Caffeine and migraine

Day seven of my struggles with migraine; was just awakened at 3am by a new one. I've been trying to "taper off" my caffeine use gradually through this time, since I suspect that caffeine (or, specifically, caffeine withdrawal) may be a major factor in causing my headaches. It may not be the only factor, or, if there is more than one trigger at work, the decisive one, but the most effective way to get rid of my headaches is to throw caffeine at them, which makes me wonder if they're really all just about withdrawal. It's always been strange to me, given how personally plausible this is in my own case - and how other migraineurs I've met describe similar symptoms - that no one seems to have investigated this seriously.

My theory, in reducing caffeine intake as a means of ending my migraines, has been:

1. My increased caffeine consumption in recent weeks may have led to a state of stronger-than-usual dependency on the substance; as of last Wednesday, when I first noticed symptoms, I was drinking as many as four cups of coffee a day, regularly - two with breakfast and two others spaced throughout the afternoon, maybe with a shift to chai or black tea in the late afternoon and evening. It was, in fact, quite a lot of caffeine to be taking on a daily basis, especially for someone who periodically quits the substance altogether and considers himself highly sensitive to addictive chemicals and behaviours...

2. My headaches are entirely thus perhaps caused by the withdrawal of the substance; I've now developed a strong enough dependency on caffeine that if I don't take it every few hours, migraine will result - even if I'm fast asleep.

3. However, if I completely quit using caffeine, cold turkey, so to speak, the headaches will become much worse, whereas now, drinking the occasional cup of chai or tea keeps them manageable. (I eliminated coffee almost instantly from my diet last Thursday, the day after the first flickering symtoms, but I've had lesser sources of caffeine through the week, spaced through my day, and have had relatively mild pain, compared to the experience of quitting caffeine cold turkey, which I've done in the past). There is also the possibility, of course, that continuing to have any caffeine in my life at present is simply prolonging this bout of migraines, and that if I had just opted to have a weekend of severe pain, I'd be over the worst of it now, but... for obvious reasons contained within the phrase "a weekend of severe pain," I have elected not to follow that route.

4. But if I can eventually taper down my caffeine use - perhaps to the point of quitting altogether - the withdrawal symptoms may dissipate. Past experience shows this - after my last round of migraines, a few years ago, I completely cut out caffeine, suspecting its role, and was migraine free for quite some time. Back then, I gradually reintroduced caffeine - a substance I enjoy and value, despite its occasional ill effects - in the form of green tea, and then black tea, with no problem, and kept up their use for years without headache, only occasionally drinking coffee during this time. I did not return to regular coffee consumption until the early spring of 2010, when my new work schedule made the use of a strong morning stimulant seem appealing. I found myself enjoying a regular coffee on the West Coast Express; and it seemed quite natural to decide to buy a coffee maker at a thrift store and make my own, to cut down expenses. But caffeine is addictive, so my morning coffee on the train, since buying the coffee maker, has turned into two or three coffees in the morning, with more consumed at work... I'm rather embarrassed that I didn't see this coming.

What's most interesting to note is that since I last experimented with kicking caffeine as a possible remedy for these headaches, a website has sprung up - Caffeine and Migraine, written by one Barry Spencer - postulating exactly the thesis I'm operating under - that migraine, and indeed primary headaches, are caused by caffeine. The introductory passage is not the best-written section; I recommend starting with the conclusion, and then going back and looking at the Caffeine and Migraine sections, respectively, for his evidence. From his conclusion:

Pharmaceutical corporations sell billions of dollars worth of headache and migraine medicines each year, including tons of caffeine sold in the form of headache remedies. The companies that manufacture and market caffeine-containing headache remedies don't want any discussion of the possibility their wares may cause more headaches than they relieve. Those companies blame their customers for chronic headaches caused by addiction to their caffeine-containing headache medicines, claiming it's their customers' fault for failing to follow the instructions on the label and taking the medicines too often. But if a company sells an addictive drug that many of its customers become addicted to, whose fault is that? Pharmaceutical companies would prefer migraine remain a chronic, incurable, but manageable condition—managed by steady use of their increasingly sophisticated and expensive proprietary migraine drugs. If research determined caffeine withdrawal was the major or sole cause of primary headaches including migraine, and that most or all migraine patients can, therefore, eliminate their migraines without resorting to expensive drug therapies, companies that make and market migraine medicines stand to lose a lot of money.

Food companies that market caffeine [also] don't want consumers making connections between dietary caffeine and headaches...

...There may be very good reasons why the causal role of caffeine in headache and migraine would go undetected, in such a climate. I admit that this rather conspiratorial take on migraine appeals to me for political reasons, but Spencer's arguments also mesh with my own experiences with migraines. I'm sure if I were to eliminate all caffeine from my diet for a period - a difficult propositon, but one I've been able to do before - my headaches would stop altogether. It's a bit of an annoyance that I like caffeinated drinks so much, considering...