How Does Caffeine Trigger Migraine?
Does caffeine trigger migraine for you? While 85% of the American population consumes at least one caffeinated beverage daily, of which coffee is the most commonly consumed drink, caffeine is a common migraine trigger for many people. Whether it is an irresistibly fragrant matcha tea or a tantalizing Java Chip Frappuccino from Starbucks, many of us relish our daily perk-me-up drinks.
However, is caffeine good for migraine? Research has shown that a number of people who experienced migraine attacks enjoyed some relief after a cup of caffeinated drink. In addition, they also reported some practical benefits of caffeine intake, such as alertness. However, should we always resort to a cup of coffee in every instance of a migraine attack?
How Does Excessive Caffeine Trigger Migraine?
Some people may have to abstain from coffee or tea because caffeine can trigger migraine attacks. There are many reasons for that. Firstly, caffeine is a diuretic substance. This means that it causes a need to urinate in users. Excessive caffeine consumption may lead to body fluid loss, leading to dehydration. Overuse of caffeine can lead to dehydration which triggers migraine attacks for some people.
Caffeine might also trigger migraine attacks because of urinary loss of magnesium, caused by reduced resorption. Magnesium is an important supplement in acute migraine prevention. Research has shown that magnesium prevents migraine by blocking N-methyl-D aspartate (NMDA) receptors, which reduces the effect of cortical spreading depression (CSD). Cortical spreading depression is often associated with migraine pathophysiology, which explains how caffeine can trigger migraine attacks.
Excessive caffeine intake also leads to caffeine dependency can lead to caffeine withdrawal symptoms, which may trigger migraine headaches. Caffeine dependency happens when the brain’s expectation for caffeine intake is not met. This may lead to caffeine withdrawal symptoms, which can trigger caffeine withdrawal headaches or migraine attacks. Research has shown that the higher the caffeine consumption, the greater the caffeine withdrawal headaches. Caffeine headaches can be traced to reduced cerebral blood flow (CBF) due to vasoconstriction.
Research has also shown that the unintended consequences mentioned above due to the overuse of caffeine leads often turn episodic migraine headaches into chronic migraine headaches.
Some drinks that are high in caffeine, such as energy drinks, may not be helpful for migraine as they contain high levels of sugar too.
The Case Against Caffeine Trigger Migraine
For some people, caffeine consumption does bring some migraine relief. The mechanism behind this has to do with its influence on adenosine activity.
Adenosine is a neuromodulator that is responsible for triggering migraine attacks. During a migraine attack, adenosine plasma level rises and exogenous adenosine triggers migraine attacks. Caffeine has a chemical structure that is similar to adenosine. This allows it to bind to the same receptors that adenosine binds to. This competitive binding antagonizes adenosine activity, which helps to reduce migraine attacks.
However, that does not mean that we should be downing a cup of coffee every time migraine attacks happen. Moderation is key.
How Much Coffee Can We Drink?
While it may feel impossible to remove coffee from our diet completely, reducing our coffee intake is definitely doable for us. How much coffee can we drink if we experience migraine attacks?
The American Migraine Foundation recommends limiting coffee intake to less than twice weekly. Studies have also shown that people who experience migraine attacks and consume coffee more than thrice a week reported caffeine dependency and more frequent acute migraine attacks.
We can also consider decaffeinated coffee or decaf for short. For coffee to be considered as “decaf”, 97.5 % of caffeine must be removed from the coffee. While this may sound like a huge reduction, it still depends on the original caffeine potency of the coffee. This means if the original coffee has a very high caffeine concentration, the decaf version may still contain a considerable level of caffeine.
Caffeine Trigger Migraine – Bottom Line
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 Nowaczewska, M., Wicinski, M., & Kaźmierczak, W. (2020). The Ambiguous Role of Caffeine in Migraine Headache: From Trigger to Treatment. Nutrients. 12(8): 2259.