Diet, Triggers

A Neurologist’s Insight on MSG & Headache

We’re lucky enough to have neurologist (and migraineur) Christina Peterson as a blog reader. She is a headache specialist and the founder of Migraine Survival and Headquarters Migraine Management.

Dr. Peterson is also an incredibly nice person who comments frequently on The Daily Headache posts. Her remarks are insightful, caring and often funny. I learn so much from her and love having her as part of our community.

A recent example is this her response to my post on MSG and headache:

OK–a couple of points.

From the article: “We now know that glutamate is present in almost every food stuff, and that the protein is so vital to our functioning that our own bodies produce 40 grams of it a day.”

Glutamate is a neurotransmitter. It has a chemical structure that is different from that of monosodium glutamate. They are not the same thing, although that may not be critical. Glutamate is rapidly absorbed from the GI tract, in whatever form–free glutamate in food, or MSG. Studies have not shown differences in plasma levels of glutamate in MSG users and non-MSG users.

Is there a difference in brain glutamate? We don’t have good ways to measure that. But at least half the receptors in the brain are glutamate receptors of one sort or another. In fact, one of the most promising migraine drugs in development right now is an AMPA/kainate drug–these are glutamate receptors. And some of the existing anti-epilepsy medications used for migraine prevention act on glutamate receptors.

This link is interesting:

Chinese Restaurant Syndrome remains controversial, but has also been attributed to fungi used in some of the dishes.

As to why there is not widespread migraine in Asia, well…the prevalence of migraine in Asians is much lower than it is in Caucasians–whether or not they live in Asia. This is well-documented in demographic studies of migraine.

As for the foods listed…there are other components to those foods that might be triggers other than glutamate. I’m not saying MSG is not a trigger, but glutamate itself? Not necessarily a bad thing.

I’ve also interviewed Dr. Peterson to learn about what her job is like, how her own headache disorder fits into her work and the most pressing issues in headache treatment. Our talk was terrific, but the post I wrote about it was not! I’ll try to revisit it soon so that you can benefit from her wisdom too.

Diet, Triggers

A Long Look at MSG

If MSG is so bad for you, why doesn’t everyone in Asia have a headache?” That headline sure got my attention and the article has me questioning the validity of MSG as a headache or migraine trigger — or its link to any other health problems.

According to the article, current negative attitudes toward the substance, which occurs naturally in many different foods, developed after an article in the New England Journal of Medicine described what has become known as Chinese Restaurant Syndrome. Apparently, the author of the NEJM article didn’t name MSG as the culprit, but because of its common use in Asian food, MSG was assumed to be the cause.

Here’s an excerpt from the recent article that summarizes it’s main points:

Science has still not found a convincing explanation for CRS [Chinese Restaurant Syndrome]: indeed, some researchers suggest it may well be to do with the other things diners have imbibed there — peanuts, shellfish, large amounts of lager. Others say that fear of MSG is a form of mass psychosis — you suffer the symptoms you’ve been told to worry about.

The fact is that, since the eighties, mainstream science has got bored of MSG. Some research continues; in 2002, for example, New Scientist got very excited over a report that MSG might damage your eyesight, after Japanese scientists announced that they had produced retinal thinning in baby rats fed with MSG. It turned out they were putting 20 grams of MSG in every 100g of rat food — an amazing amount, given that, in the UK, we adults consume about four grams of it each a week. (One project took people who were convinced their asthma was caused by MSG and fed them up to six grams of it a day, without ill-effects). However, at no time has any official body, governmental or academic, ever found it necessary to warn humans against consuming MSG.

But popular opinion has travelled — spectacularly — in the opposite direction to science. By the early eighties, fuelled by books like Russell Blaylock’s Excitotoxins: The Taste That Kills, MSG’s name was utter mud. Google MSG today, and you’ll find it blamed for causing asthma attacks, migraines, hypertension and heart disease, dehydration, chest pains, depression, attention deficit disorder, anaphylactic shock, Alzheimer’s and Parkinson’s diseases and a host of diverse allergies.

The author also shared his own anecdotal evidence from a “test” he did with foods that have naturally occuring high levels of MSG:

My friend Nic came round. He told me about a Japanese restaurant he’d been to that gave him headaches and a ‘weird tingling in the cheeks’ – until he told them to stop with the MSG. Then he was fine, he said. I nodded and I served him two tomato and chive salads; both were made using the very same ingredients but I told him one plate of tomatoes was ‘organic’, the other ‘factory-farmed’. The organic tomatoes were far better, we agreed. These, of course, were the tomatoes doused with mono sodium glutamate.

Then we ate mascarpone, parma ham and tomato pizza. Nic felt fine. So did I. I had ingested, I reckoned, a good six grams of MSG over the day, and probably the same again in free glutamate from the food — the equivalent of eating two 250g jars of Marmite.

Even though I find the author’s agrument compelling, I’ll continue to avoid MSG that’s been added to foods and eating little of the foods that have naturally occuring MSG. The problem is that I just don’t know whose arguments I can trust.

Wondering if you eat MSG and don’t know it? The author’s list of MSG-containing foods will probably surprise you.

Some of the names MSG goes under:

  • monopotassium glutamate
  • glutavene
  • glutacyl
  • glutamic acid
  • autolyzed yeast extract
  • calcium caseinate
  • sodium caseinate
  • E621 (E620-625 are all glutamates)
  • Ajinomoto, Ac’cent
  • Gourmet Powder

The following may also contain MSG:

  • natural flavors or seasonings
  • natural beef or chicken flavoring
  • hydrolyzed milk or plant protein
  • textured protein
  • seasonings
  • soy sauce
  • bouillon
  • broth
  • spices

Free glutamate content of foods (mg per 100g) — aka “naturally occuring”:

  • roquefort cheese 1280
  • parmesan cheese 1200
  • soy sauce 1090
  • walnuts 658
  • fresh tomato juice 260
  • grape juice 258
  • peas 200
  • mushrooms 180
  • broccoli 176
  • tomatoes 140
  • mushrooms 140
  • oysters 137
  • corn 130
  • potatoes 102
  • chicken 44
  • mackerel 36
  • beef 33
  • eggs 23
  • human milk 22
Coping, Diet, Exercise, Triggers

Self-Care or Alternative Medicine?

I’ve blogged a lot about meds and medical devices, but haven’t really discussed “alternative” therapies. There are two reasons for this. The first is that none of the alternative treatments that I have tried have worked for me, so I don’t think to recommend them. The more important reason is that much of the advice of alternative practitioners is what I think of as simply taking care of myself. I do employ many of the strategies of alternative medicine; I just don’t think of them as alternative.

The non-alternative alternative therapies that I try to follow:

Eat simply prepared produce and meat
Frozen veggies make this much easier and Penzeys Spices make it tastier; both make preparation a snap. I also eat a lot of organic produce and organic free-range meat. Living in the northwest give me an advantage with this; organic is easy to come by and isn’t outrageously expensive.

Avoid inhaling potentially harmful chemicals or substances
Since most artificial scents or offensive odors trigger headaches for me, this is pretty easy. Most of my cleaning products are homemade or from Seventh Generation and candles are beeswax or soy. And, as I’ve already complained, I am careful to find home furnishings that don’t off-gas much.

Avoid potentially harmful food additives
Avoid all forms of MSG, nitrates, nitrites, sulfates, sulfites, and artificial sweeteners, flavorings or colorings. This means skipping almost all convenience foods, sauces and dressings.

Exercise and relax
My beloved yoga is out, but I try to take a short walk every day, even if it is just to my favorite coffeehouse (.8 miles round trip!). Meditation is beyond my grasp, but I do try to lie down, breathe deeply and relax all my muscles for about 10 minutes each day. This is usually when I lie down to go to sleep, but I figure every little bit counts.

Use aromatherapy
Maybe essential oils help my headaches, maybe not, but I love smelling lavender, mint and orange. I smell them straight from the bottle, rub them on my temples, burn them with a candle or put them in a spray bottle with alcohol (is that a harmful-to-inhale substance?) and use them as air fresheners.

Don’t mistake me for a whole health goody goody. These are all steps I try to do, which means that I do them most of the time unless I want to go out for dinner, get my shower really clean, take advantage of high energy days or be lazy. But I do feel better when I follow the “rules.” The days I give in to reading a book and eating cookie dough all day are indulgences that I pay for with more headaches.

(P.S. Many of the foods and products I mention are more expensive than conventional varieties. I stock up on frozen vegetables when they are on sale, burn fewer candles than I used to, and remind myself that meds are expensive too.)