The complexities of caffeine and migraine: Remedy or trigger?
Caffeine and Migraine
It is perhaps our society’s biggest addiction.
Many of us love it. And yet we’ve all heard the warnings about having too much of it.
If you are prone to migraines you may have heard there is a connection between migraines and caffeine. You might have heard how coffee and other forms of caffeine can help when you have a migraine. Or you might have heard how drinking too much coffee can cause migraines.
Well, it turns out both of these statements are in fact true!
Are you confused yet? Well, let me explain.
Caffeine as a Migraine Remedy
Caffeine, such as having a strong coffee during a migraine, especially during the early stages of a migraine can often abort a migraine.
Since the exact mechanism of migraine is not fully understood no one yet knows exactly why this remedy is so effective. But it seems to be that caffeine is helping in a couple of ways.
Constricts blood vessels
About 15-30 years ago (depending on who you talk to) migraine was thought to be a purely vascular disease. A migraine, they thought, was caused by constriction followed by the dilation of blood vessels. The dilation of the blood vessels caused this increase in blood flow that triggered that pounding & pressure feeling you get when you have a migraine.
Although we now know that this isn’t the ‘cause’ of migraine. It still seems to be a part of the process of migraine.
This is one of the ways we think caffeine might be helping. By having some caffeine we cause constriction of blood vessels which helps to reverse the process of dilation that contributes to the migraine.
Inflammation & Analgesic Properties
We already know caffeine helps reduce inflammation by constricting blood vessels. Dilation of blood vessels is actually a part of the process of inflammation. Think of when you get injured and the site of injury swells up to bring blood flow to the area. That is inflammation. Caffeine will reduce that inflammation so it doesn’t worsen your migraine. There is also evidence that caffeine works as an analgesic, in other words, it helps to relieve pain.
Caffeine works as a pain reliever because of its effects on adenosine. Adenosine is a chemical that is responsible for making you feel tired. Its lesser known quality is its influence on pain perception. Caffeine blocks adenosine and this is why it helps you to feel more awake. This is also how it reduces pain. Caffeine also releases feel-good chemicals including dopamine and other endorphins which act as natural painkillers.
Affects on adenosine
Adenosine the chemical that makes you feel tired at night, and is why caffeine can make you feel alert. During a migraine blood levels of adenosine increase and it theorized to be a part of the migraine process. Caffine works on adenosine receptors by blocking them. Therefore having a cup of coffee might just block these receptors enough to stop the migraine in its tracks.
Caffeine as a Migraine Trigger
Now that you’re reassured that your caffeine addiction is actually a helpful friend, let me remind you that caffeine is a double-edged sword. Although caffeine can be a helpful migraine rescue I always recommend that if you get migraines you should probably consider quitting caffeine, including coffee, tea, chocolate, soda and medication (Excedrin, Midol, aspirin) and here’s why. Special emphasis on non-clean sources of caffeine such as soda, sweetened coffee drinks and energy drinks – you should never be drinking these if you want to improve your migraines.
Rebound
As we consume regular amounts of caffeine our bodies quickly become dependent on it. Skipping your morning coffee, having less caffeine than usual, or even waiting too long to have your morning cup of coffee can all trigger a migraine as your body reaches for homeostasis. Homeostasis describes how our body has a tendency towards a stable balance. It likes consistency and can “misbehave – ahem, migraine!” when we through it out of balance (have less caffeine than usual). Migraineurs are particularly sensitive to changes in homeostasis compared to non-migraineurs.
It no longer works well as a migraine remedy
If you regularly consume caffeine it stops working as a migraine remedy. Your body builds a tolerance to it, so you need to drink coffee just to reach homeostasis. That means that the next time you drink coffee for migraine it’s likely it won’t help.
Muscle Tension
Caffeine can cause tension in the body. Studies have shown that when comparing individuals who consumed caffeine and those who didn’t, those who consumed caffeine had more tension in their muscles. This tension can also contribute to tension headaches and migraine.
Releases stress chemicals
Caffeine increases cortisol and epinephrine levels both at rest and during periods of stress. So no matter how relaxed you were, it’s going to create some level of stress in the body. For the average person, a morning cup of coffee can be just what someone needs to feel extra perky in the morning. Keep in mind that stress hormones aren’t bad or good. We rely on natural cortisol cycles to feel awake in the day and sleepy at night.
Many migraine sufferers have already high levels of stress and resulting stress hormones in their bodies. And a stressed nervous system is one of the biggest contributors to migraines. So it’s a no-brainer to avoid adding extra fuel to the stress fire.
Causes poor sleep
As mentioned above, caffeine influences our cortisol cycles. Naturally, our bodies release cortisol in the morning and it dips at night so we can rest. Caffeine blocks adenosine receptors which make us feel sleepy to help us feel alert. It also releases endorphins and cortisol to make us feel awake. This is great for some people in the morning, but the problem is that it takes about 10 hours (this is individual and deepens on the person) for caffeine to leave your system. If you drank a coffee at 2 pm, that means the caffeine is going to interfere with your sleep if you try to go to bed at your usual 10:30 pm bedtime.
Caffeine is a natural diuretic
A diuretic causes the kidneys to make more urine. This helps the body get rid of extra fluid and salt. They are used to treat high blood pressure, edema and other conditions. This is problematic however cause it can cause dehydration and loss of electrolytes which can contribute to migraine.
Appetite Suppressant
Caffeine suppresses appetite. We talked about how caffeine can cause the release of stress hormones. When our body is in a state of stress it’s like telling the body to be ready to fight or run away. If you’re about to run away from a dangerous situation your body prepares your body to fight. It pulls all the resources it can away from non-essential functions like digestion and puts that energy into preparing your muscles and mind to fight or run. This is why it suppresses appetite. So that you’re not ready to fight a tiger and thinking – gee I could use a sandwich.
If we suppress our appetite and don’t eat, then our body releases more stress hormones to combat the loss of energy coming from food. This is a nasty cycle that is a migraineur’s worst nightmare.
Caffeine → More stress hormones → Suppress Appetite → Not enough Fuel via Food → Release More Stress Hormones → More Migraine
The additional lack of nutrients from food also contributes to migraine. Food is medicine. When we starve our body of nutrients it lacks what it needs to run. Like running a car without gasoline or oil. Eventually, it breaks down.
Malabsorption of nutrients
Coffee and Tea can cause nutrient deficiency as it interferes with the absorption of minerals and vitamins such as calcium, iron, magnesium, and B vitamins. Ironically these minerals I just listed as vitamins and minerals I recommend many migraineurs take as they help with migraine and migraineurs can often be deficient in them. If you are going to drink coffee or tea make sure you never take your supplements at the same time. It will also interfere with the absorption of nutrients in your food.
How to leverage coffee for the most migraine freedom
My recommendation is to avoid consuming caffeine regularly.
If you have a migraine test out having a strong cup of coffee at the earliest signs of a migraine. Make sure the coffee is clean, organic, single origin and fresh. No cream or sugar. You can blend in butter or coconut oil. This will help you get a slower release of caffeine. Or drink it black, with non-dairy milk and a safe sweetener like stevia or monk fruit sugar. No maple syrup, organic sugar, or honey. I don’t typically recommend tea as an alternative as the tannins in tea can be a migraine trigger for many. Drink it quickly while its still hot. Don’t wait around for it to get cold. Notice if it seems to help you or worsen your migraine.
Every migraineur is different so you need to track and test these things out. I have met migraineurs who do well with one daily cup of coffee. And I’ve met many who don’t react well to this.
Personally, I LOVE bulletproof coffee in the morning and my Husband loves drinking a lot of coffee in the morning. Because we love the ritual of drinking coffee together in the morning I drink 4 ounces of bulletproof coffee in the morning. It’s a small amount but still gives me the joy of sharing this ritual with my loved ones. This does reduce the effectiveness of coffee as a migraine remedy for me, but since I get migraines sparingly now the benefits outweigh the cons for me. When I do get a migraine I just require a greater amount of caffeine to help me beat the migraine (usually 2 cups) and I do get jittery from this. But it usually helps. Rarely this tactic backfires and having too much coffee can cause too much stress and tension and it worsens the migraine. It’s not perfect, but I think it’s important to share that sometimes there isn’t a perfect solution. We have to find what works for us with the information we have.
I am going to do a test soon and go 3 months without any coffee except on migraine days. I’ve done this many times, and I think it’s important to test things out, and know that sometimes we change over time. What worked before may need retesting in the future.
References
https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-017-0806-2
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468766/
