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Timothy C. Hain, MD, Chicago IL. 
Page last modified:
March 18, 2013
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1/3 of all migraine sufferers are helped by avoiding certain foods or drugs.
Monosodium Glutamate (MSG), also labeled Autolyzed Yeast Extract, Hydrolyzed Vegetable Protein, or Natural Flavoring: Major sources of MSG include certain soups, Chinese food and "fast" food, soy sauce, yeast, yeast extract, meat tenderizers (Accent), and seasoned salt. Many salad dressings also contain MSG. We advise you not to frequent restaurants that are unable to eliminate MSG from their food. Headaches an hour or so after eating is the most common timing. While the literature is not strong about MSG (Freeman, 2006), nevertheless MSG sensitivity is "common knowledge".
Sulfites (Potassium Metabisulfite). Used as a preservative on salads, seafood, avocado dip. Found naturally in wine and beer. Usually causes asthma symptoms, but can also cause headache. There was no literature on sulfite sensitivity and headache as of 2012.
Alcohol. Red wine, beer, etc. Red wine is the most likely and vodka is the least likely alcoholic beverage to cause a migraine. Tension headaches may be relieved by alcohol, as opposed to migraine which is often worsened by alcohol. Alcohol is the most common dietary trigger for migraine (29%, Peatfeld et al, 1984).
Chocolate. Includes carob. Chocolate may cause a delayed effect -- the caffeine in chocolate prevents an early headache. The role of chocolate is controversial (Holzhammer and Wober, 2006). Chocolate contains about 10 mg of caffeine/ounce (see following).
Cheeses, especially ripened or aged cheese (Colby, Roquefort, Brie, Gruyere, Cheddar, Bleu Cheese, Mozzarella, Parmesan, Boursalt, Romano). Cheeses less likely to trigger headache are cottage cheese and American cheese. Pizza may be a problem food. Headaches about 1 or 2 hours after eating are common pattern. The role of cheese is controversial (Holzhammer and Wober, 2006).
Caffeine. This is complicated. Caffeine lasts about 8 hours. Overuse of caffeine may increase headaches via rebound. Some very sensitive people may develop rebound from as little as 30 mg, but in most people it takes 500 mg of caffeine/day (5 cups coffee). The active ingredient in many OTC acute migraine medications is caffeine and aspirin and/or Tylenol. For example, Excedrin migraine has 65 mg of caffeine, 250 mg of acetaminophen, and 250 mg of aspirin. A large ice-tea, an aspirin and a non-extra strength Tylenol contains the same active ingredients. Add some sugar, and you can treat low blood sugar too. No controversy.
Caffeine Content:
Nitrates -- found in meat and certain medications for blood pressure and chest pain. Examples of foods are bacon, packaged lunch meats, sausage, hot dogs. Nitroglycerin, Isordil are examples of medications. No controversy (Cleophas et al, 1996)
Magnesium. Supplementation with 500 mg daily is mildly helpful in preventing migraine. This is not controversial (Mauskop, 2012; Holland et al, 2012). Generally the most convenient form is the "cal-mag" tablets. Other "non-drug" treatments that we are not so sure work include vitamins (co-Q), riboflavin (400 mg), and butterburr (petadolex).
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