After the two-month period, you can begin to reintroduce the potential trigger foods into your diet, one food at a time. Wait for a week or two before adding another. That way you can more accurately determine the effect of a particular food on your headache pattern. If your headaches increase after introducing a food, then you should assume it is a trigger and avoid it permanently. If the food does not result in any change in your headache pattern, you are not sensitive to it.
- Paula S., a twenty-eight-year-old Italian woman, came to my office complaining of headaches that occurred three days a week ... Three weeks after starting the elimination diet, Paula's headaches improved dramatically. She was feeling great, but she wanted to go back to her normal diet. As Paula slowly began to reintroduce one food at a time, she remained headache-free, until she came to her favorite cheese-filled Italian foods: ziti with mozzarella, pizza, and lasagna, which she had previously indulged in several times a week -- the same frequency with which she used to get headaches!
- Michael N.'s food reaction was one of the strangest I have seen. Michael never had a headache for the first thirty-five years of his life. One day, while driving, he bought a roll of hard butterscotch candies and put one in his mouth. Within fifteen minutes, Michael developed an excruciating cluster headache. He had trouble staying on the road but was able to make it to his destination. When he arrived, he was almost totally incapacitated. Fortunately, this attack lasted for only an hour and a half. However, Michael did not make any association between his headaches and the butterscotch candy. Three days later he ate another butterscotch candy while driving his car. Once again, within fifteen minutes he had a severe cluster headache.
Why Do Certain Foods Trigger Headaches?
What is it about these foods that trigger headaches? There is certainly no factor common to all of these foods...
Food seems to be able to cause headaches regardless of whether you tend to get migraines, cluster headaches, or tension headaches.
Although a few health-care practitioners maintain that allergies to certain foods set off headaches, most experts believe that such allergies play virtually no role in causing headaches. It is more likely that substances contained within some foods trigger the headaches either by changing the amount of serotonin in the brain or by affecting the blood vessels in the head. Amines, biochemicals involved in causing blood-vessel constriction and dilation, are found not only in the brain but in many different foods, such as cheese, chocolate, nuts, and certain meats. One common amine, called tyramine, is suspected by many experts to be a major factor in triggering headaches.
Preservatives such as nitrates and sulfites, artificial sweeteners such as aspartame and saccharin, and food additives such as monosodium glutamate (MSG) have all been implicated as headache triggers. They contain amines, which alter the constriction of the blood vessels. But for many of the foods listed below, the reason they trigger headaches remains a mystery. Scientists do know that alcohol can dilate blood vessels, and this may be one reason that alcohol can cause headaches. Many alcohols also contain amines such as tyramine and histamine. Caffeine can be a good treatment for headaches when used in moderation. Paradoxically, however, when it is taken on a daily basis, it can cause more headaches. Caffeine, in fact, is one of the most common food-related causes of headaches that I see in my practice, and it's the one thing patients often have the most resistance to giving up, until they discover that doing so can help them eliminate disabling pain.
Copyright © 2000 David R. Marks, M.D. and Laura Marks, M.D. Reprinted with permission of the authors.
