Diet for Migraines
by Sue Kira, Naturopath & Clinical Nutritionist
– Causes of migraines
– The connection between foods and migraines
– Acceptable low reactive foods
– Acceptable low histamine level foods
If you suffer from migraine headaches, then you know how horrible they are or what symptoms you experience. Migraines can be caused by a variety of reasons, many of which you may have considered. Following are some of the common causes.
Causes of migraines
- Spinal alignment issues: pinched nerves
- Infection: parasites, bacterial imbalances in the gut, Lyme’s disease etc
- Allergies: food, but also think of perfumes, skin care, cosmetics
- Histamine intolerance: different to allergy (more info follows)
- Hormone imbalances: especially if cyclic in nature
- Biochemical imbalances: e.g. MTHFR, Pyrrole disorder, mental health imbalances such as neurotransmitter imbalances
- Jaw tension: grinding teeth at night (often without being aware of it)
- Eye problems: strain, poor vision, fluid behind eyes, glare sensitive
- Blood glucose imbalances: disglycaemia or diabetes
- Vascular (blood vessel) issues in head: fluctuations in blood sugar levels can lead to spasm of the arteries in the head i.e. dilation or contraction of blood flow to the brain
- Stress: creating tension in the neck and shoulders. Magnesium deficiency is common with migraines. Magnesium relaxes muscles in the head and neck
- Food triggers (more to follow)
Some of these causes of migraines such as infections, allergies, histamines, hormones, biochemical and blood sugar imbalances can be supported by specific diets formulated for these conditions.
The connection between foods and migraines
Research has shown surprising links between migraines and food.
Certain foods can cause migraines, while others can prevent or even treat them. Coffee, for example, can knock out a migraine for some, but trigger migraines in others, especially when more than one cup a day is consumed.
Foods rich in magnesium, calcium, complex carbohydrates and fibre have been used to alleviate migraines. Magnesium and calcium regulate muscular, nerve and blood vessel relaxation and contraction.
A person who cannot efficiently obtain energy from fats in their diet may have blood sugar imbalances and find that complex carbs can offset a migraine. Conversely for others, the spike in blood sugar and a subsequent drop can trigger a migraine.
There are certain foods considered low-reactive which rarely contribute to headaches or migraines. These foods are listed below in the diet for migraines, which is a good core diet to start with to evaluate if food is contributing to your migraines.
Make sure that you give the diet at least a month’s trial, as it can take some time to clear certain substances from the body. Then if re-introducing different foods, be aware that a reaction may take up to three days to show up; for example, at a certain time in a woman’s monthly cycle, the food trialled plus the hormone shift could lead to a migraine.
The thyroid helps to maintain normal body temperatures. Low body temperature can result in recurring migraines, possibly because low temperature leads to relaxation and dilation (expansion) of the blood vessels, which results in more fluid leaking into the tissues of the brain.
The swelling brain tissues inside the closed space of the cranium may explain the characteristic throbbing pain experienced by migraine sufferers.
Even though body temperature is a possible connection between thyroid and migraines, body temperature is an important reading that many doctors don’t check in relation to migraines.
Under stress, the body temperature tends to drop as a coping mechanism, but unfortunately, the temperature can stay down even after the stress has passed, while thyroid blood tests show up as normal.
This is known as Wilson’s Temperature Syndrome and it occurs most frequently in women. The good news is that once the temperature has normalised, then the body can usually return to maintaining normal temperatures on its own. If you suffer from migraines, start checking your body’s temperature to find out if this could be a cause.
Often people can normalize their own body temperatures with lifestyle changes such as healthy diet, rest, exercise and by eliminating stress. Some people respond well to a prescription T3 medicine protocol (WT3 protocol) to increase their body temperature.
Histamine in foods has been reported as one of the biggest triggers for migraines.
With histamine as a trigger, it can be tricky to determine what foods are the problem. And that’s because histamine can be high in some foods naturally, but lower in others – and increase as time goes by.
For example, left over foods have more histamine than fresh foods. Or your histamine threshold level for certain foods may be fine, but combined with a glass or two of red wine which are naturally high in histamines and whammo, you have a splitter of a headache.
You don’t have to have conditions like hay-fever or allergies to have a histamine problem, but you may have what is called histamine intolerance.
Anybody can have histamine intolerance, but you are at higher risk if you: eat a ‘GAPS’ diet; eat a low-carb/high protein diet; enjoy gourmet foods; or consume fermented foods, because histamine is found primarily in aged, fermented, cured, cultured and smoked foods.
The best way to avoid histamines is to shun foods high in histamine and choose fresh foods whenever possible. Look for the ‘packed on’ date of the meat or fish being sold. ‘FAS’ (frozen-at-sea) may be your best bet. Grass-fed and pastured meats are not necessarily better choices, as it can depend on distance and how long it took to get to your store.
Most beef ‘hangs’ for at least two weeks before it is packed, wrapped and shipped, even if it comes from a local family farm that pastures their animals. Therefore, most beef is aged to some extent.
Once histamine develops in a food, there’s no getting rid of it. And if bacteria or yeast are still present in the food then histamine levels will continue to rise.
There is no such thing as a totally ‘histamine-free diet’, but the best way to reduce your levels is to eat low histamine foods and avoid high histamine foods. For more, go to Low Histamine Diet
High histamine level foods (to avoid):
- All alcohol and any other fermented, pickled or canned foods/drinks
- Cheese, especially matured cheeses
- Smoked meat products – salami, ham, sausages
- Shellfish, tinned fish and fish that’s not fresh
- Grains – apart from rice, buckwheat and quinoa
- Beans and pulses – chickpeas, soy beans, peanuts, cashews (not so bad if sprouted)
- All nuts and nut milks but especially walnuts (can be ok for some people in small amounts especially if soaked)
- Chocolates and other cocoa based products (raw cacao nibs without sugar can be ok in small amounts for some people)
- Black tea, green tea and coffee
- Citrus fruits plus kiwifruit, pineapple, plums, papaya, strawberries & tomatoes
- Wheat and foods containing yeast as they are a catalyst for histamine generation
- Vinegar and foods with vinegar such as mustard, mayo
- All fermented foods are high in histamine, but can be better tolerated once ‘leaky gut’ is healed. Avoid bone broth, kefir, kombutcha
- Readymade packet meals
- Salty snacks, sweets with preservatives and artificial colorings & additives – benzoate, sulphites, nitrites, glutamate, food dyes
Diamine Oxidase blockers (DAO)
DAO breaks down histamine, so avoiding DAO blockers helps your body to break down histamine more effectively. Avoid:
- Caffeine – black & green tea and coffee. Note: migraines can be triggered by caffeine withdrawal, specially if you consume large quantities
- Energy drinks, Mate tea
(These are non-histamine triggers)
- Nightshade family of foods – tomatoes, potatoes, eggplant, capsicum/bell peppers, chillies and paprika
- Onions and foods of that family such as shallots, chives, spring onions
- Corn contains an afflotoxin fungus known to trigger some migraines
- Apples, bananas and peaches – fruits that trigger migraines for some
- Food additives are among the worst triggers e.g. monosodium glutamate, aspartame (NutraSweet), and nitrites such as those in bacon and ham
- Naturally occurring chemicals in foods e.g. amines, oxalates, glutamates and salycilates
- Gluten sensitivity is a common cause of migraines via gut inflammation and toxicity
While a diet for migraines is not considered a cure, the idea is to eliminate foods considered detrimental and include foods that support your body to do its natural job of healing, which is why the diet should be free of gluten, dairy and additives.
The diet is a basic, simple diet that should not be followed indefinitely because it takes large sections of foods out of your diet. All high histamine foods have been eliminated along with other potential food triggers. Meat, chicken and fish are included, but ensure they are very fresh. Do not eat left-over meals as this will increase histamine levels.
Histamines can also be reduced with a Low FODMAPs diet, so you may find a trial of Low FODMAP foods helpful if this diet doesn’t help. But migraines are not always about histamine and other foods can cause migraines. Be guided by your practitioner to decide the best diet for you.
Acceptable low reactive foods
Low reactive foods that are acceptable are:
- Cooked green vegetables, such as broccoli, spinach, chard, or collard greens
- Cooked orange vegetables, such as carrots, pumpkin or sweet potatoes
- Cooked yellow vegetables, such as summer squash and pumpkin
- Note: most vegetables are fine, except those excluded in the foods to avoid listed above. Fresh, steamed or stir-fry are the best cooking methods. Be aware that any cooked food kept for more than 24hrs can build up histamine levels.
- Filtered or carbonated water such as Perrier or soda water are best to drink while on this diet plan, as most other drinks can be potential triggers. Rooibos tea is also a warm, herbal drink option.
Acceptable low histamine level foods
- Fresh meat, fish and chicken (frozen or fresh) and egg yolks
- Fresh fruits – except those listed in the high histamine foods to avoid
- Fresh vegetables – except tomatoes
- Milk substitutes – coconut milk, rice milk but not nut milks
- Rice, buckwheat and quinoa
- Most oils are fine but do check for rancidity
- Most leafy herbs
- Herbal teas – but not black or green tea or coffee
When you have a period without migraines, begin to re-introduce foods one at a time (with a three-day gap between each) to see if any foods trigger symptoms. Trigger foods can often be ones you really miss or may crave so be cautious when introducing your favourite foods. Get guidance from your health care practitioner for this re-introduction phase, so that you are quite clear on the best way to go about it.
Important: Before you commence a new diet, see your medical or health care professional for qualified guidance about what foods and supplements are best for your body. While on the diet do not stop any medications or supplements previously prescribed unless advised otherwise by your medical or health care professional.
Note: During the early stages of a new diet, you may experience symptoms such as fatigue, headaches or body aches, which may occur because your body is detoxifying. However, if you are unsure about a symptom at any time, check immediately with your medical or health care professional.
Client name and identifying information changed
When Josephine first came to my clinic she had cancelled three previous appointments because she was getting migraines nearly every day. Most of her migraines were in the afternoon, although she could get them at any time.
Her migraines left her feeling exhausted and then she would be ravenously hungry which made things worse, as she chose to eat food that was quick and easy to ‘grab ‘n eat’ such as cheese and crackers, sandwiches with salami or a take away bacon and egg roll.
I quickly saw that most of her food choices were high histamine foods, so this was the first thing to look at. I asked her to eliminate all high histamine foods, including meat, chicken and fish for the first two weeks, just to give her body a break from any potential triggers. For those two weeks, her diet was to consist of fresh cooked vegetables with some low histamine fruits and plain water, which she was happy to do.
After only three days into the diet she was migraine free
We then gradually re-introduced the meat, chicken and fish, making sure they were as fresh as possible. Fish that had been snap frozen at the boat (to be safe) was her first choice. After a week (and sick of eating fish) she then re-introduced fresh chicken and later, red meat. She asked her butcher what day the meat came in fresh and bought it on the same day. Any meat she was not going to eat that day was immediately frozen to avoid histamine build-up.
Incidentally, one day I purchased a rack of lamb at one of the large national supermarkets. When I opened the cryovac seal it was smelly and slimy and I knew it was not very fresh. This occurred again a couple of weeks later, so I complained. I was told that they packed the meat in a warehouse a few hundred kilometres away. The meat was cyrovaced with gas to preserve its ‘freshness’ because it could take a few days to reach the shelf (and then sit there for a few more days). They gave me a refund and I was told that they would review their packing systems – but I never went back to find out.
Anyhow, back to Josephine.
Josephine’s diet was working well until the day she re-introduced cheese, which she really missed. The result: a massive migraine. The upside was that it dramatically showed her that histamine was an issue.
Over a period of months Josephine experimented with various foods and found that some were ok and others not so good. She developed a list of foods to avoid. With her ‘safe foods’ list, I encouraged her to not have any more than one at a time, because combining two or more could cross the threshold with a very painful result.
She found out for herself later when she went to a party and ate a few of the high histamine foods together that were on her safe list and bam, another migraine. It was a learning experience, but eventually Josephine was completely migraine free.
She also learnt that pre-period was a time to have no histamine foods as the combination of hormonal shifts and the trigger foods would send her to bed with a massive migraine.
This taught me as a practitioner that even when clients say that they get menstrual migraines, if they go histamine free during that week, they often don’t get a migraine.