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We Asked A Doc To Explain How Caffeine Actually Helps Or Hurts Your Migraines

by Brandi Neal
Female hands with a coffee cappuccino cup. Top view, copy space. Toned photo
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When it comes to preventing migraines, is caffeine a friend or foe? A new study published in the American Journal of Medicine found that the answer is both. Each individual migraineur likely knows how caffeine affects their migraines via personal experience. For me, skipping my coffee is not an option. However, for some people, any amount of caffeine can trigger a migraine. In others, variables like the number of caffeinated beverages they drink can determine whether caffeine helps or hurts.

"Making changes in daily caffeine intake in either direction (more or less) can trigger an attack or increase the frequency for someone with migraine," Dr. Dawn Buse, PhD, a clinical professor in the department of neurology at Albert Einstein College of Medicine of Yeshiva University and a member of the Society for Women’s Health Research Migraine Network, who was not involved in the recently published study, tells Bustle. "While it is wise for people living with migraine to keep caffeine daily consumption low, if someone regularly consumes a higher level of caffeine on a daily basis, abruptly making changes may result in migraine attacks."

Basically, if caffeine and migraines are in a relationship, their status is complicated. In order to provide a general recommendation about caffeine and migraines, the study sought to determine the average amount of caffeine a person can consume before it triggers a migraine. In the case of caffeine and migraines, it's sort of like Goldilocks and the Three Bears. In order to trigger a migraine, your caffeine intake needs to be "just right."

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"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," lead study author Elizabeth Mostofsky, ScD, an investigator in Brigham and Women's Hospital's Cardiovascular Epidemiology Research Unit and a member of the Department of Epidemiology at Harvard T.H. Chan School of Public Health, said in a press release.

The magic number where caffeine goes from friend to foe? The study found that three or more caffeinated beverages can trigger a migraine in some people. And when it comes to those three beverages, size matters. But because the same size coffee could contain different amounts of caffeine, it's not an exact science.

"One serving of caffeine is typically defined as eight ounces or one cup of caffeinated coffee, six ounces of tea, a 12-ounce can of soda and a 2-ounce can of an energy drink," Mostofsky said. "Those servings contain anywhere from 25 to 150 milligrams of caffeine, so we cannot quantify the amount of caffeine that is associated with heightened risk of migraine. However, in this self-matched analysis over only six weeks, each participant's choice and preparation of caffeinated beverages should be fairly consistent."

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It's important to note that everyone is different. This means that what triggers a migraine in one person won't trigger a migraine in another. In addition, some medications used to treat migraines contain caffeine. However, overusing these medications can make them ineffective or potentially cause more headaches in the long run. If you're not sure if caffeine is a trigger for you, try a little experiment.

"Consider eliminating caffeine entirely, at least for several months along with stopping use of caffeine containing painkillers while [you] work with a healthcare professional to find a personalized, optimized treatment plan that works for [you]," Dr. Buse advises. "Making these changes should be achieved over a gradual taper of days or even weeks to limit the potential for withdrawal syndrome. Once better migraine management is achieved, [introduce] caffeine at a low daily level."

If you need a little help understanding your migraine triggers, you can download a migraine toolkit from the Society for Women's Health Research Migraine Network. The kit includes a headache diary so you can better understand your own specific triggers. Once you know what brings on a migraine for you, you can develop a strategy to reduce your exposure to those triggers. You may discover you can drink coffee all day like Lorelai Gilmore and never develop a migraine but one bite of processed meat has you reaching for your rescue medication.

Personally, caffeine is more of a friend than foe to me. In fact, I was once drove an hour from a remote area in Hawaii to a town with a coffee shop just to ensure I didn't develop a migraine from missing my morning java. And while studies are certainly helpful in identifying potential triggers, especially for people who have just started to get migraines, if you're a lifelong migraineur like me, do what works best for you.