Chocolate and migraine
By: Rachel Baxter, Communications Officer, The Migraine Trust
In this blog, we answer common questions about migraine and chocolate.
Does eating chocolate cause migraine attacks?
Many people with migraine avoid chocolate or are told they should avoid it, but it’s actually unclear whether it’s even a trigger. A 2020 review of research on migraine and chocolate concludes that there isn’t enough evidence to confirm whether chocolate is a migraine trigger and that people with migraine should not be advised to avoid it.
While a few studies have found chocolate to be associated with migraine in a small minority of people with migraine, most asked participants to recall their triggers after migraine attacks and choose them from a set list. Therefore, the results might just reflect common beliefs about migraine triggers rather than actual triggers.
Other studies that gave some people chocolate and some people a placebo found no differences in migraine attacks that happened after eating chocolate and attacks that happened after eating a placebo.
A large-scale study where participants record symptoms and possible triggers via electronic headache diaries is needed to tell us more about whether chocolate plays a role in migraine.
Does migraine cause chocolate cravings?
Recent research suggests that during the very first stage of a migraine attack, known as the premonitory stage, some people crave certain foods. Other premonitory symptoms include a stiff neck, excessive yawning, feeling thirsty, and tiredness. Because symptoms of the premonitory stage are much subtler than the symptoms of the main attack stage of migraine, many people don’t realise that they’re already in the throes of a migraine attack.
So, if you find yourself eating a big bar of chocolate and then a few hours later a bad migraine attack sets in, it would be sensible to assume that the chocolate might be the trigger. However, the migraine attack itself may well be the reason you wanted the bar of chocolate in the first place.
It’s also thought that the common belief that chocolate is a significant migraine trigger might be linked to menstrual migraine. Hormone changes are a trigger for lots of women, and many find they have an attack just before their period. These hormonal changes also lead to symptoms like tiredness, cramps and mood changes. It’s common to crave chocolate before or during a period because our fatigued bodies crave sugar for a quick energy boost, meanwhile, eating chocolate releases endorphins which can help improve a low mood. So, if you eat a lot of chocolate just before or during your period and find yourself experiencing a migraine attack, both may well be the result of your changing hormones.
Can people with migraine eat chocolate?
Most people with migraine should be able to eat chocolate without any problems – there’s a lack of evidence to say whether or not it’s a trigger. If you’ve been avoiding chocolate because everyone’s told you it’s a migraine trigger, it’s quite likely that you’ve been doing so unnecessarily.
Keeping a migraine diary will help you work out whether chocolate is a trigger for you, but even then it’s difficult to tell whether you’re actually craving chocolate as a result of your migraine. Keep a note of any changes you notice before your main migraine symptoms kick in, for example, if you feel strangely tired, thirsty or are yawning a lot. If you eat chocolate when you have these symptoms, it’s likely a migraine attack has already begun.
If you cut out chocolate and still get the same frequency of attacks, other triggers might be playing a role. Common triggers include changes to routine, too much or too little sleep, dehydration and drinking alcohol.
For some people, there may be a threshold whereby one trigger alone doesn’t cause a migraine attack, but two or three together do. For example, for some people a combination of lack of sleep, caffeine and chocolate might lead to an attack, while chocolate alone would not. Still, in this situation it would be hard to tell whether the chocolate is contributing to the attack or whether it’s just the combination of lack of sleep and caffeine.
It’s important to remember that chocolate is high in sugar and it’s best not to eat it in excess. Maintaining a healthy balanced lifestyle can help people manage migraine, and trying not too eat too many processed foods or refined sugars helps us stay healthy. You can read the NHS’s healthy eating guidelines here.
Can chocolate help migraine?
There is no evidence to suggest that chocolate helps with migraine.
However, there are some components of chocolate that mean it theoretically might benefit people with migraine. For example, it contains magnesium and riboflavin, both of which can improve migraine when taken as supplements (although a portion of chocolate contains much less than the recommended doses for migraine).
A couple of studies have also found that cocoa extract and a cocoa-rich diet can suppress the release of calcitonin gene-related peptide (CGRP), a molecule involved in migraine attacks, in rats. Still, much more research is needed to tell us if chocolate and its components might have a positive effect on people with migraine.
If you have any questions or concerns about your migraine, you can contact our free helpline on 0808 802 0066 or via our online form.