Migraine and caffeine
By: Rachel Baxter, Senior Communications Officer, The Migraine Trust
The relationship between caffeine and migraine is complex and still not fully understood. For some people, caffeine may act as a migraine trigger while for others it may help to stop an attack. In this blog, we answer commonly searched questions about migraine and caffeine.
Can caffeine trigger a migraine attack?
Yes, caffeine can trigger a migraine attack. Not everyone with migraine will be affected by caffeine and it may affect people in different ways. According to research, between 6.3 and 14.5% of people with migraine find that caffeine triggers their attacks.
Does caffeine cause migraine aura?
Caffeine is a migraine trigger which means consuming caffeine can lead to a migraine attack in some people. Certain people with migraine will experience aura such as visual disturbances, cognitive changes, and other sensory effects like changes to your hearing, while others will experience migraine attacks with no aura symptoms. As far as we know, caffeine won’t make it more or less likely that you have a migraine attack that involves aura. If you experience migraine attacks with aura, other migraine triggers will likely trigger these episodes too. About a third of people with migraine experience aura.
How much caffeine triggers a migraine attack?
Migraine symptoms and triggers can vary a lot from person to person. Therefore, there is not a set rule for how much caffeine might trigger a migraine attack. For certain people, just one cup of caffeinated tea or coffee may be enough to trigger an attack, while other people may need several coffees before they experience migraine symptoms. It’s best to listen to your body and keep a migraine diary to help you work out if caffeine is a trigger for you, and if so how much caffeine seems to trigger your attacks.
Why does caffeine trigger migraine?
We still don’t know exactly why caffeine triggers migraine, but there are a few potential explanations. First, caffeine is a diuretic, which means it can make you urinate more and dehydrate you. Dehydration is a common migraine trigger so for some people, caffeine may cause a migraine attack because it has caused the body to become dehydrated.
Caffeine withdrawal can also trigger migraine attacks in some people. If you regularly consume caffeine and then suddenly stop, this change in routine may be enough to trigger a migraine attack. So, to reduce your likelihood of an attack, if you normally have a morning coffee in the week, it’s best to maintain this routine at the weekend too.
Some researchers also think that caffeine’s effect on magnesium in the body may be linked to migraine. Some research suggests that people with migraine may be more likely to have low levels of magnesium, and some people find that taking magnesium supplements helps to prevent migraine attacks. Caffeine causes us to lose magnesium through our urine, so this may potentially contribute to caffeine’s effect on migraine.
It may also be possible that some people crave caffeine very early on in a migraine attack and so drink caffeine, rather than caffeine triggering their attack. It’s common to crave certain foods such as sugary foods in the premonitory stage of a migraine attack, before the main attack symptoms like head pain and nausea begin. It’s thought that some people may crave something caffeinated during the premonitory stage as this stage of migraine can make you feel sleepy and therefore you might feel like you need a coffee to wake yourself up. Find out more about premonitory symptoms and migraine here.
Can caffeine help to relieve a migraine attack?
Although the exact role of caffeine in migraine is still unclear, research suggests that the addition of caffeine can make over-the-counter pain medication more effective. It is also thought that caffeine’s effect on certain receptors in the brain called adenosine receptors may help to relieve migraine.
Everyone’s experience of migraine is unique and treatment often involves a lot of trial and error. While some people may find acute treatments containing caffeine or consuming caffeine when they’re having a migraine attack may help to treat it, this likely won’t work for everyone. If you find you are particularly sensitive to caffeine and it triggers your migraine or makes it worse, it’s best to avoid caffeine.
Why is there caffeine in some migraine medicine?
Caffeine is sometimes added to pain-relieving medicines because it can boost the effect of the painkiller. Various over-the-counter painkillers, such as Anadin Extra and Paracetamol Plus, contain caffeine.
It is important not to take painkillers too frequently as it can lead to medication overuse headache, which is where headache and migraine become worse due to taking acute medication too often. Avoid taking paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen on 15 or more days a month, and ergotamine, triptans, codeine and combination painkillers on 10 or more days a month. If you find you need to take these drugs frequently to treat your migraine symptoms, speak to your GP about trying a preventive medication instead.
I live with migraine, how much caffeine can I consume?
Everyone will have different tolerances to caffeine, however, a 2020 study on caffeine and migraine recommends that people with migraine don’t consume more than 200mg of caffeine a day. This is roughly equivalent to two cups of caffeinated tea, one mug of filter coffee, two mugs of instant coffee or five cans of Cola.
If you enjoy caffeine, it’s important to also make sure you keep your consumption consistent and have the same amount each day to avoid migraine attacks and headaches caused by caffeine withdrawal.
If you are concerned about your caffeine consumption or the effects it may be having on your migraine, speak to your GP.
Find out more about migraine triggers here. Learn more about cravings and the premonitory stage of migraine here.