Updated July 2020.
This is one of the most common questions people ask me. In general, caffeine helps the average person with headaches and occasional migraine attacks. They may enjoy a rich cup of coffee each morning to get things going as well as an afternoon pick-me-up. And, some people love to relax after a nice dinner and sip an espresso, cappuccino or cup of decaf. They may notice that their occasional tension headache or even migraine attack vanishes after enjoying a strong cup of coffee. Caffeine and migraine is often a hotly debated topic.
How Caffeine Works
Caffeine acts to constrict blood vessels and speed everything up. It is thought that the pain is relieved because of those 2 actions. Also, caffeine possibly helps by blunting the effect of a naturally occurring substance in the brain, adenosine, which is present in higher amounts during a migraine attack.
Caffeine speeds or enhances the effect of other medications taken with it. This is why one of the most popular over-the-counter medications uses a combination of aspirin and acetaminophen with caffeine to relieve the person suffering from a headache or migraine attack.
How Caffeine Affects A Person With Migraine
But, those of us with frequent migraine and chronic migraine don’t fit the description of ‘the average person.’ For reasons related to genetics, we’re hyper-responsive to things in our environment. For some, who may be caffeine-sensitive, foods/drinks with caffeine cause overall irritation and possibly trigger migraine attacks and/or inflammation. For others, they may find caffeine helpful. And, there is a third group of people who are helped by caffeine to a certain point and then, when that level is exceeded, a migraine results. Which type are you?
What Should You Do
So, what to do? If headaches and migraine attacks are infrequent and you are a regular coffee drinker, carry on. Just take notice if you get more pain when you drink more caffeinated coffee.
If you have frequent attacks or chronic migraine, you may have ‘rebound headache’ from the caffeine. Yes, the caffeine that used to help your pain may have turned on you. Caffeine is like other medications like triptans and NSAIDs. They are helpful with infrequent use. Gradually reducing your daily intake and avoiding caffeine may help lessen the number of attacks.
Reducing your caffeine must be done slowly to avoid triggering a migraine attack as your head is used to having the caffeine. Plan to wean yourself from it over the course of a week or 2.
Then, you will have a very nice upside – an additional, natural and readily available abortive therapy to use when you have your next migraine attack. Experts suggest not using coffee/caffeine to relieve headache more than twice per week.
There Are Options
If you are interested in reducing your caffeine intake gradually, or you just love coffee, there are decaf coffees that are considered migraine friendly. Swiss Water Processed (SWP) coffees are decaffeinated with only water so they don’t have a residue of chemicals that have been said to exacerbate migraine. You can also find coffees that are decaffeinated with the CO2 method which leaves no chemical residue. Either of these methods guarantee the coffee to be 99.9% caffeine free. Check out our favorite SWP and CO2 coffee recommendations on our Favorite Products page.
For additional information, check out this article on Caffeine and Migraine by American Migraine Foundation.
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