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The Migraine Diet: Judith Warner & “Heal Your Headache”

It almost bores me to write about migraine and headache diets: Nearly every news article says you should do them, but many headache specialists say that only about 25% of people benefit from them. I vacillate between thinking food triggers are bunk and not eating to avoid migraine and headache triggers.

What I’m absolutely sure of is that Heal Your Headache: The 1-2-3 Approach for Taking Charge of Your Pain is a simplified — and usually ineffective — approach to headache and migraine treatment. (Not to mention it is also terribly offensive.)

I’m not the only writer with migraine with these conclusions. The latest is The Migraine Diet by New York Times blogger Judith Warner. The following excerpts don’t do justice to Warner’s eloquent examination.

Fortunately, no one seems to have noticed that I wrote last week’s column with one eye closed. I also had the lights in my office off, the shades drawn and the thermostat turned up to about 85 degrees.

All this because I had a migraine. In fact, I was on day six of a migraine that would, by day seven, have me dissolving into tears . . .

I was suffering like this because I was Taking Control of my life. I’d recently read “Heal Your Headache,” by the Johns Hopkins University neurologist David Buchholz. And now I was following his “1-2-3 Program for Taking Charge of Your Pain.”

I stopped drinking caffeine and alcohol and stopped eating chocolate, cheese, M.S.G., nuts, vinegar, citrus fruits, bananas, raspberries, avocados, onions, fresh bagels and donuts, pizza, yogurt, sour cream, ice cream, aspartame and all aged, cured, fermented, marinated, smoked, tenderized or nitrate-preserved meats.

For a couple of weeks, I was ravenously hungry, cranky, spaced out and vaguely, deprivedly resentful. But I felt, headache-wise, somewhat improved. I had six or nine migraines, but they were less severe. And, once I got used to it, I came to almost enjoy being on my diet, exploring my capacity for hunger and self-abnegation, obsessing over what foods I could eat, and how, and when. At the very least, the diet made my friends happy. Renouncing food, renouncing pills, is so often, in our time, seen as the right and righteous, pure and wholesome thing to do.

And then the headaches returned, with a vengeance.

Funny that Warner’s post was soon followed by MSN article Discover the 3-step System to Heal Headaches: Neurologist David Buchholz Shares Practical Advice on Preventing Pain, which is nothing more than an excerpt from Buchholz’s book.

13 Responses to The Migraine Diet: Judith Warner & “Heal Your Headache”

  1. Julie says:

    Hi Kerrie, I read this article online in the NY Times last week and I emailed it to all my friends and family. The author’s writing is so funny and so true! I just knew you would post something about it. Thanks for your input about the book too.

  2. Heather says:

    The Today show recently had him and a nutritionist on — they talked about food triggers and migraines. I have read his book and felt insulted, so watching him on the TV just made me slightly ill. Still, for those of you with food triggers, may be worth going to their website and watching.

  3. Donimo says:

    We should use the phrase “The Chapter 9″ approach when faced with doctors who start blaming the patient when they have been unable to do anything to help their symptoms. Surely Judith Warner simply couldn’t handle getting over the “special status” her migraines gave her.

  4. Jaymi says:

    I feel like everywhere I go on my migraine/CDH journey this is eventually someone’s opinion. “It must be something you’re eating!” Now when I hear that, all I really hear is “You must be doing this to yourself!” It never ceases to amaze me that people can’t comprehend the sometimes unexplainable. If only eliminating a couple of foods from my diet would ease the pain. I should be so lucky! Also, thank you Kerrie for this site. I find it so helpful.

  5. Karen says:

    While I truly sympathize with all of you and your comments about food triggers, have you considered that it might be a combo of food triggers and food allergies/sensitivities?

    I have suffered from migraine with aura and other severe headaches since I was 12…over 40 years of pain. I used to share your opinion about food triggers. The list of foods to avoid seems so large and unrealistic. I still feel that way about triggers. I am unconvinced that all these foods will affect every migraine sufferer.

    I was on Topamax and Atenolol last year and still getting 15 headaches a month. I had crazy water retention cycles that made me think something hormonal was going on, even though I was over 50. My neurologist was unsympathetic, my OB/GYN wouldn’t help me, so I went to a Naturopath and asked to have all my hormone levels checked. She did that, but also tested me for mineral deficiencies and food allergies given my medical history of iron deficiency anemia (that did not go away after a hysterectomy – uterus only). Turns out I am gluten intolerant and highly sensitive to eggs, yogurt, certain cheeses, ginger, corn sugar, tumeric, mustard, several nuts, beans, some vegetables and brown rice. I later had a second opinion from Entero Labs that confirmed the gluten intolerance, malabsorbtion, and an allergy to cow’s milk. I had a DNA test done and found that I have two copies of the gene thought to be associated with gluten ataxia, which can cause neurologic problems. It was the food allergies causing the water retention that I noticed I had during my worst headaches.

    I immediately went on a gluten-free diet and started eliminating all the other foods from my diet. I also avoid aspartame and msg and nitrites even though I have never noticed a reaction to them. I just think they are not good things to put into my body. I gave up caffeine two or three years ago and only use it occasionally when I get a headache. It works now. I have been able to go off the Topamax and Atenolol. I only take vitamins now and Amerge if I get a headache.

    My headaches are not totally gone, but they are only 1/3 of what I had a year ago. I feel so much better generally. I have even lost my sensitivity to scents and odors…like cigarette smoke, which used to trigger all my symptoms.

    Here’s the thing. I don’t get this feeling of being insulted or that it is all my fault. I am happy to know what is causing my headaches. Most of the ones I have had recently were the result of my not knowing that there was a form of corn sugar in a medication or food. I have had to change toothpaste, mouthwash, etc. to avoid forms of corn sugar like sorbitol, xanthan gum (made from fermented corn sugar) and all the sorbates. I discovered by accident that potassium sorbate (on dried fruits and in Smart Balance margerine) causes headaches and all sorts of other inflammation. I don’t feel as if this is my fault at all. I blame conventional doctors for their arrogance in ignoring gluten intolerance and IgG type food allergies which can be delayed by as much as 3 days after consuming the food. I have been told by insurance companies (who would not pay for the allergy testing) and by conventional allergists that these were not real allergies, even though I can support it through headache and food diaries.

    Luckily, my neurologist has come around somewhat since my experience and he now looks for gluten intolerance and food allergies in patients who exhibit some gastrointestinal distress. The trouble with that is that gluten can be damaging your intestines without showing obvious symptoms for years. Some people with gluten ataxia only have neurological symptoms for years.

    So, if this helps some of you, great. Bottom line is that I wouldn’t just rely on the conventional list of foods triggers for Migraine. I would encourage you to be tested for gluten intolerance and food allergies and find out what specifically you are sensitive to. Then see which things in the other list might bother you. How can it be your fault if you are sensitive to something? In any event, try looking at it as a chance to be headache free and enjoy what foods you can have to the fullest. Learn to cook. It only takes some organization to be able to pull it off, even during the week. Preparing your own food puts you in control. Wouldn’t you rather be in conrol than drugged up, relying on expensive medications? I would.

  6. Anne Borden says:

    I think my comment on amazon.com is the only negative one for this book. ;)

    I followed Dr. Buchholz’s diet to a T (I was hopeful) and had 0 improvement in my migraines. In the process, I made myself and everyone around me miserable.

  7. WALTER FRADIN says:

    4-10-10
    THIS REALY HAPPENED 79 YEARS AGO

    WHEN I WAS 10 YEARS OLD, (I’M NOW 89) AFTER A ONE WEEK HEADACHE, MY MOTHER TOOK ME TO THE NEUROLOGICAL CENTER OF A MAJOR NYC HOSPITAL. THE IDIOT WHO EXAMINED ME, TOLD MY MOTHER, MY BRAIN WAS TOO BIG FOR MY SKULL, AND PUT ME ON PHENOBARBITAL.

    AS A FLYING OFFICER IN NEW GUINEA WWII, IN MY EMERGENCY KIT (PART OF MY PARACHUTE) I CARRIED 1,000 ASPIRIN, 10-100 PACKS (WRAPPED INSIDE CONDOMS TO KEEP THEM DRY) IN CASE I GOT SHOT DOWN. I WAS MORE AFRAID OF A MIGRAINE THAN OF THE JAPANESE AIR FORCE

    I SUFFERED MIGRAINES UNTIL ABOUT. 1960, WHEN A FRIENDS COMMENT LET SOME LIGHT IN.

    HE CASUALLY MENTIONED THAT EACH TIME HE DRANK DIET SODA, HE ITCHED,

    I SAID, MAYBE IT GIVES ME A HEADACHE, I DRANK SOME, AND EUREKA, A NEW WORLD OPENED UP, IT WAS THE BEGININING OF MY RESEARCH, AND SUCCESS IN BECOMING HEADACHE FREE.

    PLEASE NOTE, I DO NOT PUSH THE USE OF ANY MEDICATION. I DID USE PAIN KILLERS WHEN NECESSARY.

    THE LESSON BEGINS.

    CHEMICAL FOOD ADDITIVES ARE A MAJOR CAUSE OF HEADACHES, YOU DON’T NEED MEDICATION FOR A HEADACHE YOU DO NOT HAVE.

    THE FOLLOWING ARE NO-NO’S I HAVE PERSONALLY FOUND. YOU WILL DISCOVER MORE THINGS THAT ARE PERSONAL TO YOU.

    MSG (MONO SODIUM GLUTAMATE). THIS IS # 1 THE WORST CULPRIT.

    SACCHARINE, SPLENDA, (SWEET AND LOW OR ASPERTAME), OR (OTHER SUGAR SUBSTITUTES).

    SUGAR FREE CANDY, AND SUGAR FREE BAKED GOODS, THEY USE SACCHARINE, ASPERTAME. OR OTHER SUGAR SUBSTITUTE

    SODIUM NITRATE, AND SODIUM NITRITE, USED AS PRESERVATIVES IN DELI, AND SMOKED FISH (LOX, WHITEFISH).

    SODIUM BENZOATE, SULFITES, AND SULFIDES, (ANTI-OXIDANTS) ARE USED AS PRESERVATIVES IN PICKLES AND WINE, AND MANY, MANY OTHER CANNED OR BOTTLED FOODS.

    SULPHUR DIOXIDE, A SULFITE, – USED IN DRY APRICOTS, AND OF RECENT TIME, ALL DRY FRUITS.

    GOOGLE ANY AND EVERY COLOR OR FLAVOR ADDITIVE, NO MATTER HOW NOTHING IT SOUNDS. A PLAIN BUTTER POUND CAKE (ENTEMANNS) HAS FOOD COLORS, AND MAKES ME ILL

    COUGH SYRUPS, AND COUGH DROPS THAT MAKE ME ILL. HALLS COUGH DROPS, AND ROBITUSSIN COUGH SYRUP, HAVE RED COLORING.

    FOODS, AND MEDICATIONS HAVE COLOR ADDITIVES, WHICH ARE SULFITE RELATED.

    THE COLOR ADDITIVES INCLUDE, BUT ARE NOT LIMITED TO BLUE, RED, CARMEL,YELLOW, GREEN COLORS, ETC. ADD FLAVOR ADDITIVES TO THE LIST.

    SOME SOUND SO INNOCUOUS, YOU PAY NO ATTENTION TO THEM. GOOGLE THEM, YOU WILL BE STUNNED. YOU WILL FIND THEY ARE ALL MADE USING COAL TAR, AND “SULFITES”, DANGEROUS CHEMICALS.

    BE AWARE THAT THE USE OF THE ABOVE ADDITIVES IS CUMULATIVE IN THE SENSE THAT A+B CAN BE THE SAME AS 2X A OR 2X B ETC.

    ALL WINES, SULFITES ARE USED AS A PRESERVATIVE. RED SEEMS TO BE MORE “VIRULENT”.

    YEAST, A MAJOR CULPRIT. BEER, WINE, HAVE YEAST AND ARE NO NO’S.

    ALL SODA POP, THAT CONTAINS SODIUM BENZOATE, ARTIFICIAL SWEETENERS SUCH AS, BUT NOT LIMITED TO, SACCHARINE, SPLENDA OR ASPERTAME .

    CANNED TUNA FISH HAS AN ADDITIVE CALLED HYDROGOLIZED PROTEIN, OTHER FOOD USE AUTOLIZED YEAST, THESE ARE SNEAKY WORDS FOR FORMS OF GLUTAMATE.

    EATING OUT CAN BE VERY DIFFICULT, YOU MUST PICK SPOTS WHERE YOU ARE SURE OF THE INGREDIENTS USED.

    EAT NO SOUP IN A RESTAURANT, NEVER TRUST A WAITER WHO SAYS THE SOUP WAS MADE FROM SCRATCH, WITHOUT MAJOR QUESTIONING IT USUALLY IS MADE FROM CANNED STOCK (WHICH HAS MSG), AND THEN FROM “SCRATCH”. ASK TO SEE THE CAN.

    NO SALAD DRESSING (OTHER THAN OIL AND VINEGAR) IN A RESTAURANT. THERE IS NO WAY YOU CAN READ THE LABELS. THE SALAD DRESSINGS MANY TIMES CONTAIN MSG AND OR PRESERVATIVES.

    NEVER EAT BREADED (BREAD CRUMBS) FRIED FOODS IN RESTAURANTS, THE BREADING SOMETIMES HAS MSG IN IT.

    I WASH WITH DETERGENT, ALL FRUIT, WHERE I EAT THE PEEL. THIS INCLUDES PEACHES, AND GRAPES. THERE ARE MANY PESTICIDES, AND ANTI-OXIDANTS (sulfites), THAT MAKE ME ILL. I RINSE THEM WELL AFTER THE SOAPING. THIS IS MORE SO IN OFF SEASON, WHEN FRUITS ARE IMPORTED FROM SOUTH AMERICA.

    WHEN IN DOUBT, ABOUT ANY FOOD, DON’T EAT IT, THE PRICE IS TO HIGH. READ EVERY LABEL ON EVERY CAN AND ANY PACKAGED FOOD PRODUCT, YOU BRING INTO THE HOUSE.

    I RECENTLY CHECKED IN AN ITALIAN RESTAURANT, CANNED SNAILS AND CLAMS, HAD BISULFITES ADDDED AS A PRESERVATIVE.

    THERE ARE OTHER FOODS THAT YOU MAY HAVE A PERSONAL SENSITIVITY TO, OR MANY OF THE LISTED FOOD YOU DON’T HAVE A PROBLEM WITH, YOU CAN ONLY FIND THESE BY DIARYING THE FOOD YOU EAT, EACH TIME YOU HAVE A HEADACHE, OR COUGHING SPELL.

    I CAN’T EMPHASIZE ENOUGH HOW PRODUCTIVE AND HELPFUL DIARYING CAN BE. IF YOU START COUGHING, OR GET A HEADACHE, GO BACK MINUTES TO 3-4 HOURS. YOU WILL BE AMAZED.

    CARRY A SMALL NOTE PAD, WHEN YOU GET A HEADACHE, GO BACK IN TIME, 4-6 HOURS, AND WRITE DOWN WHAT YOU ATE, OR DRANK. KEEP TRACK OF THE OCCASIONS, A PATTERN CAN EMERGE.LOOK NFOR ADDITIVES, GOOGLE THEM, THIS IS PROBABLY THE MOST IMPORTANT ADVICE IN THIS LETTER

    DON’T BE AFRAID, OR ASHAMED TO ASK, (EVEN AS A GUEST AT A DINNER PARTY) WHAT WAS USED IN THE PREPARATION OF THE SERVED FOOD. I GO AS FAR AS TO ASK TO SEE THE LABELS. IF YOU CAN’T HANDLE IT, JUST DO NOT EAT SUSPECT FOOD.

    TRY IT MY WAY, I STILL GET AN OCCASIONAL HEADACHE. WHEN I’M CARELESS, BUT I’M ABOUT 98% HEADACHE FREE. YOU’LL BE SURPRISED HOW QUICKLY YOU GET TUNED IN, AS YOUR FREQUENCY OF HEADACHES DIMINISH.

    REMEMBER LOOK AT THE LABEL OF EVERY FOOD, OR MEDICATION YOU BRING HOME.

    AS TO NASAL DRIP, COUGHING ETC, AVOID ALL FRAGRANCES. SOAP, HAIR SPRAY, LAUNDRY DETERGENT, HAND CREAMS, SUN TAN LOTIONS EVERYTHING OF THIS NATURE, CAN BE BOUGHT FRAGRANCE FREE.

    THERE IS NO WAY TO AVOID THE OUTSIDE WORLD, CLEANING MATERIALS, (BIG TIME CULPRIT). FLOWERS AND TREES GROW. I USE A MEDICATION CALLED ASTELINE, I FIND IT HELPFUL.

    USE YOUR HEAD, WHEN YOU HAVE A PROBLEM TRY TO FIND OUT IF YOU CREATED THE PROBLEM.

    NOT VERY EASY. IT AINT PERFECT, BUT THESE TIPS WILL HELP YOU, YOU MUST HELP YOURSELF BY CHECKING ANYTHING NEW. BE ALERT. YOU ARE THE KEY TO YOUR SUCCESS. YOU DIDN’T BECOME A PILOT BECAUSE YOU ARE A DUMMY, IF YOU CONTINUE TO GET HEADACHE AFTER YOU APPLY MY PRINCIPALS, IT’S BECAUSE YOU WERE CARELESS WITHTHE NO NO’S. REMEMBER A HEADACHE YOU DO NOT GET NEEDS NO TREATMENT.

    PLEASE CALL ME, OR WRITE, IF THERE IS ANYTHING YOU DO NOT UNDERSTAND

  8. Mary says:

    I started having headaches as a young child and misdiagosed until my late 20’s. I can say I have had really horrible migraines for over 20 years now. I have been going to a nationally renowned Headache Center and got worse. I would get a minimum of 15 migraines a month with daily headaches. This summer I had read Dr. Bucholz’s book and followed the diet strictly. After about 10 days of detoxing, my headaches started to improve. I’m still on a tapering dose of topamax and recently started on pamelor. I can’t thank Dr. Bucholtz enough for writing that book. It has changed my life drastically. Now I have headache free days and even went 10 days without a migraine. That is amazing and unheard of for me! The diet can be hard. I have to pack snacks with me. Even some things on the diet seem to lower my threshold. Of course I try to avoid these when there are other factors involved like stress, barometric pressure etc. Don’t give up on the diet, it takes time and it is better than any medication. I hope to be off of all preventative meds within the next year and at the rate I’m going at, I will be! Good luck to those of you that really give this a try. It has saved my life!

  9. Jack says:

    I am 16 now, but at 14 I had a migraine w aura every 4-5 days for about 6 months. Luckily I got them in the afternoon so my grades didn’t suffer much but I was determined to find out what was causing them. I went to the doctor and they gave me the list if things to watch out for. I tried to avoid all the things and still I had headaches. Simultaneous with this all I had been drinking alot of soda, coke in particular, but as soon as we ran out noticed relief. I’m not 100% sure if it still is caffeine but they only occured after eating or drinking about 50+ mg if caffeine. To this day I still have them having been caffeine free for 2 years, even chocolate, receiving them every 3 months or so. I have found a correlation however to stress. Recently I had red eye flight to DC and upon landing on 5 hours of sleep (due to time change from California it was 8 there) we went sight seeing. Within 2 hours and not a good breakfast , except for a few tjc tacs laced with aspertame I had one of the worst migraines,( I say this because there was no bed and no way to turn off the sun). Furthermore, just last week was finals week, hence the reason I’m here, because right at the start of day 2 I got a migraine, I took the finals and did fine, I’m still confounded how, but I have never been too stressed about them in the past, and the only noticeable change was my sleep patterns were messed up during the night due to restlessness, but this happens occasionally, I’m beginning to think not allowing enough sleep and the right amount of stress may be a cause for concern. Anyway I’ve been staying away from all the sweeteners , not so much preservatives though and as I previously stated have been 99% free. I eat much healthier now too which is a plus to staying away from some of the questionable foods. So overall I’m doing alot better than before. I hope this may have shed some light on peoples questions ,because I was always told caffeine helps migraines but in the end it was a major factor in causing them.

  10. Cathy says:

    I just found out recently that all “melt on the tongue” medications, i.e., Maxalt and others have aspartame in them! Makes perfect sense. I could taste it in the Maxalt and then would get almost more sick when I took it (although it does help the migraine go away about 70% of the time). I can get a migraine from one accidental sip of Diet Coke (like when they serve it to me at a restaurant instead of Coke), so having it in my migraine medicine is NOT acceptable. I’ve switched to Imitrex pill form.

  11. I have been fighting the good fight, trying to avoid migraines, for more years than I care to remember. Every day I seem to come up with another trigger, food being the most suspect. I avoid all the usual triggers, except coffee, something I’ve been having trouble giving up.
    I’ve been working on a cookbook about feeding your dogs and your family with the same ingredients (http://www.peoplefoodforpets.com/). When I am in my cooking and recipe mode, my headaches miraculously go away. Every food on the list of foods that are a problem for dogs is a migraine trigger for me: aged cheese, alcohol, bananas, beer, caffeine, chickpeas, chocolate, citrus, corncobs, eggplant, garlic, ketchup, mushrooms, mustard seeds, onions, processed meats, raisins, raspberries, red grapes, red plums, soy sauce, tea, tomatoes, uncooked yeast dough, walnuts, wine.
    I have no idea why it’s true, but when I eat like a dog, I don’t get migraines. Added to the list for me are: milk products, including all cheeses, cream, yogurt, sour cream, and butter, and artificial sweeteners.
    I’m now into heavy-duty writing mode, not developing recipes and I’ve been lax about trying to eat like a dog. I’ve also been plagued by migraines.
    Maybe I should come up with a new migraine diet and call it the canine connection

  12. olga rocco says:

    why was I not able to print this information?

  13. JJ Ross says:

    I learned 10 years ago that my migraines were caused by many of the foods others have mentioned. It seems people would rather not think it is food related because that is so much more work than taking a pill… I do take Imetrex if I mistakenly eat something but after 10 years I can pinpoint the culprit immediately. The idea of feeling insulted about working out a food plan is beyond my comprehension.

    *******
    I’m not insulted about the idea of working out a food plan, but by the author’s implication that if his diet doesn’t work for you, then you have somehow failed. It is believed that about 25% of people with migraine have food triggers. For those folks, diet modification is tremendously helpful. For those without food triggers, it is entirely ineffectual. I always advocate for attempting to find food triggers, but do not ever want to see a patient blamed for not finding them.

    Kerrie

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