Caffeine can be both a source of relief and a trigger for migraine attacks. Caffeine and medications that contain caffeine can help to address the early pain symptoms of a migraine, and caffeine withdrawal or overuse may contribute to migraine attacks and headaches.
Some members of MyMigraineTeam, the social network for people with migraines, comment about their use of caffeine to alleviate migraine symptoms. “When I have a migraine and the tablets aren’t working, if I take them with coffee, it helps a lot,” wrote one member.
However, other MyMigraineTeam members say how caffeine triggers their migraines. “Caffeine can be a super migraine trigger in many of us. I love coffee drinks and Diet Coke, but it is usually not worth it because I need more caffeine the next day,” said one member.
Migraines affect more than 1 billion people worldwide and an estimated 23 million to 25 million Americans, but there is still a lack of concrete understanding about the underlying causes and effective methods for treating migraine attacks. Migraines are a highly personal experience — different people experience different symptoms and triggers, including hormonal changes, food and food additives, stress, and even changing weather patterns.
The research on migraines and caffeine has found that caffeine can be effective as an acute treatment for migraines. However, the risk of migraines due to caffeine withdrawal or overuse is motivation to keep a low, consistent daily caffeine intake (less than 200 miligrams). Do not attempt quitting caffeine cold turkey, as this can also cause migraines.
For people who don’t already consume caffeine daily, caffeine use should be approached cautiously and possibly with the consultation of a doctor, as there is a high chance of caffeine dependency.
Caffeine can help to relieve symptoms of a migraine attack and also speed up the pain-relieving effect of over-the-counter medications like Tylenol (acetaminophen). According to the American Migraine Foundation, caffeine can enhance the body’s ability to absorb pain-relieving medications and is even included as an ingredient in migraine medications like Excedrin, Migranal, Anacin, and Midol.
A systematic review examined findings related to caffeine and headaches and found that compared to taking analgesic (pain-reducing) medications alone, people who ingested caffeine with analgesics like ibuprofen, acetaminophen, and acetylsalicylic acid experienced more effective pain relief for their migraines or tension-type headaches.
Caffeine intake through coffee, tea, soft drinks, or energy drinks is a common home remedy for people who experience migraines, and it is sometimes recommended by doctors as a treatment for headaches (both migraine and nonmigraine headaches).
“I try to drink a lot of water, get some caffeine, and just do the best I can,” wrote a member on MyMigraineTeam on dealing with a migraine attack.
There are several mechanisms by which caffeine may work to relieve migraine symptoms.
Initially, caffeine was thought to help migraine symptoms because it works as a vasoconstrictor (a substance that constricts blood vessels and reduces blood flow) to counteract the dilation (opening) of blood vessels and increased blood flow that was thought to cause migraines. More current theories examine the neurological (nervous system) effects rather than the vascular (related to blood vessels) effects of migraines.
One theory proposes that caffeine helps to regulate the activity of adenosine (a naturally occurring substance in the brain). During migraine attacks, people have an increased amount of adenosine in the blood, and injections of adenosine have been shown to cause migraine attacks. Caffeine works to stop adenosine activity, but it is not clear how this mechanism leads to reduced headache and migraine pain.
Another recent idea is that caffeine intake may affect migraine symptoms by having an impact on the relationship between migraines and the gut-brain axis (the biological connection between the gut and the brain). One study found that coffee specifically was associated with changes in the bacterial composition in the gut. Another study found that the use of probiotics (supplements containing healthy bacteria that promote gut health) benefited migraine symptoms.
Although caffeine helps to relieve symptoms in some people with migraines, it can trigger migraine attacks and symptoms in other people. Dietary triggers are not the most common types of triggers for migraines, but studies show that about 6.3 percent to 14.5 percent of people with migraines report caffeine or coffee to be one of their triggers.
The main way that caffeine can trigger a headache is due to dehydration. Caffeine can trigger migraines after it is ingested, or people may experience caffeine withdrawal. Caffeine has also been shown to increase the risk for a worsening migraine condition — from episodic migraines to chronic migraines.
One MyMigraineTeam member said, “By using caffeine for migraines, you run the risk of a bounce-back headache, and then the pain is even worse.”
Withdrawal from caffeine has been shown to trigger migraine attacks in some people. Caffeine withdrawal is a process that results after a person becomes dependent on caffeine. From ingesting caffeine daily, the brain becomes used to this exposure and develops a tolerance to caffeine.
Then, when the brain expects to receive a specific substance (in this case, caffeine), a dependency has developed. The amount of caffeine ingested daily to develop a dependency depends on the person but can be as little as 100 milligrams of caffeine per day. If the brain is expecting caffeine, but you don’t ingest any, you will experience withdrawal. Caffeine withdrawal could lead to increased blood flow in the brain, which is a known cause of headaches and migraines.
Withdrawal headaches can last up to several weeks as the body becomes accustomed to not consuming caffeine. However, not everyone who consumes caffeine will develop a dependency or experience withdrawal symptoms.
The regular or occasional overuse of caffeine may also trigger a migraine attack. One study examined 98 adults with episodic migraines and found that headaches were triggered by consuming three or more servings of caffeinated beverages in a day. (A serving is considered 8 ounces of coffee, 6 ounces of tea, 12 ounces of soda, or 2 ounces of energy drink.) One to two servings of caffeine for regular caffeine consumers had no effect on migraines on that and the following day.
According to the American Migraine Foundation, people who experience occasional migraine attacks and consume caffeine every day are at an increased risk of developing chronic daily headaches. Furthermore, the use of caffeine can lead to the development of something called medication-overuse headache or rebound headache. This is a secondary disorder through which the excessive use of an acute medication like caffeine causes increased headaches.
As mentioned in this article, caffeine may help some people with migraines, and it may induce worse or more frequent headaches in others. Here are some tips regarding caffeine if you live with migraine:
If you have more questions about migraine attacks and caffeine, joining a support group and asking others about their experiences may be helpful.
MyMigraineTeam is the social network for people living with migraine. On MyMigraineTeam, more than 72,000 members come together to ask questions, give advice, and share their stories with others who understand life with migraine.
Does caffeine affect your migraine attacks? Share your experience in the comments below, or start a conversation by posting on your Activities page.