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Medically reviewed by Danielle Aberman, RD
The question, does MSG cause headaches? is a controversial one. Some of you reading this right now may be thinking, “What? How can that be? MSG migraine can take me down hard.” Others may be more ambivalent as they have not seen this food substance as a consistent trigger. My goal is to help you understand what MSG is and explain the contradictory messages on the internet and in doctors offices. This will help you make informed decisions about whether or not you have MSG headache.
What is MSG?
MSG, monosodium glutamate, is a food additive that is quite delicious when added to savory foods. In the US it is typically made from processing and fermenting corn. Chemically, it is a sodium molecule attached to a glutamate molecule that dazzles our taste buds by enhancing savory flavors. Because it tastes so darn good and is very cheap to make, food manufacturers love it.
You can buy a container of MSG in the grocery store. It looks like salt or sugar and is found in the spice aisle. A popular brand is Accent and it’s marketed as a flavor enhancer for meats.
MSG, when added to savory foods “wakes up the flavor” as one brand claims. It gives foods a richer, “umami” taste that many describe as meaty and deep without tasting artificial.
When MSG lands on our tongue the digestive process starts, the sodium molecule is knocked off and it becomes free glutamate. Our bodies recognize the added glutamate as the same glutamate that is naturally-occurring in other nutritious and delicious foods.
Tastes great and allows for lower sodium content in processed foods
Table salt also tends to “wake up flavor” but many people don’t wish to add a great deal of extra sodium to their diet. MSG has a lower sodium content than table salt. Food manufacturers know this, of course. They can add MSG in its various forms, inexpensively enhance the flavor, improve the texture and body of the food without skyrocketing the sodium content that must be listed on the label. Some examples of this include– Doritos and most brands of ranch dressing & barbecue potato chips.
A little about glutamate in our body
Glutamate is an amino acid that plays a vital role in our body. Of all the neurotransmitters (chemical messengers between nerve cells) we have in our body, glutamate is the most plentiful. And, it likely plays an important role in migraine as it’s considered an excitatory neurotransmitter. As you may have already learned, people with migraine tend to have an overly-responsive or especially excitable nervous system. It is thought that our migraine brain reacts too strongly and negatively to ordinary, benign stimulation compared to a person not prone to migraine attacks.
Foods high in glutamate
It is estimated that we eat about 10-20 grams of glutamate each day. There is nothing unhealthy about glutamate.
Glutamate (or glutamic acid) is found in all foods with protein including some foods that are not considered good protein sources like tomatoes and mushrooms. In general, the foods highest in glutamate go through some form of processing and are pulverized and/or liquified. The processes “naturally” bring out the flavor as it brings out the free glutamate and concentrates it. For example, soy protein is high in glutamate and when it’s pulverized and/or fermented and/or concentrated and/or made into a powder, the glutamate content significantly increases. So, soy sauce is naturally high in glutamate. Protein powders and protein bars that are made with soy protein isolate or hydrolyzed vegetable proteins are also high in glutamate although the source may be from different vegetable or grain sources. Dairy protein sources like powered dairy and whey are also “naturally” high in glutamate.
While I like to be correct in my use terms, from this point on, I will be referring to glutamate as MSG as it’s an MSG-like food component and easier on the tongue (pardon the pun). Also, I will be using headache and migraine interchangeably even though migraine is more than a headache and some people with migraine do not have headache. Many people get headaches that are distinct from migraine.
Chinese restaurant syndrome and MSG headache
Decades ago, the reported reaction to MSG foods was called “Chinese restaurant syndrome” as popular Asian sauces are high in the MSG-like substance, glutamate. It was also prevalent in other foods and cuisines, but Chinese food got the most negative attention. This interview about how much of the controversy started is fascinating and may help you keep this query into MSG sensitivity in perspective.
I don’t have comparative data, but I think there is probably more MSG and other forms of glutamate added to our food supply now given how popular processed and convenient foods are these days. This includes many foods that are considered healthy like protein powders and meat substitutes.
There is an important fact that deserves emphasis here. Most quality Asian restaurants do not season with a shaker of MSG. This assumption is often insulting to the chefs and owners. It’s disheartening to me that I still see signs in some restaurant windows that say “No MSG.” Instead Popular traditional Asian meals are naturally high in glutamate as it is a key part in what gives the cuisine it’s characteristic, rich, “umami” flavor. Soy sauce, teriyaki sauce, oyster sauce, fish sauce are all high in natural MSG, glutamate.
When you do an internet search on the term you will find conflicting information on MSG migraine and MSG headache. The topic is indeed controversial and deserves a deeper look.
Spoiler alert– I think it all comes down to two factors – MSG sensitivity and sensitivity to other food components that are eaten along with MSG..
Does MSG cause headaches?
MSG headache has conflicting research but most (not all) human studies show a lack of evidence of MSG linked to migraine. If you mention this to groups of people with migraine you will often get quite an impassioned reaction. Recently, in social media, someone asked if there was anyone who does not get MSG migraine. Clearly there is a disconnect between the studies and the experience of people who often get MSG headache and know that they have MSG sensitivity.
MSG sensitivity and the flawed research
In the many studies reviewed for this article I saw 2 significant problems.
Flaw number 1 – “Healthy volunteers” Most of the well-designed studies were done on “healthy volunteers” rather than people who reported MSG sensitivity. It can only be assumed that the healthy volunteers had never been diagnosed with a primary headache disorder. And, they likely never suspected they had MSG headaches. The few done on those with reported MSG sensitivity showed a negative reaction to MSG.
In this article on the top 10 most common migraine triggers from the American Migraine Foundation, it lists stress, sleep disturbances, hormones, caffeine and alcohol, weather, diet, dehydration, light, smell and medication overuse. If you design a study with “healthy volunteers” that were not diagnosed with migraine or self-reported being prone to headaches, I am highly doubtful that you would see a connection to those triggers. Would researchers really expect “healthy volunteers” to have a hormone or weather triggered migraine? Do your “healthy friends” without headache disorders get headaches or migraine episodes from weather changes and hormones? These are known triggers for those of us with headache disorders but not something experienced by “healthy volunteers.” So, I think the data from the studies is not valid in the migraine population.
Flaw #2- Migraine threshold- headache specialists generally agree that migraine is not typically triggered by just one factor. Rather, it’s a confluence of an individual’s common triggers. Many of those triggering factors are listed in the AMF article above. The concept of attacks occurring when you exceed your trigger limit or “migraine threshold” is explained clearly in this article by Eileen Zollinger about the Bucket Theory. It’s a must-read.
So, even if the study participants reported that they had MSG sensitivity, there was no measure or allowance for the many other factors that lead up to their MSG headache and migraine episodes. Admittedly, allowing for these factors is a huge challenge in migraine research especially when it comes to studying diet and lifestyle.
Toward the end of this article, I discuss my personal experience with MSG headaches. Do I believe there is an MSG link to migraine? For me and many others like me, the answer is a firm yes.
What is the science behind MSG headaches?
At Migraine Strong, we pride ourselves on supporting our articles with published, peer-reviewed research. But, that evidence is not always available with migraine especially when it comes to non-pharmaceutical treatments. This is when other supporting evidence like professional experience, observation, headache specialist interviews, information provided by the Migraine World Summit and of course, personal experience come into play. We try our best to fill in gaps where we think the published research is lacking, but other evidence exists.
I must also acknowledge my professional and personal bias here. I am a registered dietitian with migraine and a passion for helping people get migraine and headaches in good control. There is nothing that gives me greater satisfaction than helping someone with debilitating migraine identify a controllable trigger. Diet and/or supplementing with magnesium or ginger are safe and inexpensive helps at our fingertips. There is a great deal more to managing migraine than diet and supplements so we encourage everyone reading this to also consider a multi-modal approach described by our Treatment Pie.
MSG and the brain
One of the facts that is often pointed out when looking at the issue of MSG migraine is that MSG does not cross the blood-brain barrier (BBB) in healthy people. I must say that in several articles and blogs about the topic, there seems to be a bit of condescension for us silly people that “believe in MSG headaches.” Again, I refer to the fact that those of us with headache disorders may certainly have faulty metabolism. Perhaps we have an impaired BBB leading to altered integrity and some permeability. In this paper about glutamate and blood-brain barrier permeability, the following was concluded:
“Transient modulation of BBB integrity has important implications for facilitating BBB repair and maintenance in neurological disorders, such as epilepsy and stroke, as well as enhancing BBB permeability for the delivery of therapeutics into the brain.”
Perhaps the migraine brain can be listed with those other neurological conditions mentioned above.
MSG and the gastrointestinal tract
There is growing research about the gut-brain axis and how the gastrointestinal system sends signals to the brain and vice-versa. As mentioned earlier, glutamate is the most abundant neurotransmitter in the brain. It is also found in high concentrations in the GI tract.
It is thought that some medications and non-pharmaceutical treatments are effective in part due to their action on glutamate. Perhaps people with MSG sensitivity can blame MSG migraine episodes on the effect of concentrated MSG in their GI tract triggering the cascade of metabolic changes that bring about the migraine attack. Maybe glutamate in the gut signals a boost of glutamate in the brain. Glutamate in the brain can excite pain pathways. This article on glutamate and the GI tract explains:
“This review provides a description of the most up-to-date evidence on glutamate as a neurotransmitter/neuromodulator in this bidirectional communication axis. Modulation of glutamatergic receptor activity along the microbiota-gut-brain axis may influence gut (i.e., taste, visceral sensitivity and motility) and brain functions (stress response, mood and behavior) and alterations of glutamatergic transmission may participate to the pathogenesis of local and brain disorders.”
Is MSG being framed? Maybe it’s not MSG linked to migraine but something else.
It’s possible that MSG is innocent. Many foods that have deep, rich delicious flavors also happen the be high in biogenic amines like tyramine, phenylethylamine and histamine. When you become familiar with the list of foods high in glutamate and the list of foods high in biogenic amines like tyramine and histamine, you will notice that there are many foods on both lists. For example, parmesan cheese, soy sauce and walnuts are on both lists to avoid. The National Headache Foundation has this low-tyramine diet on their website so you may see the list.
The migraine-oriented diet approach we discuss most often in our private Facebook group is the Heal Your Headache (HYH) diet made famous by Dr. David Buchholz. We consider this book to be a must-read for people with migraine. To support people in implementing the diet portion of the book, we published this article explaining the HYH diet in detail. The diet is low in MSG and tyramine and lowish in histamine.
So, how do you figure out if you have MSG sensitivity or sensitivity to some other foods/food components? You can commit to a migraine-oriented elimination diet and following the other guidelines in Dr. Buchholz’s book. Elimination diets are designed to be done in a specified time frame to see if you get results. Assuming you get results by eliminating the specified groups, you begin adding foods back in to see if they trigger attacks. This may help you tease-out whether you possibly have MSG sensitivity or if tyramine is the culprit masquerading as the “sinister” MSG.
Frequently asked questions about MSG headache and migraine
Some of the information in the below FAQ section has been discussed above. There is also a great deal of new information below.
Is MSG safe for people with migraine headache? How about glutamate?
MSG is considered safe by the US Food and Drug Administration. There have been many studies that support its safety. This does not mean MSG is head-friendly for those with frequent headaches or diagnosed headache disorders like migraine and vestibular migraine.
At Migraine Strong, we often encourage people who suspect they have MSG sensitivity to consider a migraine-oriented elimination diet.
If it’s not MSG being added to my food, what is it that makes me think I have MSG headache?
Mono-sodium glutamine is a food additive. Glutamate is an amino acid that is naturally abundant in some delicious, nutritious foods as well as some highly processed foods that are less nutritious. Our bodies treat MSG and natural glutamate the same.
Many foods high in glutamate are also high in other natural food components that could be the culprit (i.e. tyramine). MSG/glutamate may be “framed” and falsely accused.
Does MSG cause headache?
Maybe for some people. Most headache organizations include MSG as a possible dietary trigger. Many headache specialists are suspicious of MSG and encourage people to keep food records to see if they notice a pattern. This task is challenging when you realize how many common foods contain added MSG and natural glutamate. It’s hard to track a cause and effect relationship without training in reading labels as well as a thorough understanding of MSG and glutamate. For example, most people would not think of their nutritious protein smoothie as high in MSG/glutamate. MSG is not on the label but “natural glutamate” is in high concentrations from pea protein, soy protein, milk proteins and other source.
Unfortunately, most doctors do not have the diet expertise and/or time to guide their patients through dietary approaches to migraine management. Thanks to the internet and social media, people are better informed now.
The International Headache Society removed MSG from its list of triggering factors in January of 2018. I’m sure this was a controversial decision. In my opinion this was based on studies that did not include people prone to headache and migraine. Rather, “healthy volunteers” were studied. Additionally, there was no consideration of the widely accepted view of the migraine threshold.
Does MSG cause migraine?
Cause? No. Migraine is a neurological disease that is most likely due to a variety of different genes. Is MSG linked to migraine? MSG is considered a common food trigger that may start the cascade of metabolic changes that bring on a migraine episode.
How to get rid of MSG headache?
MSG headache relief can be achieved in a number of ways. First, understand where MSG is in food and food additives. It is hidden in a variety of surprising foods. You might not need to rid your diet of all the sources of added MSG and natural glutamate, but it makes sense to understand where you may unknowingly be getting a big dose. Second, make sure you are properly hydrated. Third, ask your pharmacist about appropriate over-the-counter remedies. Fourth, read our articles that address natural migraine relief such as ginger, magnesium, tea essential oils and other natural, non-prescription remedies that may help you with MSG headache relief.
Headaches are different than migraine episodes. Many times MSG headaches can be relieved without prescribed medicine. However, full migraine episodes from MSG are no different than other migraine attacks. You will likely need your usual acute migraine medications.
What are the many names of MSG in foods?
Food manufacturers know that some consumers read labels carefully and reject products that specify added MSG. The US FDA requires that food sold in the US be labeled properly. So, the manufacturers came up with clever ways of modifying recipes and reporting ingredients.
Looking for a reputable link to share with you proved to be too challenging for me. Overwhelmingly, the articles were too alarmist about MSG sensitivity. They stoked fear about foods so much so that it would hard to motivate the average person to look at the many foods that are not loaded with “hidden MSG.” The graphic below will help you when looking at food labels and making grocery choices.
Knowing about foods you often eat is very important so you can choose wisely. However, keep in mind that exceeding your personal migraine threshold is dependent on many factors including the dose of the “hidden MSG.” If an ingredient is listed as the last ingredient while the rest of your meal is low in natural glutamate, go for it and don’t stress-out.
What are “natural flavors”?
“Natural flavors” are important to those with MSG headache but mainly when it comes to savory foods. The term covers a tremendous number of natural substances that may or may not be sources of MSG. This article on natural flavors explains more about the general topic.
Manufacturers do not have to disclose what is in their “natural flavors” when you call to ask. Some companies will tell you. Other manufacturers will confirm or deny a specific ingredient if you ask about the distinct ingredient. Might it be enough to trigger an MSG headache? Maybe and maybe not.
A practical way to look at “natural flavorings” is to see where it appears in the ingredient list. If it is at the end of a long list and the ingredients above it are not sources of MSG, it might be worth taking a chance. For example, Ritz Crackers has natural flavors as the very last ingredient. The ingredients ahead of it are not high in MSG. Compare that to Doritos. The label shows natural flavors in the middle of the ingredient list with other sources of glutamate (including actual MSG) ahead of natural flavors. Ritz crackers are the better choice.
I am not a food scientist but through personal and professional experience, it seems that sweet foods that list “natural flavors” may be less of a concern for MSG content. So, we tend to focus mostly on savory “natural flavors.”
If you are doing the HYH diet strictly, you will be avoiding all foods with the hidden sources of MSG and natural flavors in savory foods. This can be quite difficult for many people, especially those who usually rely on convenience items. There is no judgement here. Do the best you can and avoid big doses of natural MSG, added MSG and hidden MSG.
My story with MSG
It’s actually my story with MSG and tyramine as both were my enemies for a few years.
Until my 40s I had always eaten a great deal of foods high in tyramine and MSG without an obvious problem. I often ate Asian food 3 times a week. I added heaps of grated parmesan cheese to most veggies and soups.
While I was a headachy a person, dietitian and foodie, I never made the connection. My headaches and occasional migraine attacks were manageable. Then along came perimenopause shortly after I turned 40 and I was debilitated by unrelenting headaches and spikes of migraine attacks.
Through a low tyramine and low glutamate diet similar to the Heal Your Headache diet, magnesium and other lifestyle changes, I was able to get my life back. Hormonal fluctuations and stress along with my diet were way too much for my migraine brain for several years.
I am happy to report that I have been in menopause for a few years and only have a touch of tyramine and MSG sensitivity. My story is not unique.
Food sensitivities can and do change over time. Given these changes and all the factors that contribute to migraine threshold, it is no wonder why this topic is hard to study and why identifying food triggers can be so hard.
Feel free to find support in getting control of migraine in our Facebook group.
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