Migraine headaches have been around for thousands of years and have been described in the ancient medical texts.
If you or someone you love suffers from migraine, you know the symptoms: blinding pain, so severe it causes nausea, sometimes associated with jagged vision, flashing lights, numbness or tingling, lasting for hours.
Although a group of drugs called triptans can be effective at relieving migraine, preventing these headaches is a major challenge.
So I am writing to share my knowledge and bring to light research, references, links and resources to help people learn more about this topic.
Many factors may act as migraine triggers, including stress, odors, temperature and hormonal changes, but the single migraine trigger over which you have the greatest control is food.
Migraine Headaches and Diet
Over the past 150 years, numerous researchers have reported a link between migraine and the food we eat. Some scientists attributed this link to allergy, others to a chemical effect of food on the brain.
Migraine diets have been developed but are of limited value for most people. They're based on the idea that certain foods, like nuts, cheese and chocolate, contain chemicals that produce changes in blood flow, which trigger the onset of headache.
The problem with the chemical induction theory of migraine is that it's never been proven to really occur.
Red Wine Headache
The only headache that's been proven to be chemically triggered is red wine headache, which is quite distinct from common migraine.
When studied in double-blind placebo control trials, Tyramine, found in aged cheeses and the principal food chemical believed to trigger migraine, was incapable of causing migraine headache. [1, 2]
Food Allergies Provoke Migraine Headaches
In contrast, numerous studies have shown that the immune system is involved in migraine. Italian researchers found that people with food-induced migraine develop complexes in their blood in which food proteins clump together with antibodies directed against these proteins; these are called circulating immune complexes. 
Their appearance is associated with an intricate set of immune responses, which indicate that some type of allergic reaction is taking place. [4, 5]
The significance of understanding that food allergy provokes migraine is the recognition that everyone's "migraine diet" will be different, depending upon which foods they're allergic to.
Many researchers have shown that an allergy blocker called sodium cromoglycate, taken orally before food, can block the induction of food-induced migraine [6, 7, 8, 9,10] and appears to work by preventing the formation of food-containing circulating immune complexes. This type of allergic reaction cannot be detected by conventional allergy testing, which is based on the presence of a type of antibody called IgE.  IgE antibodies are important for conditions like hay fever, but do not appear to play any role in migraine.
Double-Blind Placebo-Controlled Study
A recent double-blind placebo-controlled study demonstrated that dietary changes based on the presence of a different type of antibody to food protein, IgG antibody, is an effective strategy for reducing the frequency of migraine attacks.  IgG antibodies are the main type of antibodies found in circulating immune complexes. In this study, patients with frequent migraine headaches (at least 4 per month), had their blood screened for IgG antibodies to 266 foods. For each individual, foods to which they had high levels of IgG antibodies were identified. They were then given diets prepared with or without these foods, in such a way that neither they nor the scientists studying them knew which foods they were eating. When people consumed the diet that eliminated the high IgG foods, the frequency of migraine headaches was significantly reduced. The migraines were not completely eliminated, however, and their severity was not reduced. The headaches that occurred were the usual migraines the patient habitually experienced.
Food Allergy Testing
IgG food allergy testing is commercially available through many different laboratories in the U.S. It is not a perfect test, but it can help people with migraine headaches and their doctors create an individualized diet that will reduce migraine frequency.
If IgG food testing is not available to you or does not help you to design an effective migraine diet, you can identify food triggers for migraines by using a technique called "elimination and challenge."
You can find the details of this technique and studies showing its effectiveness, especially for migraine with onset in childhood, in an article I wrote with Dr. L. M. McEwen, "A Role for Food Intolerance in Childhood Migraine."
Dietary Supplements and Migraine Headaches
In addition to diet, there are several nutritional supplements that have been shown to decrease the frequency of migraine headaches in controlled clinical trials.
Supplements That Can Help Migraines
(The amounts given are approximate based upon the research, of course the amount each person should take varies according to the individual.)
- Magnesium, generally about 300 milligrams per day
- Coenzyme Q10, generally about 300 milligrams per day
- Alpha-lipoic acid, generally about 600 milligrams per day
- Riboflavin (vitamin B2), generally about 400 milligrams per day
- Feverfew (Tanacetum parthenium), dose will vary with preparation
For more on the benefits of the mineral Magnesium, see my article
"Holiday Stress and Magnesium Deficiency Symptoms"
And to get more information on the herb feverfew, read my article "Feverfew -- Know What Herbs Do What"
More information about the research that's been done with these supplements, including references, can be found, without charge, at the health application I created called Pill Advised, by logging in and looking for beneficial interactions between supplements and drugs for migraine. To locate the references, after login, enter the name of a migraine drug or enter "sumatriptan," which was the first migraine-specific drug. You can also use the application to learn more about drugs, supplements and over the counter medications you may want to know about.
If the video doesn't play, click here to watch on YouTube
Now I'd like to hear from you ...
Do you experience migraines or headaches?
Have you taken anything for it, and what helps?
Please let me know your thoughts by posting a comment below.
Leo Galland, M.D.
Important: Share the Health with your friends and family by forwarding this article to them, and sharing on Facebook.
Leo Galland, M.D. is a board-certified internist, author and internationally recognized leader in integrated medicine. Dr. Galland is the founder of Pill Advised, a web application for learning about medications, supplements and food. Sign up for FREE to discover how your medications and vitamins interact. Watch his videos on YouTube and join the Pill Advised Facebook page.
1. Forsyth WI, Redmond A. "Two controlled trials of tyramine in children with migraine." Dev Med Child Neurol 1974; 16: 794-799
2. Moffatt A. M., Swash M, Scott D. F. "Effect of tyramine in migraine; a double-blind study." J Neurol Neurosurg Psychiatr 1972; 35: 496-499.
3. Marteletti P, Sutherland J, Anastasi E et al. Evidence for immune-mediated mechanism in food-induced migraine from a study of activated T-cells, IgG4 subclass, anti-IgG antibodies and circulating immune complexes." Headache 1989; 29: 664-670
4. Marteletti P. T cells expressing IL-2 receptor in migraine. Acta Neurol (Napoli) 1991; 13: 448-456
5. Marteletti P, Stirparo G, Rinaldi C et al. "Disruption of the immunopeptidergic network in dietary migraine." Headache 1993; 33: 524-527
6. Marteletti P, Bussone G, Centoze V et al. "Prophylaxis of food-induced migraine with cromolyn sodium: efficacy of short- and long-term use." Cephalalgia 1989 (suppl 10): 441-442
7. Mansfield L.E., Vaughan T.R., Waller S.F. et al. "Food allergy and adult migraine: double blind and mediator conformation of an allergic etiology." Ann Allergy 1985; 55: 126-129
8. Monro J,BrostoffJ,Carini C. et al. "Food allergy in migraine." Lancet 1980; 2: 1-4
9. Monro J, Carini C, Brostoff J. "Migraine is a food allergic disease."Lancet 1984; 2: 719-721
10. Paganelli R, Levinsky R.J., Brostoff J. et al. Immune complexes containing food proteins in normal and atopic subjects after oral challenge and effect of sodium cromoglycate on antigen absorption. Lancet 1979; 1: 1270-1272
11. Doering P. "Drug therapy of food allergies." In: Perkins J. E. (ed) Food Allergies and Adverse Food Reactions. Aspen Publishers, Gaithersburg, Maryland. 1990. pp 69-79
12. Alpay K, Ertas M, Orhan EK, et al. "Diet restriction in migraine, based on IgG against foods: a clinical double-blind, randomised, cross-over trial." Cephalalgia. 2010;30:829-37.
This information is provided for general educational purposes only and is not intended to constitute (i) medical advice or counseling, (ii) the practice of medicine or the provision of health care diagnosis or treatment, (iii) or the creation of a physician--patient relationship. If you have or suspect that you have a medical problem, contact your doctor promptly.
Follow Leo Galland, M.D. on Twitter: www.twitter.com/Pilladvised/