September 05, 2020
I have a sense of dread when I feel a migraine coming on. I suffer from cluster attacks – intense, recurrent periods of pain usually centred over one eye or temple. They’ll recede, only to come back again and again for a few hours or a day, leaving me feeling weak and wrung-out. And because my migraines are triggered by sleep deprivation, I’m caught in a vicious cycle of tiredness and pain. Over the years I’ve found a remedy that works for me – a regular sleep pattern (and enough of it), plus a combination of vitamin B12 and CoQ10, both in my diet and, when I’m feeling particularly vulnerable, as a supplement (see the box, below).
I’ve met hundreds of migraine sufferers in my nutrition practice over the years, and while everyone’s triggers are different, I’ve seen time and again the huge improvement that a few dietary changes can make to their wellbeing. What we eat, what we don’t and when we do it has been proven to impact on symptoms and severity of migraines. Some people find that skipping meals triggers an attack, so having one of my Nourish Drinks to hand when they're on the go can help. Research shows that increasing anti-inflammatory omega 3 fatty acids and reducing inflammation-causing omega 6 fatty acids can reduce frequency of attacks, for example. And avoiding trigger foods is key to prevention in those with food sensitivities.
Hormones, stress, tiredness and low-blood sugar can spark migraines, and these are all triggers that can be influenced by the food we eat. Other causes – environmental factors such as lights, sounds and smells, or certain medication – may not have a direct link to our diet, but giving our body the nourishment and support it needs can help us to manage symptoms such as pain, exhaustion, sickness and loss of appetite.
It’s believed that migraines are caused by chemical changes in the nerve cells of the brain. For some of us, certain chemicals or compounds in our food can be the culprit. You may be sensitive to MSG, the flavour enhancer found in many processed or Chinese foods. Or keeping a food and migraine diary may reveal that Tyramine, an amino acid found in mature cheese, peanuts, chocolate, broad beans and fermented foods such as sauerkraut, could be your migraine weak spot.
Caffeine is a tricky one. It’s often included in painkillers as it helps the drug to be absorbed more quickly by the body, helping your head to feel better faster. And some people (myself included) find that starting the day with a cup of caffeinated tea or coffee can stop a headache developing later on, or prevent . However, drinking a lot of caffeine-rich drinks may make you more prone to migraines if you are particularly sensitive to its effects. If you think that may be the case, reduce the amount of caffeine you drink gradually, as rapid withdrawal can cause its own type of headache.
Alcohol is easier to make a decision about. From my own experience and from treating patients, it’s apparent that drinking alcohol on an empty stomach, when dehydrated, exhausted or stressed, can give you an alarming headache or migraine. You may find red wine or fizz is the worst offender, or (like me) that white wine is worse. It all depends on the type of grape and the additives, such as sulphites, that have been added. Keep a diary (see below) to see if there are certain drinks that affect you most. And if you do plan to have a glass or two, avoid mixing your drinks, drink plenty of water, and eat some food beforehand to help your body process the alcohol more easily.
Find your balance
Keeping your blood sugars balanced can make the difference between a migraine and a pain-free day. Avoiding high-GI sweet foods will stop the energy highs and lows that seem to trigger migraines in some people – so skip the cakes, biscuits, sweets and fizzy drinks. If you do crave something sweet, pears, dried apricots, plums, grapes, dates and kiwi fruit seem to be tolerated well. Combining your treat with a hit of protein – a sticky Medjool date with a walnut, or some cheese with slices of fresh apple – will help to slow down the absorption of sugar into your blood stream, meaning it’s less likely to trigger an attack.
Skipping meals is also likely to spark a migraine, especially breakfast. Three balanced meals a day, plus a couple of healthy snacks such as a Nourish Drink, which contains a balance of protein and carbohydrates, should be enough to keep your blood sugar stable. If you feel the pain coming on, nibble on something bland, such as a slice of toast or some rice cakes, and drink some water; it can be just enough to lessen the severity of the migraine.
Sipping a Nourish Drink may help prevent migraines triggered by lack of food
How to keep a migraine diary
Identifying your migraine triggers can help head off attacks before they start, or at least make them less frequent. Here’s how to keep a record – and what to do with the results
Make a migraine memo When a migraine strikes, write down the date and time it started, any warning signs you experienced, the symptoms you feel, any painkillers you took when it ended. Keep your diary for a couple of months, or long enough to identify any patterns in your migraines. You can always return to your diary at a later date if the triggers or symptoms seem to have changed in any way.
Analyse the information When the pain subsides and you have a clear head, look over your entries for each migraine. Try to spot any similarities in your experience; red wine may be the link, feeling stressed at work, or the strong perfume your best friend wears.
Create an action plan A little planning may make the difference between managing your migraine and retreating to a darkened room. If you know low blood sugar is your trigger, for example, carry healthy snacks that will give you sustained energy – a mix of protein and carbohydrates is best, so a few nuts and dates, or a Nourish Drink, is ideal. If dehydration is the cause, always carry a water bottle with you. If it’s caffeine, carry herbal teabags with you.
Certain vitamins, minerals and herbal supplements have been proven to help prevent migraines. Here, Jane picks her favourites…
Vitamin B2 (also known as riboflavin) ‘In the only study to look at vitamin B12 on its own as migraine remedy, more than half the participants had a 50 per cent reduction in migraine attacks. Lean meats, eggs, diary products and green leafy vegetables all contain small amounts of vitamin B12, but levels are reduced by cooking and pasteurisation processes. If migraines are an issue, I recommend a supplement of around 400mg a day, combined with CoQ10 (see below).’
CoQ10 Trials of this antioxidant show a reduction in the number of migraine days, with significant improvements after five to 12 weeks – so stick with it. I recommend a dose of 200mg a day.’
Chromium ‘This mineral – found in green vegetables such as broccoli and green beans, apples and wholewheat bread – aids the action of insulin in the body, helping to stabilise blood sugar levels. You may want to take a supplement if energy lurches trigger your migraines; 50-200mcg per day is the usual recommended dosage.’
Magnesium ‘Many people swear by this mineral for relieving migraines. It helps to relax muscles, which can reduce tension and relieve pain, and can promote better sleep. Take around 400mg in the evening.’
Vanilla essence ‘A brilliant standby if sweet foods are your migraine trigger. A sniff of vanilla can reduce sugar cravings, so you’re less likely to give in and risk an attack.’