HeadWise HeadWise: Volume 4, Issue 4 - Page 13

You ask. Our headache experts answer. Avoiding Caffeine = No Headache I am a former migraine sufferer who was plagued for 27 years with chronic, right-sided migraine attacks. Five years ago, I discovered what was causing my migraines, I eliminated the trigger, and I have been free of migraines and drugs ever since. I am writing you, to share my discovery in the hopes that it will help legions of headache sufferers. In 2008, I was co-authoring a blog. In a post one day, I mentioned that I had migraines. Two of the readers of our blog commented on the post, telling me that the only way they had gotten rid of their own migraine headaches was to eliminate caffeine completely from their diet. Not only did I not believe that I consumed enough caffeine to make a difference, I was in the habit of having one cup of coffee in the morning that was made of half strength caffeine (half-caf ). Then, I would have a glass of iced tea for lunch, and sometimes, chocolate in the evening. Not only did I believe that caffeine in such small amounts could cause a problem, but I believed for many years that the caffeine must have been helping me because it was in the very headache medications, which my doctors prescribed. In fact, for years, even with the blessing of my doctors, when I would get a migraine, I would drink a cup of coffee to try to abort the attack. It never worked of course, but at the time, I believed the attack may have been worse without it. Adhering to my reader’s advice, I decided to wean myself off of a habit that I had my entire adult life except when I was pregnant, during which time I did not drink caffeine and during which time I, incidentally, did not have headaches. I was told that the lack of headache was a natural benefit of the pregnancy. I first reduced my cup of half-caf in the morning to quartercaf. The day after I began this reduction, I had a withdrawal headache that lasted me a solid week. The following week, when I switched to full decaf, again, I had a headache for a week. Next came the tea. I reduced it twice with an extended headache resulting each time. At that point, there was no doubt in my mind as to how profoundly the small amounts of caffeine were affecting me. The last to go was chocolate and again, a headache. Once my system was cleaned, I was cured. reader mail I am 55 years old now and I have been through menopause in the past 3 years. Had this discovery occurred simultaneously with menopause, I might question which was responsible. However, the discovery preceded menopause and I am certain that the cause was attributable to the caffeine. – Lisa T. “Caffeine has long been a controversial topic in the headache world. Due to the very large diversity of patient profiles and headache types, which we currently classify into about 200 categories, it is certainly conceivable that certain patients have an exquisite sensitivity to the drug, while others have no sensitivity whatsoever. Many headache remedies incorporate caffeine and many patients report aborting headaches with an anti-inflammatory and a simple cup of coffee. There are case reports of caffeine being useful in treating hypnic headaches as well as caffeine withdrawal headaches. On the other hand, caffeine is a common ingredient in the combination medications which cause medication overuse headaches. It is a question of the setting in which caffeine is used, or abused. In my experience, many patients have quit caffeine at my request and a few have noted reduction in headaches but most patients have noted no change. The only logical conclusion is that some people have a sensitivity to caffeine, but this is not a generalization which should dogmatically be applied to all migraine patients. It is certainly reasonable, however, for patients with refractory headaches to taper off caffeine gradually to see if they might benefit. Remember, many people will use caffeine as a stimulant because of daytime sleepiness which might arise from undersleeping, insomnia, or sleep apnea, so another important question is to ask why people are using caffeine and seek the underlying cause, which might be the key to their headache problems.” www.headaches.org Edmund Messina, MD The Michigan Headache Clinic East Lansing, MI | National Headache Foundation 13