Here's Exactly How Much Caffeine Can Trigger a Migraine

If you’re a regular migraine sufferer, you might turn to a cup of joe to ease your symptoms. But new research found that there’s a fine line between caffeine helping migraines and making them a lot worse. Specifically, having three or more servings of beverages with caffeine was linked to an increased chance of having a migraine that day or the next, according to a study published in the American Journal of Medicine. 

Migraines are actually the third most common illness in the world, affecting more than one billion adults around the globe. Besides a serious headache, migraine symptoms can also include nausea, changes in mood, light and sound sensitivity, and visual and auditory hallucinations. Migraine sufferers say that everything from the weather to poor sleep to hormonal changes, stress, medications and certain foods or drinks can trigger one, but there isn’t much research on exactly what causes migraines. This new data, researched by Beth Israel Deaconess Medical Center (BIDMC), Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health (HSPH), specifically examined caffeine as a migraine trigger.

“While some potential triggers — such as lack of sleep — may only increase migraine risk, the role of caffeine is particularly complex, because it may trigger an attack but also helps control symptoms,” Elizabeth Mostofsky, ScD, an investigator in BIDMC’s Cardiovascular Epidemiology Research Unit and a member of the Department of Epidemiology at HSPH who led the study, has said. “Caffeine’s impact depends both on dose and on frequency, but because there have been few prospective studies on the immediate risk of migraine headaches following caffeinated beverage intake, there is limited evidence to formulate dietary recommendations for people with migraines.”

The researchers followed 98 adults who have episodic migraines regularly and asked them to fill out electronic diaries every morning and evening for a minimum of six weeks. They recorded how many servings of caffeinated coffee, tea, soda and energy drinks they had, along with tracking other common migraine triggers including medication, alcoholic consumption, activity levels, depressive symptoms, stress, sleep patterns and menstrual cycles. They also recorded two headache reports per day, noting the onset, duration and intensity, as well as if they took any medication.

The data revealed that having one or two servings of caffeinated drinks didn’t have an impact, but three or more showed a correlation between having a headache on the same day. However, for people who rarely drank caffeine, just one to two servings of it could lead to a headache.

“Despite the high prevalence of migraine and often debilitating symptoms, effective migraine prevention remains elusive for many patients,” Principal Investigator Suzanne M. Bertisch, MD, MPH, of the Division of Sleep and Circadian Disorders at Brigham and Women’s Hospital, Beth Israel Deaconess Medical Center, and Harvard Medical School, who also worked on the research, has said. “This study was a novel opportunity to examine the short-term effects of daily caffeinated beverage intake on the risk of migraine headaches. Interestingly, despite some patients with episodic migraine thinking they need to avoid caffeine, we found that drinking one to two servings/day was not associated with higher risk of headache. More work is needed to confirm these findings, but it is an important first step.”

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