If you’re reading this, chances are that you or someone you know suffers from headaches. Take comfort in knowing that you’re not alone! Headaches affect as many as 50 million Americans a year and account for more than 18 million visits to the doctor. In fact, headaches are the leading cause of absence from work; some researchers have estimated that 30 million workdays are lost each year because of the problem. But numbers do not even begin to tell the story. The pain of a headache can completely disrupt a person’s life. I have seen patients whose headaches are so severe that they are afraid to plan activities such as vacations, weddings, dinners, or dates. Their lives center on the dread of the next headache attack. Mary P. is a perfect example. When Mary came to my office, she had suffered from two to three headaches a week since her early twenties. Now that she was forty, her headaches were occurring on a daily basis. She complained of a constant throbbing sensation from the back of her head to her forehead. The headaches had become so severe that she was having difficulty taking care of her seven-year-old daughter and four-year- old son. The constant pain was also taking a toll on her marriage. The only way she could get through a day was by taking a lot of pain medicine.
Like Mary, many patients complain that their suffering is worsened by a feeling of helplessness. They have been told by friends and physicians alike that they will have to “learn to live with it.” At one time or another, most headache sufferers have also been told, “It’s all in your head.” Often they blame themselves for their condition. The combination of fear, helplessness, and self-criticism can lead to depression and/or the chronic use of pain medication. Many doctors now think that heredity may play a major part in the underlying cause of headaches. As I often tell my patients, if you really want to cure your headaches, you need to pick your parents better! I suspect that what a person inherits is the predisposition to getting headaches. I think of it like this: Everyone is born with a certain threshold for getting headaches. Some people have such a high threshold that they never get a headache, no matter how many “headache triggers” they are exposed to. Others have a headache threshold that is high enough so that they suffer from headaches only occasionally, and usually only with extreme triggers, such as severe stress or sleep deprivation. Frequent headache sufferers, on the other hand, are very sensitive to trigger factors and may get headaches in response to a multitude of them.
Headache Triggers Stress, lack of sleep, bright lights, weather changes, and strong odors are all potential headache triggers. But what many people, including many doctors, don’t realize is that some of the most common causes of headaches are ordinary foods that most of us eat every day. Avoiding those so-called food triggers can be one of the most effective and least invasive ways to treat headaches, without the risk of side effects and allergies (not to mention the cost) associated with the use of medications. In fact, by just following an appropriate headache-prevention diet, you may be able to get rid of most or all of your headaches!
You may still need to take medication for your pain. But medications have side effectsespecially when they are taken too frequently. Indeed, one of the most frustrating things about treating headache patients is that they tend to be more sensitive to medications and experience more side effects than people without headaches. Whenever possible, it is ideal to be able to treat headaches without resorting to the use of medication. This is where diet modification is useful.
Diet modification worked for Mary P. After stopping her chronic pain medicines, we were able to identify many food triggers that she had previously been unaware of: Chinese food (even without MSG), cured pork products, aged cheeses, bananas, citrus fruits, and peanut butter cookies. Each of these foods caused a severe headache within hours of consumption. Once Mary identified her headache triggers, she modified her diet to avoid them. Her headaches became less frequent, and her relationships with her husband and children improved dramatically. Mary is just one person who has been helped by eliminating trigger foods from her diet. There are many others:
- Indira P., a thirty-year-old Indian woman, moved to America in 1996 to make an arranged marriage. Shortly after her arrival, Indira developed headaches that occurred almost every day. But she spent the following winter in India and had no headaches while there. When she returned to the Unitted States, her headaches recurred. Indira did not believe that any of her headaches were caused by foods. However, I became suspicious after hearing thaaaaat she had experienced no headaches while vacationing in India. I asked her what her husband did for a living. As it turns out, he operated a food truck that served sandwiches, and every day he would bring some home. Indira usually ate either a turkey and Swiss cheese or a cheese steak sandwich for lunch. I advised Indira to eliminate cheese from her diet, and when I saw her two months later her headaches were much better.
- Sharon M. had daily headaches for about a year. The symptoms were typical of chronic tension-type headaches: a “tight band” around her head that was fairly constant and usually not associated with nausea or vomiting. After ruling out any serious cause of Sharon’s headaches, I put her on the headache-prevention diet. Sharon kept a detailed record of everything she ate. (She is a bit compulsive, and in this case, it worked to her advantage.) When I next saw her two months later, she had experienced only a few headaches. Then, after slowly reintroducing the foods known to be common headache triggers, Sharon identified freshly baked bagels, pickles, chocolate, and citrus as some of her headache triggers. As a result, her life was, in her words, “totally changed.”
- John R. loved diet cola. At his initial evaluation, he said that he drank four glasses a day. Since diet cola contains artificial sweeteners and caffeineboth potential headache triggersI recommended that he gradually reduce his intake and switch to something else. But, like many patients, John was reluctant to give up his favorite soft drink. He stopped drinking it for a short period of time, then tried to reintroduce it. Within hours, he suffered a severe migraine headache.
John tried on four more occasions to reintroduce diet cola. Each time ended with the same result: a migraine. Finally, he was forced to admit to himself that his favorite soft drink wasn’t worth the pain.
-Trisha P., age fifty-nine, suffered from headaches since she was eight. When Trisha first came to see me, she complained of frequent headaches and was taking too much pain medicine, which can cause “rebound” headaches. I discontinued her medication, and within a few short weeks, Trisha’s headaches became much less frequent. To see if we could eliminate the rest of her headaches, I suggested that she avoid certain foods. After doing so for a few weeks, Trisha gradually began adding them back to her diet, one at a time, to try to identify the offenders. She reintroduced cheeses, artificial sweeteners, and pickles without any problems. One night, Trisha decided to have a piece of ice-cream cake with chocolate sprinkles on it. Seven hours later, she awakened with a migraine. Three days later, she ate a chocolate candy bar and developed a migraine within four hours. Since cutting chocolate out of her diet, Trisha has been doing fine, with only an occas...