Cause of Migraines

Is Chocolate Another Migraine Trigger

Chocolate is considered a common migraine trigger; the connection between this guilty pleasure and the excruciating pain of migraine headaches was investigated during a large study, the results of which were published in the Lancet(1).

Chocolate is one of the few foods which has been investigated in double blind controlled studies, to determine how much of a trigger it really is – unlike many other food products, which have merely been included as part of larger studies using a wide range of possibilities.

These double blind, focused studies seem to leave some ambiguity in the subject. A 1974 study undertaken at the London Hospital apparently concluded that whilst chocolate may be a trigger, it wasn’t a significant one(2). This was a full five years prior to the Lancet study, which ranked chocolate near the top of the list along with other triggers, considered predominantly to cause migraines.

Another study done in 1997 also used a double blind protocol and placebo to try and pinpoint chocolate as an aggressive migraine trigger – again with inconclusive results. The study, carried out at the University of Pittsburgh, Pain Evaluation and Treatment Institute, concluded there was no difference between patients given chocolate and others given the carob placebo in either occurrence or severity of migraines(3).

Of course, one must take into account the overwhelming amount of anecdotal and testimonial evidence from hundreds of thousands of migraine sufferers who report chocolate as a trigger. Many of these claim that removing it from their diet caused instant cessation – whereas accidental or careless reintroduction caused just as immediate recurrence of symptoms.

There is one as of yet formally unpublished study, on which correspondence exists – a trial on 20 patients who believed migraine to be a trigger were challenged with either chocolate or a placebo. The 8 receiving the placebo had no incidence of migraine – five out of the 12 who received chocolate did have a typical migraine attack. The small number of people in the test group meant that the subsequent results were not completely conclusive.

As is so often the case with food intolerances, what one person can eat without an ill-effects, can create an unpleasant or even harmful reaction in another. Consider the simple peanut – a killer for some, a harmless snack for another.

Obviously scientific studies are interesting and essential, but however much we crave it, chocolate is something we can live without. The most effective method to discover if it’s a trigger food for the individual, is to cut it out from their diet for a few weeks. If your migraines are bad enough, it’s a simple sacrifice to make.

(1) Grant ECG; Food, Allergies and Migraine; Lancet, May 5 1979;966-969

(2) A. M. Moffett, M. Swash, and D. F. Scott – Neurol Neurosurg Psychiatry. 1974 April

(3) Marcus DA, Scharff L, Turk D, Gourley LM – Cephalalgia 1997 Dec; 17(8):855-62

(4) CM Gibb, V Glover, M Sandler, Bernhard Baron Memorial Research Laboratories

Research by Grace-Alexander

By: Joy Healey

Joy Healey qualified in 2000 as a nutritionist at the acknowledged Institute for Optimum Nutrition in London; with her dissertation topic being migraine. Check out: www.natural-migraine-alternatives.com for immediate receipt of an e.book full of further recommendations for natural, alternatives and approaches to treat and prevent migraine. Keep up-to-date with new information on migraine at: natural-migraine-alternatives.blogspot.com

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Migraine Acupuncture research

Researchers in Denmark recently demonstrated that acupuncture offers significant benefits for migraine sufferers. The researchers monitored 85 patients with a history of migraine in a randomised, double-blind study in which acupuncture treatment (dry needling to acupoints in the neck) was compared to the drug metoprolol in the prevention of migraine attacks. All of the patients, investigators and statisticians were blinded as to treatment, and the therapist was blinded as to results.

The study took place at an outpatient pain clinic in the northern Copenhagen area and the patients who participated in the study were either referred by their general practitioners or had responded to newspaper advertisements. Certain patients were excluded from the study; those who were pregnant or had previous experience with acupuncture or beta-blocking agents, those with chronic pain syndromes, and those with known contraindications to treatment with beta blockers. The patients were then allocated to one of two groups: the first group were given a 17-week regimen with acupuncture and placebo tablets and the second group were given placebo acupuncture stimulation and 100 mg of metoprolol daily.

The results revealed that both groups exhibited significant reduction in frequency of migraine attacks and there was no difference found between the two groups of patients in the average frequency or duration of migraine attacks. However the severity of the attacks was found to be lower in the metoprolol group but this was also accompanied by a range of adverse side effects. The researchers therefore concluded that acupuncture offers " a valuable supplement to the list of migraine prophylactic tools" being equipotent to metoprolol in the influence on frequency and duration (but not severity) of attacks, and superior in terms of negative side-effects.

There is no doubt that this study provides additional weight to the argument that acupuncture should be more fully integrated into western medicine, at the very least as a complementary tool for pain control. However it should be noted that the study, like many others, attempts to define acupuncture treatment in western medical terms, with standardised treatment being administered to every patient in the treatment group without consideration to the specific needs of the individual patient or the more complex systems and meridians (flows of energy) upon which oriental medicine is based. It would be more helpful and certainly increase our understanding of the true benefits of acupuncture treatment if researchers would give thought to the oriental approach to medicine when devising research studies and allow qualified acupuncturists the opportunity to treat each indivdual according to their diagnoses. As in all other forms of holistic therapies, treatment cannot be standardised for every patient because the cause of the problem may differ in each individual case.

Courtesy of Hesse J; Mogelvang B; Simonsen H. Acupuncture versus metoprolol in migraine prophylaxis: a randomized trial of trigger point inactivation. Pain Clinic and Medical Department, Skodsborg Sanatorium, Denmark. Journal of International Medicine (ENGLAND) May 1994, 235 (5) p451-6

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Migraine Trigger Elimination Dieting

Science can’t explain why so many migraineurs claim that there is a link between certain foods or beverages and their headaches, but they do. Sadly, the food triggers are different for each migraine suffererit’s not like someone who needs to lower their cholesterol and the doctor tells them to eat egg whites and lose the bacon, migraineurs have to figure out their triggers on their own. The best way to do this is with an elimination diet.

The first step in any elimination diet is to put together a suspect list. A migraineur has had a headache the day after every football party for years. What is served? Who hosts? What items never change from party to party? If it doesn’t happen every time, what was different? Did someone else make the potato salad this week? List the suspects and move to step two.

This is the hardest step in an elimination diet. Until a suspect is identified, everything from the meal that seems to trigger a headache must be eliminated. Then the dieter can add items back into their life, one at a time, until they identify a trigger. Once the trigger is identified, it can be avoided.

Do not stop with the first trigger identified. Most migraineurs have multiple triggers. If an elimination diet is going to help someone, he or she needs to identify all the triggers.

For many migraineurs, the trigger is not a single food, but a combination of foods. For example, avocados trigger migraineur A and B is okay with them. However, when B eats guacamole he gets a headache every time. Why? Guacamole is made up several common triggers including avocado, citrus juice, seasonings, and vinegar. B may be okay consuming any one of these alone, but combine them and its sure formula for a headache.

By: Li Ming Wong

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