** This article is written for information purposes only. It is not medical advice or a substitute for medical advice. Consult your doctor for any changes to your migraine care plan.**
What is a migraine diet?
While there is no one migraine diet, most dietitians, doctors and other health professionals in the know are talking about a low tyramine diet that is also low histamine, MSG (monosodium glutamate) and sulfites.
Many years ago, when we started our very popular and peppy private Facebook group, the title of group specifically referred to the Heal Your Headache (HYH) diet by name. We have since changed the name to Migraine Strong, but diet continues to be a significant part of the focus for people helping themselves get migraine attacks under control, as well as lessen the intensity and duration of vestibular migraine (VM) flares.
In general, diet is very popular topic as it is often a game-changer for many of us in the cranky neuron club. The Heal Your Headache diet is a type of low tyramine diet very popular in the migraine community and used synonymously with migraine diet. I will be using these terms interchangeably.
Diet has been one of my most useful tools in helping me get my life back. It cut the frequency and intensity of my attacks. It helped fade my ever-present head pain, altered vision and other symptoms.
How does the HYH diet work to help our heads?
The Bucket Theory
This migraine diet works by minimizing your most controllable trigger. We cannot control the weather or most external stress, but we can avoid foods that we know trigger us. That is the main goal of the migraine diet – minimizing triggering foods so they can then be identified.
When you eat only foods commonly considered head-friendly, you are lessening your trigger load. The simple concept of The Bucket Theory is important. When you lower your trigger load and increase your migraine threshold you reduce the severity, frequency and intensity of attacks.
Additionally, you are better able to tolerate potential triggers outside of your control like a weather front, hormonal changes or being stuck in a car with someone wearing perfume.
Some naturally-occurring food components and food additives are the culprits in the common food triggers.
A migraine diet not only avoids foods high in tyramine, but also foods high in glutamate. So, the Heal Your Headache diet is low in tyramine, histamine and other biogenic amines as well as low in glutamate and some food additives like sulfite.
Tyramine and Other Biogenic Amines like Histamine
Tyramine, histamine and highly processed foods are well documented migraine triggers and eliminating them helps many improve symptoms in many people.
Tyramine is an amino acid that is present in many common foods. In our body, it is a neuromodulator and part of “the biochemical soup.” This soup is part of what determines whether or not our nervous system gets stirred-up or is quelled (neuromodulation).
Histamine and phenylethylamine are other biogenic amines often found in the same foods. They are also naturally-occurring. In general, the ripening process and the aging process increases their concentration. So, freshly roasted chicken may be low in biogenic amines but when it’s eaten 3 days later as a leftover, it is higher in biogenic amines.
While the migraine diet is a low tyramine diet, it also happens to be “lowish” in histamine. Histamine is a known problem for some of us with migraine brain.
Many processed foods contain countless forms of hidden monosodium glutamate. Glutamate, the G in MSG, is another amino acid (glutamic acid) found in foods. In our body, it is a neurotransmitter and plays many important roles. It’s the most prevalent of all the neurotransmitters in the brain and is considered excitatory. For those of you that read a lot of our articles, you know that our migraine brains over-respond to normal stimulation. In essence, our brains are too responsive to environmental stimulation. While glutamate and its stimulating qualities are vital for our neurochemistry, some believe that imbalances in glutamate contribute to the cascade of neural activity that results in a migraine attack.
Just a Little Bit of Food Science
It’s important that you know that MSG is both a man-made food additive and a naturally-occurring component of many delicious, flavorful foods. An example of a tasty food that does not have added MSG is soy sauce. The glutamate content develops during the process of fermenting the soybeans, wheat and salt. It’s an aged, fermented brew.
When you order from “no-MSG” Asian restaurants, if they are using traditional Asian sauces and fermented products, you will be eating natural glutamate. Your body does not recognize the difference between natural glutamate and added MSG.
There is a very long list of foods additives that are high in MSG or MSG-like ingredients that may trigger migraine attacks. When following a migraine diet, it’s good to be familiar with many names of MSG. Here is a nice graphic.
The Good News
When you follow the Heal Your Headache diet you are following a low tyramine diet, that is also low in glutamate. The lengthy list of allowed foods are low in both categories. In general, those who implement this game-changing migraine diet tend to eat foods that are wholesome and less processed.
It’s hard to know exactly what is at work when you follow the HYH diet. Is it because you minimize the biogenic amines (tyramine, histamine, etc.)? Is it because MSG is minimized? Or, is it some other food component like added sulfites or food coloring that are not being consumed because you are mainly eating fresh foods that are less processed? As a registered dietitian and one who loves science, I wish I knew. Since we are all unique, the answer may be different from person to person.
Dr. Buchholz’s Version of the Migraine Diet – The Heal Your Headache Diet
A well-known headache specialist from The Johns Hopkins University School of Medicine wrote a book including a migraine diet in 2003. The book is called Heal Your Headache The 1,2,3 Program for Taking Charge of Your Pain. You are highly encouraged to buy or borrow this must-read. Seriously. It’s a MUST-READ for all of us.
Diet is one piece, but he focuses on other imperatives for us to help get ourselves better, including rebound headaches. The way he explains the migraine process and what is needed to rein it in is fascinating.
4 Steps to Success with the HYH Diet
So many triggers are beyond our control – external stress, consistent sleep, lighting, scents, hormones and sounds. Food is the most controllable. Spending time trying to figure them out often pays off bigtime.
Following these steps will have you understand how to help make the migraine diet work for you.
Step 1 – Commit to it fully (but expect to make some mistakes).
There’s never a better time than now. Pick a date and stick to it. If you wait for the perfect time, you’ll never start.
Some people are dramatically better in a few weeks. Others need a few months. Dr. Buchholz suggests giving the diet 4 months. Why so long? He knows that it often takes a few weeks for people to understand the diet and get in the groove. Then, it takes a while for your system to respond by calming.
Step 2 – Gather your resources and support
When I started, all I had was a one-page printout of the migraine diet from University of California, Berkeley, the excellent migraine handout from Johns Hopkins Headache Center and a few printouts from internet sources about the tyramine content of some foods. Even as a registered dietitian and skilled cook, pulling it together was extremely frustrating.
I highly recommend joining our Facebook group if you aren’t already in it. The migraine diet will be so much easier to do when you can share resources and ask questions about certain products and ingredient labels. There is power in community support.
The Dizzy Cook– Another excellent resource that would have helped me have more tasty and interesting meals is The Dizzy Cook. While the Heal Your Headache book is a must-read, The Dizzy Cook Cookbook by Alicia Wolf is a perfect companion as it gives you countless recipes that are different from the ones on her website. You can follow the low tyramine diet and eat delicious, varied meals. No need to be bored!
Healthcentral published and excellent article called “Let’s Talk About Migraines” that is a wonderfully rich resources for migraine info. The way they describe what migraine is is especially interesting and unique. While food triggers are mentioned, the migraine diet is not. Read it to enhanced your understanding of migraine.
Step 3 – Focus on what you CAN eat
Below is a list of many foods that you can enjoy. It’s not an exhaustive list but it is enough to give you and idea of what you can eat. There’s enough here even for those who are picky. It is so important to understand that the migraine diet is temporary. Once your symptoms are in much better control, some of your favorite foods are added back. More on this later.
Dr. Buchholz gave this wonderful interview shortly after his book was released. I highly recommend reading through his answers about the diet as it will explain a lot of nuances. Dr. B acknowledges that the his list is not going to capture 100% of the triggers out there. But he believes that his diet covers about 90% of the common food triggers.
During the interview, Dr. Buchholz said, “My approach is that you’ve got to draw the line somewhere or the list just becomes so lengthy and unwieldy that no one is ever going to begin to address it. So I normally don’t steer people away from all those items, but I would advise anyone who observes from their personal experience that something like, let’s say, strawberries seems to be a trigger for them. Well, if you’re a headache sufferer I would stay away from them.”
Step 4 – Understand the Common Triggers (you might be surprised!)
This section follows the lists of foods you can eat as the list of common triggers for the migraine diet is intimidating. Some people get discouraged before they start. It’s very important to understand where the common food triggers are.
Let’s go through the food categories where we find these substances in higher amounts. I will use the same categories as in Dr. Buchholz’s book as he groups them nicely.
Monosodium Glutamate (MSG) – Avoid Asian-style restaurants and most other restaurants that use a lot of sauces; Commercial and homemade soups using bouillon and “soup starters” that add flavor; The seasoning called Accent and other seasoned salt; Barbecue and other flavored chips and snacks, seasoned corn chips like Doritos; yellow rice and other flavored rice dishes; croutons and bread crumbs; commercial and homemade gravies made with bouillon or flavor enhancers like Gravy Master; frozen entrée; veggie burgers; protein concentrates, texturized proteins, processed and canned foods with flavorings; Low-fat and low-calorie processed foods; commercial salad dressings.
Many foods with glutamate are also high in tyramine, histamine and other potentially triggering food additives.
Check labels and be wary of labels that say “natural flavoring.” A good general rule to avoid MSG is to include mostly natural whole foods in your diet. These foods do not contain this flavor enhancer. Use herbs and spices in your cooking for flavor.
Processed Meats and Fish – Avoid aged, canned, cured, fermented, marinated, smoked, tenderized or preserved with nitrites or nitrates. Hot dogs, sausage, salami, pepperoni, bologna (and other lunch meats with nitrites), liverwurst, beef jerky, bacon, pates, smoked or pickled fish, caviar and anchovies. Avoid beef and chicken liver which are high in tyramine.
Many processed meats are high in tyramine, nitrites, nitrates and MSG not only because of additive but because they are not fresh. They often sit in the factory, transit and in the deli case for a long time before you serve them on a plate. Choose fresh meats, poultry and seafood. Be aware even fresh poultry especially turkey can be injected with artificial flavorings so read labels.
Cheese and Other Dairy Products – Aging increases tyramine, histamine and glutamate. The older the cheese is, the worse. Beware of cheese containing foods including pizza and cheese breads. Avoid yogurt, sour cream and buttermilk
Fresh or unaged cheeses like cottage cheese, ricotta, cream cheese and good quality American cheese, mozzarella and goat cheese are allowed.
Nuts- All nuts and nut butters are to be avoided as they are high in tyramine. Peanuts are legumes, not nuts, but should also be avoided.
Pumpkin seeds, sunflower seeds and sesame seeds are widely available and allowed.
Alcohol and Vinegar – Avoid red wine, champagne, beer and dark heavy drinks. Vodka seems to be best tolerated of all alcohols, but avoiding alcohol is best. Avoid vinegar except for clear, distilled vinegar.
Don’t overdo condiments (ketchup, mustard, mayonnaise) made with vinegar. Homemade salad dressings are best tolerated.
Certain Fruits and Juices – Avocados; citrus fruits (oranges, grapefruits, lemons, limes, tangerines, clementines), pineapple and their juices; Avoid bananas and dried fruits such as raisins (contain tyramine and sulfites). Avoid raspberries, red plums, papayas, passion fruit, figs and dates.
Avoid over-ripened and damaged fruits (high in tyramine and histamine). All other fresh and frozen fruits are allowed (apples, apricots, blackberries, blueberries, cantaloupe, cherries, cranberries, grapes, melon, mangoes, nectarines, peaches, pears, strawberries and watermelon).
Certain Vegetables, Especially Onions – Onions, sauerkraut, pea pods (snow peas, sugar snap peas) and certain beans (broad Italian, lima, fava, navy and lentils). Allowed: All other vegetables and beans including leeks, scallions, shallots, spring onions and garlic.
Onions, especially raw and less-cooked can be powerful triggers. The dried and minced seasoning is often tolerated as well as deeply caramelized onions in small amounts.
Fresh Yeast-risen baked products – Less than one day old homemade or commercial breads. Especially sourdough, bagels, doughnuts, pizza dough, soft pretzels, some coffee cakes made with yeast. Fresh yeast is high in tyramine and glutamate.
Baked goods made with yeast are an exception to the “fresher is better” rule. Packaged commercial breads are less likely to trigger headaches.
Sugar subsitutes- Aspartame. In general, sugar substitutes are triggers for many people. The more natural ones like stevia and others may be better choices.
“Others” – Soy products, especially if cultured (miso), fermented (tempeh) or otherwise highly processed (e.g., soy protein islolate/concentrate). Avoid soy sauce (MSG). Possibly tomatoes (and tomato-based sauces), mushrooms… whatever gives you a headache. can also be a trigger.
Soy oil and soy lecithin are safe. Vegetable oils are allowed.
Unprocessed soy like edamame is allowed.
Chocolate – Avoid all forms of milk and dark chocolate. White chocolate is ok. Chocolate is high in tyramine, histamine and other potential triggers like theobromine & phenylethylamine.
Caffeine – Avoid coffees, colas and teas with caffeine. Herbal teas are allowed.
Discussions about caffeine and migraine are typically lively. Some insist it’s a helpful and others insist it’s harmful, so who is right? Both. It’s harmful to those who are sensitive to the substance. The migraine diet specifically eliminates caffeine. You can learn about why caffeine should be avoided (temporarily) in this article.
Tips to make this a whole lot easier:
- Cook extra chicken, beef or pork and package them in individual containers and freeze them. This will keep them fresher and handy for future meals.
- Make large batches of freezable meals like soups and stews and package them in individual sizes.
- In the beginning, find some head-friendly foods that you really enjoy and make sure you have plenty on-hand so you don’t get tempted. Understand that the first few weeks may be a little repetitive until you get the hang of things.
- Prep allowed veggies and fruits all at once. You are much more likely to have what’s on your list instead of grabbing a no-no like yogurt if the food is already washed and trimmed.
- Commercial breads that are 100% HYH-friendly are often hard to find. Preferably, look for breads that are not made with malted barley flour Take the pressure off and buy the best one you can.
- Find a few pre-packaged items for “grab and go” so you have food when you are away from home longer than planned and food options are very limited. My personal favorite was Nature Valley Granola Bars, Oats N Honey. Some people choose potato chips as there are many brands that are made simply of potatoes, oil and salt.
How and When to Add Foods Back
Fast-forward – You are following the diet and have had substantial improvement. And, you are pretty sure you have achieved your “baseline.” Kudos to you for all the work you have done. It’s now time to start challenging some foods to see if they are head-friendly for you or they are triggers.
Eileen Zollinger wrote an excellent article about adding foods back at the end of the migraine diet’s run. In short, you pick one food to challenge and eat it every day for at least 5 days in a row. You do not add other new foods during this time. Pay attention to your response (or lack there of). It’s necessary to eat the new food for several days to see if quantity is troublesome or if it’s a problem mixed with other small triggers like weather or fragrance exposure.
The Migraine Diet is Temporary
It’s not forever. This way of eating works by removing the common culprits and seeing if your body responds. From personal and professional experience, most people find relief. Some get a little better and some get substantially better.
I’m a firm believer that we should all “eat the rainbow” and enjoy nature’s bounty. Varied diets are important for our overall health. Do not be intimidated by the diet. Seek guidance and support. Do not get stuck on the diet either. If you get wonderful relief, figure out how to enjoy some of your favorites again.
If you do not find significant relief, there are still options for you from a diet and lifestyle approach. It’s also important to know that diet is just one piece of the Treatment Pie. Migraine is complex. It’s a high-maintenance condition for those with high-frequency episodic attacks, vestibular migraine and chronic migraine.
Education, hope and support are key.
31 thoughts on “Heal Your Headache Diet: The Migraine Diet Beginner’s Guide This Dietitian Wishes You Knew”
Thank you for this wonderful article. It has inspired me to reread my HYH book and start again to conquer my migraines!
We are wishing you luck! Make sure to join our Facebook group for support with the diet and beyond. – Migraine Strong Team!
The Dizzy Cook is amazing! She makes it so easy to follow the migraine diet.
I am wondering if Rosemary Extract, usually used in the more ‘natural’ sausages and ground turkey, is ok?
Yes that should be fine.
So is the HYH diet or keto better for migraine?
Hi Traci. The answer to this depends on the person. Some people will get more relief from one diet compared to another. And, some will find one diet fits their lifestyle and food preferences more than another. I think it makes sense to start with the HYH diet to identify food triggers. Hopefully, the person with migraine can identify a handful of foods that trigger attacks and they can avoid those foods and add a lot of foods back into their diet. If the person has a lot of triggers and/or HYH didn’t being them much relief, I think keto or low-carb may be a good next approach. Personally, I did HYH first and found success but my diet was very restricted. So, I tried keto and loved it and found it was also helpful for my head. I preferred keto. – Danielle
What do you know/think about lemon essential oil used instead of lemon juice?
Hi Brenda. Good question. I really don’t know for sure if the botanical oil would be better tolerated than the juice as I haven’t seen that specific item detailed on any listed that came from lab testing. I would avoid it during the elimination phase. It’s hard to find a replacement for lemon as it’s flavor is so unique. For me and many others it has been worth it. – Danielle
Thank you for the very helpful article! I am using the HYH diet to try to help my 8 year old son who has been suffering from abdominal migraines for years. Like your bio, I tried all sorts of gut healing whole food diets in the past that never seemed to make a difference. Thankfully the HYH diet does seem to help him. He is taking cyproheptadine for his migraines, an antihistamine, and it does seem to help him. Based on that, I have been wondering if I should try eliminating more histamine sources than the basic HYH diet recommends. Do you think that would be beneficial? Do you have a list of foods that are high in histamine that you could easily share? Thank you very much! -Elizabeth
Hi Elizabeth. Thank you for your kind words. I’m glad your son is doing better. I like the list here: https://www.mastzellaktivierung.info/downloads/foodlist/21_FoodList_EN_alphabetic_withCateg.pdf
You might find green light therapy interesting as it’s not another medication. We have 3 articles about it and have another coming out soon. It’s good for reducing pain, not just helping with light sensitivity. https://www.migrainestrong.com/allay-lamp-green-light-therapy-for-vestibular-migraine/ I hope he continues to get better 🙂 – Danielle
Thank you for this article! Currently reading Heal Your Headache. 🙏🏽💕
Awesome! I hope it helps you!
Thank you! Very helpful and I need to start following the protocol. I notice pre migraine symptoms will start ( tired/yawning, irritable) I then i become stuffy/nasally on my left side and then a temporal migraine occurs. Pain usually lasts 2-4 days and imitrex takes edge off most times. I also have more food cravings at that time 😥 Safe to assume food triggers are the the culprit?
It’s hard to know if you have food triggers. The cravings could be just part of migraine. The best way to know if you have food triggers is to do the an elimination diet. The HYH diet is a good one to try and has helped many people. Just a comment about your treatment, if the Imitrex is just taking the edge off and the attack is lasting that long, I would ask your doctor what else you can do so you don’t lose so much time and vitality to migraine. There might be an adjustment in dose, timing or type of medication that may help. Good luck to you.
This article is very informative. Thank you. I’ve been trying to join the Facebook group for a couple of weeks now and my request is still pending. Is this still an active group?
Hi Kellee. It is a very active FB group. Sorry for the delay. I just approved your request.
Thanks for the article. Is nutritional yeast ok to eat on this diet?
Hi. Thank you for writing. Unfortunately, nutritional yeast is to be avoided during the elimination phase.
And how about coconut milk?
Technically, Dr. Buchholz discourages coconut. From experience, I’ve seen a lot of mixed results, so I would avoid it during the elimination phase.
Thank you for such an informative article. I am wondering if cooking reduces the triggering nature of any of these foods? For example, can I bake with yogurt and ripe bananas s as bc have them be less triggering?
Also, do you practice telehealth? If so how does one set up a consult?
Hi Nancy and thank you for writing. SOME foods are tolerated better after cooking. We notice this with onions often. As far as yogurt and bananas, it’s possible but I’m wondering if it’s because of the “dose.” When you eat a banana or yogurt, it’s possible that the amount is significantly more than the yogurt and banana in what you are cooking. Yes, we provide telehealth. If you are considering working with us, feel free to send us an email at Migraine [email protected].
Would this diet be beneficial too for thise who suffer with hormonal migraines? I dont get them at any other time than hormonal shifts (documented for 3 years, it is most definitely hormones, happens at the sames every month).
It might, but if you have true menstrual migraine and your attacks are never not associated with your period, I’d just implement the restrictions the week prior to the expected start of menstruation. You could also look into trying Vitamin E if you haven’t already.
I found this article very interesting. I also found it interesting that hot dogs and bologna was on the list of things not to eat. Way before I even started getting migraines when I was much younger maybe a teenager I believe I noticed that they both would give me a headache so I just avoided them. I also noticed (before I started getting migraines) that orange juice would also give me a headache. When I first started to get migraines I did notice citrus things would trigger a migraine so Ive been avoiding all those for while. But my question is. Is there a good site or place to find more about the MYM. Or should I just read labels and the book. I was trying to look online for some more information because I can’t get the book right now, but couldn’t find anything very helpful. Thank you for this article I look forward to reading more.
Hello, I’ve found this very interesting and have a question. Have you seen Angela Stanton’s migraine approach which involves eating only meat and removing all grains and sugar as she believes migraine is caused by electrolyte imbalance (sodium and potassium out of sync) and the root cause is carbohydrates? I personally love food and take great pleasure from it, so the Heal Your Headache diet is far more realistic for me and better for my mental health too. But I wondered what you thought and if it had been analyzed at all. Thank you.
It’s good to know of different options that are migraine-oriented. HYH is just one approach. I’m also a fan of the salty low-carb or salty keto for some people too. I’m familiar with the overall Stanton approach as it’s low carb with a focus on real foods. That I agree with. I disagree with some of her thoughts on migraine’s root cause though. Good luck to you and thank you for commenting.
Thank you for this! I loved the book so much, I bought two copies and wound up loaning both copies out to friends. Now I’ve lost my favorite salad dressing recipe after all these years. I just can’t remember it. I know it had olive oil and honey mustard and a type of vinegar but maybe not?
I’m not opposed to doing this but I don’t know how to cook almost at all. I find most recipe books confusing because it assumes I know the basics of cooking in the first place. To go from occasionally trying to make something and failing to every meal needs to be made by me from scratch and that’s all I can eat basically is a tall ask. Are there any tips when that’s your starting line?
Hi. Thank you for writing. Without knowing your prep and cooking skills, it’s hard to know what tips will help. In general, if someone doesn’t like to cook or has limited skills, I suggest keeping meals very simple and based on simple, whole food ingredients. For example- steamed or microwaved broccoli with butter, salt and pepper. A baked or microwaved potato with butter, salt, pepper and herbs. Plus something grilled like chicken, a burger or steak. Some grocery stores have a nice section with foods that are freshly prepared. Buying their baked chicken and roasted veggies may be a good option. It could be that the HYH diet is not a good approach. Perhaps making a change to more simple, whole foods and avoiding highly processed foods would be helpful. I hope you start feeling better very soon. – Danielle