This post was written by Dietician Nutritionist Kacie Ferguson – these questions were asked by you on Instagram! If you have further questions, direct them to Kacie, whose information can be found at the bottom!
My name is Kacie, but you may know me as the Migraine Nutritionist.
I help people with chronic migraine go from frequent debilitating flares to enjoying more pain-free days, without getting lost in the confusion or overwhelm. I do this through my personalized 3-month coaching program focused on Mindfulness, Exercise, Nurture, and Diet (MEND).
I’ve been experiencing migraine attacks since I was just 10 years old, and have learned how to complement traditional migraine management with a holistic approach for better outcomes. I am a Registered Dietitian Nutritionist that helps migraine clients navigate lifestyle and nutrition strategies.
Today I’ll be answering questions submitted by YOU about migraine nutrition.
If Caffeine & Alcohol Both Trigger Migraine, what else should I avoid?
There actually aren’t any universal dietary triggers for migraine! However, there are many “common” or well-known food triggers. Ones I see a lot are…
- Aged foods – Tyramine is a chemical that increases in foods over time.
- Alcohol – This causes dehydration and contains high tyramine and histamine levels.
- Caffeine – A change or withdrawal of caffeine is the typical trigger.
- Histamine – Some foods are naturally high in histamine, some cause a release of histamine in the body, and histamine is released from exposure to allergens.
For more depth on common migraine food triggers, read my article titled “Food Triggers & Migraine”.
What are The Top 3 Things I Should Eat to Deter Migraine?
Incorporating each of these foods in every meal and snack will help you feel your best and prevent migraine attacks.
- Fat – avocado, olives, seeds, dairy
- Fiber – fruits, veggies, grains
- Protein – meat, seafood, beans, eggs
That probably wasn’t the answer you were looking for, but that’s the best place to start! Creating balance in the diet is what I first focus on with clients.
Once you have these basics down, here are my top 3 recommendations to consider including:
- Ginger – this can help prevent attacks and treat nausea
- Fatty fish – full of healthy omega-3 fats
- Leafy greens – rich in antioxidants, fiber, and magnesium
What are the Best Foods For Migraine?
My nutrition philosophy includes intuitive eating and gentle nutrition. I try not to label foods as “good” or “bad”.
What I’d like to suggest instead is consuming a variety of nutrient-dense foods.
- Don’t be scared of using canned or frozen alternatives!
- In canned items, look for “no salt added”
- Whole grains
- The first item on the nutrition labels of breads and wraps should read “whole grain”.
- Beyond the obvious meat and seafood products, make sure to include plant proteins. Some of my favorites include canned beans or peanut butter.
- Fat is flavor! And so important for brain health. Things to look for include unsaturated fats (nuts, seeds) and omega-3 fats (fish, chia seeds).
I’m doing the Heal Your Headache Diet, Should I Reintroduce Coffee?
The purpose of elimination diets like the “Heal Your Headache” diet (HYH) is to learn what your personal triggers are.
In the elimination phase, you have a short list of “safe” foods to stick to for a period of time. If you see results from elimination, it can be tempting to stick with your short list of “safe” foods, but that may do more harm than good. You may develop food fears (fear is a potent attack trigger!), new food sensitivities, or even nutrient deficiencies.
Caffeine can be tricky for migraine though (even more tricky in vestibular disorders)! My recommendation would be to proceed with caution. Start small, have a cup of half-caff or an alternative like tea. Over time you’ll be able to determine how caffeine impacts your migraine and whether it can fit into your diet.
What if I can’t give up coffee?
People with migraine are frequently advised to cut out coffee. I don’t think this advice is appropriate for everyone!
Here’s who DOESN’T need to cut back:
- If you’ve eliminated coffee before and saw no results.
- If you have infrequent migraine attacks.
- If your coffee consumption is mild, under 2 cups a day.
If you need to cut back but really don’t want to (I get it, I’m a coffee lover too!) I have a 5-step painless process to follow.
- Reduce your volume of coffee, ideally to 1 or 2 cups a day.
- Switch from 100% caffeinated to 75% caffeinated + 25% decaf.
- 50/50 mix of caffeine and decaf.
- Taper to 25% caffeinated + 75% decaf.
- Enjoy your freedom from caffeine!
People with vestibular disorders tend to be more sensitive to caffeine than the “average” person with migraine, so I recommend you seriously consider following this 5-step process!
Caffeine can be a tricky topic to navigate, read my article titled Caffeine & Migraine: Friends or Foes? to learn more.
Should I do a Food Sensitivity Test First? Which do You Recommend?
I love food sensitivity tests, but it shouldn’t be a first resort. There are often many other strategies to try first!
With my clients, we first look at their daily routines. There are so many small but powerful switches that can be made to prevent migraine attacks like getting better sleep, eating snacks throughout the day, adding a few minutes of mindfulness, and more.
However, if your diet and lifestyle are consistent but you aren’t seeing improvement, it may be time to look into food sensitivities.
I recommend the MRT (Mediator Release Test) for food sensitivities. This is a blood test that analyzes your immune response to 170 foods and chemicals. Not only will you see what you’re potentially sensitive to, but you’ll see just how reactive you are to each food or chemical.
Most food sensitivity tests just look at IgG, just one antibody potentially released in response to a sensitivity. MRT looks at the release of inflammatory mediators (what actually causes symptoms) after an immune response from antibodies or white blood cells.
Another reason I love MRT is the support you receive from a dietitian. After the test results come in, we work together to create your own personalized elimination diet. You eat non-reactive foods until your symptoms subside, then reintroduce your potential sensitivities to see what foods are safe for you.
What are the Best Vitamins to Take for Vestibular Migraine?
Speak to your physician before trying new supplements. Sometimes there may be a reaction with your prescription medication or something in your health history that could be a red flag.
Common supplements I recommend include:
- Vitamin B2
- PA-Free Butterbur
- Vitamin D
If I’m to Take 600mg of Magnesium, how much Magnesium Oxide (4% bioavailable) is it? 16g?
Magnesium is one of my favorite supplements for migraine! It’s shown to both prevent attacks and treat attacks. Speak to your physician about a suggested dose, but typically 400-500mg is recommended for migraine.
To create a supplement, Magnesium is bound to another compound like citrate, oxide, glycinate, malate, or something else. Some of these compounds are larger than others, changing how much magnesium is available to absorb.
It’s true that Magnesium Oxide has a lower level of bioavailability, but it’s an affordable option and can be beneficial if you struggle with constipation. Alternatives I would suggest include:
- Magnesium Citrate – This type is more bioavailable, also helps relieve constipation, and is very popular.
- Magnesium Glycinate – This type won’t cause digestive symptoms!
- Magnesium L-Threonate – Although more expensive, this type passes the blood-brain barrier, which could be beneficial for treating attacks. (During attacks, we tend to have low levels of magnesium in our brains.)
Is the Mediterranean Diet Conducive for Healing from Vestibular Issues?
I love the Mediterranean diet! Time and time again, it has been ranked as one of the best diets by nutrition experts. The American Heart Association defines the Mediterranean diet as:
- emphasizes vegetables, fruits, whole grains, beans and legumes;
- includes low-fat or fat-free dairy products, fish, poultry, non-tropical vegetable oils and nuts; and
- limits added sugars, sugary beverages, sodium, highly processed foods, refined carbohydrates, saturated fats, and fatty or processed meats.
A balanced, nutrient-rich diet like this is great for everyone! This includes people with migraine, vestibular migraine, or other vestibular disorders.
There’s no single perfect diet for vestibular disorders, so don’t be discouraged if the Mediterranean diet doesn’t work for you. However, I’d like to highlight some of the features of this diet you could incorporate into your way of eating to ease vestibular symptoms.
- Hydration is incredibly important! Drink plenty of water and load up on hydrating foods like water-rich fruits and vegetables.
- Limiting salt can benefit some conditions like vestibular migraine. Focusing on whole foods, opting for “no-salt-added” canned products, and limiting how often you dine out are some easy ways to eat less salt.
- Limiting sugar may ease dizziness and related symptoms. Replace traditional sweets with fruit over time to slowly taper off of sugar.