Got Migraines? Then You’ve Got Food Reactions

I was recently reviewing a patient case involving migraine headaches. Let’s call her Sabrina. I was in our “cloud” e-file looking for another patient’s chart, and accidentally clicked on hers. I remembered Sabrina fondly and wondered how she was. I hadn’t seen her in a good year or more, because she’s a happy, busy, new mom, who is no longer a “migraineur” (one who suffers with migraine headaches).

The main culprit in her case? FOOD SENSITIVITIES. She also happened to have very low red blood cell magnesium, but if I were forced to create a hierarchy for these two important interventions, food would still top magnesium.

In my experience thus far, food is ALWAYS an issue in my patients with migraines (with or without aura, associated with hormones or not). Magnesium insufficiency is often an important factor, but not always.

My friend, Alex Vasquez, ND, DC, DO, introduced me to an older Lancet paper demonstrating that, on average, a full 10 foods needed to be removed from a migraineur’s diet. (Volume 313, Issue 8123, 5 May 1979, Pages 966-969) This is a great, interesting paper validating the multiple-foods-as-headache-trigger we see clinically time and again.

Functional clinicians understand that 10 food reactions suggest underlying intestinal hyperpermeability (IP), a.k.a. leaky gut. Treating the IP almost always means that some of these foods can be reintroduced and tolerated. In fact, in my experience, I have NEVER found that a migraineur needs to avoid 10 foods indefinitely. Usually, just a couple of foods are the problem children, and migraineurs gladly make the pain/food trade-off. For some, additives and preservatives may be continued triggers; therefore, a very “clean” diet needs to be followed—but that’s a good thing. Who wants to consume those chemicals anyway?

One more case. Another patient suffered with migraine for an unimaginable 56 years. She even received an occipital nerve stimulation implant, which was unsuccessful in addressing her headaches, so she had it removed. Were foods a factor in her case? Oh, yes. Was it magnesium? Probably, but I can’t remember off the top of my head. Foods were first. Low serotonin turnover, contributing to depression and insomnia, was another issue.

My experience is that the underlying migraine mechanism includes a Th2 (allergic) bias. Research does appear to offer some support for this idea as well. And for the menstrual migraineur, estrogen appears to push Th2-associated cytokines (inflammatory chemicals). (Curr Drug Targets Inflamm Allergy. 2004 Mar;3(1):97-104) Thus, controlling estrogen dominance has a secondary effect on the allergic response. Interesting. I prefer the IgG4 food panel test for these people, because IgG4, particularly in its role as IgE-blocking antibody, is regulated by Th2.

So, for the migraine patient, my standard approach includes an IgG4 food sensitivity test. I also test for evidence of lower serotonin and other nutrients, by checking organic acid and amino acid levels. (The Triad has all of these components–a perfect assessment tool for migraine patients.) We base our initial treatment on the laboratory findings and—lo and behold—it works.

Migraine trigger foods differ from person to person, but the top offenders I’ve seen in my practice go along with the top most common food allergies: wheat, egg and dairy. If you are a migraine sufferer, you can consider eliminating these foods from your diet completely for at least 6 weeks to see if you benefit. However, because trigger foods can vary widely, I recommend that you get the guidance of an integrative doctor and do a full elimination diet or complete testing for food sensitivities and nutrient insufficiencies.

(originally published at

To read a detailed, referenced case study involving migraine headaches and depression, please see Case Studies in Integrative and Functional Medicine.

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2 Comments On “Got Migraines? Then You’ve Got Food Reactions”

  1. Magnesium deficiency, stress responses, sleep disturbance, lack of physical exercise also important, nave seen this in my own practice. I am hopeful that this new medical movement will not become as monolithic as traditional medicine- attributing everything to diet can miss the boat on other equally important factors. Diet Yes! Bot other factors too…

  2. Of course, you are correct– hence the need for truly individualized medicine where all possible etiological factors are recognized in a given case. Interestingly, I find more often than not–having worked in a large pain clinic, where this individual was referred to me–that diet is often not given its full due as a major factor in migraine.

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