Stress headaches. Sinus headaches. Tension headaches. Migraines. We’ve all heard the terms before, but what’s the difference? In short… nothing. All of these common ailments are really the same thing… migraines. That is to say they are all caused by what’s known as the migraine mechanism. The difference is in their symptoms.

In the migraine mechanism, blood vessels in the brain become inflamed and dilated, causing decreased blood pressure to the brain. This can cause myriad symptoms, ranging from your stereotypical throbbing migraine to visual artifacts or something as innocuous as “cloudy” thinking. It’s all migraine.

The causes of migraine are many… far too many for a simple article such as this. There exist what are known as migraine “triggers.” These are substances, foods, or even actions which increase the likelihood of having a migraine. Each of us has our own trigger threshold and we all respond differently to our own unique triggers. As long as the aggregate of our trigger exposures remains below our threshold, we have no migraines. Once our trigger load goes above threshold…. bam! Migraine. Some triggers have an immediate effect, others can take days or even a week to have their effect. While we may all have our own unique migraine triggers, some are more common than others.

Among the most common triggers, and those over which we have the most control, are the dietary triggers. There are hundreds of potential dietary triggers, but among the most potent are caffeine, alcohol and monosodium glutamate. Any alcoholic beverage is a potential trigger, but red wines are the most notorious, as they contain high levels of sulfites, a notorious migraine trigger.

Caffeine is perhaps the most potent of the migraine triggers and one of the most commonly consumed. The irony here is that caffeine is a staple ingredient in over-the-counter migraine / headache remedies. The caffeine causes constriction of those dilated blood vessels in the brain, affording temporary relief. Unfortunately, caffeine, in addition to being a migraine trigger, is a rebound drug… that is to say while it make relieve the headache you have NOW, it makes you more likely to have a WORSE headache LATER. It’s a vicious cycle.

Monosodium glutamate, or MSG, is a common food additive. It’s an effective flavor enhancer and is thought it some culinary circles to be the sole way of achieving what’s known as “umami”.

There are five cardinal flavors: sweet, salty, sour, bitter and umami, or savory. MSG is also thought to be the most potent dietary migraine trigger of all. It’s also a known carcinogen among other things. Restaurants and food manufactures must clearly state if they add MSG to your food. So if you receive no such warning, your safe, right? Not so fast. They have to advise you if they’ve added MSG… they don’t have to tell you if MSG naturally occurs in whatever they’re serving you. Soy sauce contains MSG, as does any other fermented soy product. In fact, the entire family of so called glutamates are migraine triggers. MSG also is a naturally biproduct in hydrolyzed proteins, a common food additive. It’s harder to avoid than you may think.

So what do we do about it? Well, it’s a process… a highly effective, if not lengthy, process. It involves elimination of triggers with their gradual reintroduction so as to be able to identify your own most potent triggers, then eliminating those permanently. Also involved is raising your trigger threshold, making migraines harder to get. The techniques behind all of that are beyond the scope of this article, but can be found in an awesome book called Heal Your Headache, by Dr. David Bucholz. I can’t recommend it enough. Happy reading.

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