The FDA has approved several medications, starting with Aimovig (erenumab), to prevent migraine headaches. Readers are also curious about other approaches to prevention. One reader asked about the data behind a migraine elimination diet, while another offered a testimonial on not eating nightshade vegetables to avoid migraines.
Could Nightshades Trigger Migraines?
Q. I started having migraines when I was twelve, almost 60 years ago. Most of the time over-the-counter medications like Excedrin Migraine worked to keep me functioning. But I had headaches at least two days each week and would end up having to go to bed in a dark room at least one day a month.
Since I don’t like taking prescription medications, I never tried any of the new migraine prevention medicines. I recently had allergy testing done and learned that I am sensitive to foods in the nightshade family. Consequently, I stopped eating all nightshade foods about three months ago. Since then I have had no more migraines! Is this typical for people with food allergies?
A. Your experience is far from typical. However, people who suffer migraines report a wide range of triggers (Headache, July 2020). A few of the most common culprits include alcohol (especially red wine), chocolate, cured meats, aged cheese and fermented foods.
We could find no scientific studies to support nightshade vegetable restriction for most people with migraines. Such foods include potatoes, tomatoes, eggplant and peppers, although a few more exotic foods like goji berries also belong to the family. Relatively few people are allergic to these popular foods. You will find more information about how to avoid migraines in our eGuide to Headaches & Migraines.
Is There a Diet to Avoid Migraines?
Another reader is also curious about using diet to prevent headaches.
Q. People with frequent migraines are often advised to follow an elimination diet. Is there any evidence regarding its effectiveness?
The Science Behind Migraine Elimination Diets:
A. A comprehensive review of diet and headache in the journal Headache (Oct. 2016) notes that this is a controversial topic. Unfortunately, the research on diet to avoid migraines is not as rigorous as one might wish.
What Foods May Set Off Headaches?
Some migraine sufferers find that they get headaches if they drink coffee, milk or alcoholic beverages like red wine. In addition, many people report migraines as a consequence of eating chocolate, citrus fruits, aged cheese, nuts or processed meats such as salami. Further, some people may react to MSG (monosodium glutamate), caffeine and artificial sweeteners such as aspartame. Canadian scientists found that between 10 and 64 percent of people suffering frequent migraines reported one or more of these foods as a trigger (Zaeem et al, Current Neurology and Neuroscience Reports, Nov. 2016). Sadly, researchers have conducted very few well-designed studies to confirm the benefits of elimination diets.
Earlier, Italian patients with recurrent migraines reported significantly fewer during the low-fat portion of a controlled trial (Ferrara et al, Nutrition, Metabolism, and Cardiovascular Diseases, April 2015). Illustrating the complexity of this topic, however, Italian researchers suggest that ketogenic diets can help people avoid migraines (Nutrients, July 5, 2021). Such diets are very high in fat and low in carbohydrate content. Consequently, they are the exact opposite of the low-fat diets previously endorsed.
Will You Try a Diet to Avoid Migraines?
Consequently, both physicians and patients would welcome better research. People who suffer migraines may want to try a diet to see if eliminating specific foods helps them avoid migraines.
Are you interested in trying such a diet? Otolaryngologist David Kaylie, MD, FACS, shared one with us after a recent interview. He suggested that many episodes of dizziness are best explained as the onset of migraines. Following an elimination diet to avoid migraines may be one of the best ways such patients can prevent vertigo.
If you have frequent migraines, you may also wish to listen to our interview with Dr. Jennifer Kriegler of the Cleveland Clinic. It is Show 1055: What Are the Best Treatments for Headaches?