravings as a window to explore your deeper emotional needs. To learn more about how to support your hormonal health (whether you are menstruating or have already hit menopause), read my blog post “Finding Hormonal Balance in the Red Tent”.

Key Points

Aside from coffee addiction, chocolate cravings and binges are probably one of the most formidable hurdles to overcome if you want to reduce and eventually eliminate your migraines.

Theobroma cacao is a nutritious sacred healing plant with many health benefits, but it is also a highly processed and fermented food that contains biogenic amines. So if you want to integrate cacao and chocolate into your life in a more healthful way, choose organic chocolate with a minimum of additional sugar and other additives. Eat cacao in small amounts only, being conscious of where you are at in your monthly cycle, and honoring that time by minimizing other foods high in biogenic amines so that you will be less triggered by any cacao you do choose to eat.

Even assuming you are eating a high quality organic cacao with less sugar or dairy, and eating a relatively low histamine diet, cacao can still be a trigger, especially if your migraines are very frequent or chronic, and if key minerals needed to break down biogenic amines are depleted.

Know that if you get your minerals balanced with an HTMA, you’ll certainly be able to eat chocolate more freely again, as your body is replenished with the nutrients you need to convert those biogenic amines into less harmful forms. If my own journey healing migraine is any testament, chocolate will one day be something that you can eat freely and even in quantity as a favorite way to get minerals through food.

Finally, by coming into more conscious relationship with this plant and its properties, appreciating its mineral content, and truly savoring it when you do eat it, you can use it medicinally rather than as a reflexive coping mechanism. And part of becoming more conscious of how we eat emotionally involves asking ourselves how we can meet our emotional needs in other ways that may be more supportive than eating chocolate.

I like to dip a chocolate bar in some homemade pecan butter (easy to make and high in manganese) and swoon in mineral bliss. You will eventually be able to also, but in the meantime, enjoy coming into more deliberate relationship with the beloved Theobroma Cacao, your cycle, and your own unique needs.

Quick Answer: Does Dark Chocolate Cure Headaches?

Dark chocolate

You’ve probably heard the best cure for a headache is a cup of coffee, especially if you’re going through caffeine withdrawal.

Dark chocolate contains caffeine — enough to help relieve a headache, but not so much that you’re going to have a hard time sleeping.

Is dark chocolate bad for headaches?

Research recently presented at the International Headache Society suggests that cocoa may actually protect the nerve cells that cause migraine headaches. But 22 percent of headache sufferers identify chocolate on the list of foods that trigger migraines or headaches.

Does dark chocolate cure migraines?

One of the main reasons dark chocolate can be used to prevent and decrease symptoms of headaches is due to its high magnesium content. Stress (one cause of and response to headaches) drains magnesium from the body, so what better way to relieve stress and prevent migraine and headache pain then to eat Dark Chocolate!

Does chocolate get rid of headaches?

Caffeine, which is present in chocolate, actually gets rid of migraines when used sparingly.” Dr. Halpern doesn’t recommend intentionally eating lots of chocolate to prevent an attack, since that could backfire.

How do you make a headache go away fast?

Here are some tips for headache relief:

• Close your eyes and rest.
• Massage your neck and temples.
• Warm up your neck Try putting a heating pad or a warm cloth around your neck and the base of your skull to ease tension headaches.
• Relax.
• Minimize stress.
• Watch what you eat and drink.

Does chocolate contain tyramine?

Chocolate has only small amounts of tyramine but does contain dopamine and serotonin – two biochemicals much more likely to have a positive rather than negative effect on migraine 3. Tyramine was thought to occur in a wide range of foods, including cheese, citrus fruits, red wine and chocolate.

Why does dark chocolate cause headaches?

Some who suffer from migraines list chocolate as a possible trigger food. Some neurologists say it is a migraine trigger because it contains the amino acid tyramine (see No. 4). But the connection could be that women tend to crave chocolate during stress and hormonal changes, both of which also may trigger headaches.

What drink helps headaches?

Drink Caffeinated Tea or Coffee

Sipping on beverages that contain caffeine, such as tea or coffee, may provide relief when you are experiencing a headache.

What foods should you avoid if you have migraines?

However, some foods that commonly trigger migraines include:

1. aged cheeses.
2. alcohol, particularly beer and red wine.
3. chocolate.
4. cured meats.
5. food preservatives, such as nitrates, nitrites, MSG, and artificial sweeteners.
6. smoked fish.
7. yeast extract.

What is the main cause of migraines?

Emotional triggers: Stress, depression, anxiety, excitement, and shock can trigger a migraine. Physical causes: Tiredness and insufficient sleep, shoulder or neck tension, poor posture, and physical overexertion have all been linked to migraines. Low blood sugar and jet lag can also act as triggers.

Why do I wake up with a headache every day?

This can occur at night as a sleep disorder, which is referred to as sleep bruxism. It can cause you to have a headache when you wake up in the morning. Bruxism is also linked to other sleep conditions like sleep apnea, and it may cause damaged teeth and jaw pain.

Where is the pressure point for migraine?

Pressure point LI-4, also called Hegu, is located between the base of your thumb and index finger. Doing acupressure on this point to relieve pain and headaches.

What is best for headaches?

For most run-of-the-mill headaches, it’s usually best to try acetaminophen (Tylenol and generic) first. If acetaminophen doesn’t relieve your pain, consider ibuprofen or naproxen (Aleve and generic). Both are Consumer Reports Best Buys.

Do Sweet potatoes have tyramine?

Sweet potatoes

This delicious vegetable is, unfortunately, chock full of tyramine, which is formed when high-protein foods break down or age. According to the National Headache Foundation, tyramine triggers migraines.

Do apples have tyramine?

Avoid over ripened fruits (high in tyramine). All other fresh fruits. (apples, apricots, blackberries, blueberries, cantaloupe, cherries, cranberries, grapes, melon, mangoes, nectarines, peaches, pears, strawberries and watermelon).

What food contain tyramine?

Specific foods with high tyramine content include:

• strong or aged cheeses like cheddar, blue cheese, or gorgonzola.
• cured or smoked meats or fish, such as sausage or salami.
• beers on tap or home-brewed.
• some overripe fruits.
• certain beans, such as fava or broad beans.

90,000 Gourmet Migraines: Which Foods Cause Headaches | Proper nutrition | Health

Experts say: simple food is not only cheaper and more affordable, but also healthier than overseas delicacies. A high percentage of fat in all this yummy is a threat of high cholesterol, an excess of salt is a risk of hypertension, and some other substances are a direct path to the development of headaches.

Amines against joy

In the first place among the products that provoke migraines – food that contains amines (biologically active substances that first force the vessels of the brain to contract and then to expand).With the expansion of blood vessels, a painful spasm occurs. The amine class includes tyramine in particular. This ingredient gives a spicy taste and aroma to expensive cheeses, ham, smoked fish, crabs, sausages and other meat and fish products.

Tyramine in the body competes with one of the important mediators of the brain – serotonin, removing it from the body. Whereas it has been scientifically proven that it is the violation of serotonin metabolism (which is also called the hormone of joy) that is the reason for the development of migraines in a large number of people.Amines are found not only in cheeses and sausages, but also in marinades, sauces and pickles, and even in some fruits (citrus fruits, pineapples, bananas) and nuts.

Payback for pleasure

Do you remember the famous Tsvetaeva phrase “to treat sadness with chocolate”? But this delicacy really improves mood, since cocoa produces in the brain a substance related to opium – phenylethylamine. And all would be fine if sharp fluctuations in the hormone of joy would not lead to the same sharp decrease in serotonin and, as a result, to an attack of the most severe migraine.Alas, tasty and healthy dark chocolate, which contains a large percentage of cocoa, is one of the most frequent provocateurs of gourmet migraines. So it’s better to be careful with this delicacy too. But white and milk chocolate usually does not threaten a headache. But, however, it threatens with tooth decay and obesity.

Coffee addicts often suffer from throbbing headaches. After all, caffeine is highly addictive, and when its effect on the body weakens, the blood vessels of the brain greatly expand, which causes pain.So it’s better not to consume more than one cup of coffee a day. By the way, caffeine is also found in tea, cocoa and cola. Be careful with them too.

And about alcohol. By drinking too much alcohol, we naturally understand that a hangover the next morning cannot be avoided. Well, it is reasonable – you have to pay for the pleasure. But how disappointing it is to pay with a severe headache for just one glass of fine, expensive wine or for half a mug of brewed beer according to all the rules! But, alas, it is dry aged red wine, champagne and expensive beer (especially dark) that most often cause migraines.Pay attention to this!

Chinese restaurant syndrome

Everyone has heard about monosodium glutamate. True, most are sure that this flavoring additive is contained only in cheap fast food: bouillon cubes, crackers and chips. In fact, you can get a hefty portion of glutamate in an expensive restaurant. Chinese and Thai establishments are especially addicted to this additive. However, this is not such a big sin. After all, the Chinese and Thais extract their glutamate from natural products (usually from fermented fish and shrimp), while the Europeans use a chemically synthesized product.In principle, monosodium glutamate is not harmful, unless, of course, you eat it in excess (that is, more than 9 g per day). Still, in 10% of people, even a pinch of this spice causes a headache (as well as excessive sweating and shortness of breath). It is these symptoms that have earned the name “Chinese restaurant syndrome.” Those who are intolerant to glutamate should not only avoid southeastern restaurants, but also carefully read the composition of the products they buy (sometimes glutamate is hidden under the name of hydrolyzed vegetable protein).

Life without salami, but with sugar

Nitrite (a substance used to preserve meat and also to give it a special taste and pinkish color) can also cause migraines in some people. By the way, not only expensive meat products, but also affordable sausages can lead to a headache attack. No wonder they even have a special “hot dog headache” (manifested by throbbing pain in the temples half an hour after the use of nitrites).

And finally, one cannot fail to mention the artificial sugar substitute – aspartame, which can also cause headaches.Therefore, it is safer to add some real sugar to tea, and also to be careful when buying gum, fruit juices, low-calorie ice cream and desserts that include sugar substitutes.

Migraine provocateurs

People with migraines often report that their attacks are caused by some kind of provoking factor (trigger).

A study involving 200 people with migraines showed that 90% of them know at least one provocateur of their own migraines.The most frequently cited were physical or emotional stress (77%), menstruation (72% of women), bright lights or flashes of light (65%) and harsh odors (61%) [1].

How do migraine triggers work?

According to modern concepts, the cause of migraine is the increased excitability of nerve cells (neurons). This is a hereditary feature of the brain. Neurons in people suffering from migraine are very sensitive to various external and internal influences. May be affected by:

• Changes in hormone levels during the menstrual cycle,
• stress
• and, paradoxically, the resolution of stress,
• sleep disturbance (both insufficient and excessive sleep),
• alcohol,
• bright light or flash light.

In response to a trigger, electrical activity in easily excitable nerve cells changes and a cascade of biochemical disturbances is triggered that cause symptoms of a migraine attack [2].

What is important to know about migraine provocateurs (triggers)

1. Sometimes “your” attack provocateur can cause it, sometimes not.
2. A migraine attack requires a combination of two or more triggers.
3. What is a trigger can also relieve a migraine attack (eg, caffeine).
4. “Classic” migraine triggers: red wine, dark chocolate, stress – not all migraine sufferers provoke an attack.

1. A word about caffeine

Having heard from a doctor or acquaintances that caffeine can provoke an attack, many people with migraines completely refuse tea and coffee and look for a pill in horror after accidentally drinking a caffeine-containing drink.

Indeed, caffeine can cause migraine attacks in some.But he can also take it off!

It works like this. During a migraine attack, the work of the gastrointestinal tract slows down. Taken tablets remain in the stomach, but must be absorbed in the intestines. Caffeine increases gastrointestinal motility and helps pain relievers be absorbed.

And caffeine also has a direct anti-migraine effect – therefore it is included in various combined pain relievers. But it is important to remember that these medications should not be overused, as excessive caffeine intake can make migraine attacks more frequent and worse [5].

Should I stop eating certain foods?

There is no scientific evidence that would confirm or deny the effectiveness of “anti-migraine” diets. People with migraines tend to notice which foods are causing their attacks and learn to avoid them. Foods that can trigger a migraine attack include red wine, beer, dark chocolate, hard cheeses, citrus fruits, nuts, foods containing preservatives, and fast food.

Hunger can also trigger migraines.Therefore, it is important to eat regularly and in a balanced way (eg following a Mediterranean diet). And it will be much more effective in preventing seizures than complex diets [4, 5].

Literature:

1. Andress-Rothrock D., King W., Rothrock J. An analysis of migraine triggers in a clinic-based population. // Headache. – 2010. – v.50. – 1366-1370.
2. Chakravarty A. “How triggers trigger acute migraine attacks: a hypothesis.” // Med Hypotheses. -2010.- v.74. – p. 750-753
3. Dodick D.W. Migraine triggers. // Headache. – 2009. – v.49. – p. 958-961
4. Martin P.R. “Behavioral management of migraine headache triggers: learning to cope with triggers.” // Curr Pain Headache Rep. – 2010. – v.14. p. 221-227.
5. Rothrock J.F. “The truth about triggers”. // Headache. – 2008. – v.48. – p. 499-500

Photo by alexey-turenkov_unsplash

90,000 Alla Wayne: Six myths about migraines, five of which are almost true

1.The causes and mechanism of migraine are still a mystery to science

The specific mechanisms of a migraine attack are indeed partly a mystery. Migraine patients have a lowered threshold of sensitivity to a number of irritating factors that do not lead to a headache attack in all other people. But what exactly is the reason for this is not fully understood. This sensitivity to stimuli is probably largely genetically determined. Just a few weeks ago, the results of a joint international study of 50 thousand people were published, which showed that the peculiarities of the DNA of chromosome 8 seriously increase the risk of developing migraines.However, additional circumstances are needed for an attack to occur. This could be extreme fatigue, menstruation, atmospheric changes, or rest after stress.

2. Migraine starts from bad wine

None. The phrase “Chateau Migraine” has become firmly established, denoting bad wine, allegedly contributing to the occurrence of a migraine attack. Indeed, some firmly believe that migraine attacks occur after drinking wine. Most often they mean red wine, but national characteristics play a role here – for example, the French and Italians are convinced that they have an attack only after white wine, and red by definition is of better quality and better.Others argue that only wine from certain areas gives them a fit, such as Bordeaux or Burgundy, and they can drink wine from other places without problems. In theory, the difference in perception of different wine varieties can be explained by different grape varieties. It is known that each grape variety cultivated in certain areas has its own unique biochemical and pharmacological properties (cabernet sauvignon and merlot in Bordeaux, pinot noir in Burgundy, etc.). The only problem is that there is no scientific evidence to support these facts.No study has been able to demonstrate a link between a migraine attack and wine, white or red, from different areas and from different producers. It is impossible to rule out that someone has a special sensitivity to wine, but this is extremely rare, while you still need to be sure that it is a migraine that occurs, and not another form of headache, more familiar and understandable – for example, as a result of excessive alcohol consumption and all the associated subsequent effects (certainly an interesting topic for a separate discussion).

3. Cheese, coffee, chocolate and oranges provoke migraines

Yes and no. Among the foods that sufferers associate with migraines are primarily chocolate, cheese and citrus fruits. There can be at least two explanations for this. The first is related to the phenomenon of selective memory. What is it? We remember significant moments: perhaps the patient ate many times, for example, cheese, but only that day of a severe migraine attack was remembered, and since then there has been a deep conviction that cheese is to blame for everything.But there is another explanation: in the phase of precursors of a migraine attack, patients may change their mood, taste changes occur, sometimes, like during pregnancy, they are drawn to sweet or spicy. They eat this product more than usual, and then pain appears, but it’s not the food that is to blame.

Are there foods that are really harmful for migraine sufferers? Yes, although few people think about it. This is caffeine, which means coffee, tea, coca-cola and all other products containing it. By changing your diet to eliminate caffeine, you can dramatically reduce the number of seizures – a simple, yet extremely effective way.But depriving yourself of the pleasure of drinking good wine and eating cheese and chocolate is probably not worth it.

4. Migraine causes hallucinations

I would not call it hallucinations, rather, it is a distorted visual perception. In one third of patients, an attack begins with a so-called aura, most often manifested in the form of visual disturbances that last from several minutes to an hour. In 1991, the Mosaic Vision exhibition was held in San Francisco, featuring works by migraine sufferers, in which they depicted what they experience during an attack.The curator of this collection, Derek Robinson, had to wait over 10 years before a foundation called Migraine Art. Migraine Art. The Migraine Experience from Within. The collection mainly consisted of displays of visual phenomena during migraine aura.

In children, migraines can be accompanied by an aura in the form of the Alice in Wonderland syndrome – yes, the very Alice Lewis Carroll, when visual illusions arise in which objects change shape (metamorphopsia) and, for example, lengthen or decrease (microscopy), or they increase (macroscopy), and sometimes they just become of a different color, etc.In 1999, an article was published in the Lancet magazine, proving that many migraine states of Lewis Carroll are the basis of the illusory world of his heroine Alice. In the early editions of the Alice books, this was accurately illustrated by Sir John Tenniel, who was guided by sketches in Carroll’s manuscript.

5. Migraine is a female disease, but in pregnant women the migraine goes away

Not quite. Not so long ago, migraines were viewed as “a disease of hysterical ladies in dark glasses who want to attract attention.”According to epidemiological studies conducted in various countries of the world, migraine suffers from 3 to 16%, and according to some estimates, up to 30% of the population. At the same time, the migraine has a female face: the ratio of men and women is approximately 1: 3 (there is even a menstrual form of migraine). The peak prevalence of the disease among women is at about 40 years, among men – at 35.

As for pregnancy: the course of migraine is closely related to hormonal changes, so it is not surprising that the disease can behave differently.It all depends on the form of migraine: the usual migraine without an aura during pregnancy often (in a third) disappears altogether, and in the rest it can proceed more easily, although the attacks do not become less frequent, but they are less painful and easier to tolerate. The same ratios apply to the period of breastfeeding. However, in this group of patients there are unlucky people who get worse during pregnancy. Those who have a migraine with an aura do not experience relief during pregnancy, moreover, it is during this period that the first attack may occur.

6. Migraine cannot be treated, you can only anesthetize

None. This is not just a headache, but a serious neurological condition. Does this mean that we urgently need to do all sorts of additional examinations? No, don’t! This is a clinical diagnosis that requires consultation with a neurologist and the selection of the correct behavioral strategy and appropriate medications. It is necessary to treat it, because it has been shown that patients with migraine are twice as likely to get myocardial infarction and three times more likely to have cerebrovascular accident.

Frequent use of analgesics (twice a week or more) is absolutely wrong, and it doesn’t matter what drugs they are: citramon, paracetamol or pentalgin. With this abuse of analgesics, attacks of any headache become more frequent, the so-called abusal headache occurs, and the migraine becomes chronic. What will happen if you do not treat, but simply numb the pain with pills? Well, look: when we conducted a comparative assessment of the quality of life in patients with migraine, coronary heart disease, hypertension and diabetes, it turned out that the situation is the worst in patients with migraine.It is clear that migraine attacks significantly affect the ability to work and the quality of life, but it has been scientifically proven that if migraine attacks occur only twice a month, then the patient loses at least two years of life in a creatively active age (between 15 and 45 years).

THIS Mysterious MIGRAINE | Science and Life

The head hurts. One of the first symptoms of many diseases. But there is a disease for which a long, exhausting, sometimes almost unbearable headache is the main manifestation.It’s a migraine.

MIGRAINE – CIVILIZATION SATELLITE

Doctors have known this disease for more than three thousand years, but its causes are still not fully understood. Of all living beings, only man suffers from migraine. Migraine is more common in people prone to anxiety-depressive states, emotionally excitable, not psychologically resistant to stress. The name “migraine”, which came to the Russian language from French, is a distorted Greek word “hemicrania”, which means “disease of half of the head” (from hemi – half, cranios – skull).This is exactly what the ancient Roman physician Galen (II century AD) called this disease. Indeed, with migraine, pain occurs mainly in one half of the head, although then it can spread to the other.

Nowadays, more than 80% of people suffer from headaches of various types, but not everyone considers it a disease and does not go to doctors. Of course, not all headaches are associated with migraines. Doctors distinguish two types of headaches: tension pain – bilateral, compressive, and migraine pain – pulsating, localized on one side.

GUILTY GENES

Migraine, or rather, a predisposition to it, is genetically inherited. Most researchers believe that this disease has a dominant type of inheritance, and it is transmitted through the maternal line. Among men with migraines, four out of five cases have mothers who have the disease.

Usually, the first signs of the disease appear during puberty. In women, it occurs 3-4 times more often than in men, and migraine attacks are often associated with the menstrual cycle.In most cases, migraine occurs in young people – up to 30 years. Migraine also occurs in children (cases of the disease are known at the age of five). By old age, the disease fades away.

The intensity and frequency of headache attacks largely depend on the circumstances of a person’s life. If all goes well, seizures are rare. Stress, physical and emotional overload provoke migraines. Migraine, as a rule, does not cause complications, does not pose a threat to life, and does not lead to complete disability.It just interferes with life.

HOW DOES IT HAPPEN

A simple migraine has three stages. Usually, several hours or even days before the onset of the painful phase, performance and mood deteriorate, and precursor symptoms appear: pallor, indifference, drowsiness, yawning, nausea. With the so-called “visual” migraine, immediately before the attack, flashes, flickering, zigzag stripes appear before the eyes. Then an acute headache occurs, which lasts from several to 15-20 hours.Usually, during an attack, a person does not tolerate bright light, loud sounds, loses his appetite, his nausea increases, sometimes to vomiting, his face turns red, chest pain, chills appear. And finally, after the attack comes the third stage – prolonged sleep.

Doctors note other clinical manifestations of migraine, for example, impaired motor activity of the limbs. Moreover, if the right half of the head hurts, then violations occur in the left leg or arm, and vice versa.

It is believed that in the first stage of a migraine, the blood vessels in the head become narrowed and as a result of this, there is a decrease in blood flow.Then, in the painful phase, the carotid artery expands.

Psychophysiological traits of nature such as increased excitability and emotional lability, resentment, ambition, intolerance to the mistakes of others, love of excellence, initiative, ambition are associated with migraine. Strong, strong-willed, active people suffer from this disease. Migraines often coexist with hysteria, epilepsy, and allergies. Migraine patients are usually stubborn, self-centered, easily irritated, internally tense.At the same time, they are conscientious, even prone to meticulousness and excessive detail. They often experience unreasonable anxiety, dissatisfaction, and disappointment.

WHAT TO AVOID AND TO BE SAFE

A migraine attack can be triggered by a wide variety of circumstances – stress, release after emotional distress, negative emotions, weather changes, the onset of menstruation, lack of sleep or, on the contrary, excessive sleep with dreams, physical exertion.This range also includes food products: cocoa, chocolate, milk, cheese, nuts, eggs, soy sauce, sardines, tomatoes, celery, citrus fruits, red wine, fatty foods. Irregular eating (for example, long breaks between meals), constipation, alcohol are also risk factors. Sometimes medications, such as oral contraceptives or drugs that dilate blood vessels, are the cause of the attack. Bright light, flickering images on a TV or computer screen, loud noise can also trigger migraines.

CAUSES OF MIGRAINE

The biochemical mechanisms of the onset of migraine attacks have been little studied, but it is known that this disrupts the metabolism of certain substances, primarily serotonin, as well as catecholamines and histamine. The peptide bradykinin (it has a strong vasodilating effect), prostaglandins and heparin are involved in the development of migraine.

It is possible that migraine is caused by congenital disorders of the hypothalamus – the part of the brain that regulates metabolism, body temperature, interacts with the nervous and endocrine systems – as well as the thalamus, which controls the sensory functions of the body.With these disorders, the level of serotonin in the brain decreases, which leads to symptoms such as nausea and vomiting, chills, sleep after a painful attack, and depression. The constant lack of serotonin “mobilizes” platelets, which contain a large amount of this substance. There is a sharp release of serotonin from platelets, which leads to an immediate narrowing of the vessels of the brain. Excess blood, which, due to vascular spasm, is forced to pass through the external carotid artery, press on the vascular wall, dilate the artery and cause a painful attack.The right hemisphere of the brain contains more platelets, so the right side of the head hurts more often in migraine sufferers. It is not surprising that drugs regulating serotonin metabolism, such as dihydroergotamine, triptans, are most effective for relieving headaches during a migraine attack. By the way, the provocative effect of some food products, especially chocolate, is due precisely to the fact that they contain substances that contribute to the formation of serotonin – tyramine and phenylethylamine.

LOOKING FOR OUTPUT

Is it possible to find out about the approach of an attack not by subjective sensations, but with the help of medical devices? According to the Moscow neurologist, corresponding member of the Russian Academy of Medical Sciences A.Wayne, a patient with migraine gradually increases the bioelectrical activity of the brain. When it reaches its maximum, an attack begins, and brain activity immediately returns to normal. Then it starts all over again. Boosting brain activity helps lower aspirin. In some patients, long-term systemic use of aspirin in low doses for 6-7 months, regardless of whether there is a headache or not, effectively prevents the onset of seizures.

Yet migraines are difficult to treat.Common pain relievers and vasodilators are most commonly used during seizures. In the treatment of migraine, beta-adrenergic receptor blockers, monoamine oxidase inhibitors (an enzyme that destroys serotonin and other biogenic amines), clonidine, antiepileptic drugs, tranquilizers, heparin, 5-hydroxytryptophan are sometimes used. Treatment is complicated by the fact that with migraine, the absorption of drugs is impaired and the drugs are poorly absorbed.

MIGRAINE AND GENIUS

Some researchers, for example V.P. Efroimson, author of the book “Genius and Genetics” (M., 1998), believe that gout, Marfan syndrome and other diseases act as companions of creative giftedness. It is known that in such diseases, the body produces excess amounts of substances that have a psychostimulating effect (with gout – uric acid). And it is possible that thanks to these substances, creative inclinations are realized more successfully.

Maybe the migraine is associated with genius? Indeed, the list of outstanding personalities who suffered from migraines is impressive: Julius Caesar, Alexander the Great, Pontius Pilate, E.Poe, Peter I, C. Darwin, L. Beethoven, P. Tchaikovsky, F. Chopin, R. Wagner, K. Marx, Z. Freud, A. Chekhov, K. Linnaeus, G. Heine, G. Maupassant, F. Nietzsche, Napoleon, F. Dostoevsky, N. Gogol, Calvin, B. Pascal, A. Nobel … From women – Charlotte Bronte, Elizabeth I Tudor, Virginia Woolf.

However, according to A. Wein, among geniuses, the percentage of migraine diseases is the same as among the entire population. But among migraine patients, there are many people who are ambitious and purposeful. So sometimes a migraine attack is a price to pay for being active.

See in the issue on the same topic

Something else about migraines.

11 products that cause migraines – Zahav.ru Salad

Migraine is a common and extremely unpleasant disease due to the many severe and sometimes dangerous symptoms that occur during its course. Frequent companions of this ailment are one-sided headache, nausea, dizziness, sensitivity to light and strong odors. Stress, lack of sleep, a lot of work, and daily problems can cause severe headaches.However, few people know that the foods you eat can also worsen migraines. MedicForum decided to find out what to give up in order to get rid of migraines.

How can food help with migraines?

In some cases it may even be due to food intolerance. Your immune system has to “fight” these components, and it releases substances that cause headaches.

It is estimated that between 20 and 40% of all migraine attacks are largely caused by inadequate nutrition.The researchers found that diet had a greater effect on migraine attacks in children than in adults. This is due to dietary preferences – children are more likely to eat sweets, peanut butter, pizza, or hot dogs than adults.

The main foods that contribute significantly to migraine headaches are chocolate, cheese, citrus fruits, fast food and alcohol.

Substances that can adversely affect migraine sufferers

Experts have identified groups of compounds formed from food in the biochemical metabolic processes that are directly related to the increased sensitivity of the body of migraine sufferers.One of these groups of compounds are amines – these are nitrogen derivatives from protein components. Amines are always present in the human body, regardless of the type of diet.

Dopamine sources include, for example, peanuts, peas, beans and soybeans. Tyramine is mainly formed during the ripening of foods such as yellow cheese, yogurt, buttermilk, sourdough, dried and canned meat or fish. Cold water fish such as salmon and tuna are rich sources of histamine.Phenylethylamine is found primarily in chocolate. Octapamine and synephrine are abundant in citrus fruits. And tomatoes and pineapples are a source of tryptamine.

In addition, vasoactive substances, vapors that affect vasoconstriction or vasoconstriction in the brain, are also considered dietary factors that provoke migraine attacks – they can increase the frequency of migraine attacks in people especially sensitive to these compounds. Other substances that adversely affect the health of migraine sufferers are alcohols and caffeine, as well as enhancers and preservatives added by food manufacturers.Among others, monosodium glutamate, called a flavoring agent, aspartame, artificial sweeteners, sulfites that give the product the right color, in addition, phenols naturally present in tea, coffee and some fruits, as well as in large-scale food colors.

Researchers make various hypotheses about how dietary substances affect migraine attacks. According to one theory, this is caused by a deficiency in certain enzymes that other people have in the right amount.Other scientists reject this hypothesis, suggesting another: the effect of active substances on the contraction and relaxation of blood vessels.

However, most experts agree that sensitivities to certain foods that lead to migraines are not food allergies.

Here are the foods that can cause headaches:

1. Legumes

All legumes contain tannins. It is a substance that causes migraines.

To reduce your symptoms, reduce your consumption of legumes to a minimum or eliminate them entirely.

2. Pickles

In fact, pickles are not the only problem. This also applies to other canned foods such as:

• Peppers

• Eggplant

• Olives

• Carrots

Try to stop eating any food that contains pickle or vinegar.

3. Spices

If you often suffer from migraines and love Mexican food, unfortunately, you need to reduce the amount of spicy foods you eat.

Capsaicin in hot peppers can cause headaches or worsen migraine symptoms.

4. Nuts

They are very healthy and contain a lot of proteins. However, if you suffer from regular migraine attacks, it is worth limiting their use. For example, almonds, walnuts, and cashews contain a substance such as sulfite, which is a potential cause of headaches.

5. Avocados and plums

These seemingly harmless products do not occupy a place on this list by chance.And this is due to the fact that they both contain a compound that causes migraines – tyramine.

If you like to eat avocados or plums for dessert, you should reduce your intake to once a week.

6. Bananas and citrus fruits

The combination of tyramine and histamine in these fruits is one of the main causes of headaches.

This does not mean that you should stop eating bananas or citrus fruits because they are very good for your health. The idea is to reduce or avoid them when you are suffering from migraines.

7. Flour

It contains the natural chemical coumarin, which intensifies when it comes into contact with baking powder.

8. Smoked meat

Sausages, ham and bacon contain many substances that can cause headaches. These foods don’t just contain tyramine. They also contain conservatives and other chemicals that are harmful as they exacerbate migraine attacks.

9. Dairy

Cream and (whole) milk are fatty dairy products and should be avoided if you have a headache.

10. Alcoholic drinks

Everyone knows that the abuse of these drinks is harmful to health. They also contain tyramine, which causes migraines, dizziness, and confusion.

On the other hand, we do not recommend drinking red wine, because, in addition to tyramine, it contains sulfites and tannins, which increase the symptoms of the disease.

11. Chocolate and coffee

Both contain caffeine, tannins and other compounds that cause headaches.Decaffeinated coffee can also trigger migraines, especially if you add cream.

Private educational institution “KB” Russian Railways-Medicine “named after ON THE. Semashko “

Migraine is a disease known since ancient times. The first mentions are in the writings of the Sumerian civilization (3000 BC), in the writings of Hippocrates and others. Tchaikovsky, Chopin, Freud, Napoleon, Leo Tolstoy, Edgar Poe, Picasso, M. Bulgakov suffered from migraine. Almost all people have experienced a migraine headache at least once in their life, although this, of course, is not a reason to consider them migraine patients.According to epidemiological studies, migraine currently affects from 5 to 16% of the population of developed countries. Migraine is more common in women, in adolescence and young age, and 45% – begins in childhood.

In addition to age and sex, hereditary factors play a certain role, which have now undoubtedly been proven. So, if one mother had migraine attacks, the risk of the disease is 70%, if one father has -20%, if both parents had migraine attacks, the risk of the offspring’s disease reaches 60-90%.

Migraine attacks significantly affect the quality of life, during an attack, 70% of the ability to work decreases, a third of patients stop their normal activities. In a survey of people suffering from migraines, 66% noted that they are afraid to let other people down because of their illness, 54% reported that attacks affect their relationship with relatives and friends, 76% of patients refuse business and social events because of attacks …

What is a migraine? This is a disease manifested by paroxysmal attacks of severe headache of a pulsating nature, more often in one half of the head.In most cases, the attack is accompanied by nausea, vomiting, photophobia (poor tolerance to bright light), phonophobia (poor tolerance to loud sounds).

Often the headache is preceded by a prodromal period, which is characterized by a deterioration in mood, irritability, anxiety, unreasonable fatigue, and decreased concentration. In 1/3 of patients, an attack is preceded by an aura – local neurological disorders that increase over 5-20 minutes and completely disappear within an hour.At the same time, visual disturbances in the form of glittering dots, loss of areas of vision are typical, as well as a combination with unilateral paresthesias that spread from the fingertips to the upper limb and face.

The headache begins after the aura, it is formed from a feeling of discomfort that develops into a gradually increasing pain. Migraine headache can be extremely intense, severe, excruciating, difficult to bear. During attacks, the headache is so significant that patients stop all activity, try to retire, hide from noise and bright light.

Many patients are drowsy, yawn, and sleep is often salutary. Along with nausea and vomiting, many patients experience other vegetative symptoms: chills, sweating, palpitations, dry mouth, yawning, and abdominal discomfort. In some cases, these disorders are formed in a vegetative crisis or panic attack.

International Association for Diagnostic Criteria for Migraine:

• Unilateral localization of headache.
• Pulsating nature of the headache.
• Seizures lasting from 2 to 72 hours.
• Moderate to severe headache intensity.
• Worse, physical activity.
• Nausea and vomiting.
• Photophobia and phonophobia.

Sensory stimuli (heat, noise, strong light, cold, odors), intense sports, fasting, intense mental stress, strong emotions, lack or excess of sleep, some foods (chocolate, nuts, cocoa, citrus fruits ).

Despite the fact that migraine has been known for a long time, its pathogenesis has not yet been fully elucidated.

However, it is now known that migraine is a hereditary dysfunction of vasomotor regulation. The pathogenesis of migraine is presented in the form of interaction of neurogenic (trigeminal nerve involvement), vascular, neurochemical (changes in the concentration of serotonin, bradykinin, etc.) components, clarification of the role of each of which will require further study.

The leading theory today is the trigemino-vascular theory.The trigeminal (trigeminal) sensory nerve carries information to the brain from the tissues of the face, teeth, and the meninges. Under certain conditions, when this system is tense, it affects the receptors from which it originates (i.e., in the opposite direction). In this case, changes occur in the vessels of the meninges, which cause pain. If the excitability of the left trigeminal system is increased, left-sided headaches occur, and if right-sided, then, respectively, right-sided.

Proved phasing in the development and course of a migraine attack.During the first phase, vasospasm occurs, clinically this is a short period preceding the headache. In the second phase, dilatation of arterioles and venules occurs, this is actually an attack. In the third phase, edema of the vascular walls and periarterial tissues develops. In the fourth stage, there is a complete reverse development of these changes.

Diagnosis of migraine is mainly clinical. Despite the obvious symptoms, only 10% of children are diagnosed with migraine. But once the diagnosis is made, it is important to convince the child and his parents of the benign nature of migraines.

Treatment

Various drugs are used to relieve migraine attacks; conditionally they can be divided into nonspecific (they have only an analgesic effect) and specific (they can stop the development of an attack). The drugs of choice for treating migraine attacks in children are ibuprofen (10 mg / kg) or, less preferably, paracetamol (10 mg / kg).

Specific anti-migraine drugs are ergotamine, dihydroergotamine, sumatriptan, naratriptan, zolmitriptan.It should be noted that the safety and efficacy of these drugs for children has not been established. The rather high cost of these drugs also limits their widespread use.

Ergotamine is a vasoconstrictor, its analgesic effect is so specific that the drug can be used in the diagnosis of migraine ex juvantibus. Usually they use a 0.1% solution of 15-20 drops or 1-2 mg in tablets.

Dihydroergotamine has a slightly less pronounced effect, exists in the form of a nasal aerosol (diidergot), in the form of drops for oral administration and in the form of a solution for injection.

Sumatriptan (Imigran) tablets 50, 100 mg, nasal spray, injection solution. The nasal spray is especially useful for those patients who have a migraine attack with nausea and vomiting.

Zolmitriptan (Zolmig) – a selective agonist of serotonin receptors, has a fast action in combination with a low recurrence of attacks and a stable effect with prolonged use. Effective when taken during an attack at a dose of 2.5 mg.

Naratriptan (Naramig) tablets 2.5 mg. The mechanism of action is similar to zolmitriptan. The above drugs should be taken as early as possible during an attack, however, these drugs should not be used for prophylaxis.

The main purpose of preventive, i.e. Interictal treatment is to reduce the frequency and severity of attacks. It is very important to identify provoking factors for each patient and decide how best to eliminate or weaken them. It is important to organize the daily regimen and adequate sleep, to limit cocoa, chocolate, nuts, and alcohol in the diet.It is important to try to eliminate stressful negative situations that may require psychological therapies. Medicinal prophylaxis of migraine is indicated for frequent attacks. The drugs used came from adult practice: beta-blockers, antidepressants. Some patients note a good effect after courses of treatment with drugs of the nootropic series, vascular agents, anxiolytics.

Migraine: particularities of therapeutic nutrition

According to the statistics of the World Health Organization, migraine is the main cause of spontaneously arising headache and one of the diseases that most severely disrupt human social adaptation.Let’s consider how to delay and reduce the onset of migraine attacks with the help of the food factor.

Manifestations of migraine

70% of patients with migraine have a hereditary predisposition to this disease, while the leading role belongs to maternal genes: if the disease is in the mother, then in 72% of cases it occurs in children. Migraine attacks can begin at any age, but most often they appear at 20-30 years old, and begin to pass after 50.

Migraine pain occurs as a result of vascular pathology, in which there is a “dance” of vascular tone: at first, the vessels expand unevenly, putting pressure on the nerve cells next to which they are located (this causes the first headache attack).Then there is a sharp narrowing of blood vessels and blood circulation in nearby tissues is disrupted, which also causes pain.

An important part in the development of an attack are metabolic disorders and the equilibrium content of serotonin and histamine involved in the regulation of the nervous and immune systems. The first constricts the vessels, the second dilates. In people with migraine, serotonin is usually not enough, and histamine, on the contrary, is too much. The concentration of these substances is influenced by many factors, including the length of sleep, stress, physical and mental stress, the tendency to allergic reactions, as well as the foods we prefer from day to day.

Another name for migraine is hemicrania, which means “half of the head” in Greek. This is due to the fact that, as a rule, migraine pain is localized on one side and in the same place, while it is pulsating in nature and increases with movement, bright light or tension. Another key symptom of a migraine is nausea and vomiting during an attack, which does not bring relief.

Sometimes the pain is preceded by the so-called aura – a harbinger of an attack, in which the patient feels blurred vision (“fog” or “flies” in front of the eyes), incomprehensible auditory, taste or olfactory sensations (noises and smells).Perhaps a violation of sensitivity in the hands, a feeling of numbness. The aura lasts from 5 minutes to an hour and usually goes away before or with the onset of pain.

Starting moments of migraine

1. Environmental factors
Change of seasons, fluctuations in temperature, pressure, humidity, heat or frost, dry air in the room can act as provocateurs. The same goes for noise, unexpectedly loud noises, bright flickering lights, or fluorescent lighting that irritate the nervous system.

2. Sleep disturbance
This is especially true for such a form of headache as “sleep migraine”. In this case, an attack can develop both against the background of lack of sleep, and during oversleeping. Late bedtime or late awakening, jet lag, sleepless nights – all of these factors can contribute to the onset of migraines.

3. Internal problems
Migraine attacks can occur due to chronic pain in the spine as a result of cervical osteochondrosis, increased intracranial or intraocular pressure, muscle spasms of the neck, arterial hypertension.In addition, a lack of magnesium and iron in the body, sharp drops in blood glucose levels, and anemia can act as internal provocateurs.

4. Taking medications.
Migraine-like seizures can occur if a doctor has prescribed drugs that affect vascular tone (for example, nitroglycerin, ranitidine, hydralazine, and histamine in drugs).

5. Psychophysiological factors Emotional overload, prolonged tension, sudden relaxation after a stressful situation, nervous breakdowns, anxiety and attacks of fear, suppression of emotions, both negative and positive.These psychophysiological provocateurs provoke the so-called “panic migraine”. Most often, such migraines are caused by ambitious people and perfectionists with high demands on themselves.

6. Physical stress
Injury, excessive physical activity, overwork can also cause an attack of migraine headache.

7. Nutritional factor
Substances contained in food can also provoke a migraine attack. This is due to the fact that in the composition of a number of products there are components that relax the blood vessels or cause them to narrow and expand uncontrollably, which, as a result, triggers the mechanism for the development of a pain attack.
Let us consider in more detail the main provoking factors and, in contrast, substances and products that prevent the development of a migraine attack.

Food migraine provocateurs

The concept of migraine as a disease that depends on nutrition was expressed in the early 80s of the last century. The group of the following food products is considered as provoking and intensifying factors of migraine:
1. Foods with vasoactive (that is, influencing vascular tone) substances, such as tyramine and phenylethamine.
2. Histamine-containing products.
3. Products containing nitrates and caffeine.
4. Products containing food additives – glutamates.
5. Products contaminated with molds.

How do substances provocateurs work and which products need to be added to the “red” list?

Tyramine

This is an organic substance from the amine group, formed from the amino acid tryptophan, which is rich in protein products. In addition, many foods that were initially low in tyramine accumulate in large quantities after long-term storage or high-temperature processing.By the way, in fresh fish and meat, despite the fact that these are foods rich in tryptophan, there is almost no tyramine.

Here is a list of foods that must be avoided, since they all initially contain or accumulate large amounts of tyramine, which can cause narrowing of blood vessels and provoke a migraine attack:
• fermented bean curd (tofu), fermented soybeans, soybean paste;
• Roquefort cheese, cheddar, brie, parmesan;
• smoked, salted, dried, pickled fish and meat;
• concentrated meat and fish broths;
• sausages, sausages, small sausages, salami, pepperoni;
• sauerkraut;
• soy sauce, miso, tempeh;
• edible yeast pastes and naturally fermented kvass.

Phenylethylamine

Phenylethylamine triggers the production of norepinephrine, a mediator that narrows blood vessels, including the brain, and can trigger a migraine attack. Foods containing phenylethylamine: natto (fermented soybeans), eggs, and chocolate.
In addition, this substance can be produced from the amino acid phenylalanine, which is rich in beef, chicken, porcini mushrooms, chanterelles, spinach, sesame seeds and peanuts.

Histamine
Histamine is a derivative of the amino acid histidine.Under the action of histamine, narrowing of small veins and expansion of small arteries are observed, which leads to a drop in vascular tone and causes a painful reaction, provoking migraine.
A large amount of histamine is found in fish of the mackerel family – mackerel, tuna, king mackerel, etc.; in fish of the salmon family. Fermented cheeses, sauerkraut, smoked meat and fish, seafood, dried ham, tuna, beef sausages, herring caviar are distinguished by a high histamine content. It is also worth giving up soy products and any marinades, limiting coffee and cocoa.

Nitrates
The onset of a migraine attack is not due to nitrates themselves, but to the fact that some microbes of the oral microflora convert nitrates to bivalent nitric oxide (NO), which is known to “trigger” headaches.
Nitrates are found in foods such as sausages, ham, cooked sausages, hamburgers, corned beef, bacon, salami, smoked sausage and fish, and cheddar cheese. Sodium nitrite is added to these products to add appetizing color and long-term preservation of the processed product.Moreover, the brighter the color of the finished product (for example, bright red ham), the higher the concentration of nitrates there.
Of vegetables, lettuce, spinach, celery, rhubarb, radish, radish, beetroot, eggplant, potatoes accumulate the largest amount of nitrates.

Caffeine
Caffeine in small amounts stimulates the brain, but excessive use can cause severe headache associated with uneven spasm of the cerebral vessels.
Although caffeine is associated with coffee, it is also found in tea and slab chocolate (especially bitter), chocolate milk, chocolate milkshakes, hot chocolate, and is often added to soft drinks (cola, pepsi, etc.)) and over-the-counter medications such as pain relievers and cold medications (such as actamine, anacin, excedrin, vivarin, etc.). Therefore, it is necessary to carefully monitor the use of these drinks and carefully read the composition of the medicines that the doctor has prescribed for you.

Glutamates
Migraine sufferers are usually sensitive to this substance. Glutamic acid salts (glutamates) are added as a dietary supplement to industrial foods because they enhance the sense of taste by stimulating receptors on the tongue.Despite the fact that glutamic acid is a natural amino acid for our body, it should be used limitedly, that is, to comply with the consumption rate of products to which this food supplement is added, and for those who have migraine pains, try to avoid these products altogether. This is due to the fact that in the human body, glutamic acid is converted into gamma-aminobutyric acid (GABA), which is a stimulant of the central nervous system. And at high concentrations of glutamate in the daily diet, the manifestation of a pharmacological effect is possible – overexcitation of the central nervous system and impaired vascular tone.If at the same time a large concentration of glutamic acid and its salts is received (for example, this can happen after eating oriental cuisine, the so-called “Chinese (Japanese) restaurant syndrome”), a migraine attack may occur, accompanied by a feeling of heat, reddening of the face, nausea, vomiting, fluctuations in blood pressure, fever, insomnia, palpitations.
In this regard, it is necessary to avoid commercial products that contain glutamates, as well as limit the use of mushrooms, Roquefort cheese, ketchup, soy sauce, seafood, which contains a lot of natural glutamic acid.

Mold (yeast) fungi
These invisible substances also affect the tone of the cerebral vessels and can provoke migraine attacks.
Grains, nuts (especially peanuts), legumes, coffee are most often affected by molds. There are also many cultivated yeasts in carbonated drinks and moldy cheeses (Roquefort, Brie, Camembert, Dorblue, etc.). Moreover, they are very stable and practically do not deteriorate when heated and cooked.
Molds grow very quickly on rotten fruits and vegetables, and cutting off problem areas does not make this product safe.This is due to the fact that molds penetrate deeply (often invisibly) into the product, and cutting off the mold and rot visible from the outside cannot save you from danger.

Nutrients and products that protect against migraine

Magnesium
Deficiency of this mineral leads to such pathophysiological phenomena as spasm of the cerebral (head) arteries and increased release of pain mediators (the so-called substance P), which can trigger a migraine attack.
Therefore, it is recommended to consume a sufficient amount of magnesium in the following foods: nuts, beans, lentils, basil, coriander, cabbage, chard and any dark green leafy vegetables, as well as greens and beet tops, brown rice, barley, whole oats, pumpkin seeds, sunflower seeds and flax seeds, which will provide high levels of magnesium.
However, it must be remembered that an excess of sugar, fat and phosphorus in the diet impedes adequate absorption of magnesium and makes it difficult for the body to enter it.

Vitamin B2 or riboflavin
This vitamin has an antioxidant and vaso-stabilizing effect, which has a normalizing effect on the tone of cerebral vessels. This vitamin is rich in foods such as pine nuts, irga, honeysuckle, liver, broccoli, avocado, asparagus, seaweed, brown rice, lentils, sea bass, sardines.

Polyunsaturated omega-3 fatty acids
These beneficial fatty acids affect the production of serotonin, a neurotransmitter that normalizes vascular tone. Sources of omega-3 fatty acids include sea cold water fish (sardine, herring), flax seeds, and soybean, flaxseed, corn and olive oils.

Active components of ginger
Due to the fact that this burning root contains vitamins C, B1, A, and especially riboflavin, as well as calcium, magnesium, iron, zinc, sodium, potassium and active components: felandrin, cineole, citral, borneol , gingerol and camphine quickly and effectively relieve migraine headaches.
For this, it is recommended to take half a teaspoon of fresh ginger in powder form, diluted in a glass of water or as part of a meal.