Dietary Triggers: Where to Begin?
When I was first diagnosed with vestibular migraine, my doctor handed me a 1/4 page piece of paper with a list of about 80 foods that I needed to avoid as part of my treatment plan. The list was in alphabetical order, and contained everything from well-known migraine triggers like alcohol and caffeine to seemingly random foods like croutons and raisins. I felt completely stressed and overwhelmed. How could I possibly avoid all of these foods, and why did I have to? I began to feel like despite my best intentions, migraine triggers were hiding in everything I ate. Mealtimes became the most stressful parts of my day, and I was afraid to eat almost anything.
If I can understand why the trigger avoidance diet works, I can follow it. So, I started to search online and throughout the migraine literature about dietary triggers and how they interacted with the brain. I wanted to find patterns in the list of potential migraine triggers and understand why foods like croutons and raisins could make me dizzy. It soon became apparent that there are a handful of chemicals that can trigger migraines in certain people: caffeine, alcohol, tyramine, MSG, Aspartame, preservatives, dyes, etc. And, the list of ~80 foods that my doctor had given me can be categorized beneath each of these chemical triggers. For example, foods containing tyramine include: anything over-ripe/old/aged/smoked/pickled/fermented, raisins, cheese, wine, beer, broad beans, sauerkraut, sausage, yeast extract, and more.
I used to eat raisins most days in my trail mixes, in my cereal, or with a bowl of oatmeal. I considered them harmless; I never noticed any ill effects after consuming them and I find them delicious! But as I started the process of removing major triggers from my diet– alcohol, chocolate, caffeine, bananas, cheeses, preservatives, dyes, etc.– I began to notice that I would feel ok before a meal, and dizzier afterwards. I diligently kept track of the foods I was eating in relation to my symptoms through my migraine journal. There was one particular day in which I woke up feeling better than normal, ate oatmeal with raisins for breakfast, and suddenly felt dizzier and out-of-sorts by lunchtime. A few weeks later, I had mozzarella cheese with dinner and woke up the next morning with the nystagmus and the room spinning. A light went off in my brain– I’m tyramine sensitive! Both raisins and cheeses fall under the tyramine category. Without having to continue the process of trial and error, I could simply assume that I should avoid high-tyramine foods. As I realized that these 80 foods could be sorted into a list of more manageable categories, I slowly learned how to modify my diet for my sensitivities.
Dietary Triggers and the Brain: A Series
This experience of discovering food sensitivities by understanding which chemical trigger I was responding to made me wonder– why does tyramine worsen my migraines? The same question can be asked for all of the other known chemical triggers: tyramine, caffeine, alcohol, MSG, Aspartame, preservatives, dyes, etc. In this upcoming My Migraine Blog series, I’ll be summarizing my findings regarding each of these chemicals and the way they interact with our bodies to cause migraines in certain people. Stay tuned for each of the following write-ups, which will appear here in green once they’re posted: