The Headache Prevention Cookbook

More Case Studies

When I first saw Nancy R., she drank the equivalent of five cups of coffee a day. On top of that, she was taking a caffeine-containing pain medicine for her headaches on an almost daily basis. I warned her about the problems of "caffeine-rebound" headaches, but she insisted that she couldn't make it through a day without caffeine. After one year, Nancy's headaches became so severe that she began to feel desperate. Again I brought up the issue of her caffeine use, and we developed a plan: Nancy would stop her caffeine-containing pain medicine immediately and would begin tapering off her coffee intake, reducing it by one cup every three days until she had given up coffee completely. During the first couple of weeks off caffeine, Nancy had a number of bad headaches, but when I saw her a month later, her headaches had virtually disappeared.

Chocolate, caffeine, and red wine are common headache triggers, but as the stories of Mary, Indira, and John suggest, there are other, less well known offenders: most cheeses, citrus fruits, beans, freshly baked bread, artificial sweeteners, and preservatives, to name just a few. (A list of foods that frequently trigger headaches can be found on page 27.) Not all these foods cause headaches all the time -- most people are affected by only a small number of them. Some of my patients are unaffected by chocolate but will get a pounding headache from bananas.

Amy C. came to my office complaining of daily headaches that would get so bad that she had to close her office door and turn out the lights for hours at a time. Amy worked as a newswriter and producer, a high-stress position that regularly required twelve- to sixteen-hour workdays. She was not sleeping well, not exercising, and not eating properly. Amy skipped meals frequently, and when she did manage to eat, she ate as quickly as possible. She had gotten into the habit of eating bananas every day because of their convenience. Unfortunately for Amy, bananas are on the headache hit list, at least in large quantities. When Amy cut them out of her diet, her headaches improved.

Rhonda B.'s headaches, which used to trouble her only a few times a month, had become a daily torment. She had lost over forty pounds on a diet that prescribed eating three oranges and one grapefruit each day in addition to other low-fat foods. In Rhonda's case, it was the quantity of the citrus fruits that was the problem. Cutting back on her consumption of oranges and grapefruit helped keep her headaches in check.

Some people are affected by a particular food only at certain times. Eilene M., for example, was troubled by migraines around the time of menstruation. The migraines lasted for up to three days at a time, causing her to miss work. Eventually, Eilene noticed a pattern: Beginning about two days prior to her period and continuing until its end, eating bananas, grapefruit, or yogurt would cause her to develop a severe migraine within ten minutes. During the rest of the month, these foods did not affect her. Fortunately for Eilene, her menstrual cycle is regular, so she can avoid those food triggers during that time of the month.

Identifying Troublesome Foods

Not every headache sufferer is sensitive to food triggers. The first step before undertaking any regimen is to see a doctor and determine if there is any underlying condition that may be causing your headaches.

But a significant percentage of sufferers are affected by food, and I see it every day in my practice. Unfortunately, there is no physical sign or blood test that will tell you if some of your headaches are caused by food. And if you're not paying very close attention, you may not notice a pattern even if it's there. For that reason, I recommend that every headache sufferer try diet modification, at least temporarily. To discover if your diet is contributing to your headaches, you'll need to start with what doctors call an "elimination diet," in which you will try to eliminate all potentially troublesome foods.