Fighting Food-Related Headaches

Crunching numbers at the Congressional Budget Office might give most of us a headache. But for budget analyst Geoff Gerhardt, the problem is munching, not crunching. According to his calculations, ham plus cheese equals a classic migraine.

"It's like being hit by a truck," says Gerhardt, who has had migraines for more than 15 years. "Four to five hours after eating processed meats or certain kinds of cheese, I start having trouble with my vision. Then I get a strong pain in one temple or the other, accompanied by nausea and loss of balance."

Seymour Diamond, MD, founder of The Diamond Headache Clinic in Chicago, says more than a quarter of migraine sufferers have specific triggers, including food. "One of the most common triggers is aged cheese," Diamond tells WebMD.

Hold the Cheese, Please

The trouble with aged cheese is that it's high in tyramine, a substance that forms from the breakdown of protein in certain foods. The longer a food ages, the greater the tyramine content is. For people with a sensitivity to tyramine, The Cleveland Clinic warns against the following types of cheese:

• Blue cheeses
• Brie
• Cheddar
• Stilton
• Feta
• Gorgonzola
• Mozzarella
• Muenster
• Parmesan
• Swiss
• Processed cheese

Other foods high in tyramine include processed meats, pickles, onions, olives, certain types of beans, raisins, nuts, avocados, canned soups, and red wine.

Doctors concede it can be difficult to avoid all of these foods. Nestor Galvez-Jimenez, MD, a neurologist with The Cleveland Clinic Florida, says some of his tyramine-sensitive patients prefer to take their chances. "They want to drink wine even if they know it will give them a headache. In that case, I recommend a preventive dose of medication before dinner." He stresses that patients should discuss this idea with their doctors before trying it.

Avoid Additives

Certain food additives, including nitrites and some food colorings, are also common headache triggers. Like tyramine, these additives may increase blood flow to the brain causing headaches in some people.

"We don't understand exactly why this happens," Galvez-Jimenez tells WebMD, "but it has to do with changes in blood vessels."

Unlike classic migraines which affects are also triggered by a substance and are felt on one side of the head, headaches induced by additives or other substances are usually sensed on both sides of the head:

• Occur within a specific time after substance intake
• Disappears when a substance is eliminated or within a specific time thereafter

Monosodium glutamate-induced headaches, previously known as Chinese restaurant syndrome, occur within an hour after ingestion of MSG and can cause at least two of the following:

• Pressure in the chest or face
• Burning sensation in the chest, neck, or shoulders
• Dizziness
• Abdominal discomfort

Experts continue to debate the effects of MSG, an additive found in soy sauce, Chinese foods and many packaged foods. "MSG is a big one," says Galvez-Jimenez.

But Diamond, who is currently executive chairman of the National Headache Foundation, says new research may show MSG is not a typical trigger after all.