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Caffeine and Migraines

Caffeine and its role as an abortive or trigger for migraines has been long debated. It creates a lot of confusion for patients as many migraine relief medications or over the counter abortive medications contain caffeine in their chemical compound!

We have patients that know that if they miss their morning cup of coffee, they WILL get a migraine that day. Or if they try to wean off of caffeine their migraines will return. Does this sound like you?

We are here to share with you that any sort of consumption of caffeine such as coffee, chocolate, even decaffeinated beverages is not beneficial for someone who suffers from migraines.

Yes we said it. People who suffer from migraines SHOULD NOT intake caffeine.

We know this is not what a lot of patients who suffer from migraines want to hear but here is why….

Caffeine in medications is used as an abortive measure. Meaning these medications are designed as a strategy to reduce pain once the head pain has already begun. The problem with this is that migraines can start up to two or three days before any symptoms or pain has been experienced. Even an aura or any sort of visual disturbance can cause a migraine to occur days later.

We now know that a true migraine is not just head pain. A migraine is a neurological disorder that is caused by a cortical spreading depression throughout the brain which can result in severe head pain. Cortical spreading depression is a slow propagated wave of activation neurons across the brain which causes an alteration in brain function.

The caffeine in these medications is used to get rid of the pain once the migraine has already begun, they are not designed to stop the actual migraine event or address the actual cause of the migraine.

This is where it can get confusing. Caffeine can help to reduce the pain felt from a migraine in its acute phase, but it does not prevent the migraine from ever occurring or prevent the cortisol spreading depression from beginning. Actually, caffeine causes an increase in sensitivity, leaving migraine patients more susceptible to experience another migraine.

Why do I feel worse when I reduce my intake of caffeine?

This is due to withdrawal of caffeine from the body.

Why would caffeine make me more susceptible to getting a migraine?

Individuals that suffer from migraines are genetically predisposed to having dysfunction in the brain which results in the individual’s neurons to be more susceptible to becoming overstimulated.

Let’s explain this further.

Our neurons are the single cell that makes up our brain and nervous system. All neurons have a membrane potential in their cell bodies. Once a neuron’s membrane potential hits threshold an action potential is created. An action potential is how neurons communicate with each other by transmiting signals and messages that are carried throughout our nervous system. In a migraine patient, the neuron’s membrane potential is CLOSER to threshold than compared to someone who does not suffer from migraines. Meaning, that it is easier to cause the membrane potential to hit threshold in a migraine patient versus someone who does not suffer from migraines. Which is why a lot of migraine patients are sensitive to sound, light and movement because it will cause the neurons to hit threshold and the cortical spreading depression will begin, resulting in a migraine.

How does this relate to caffeine intake?

Caffeine is a stimulant and it causes an individual’s nerves to be more excitable and closer to threshold. When a patient who suffers from migraines intakes caffeine the resting potential of their neurons becomes closer to threshold which makes their neurons more susceptible to hit threshold and result in a migraine. This is also a reason it can be difficult for a patient to figure out their migraine triggers. In this case scenario, anything like working on a computer screen, sunlight, or loud sounds can cause a migraine to occur if the neurons are that close to being activated. This is why it is best for an individual who suffers from migraines to avoid caffeine.


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