As is frequently the case with food intolerances, one person will not react to a specific food, whilst another can suffer a severe reaction to the same food. Consider the shellfish - a killer for some, a healthful food for someone else.

Caffeine is a double edged sword when it comes to migraines, as many believe it causes them - yet it is a major ingredient in many headache medicines as well. Many studies have been done on the efficacy of caffeine when used to relieve migraines; as a natural vaso-constrictor, it would seem that caffeine might help rather than intensify migraine pain. Several studies have shown that when caffeine is included as an ingredient in migraine medications, relief is faster and more complete(1).

However, there is some evidence to suggest the link between caffeine and migraines hinges on a borderline addiction. Weekend headache or Sunday migraine often occurs when the usual daily routine is disrupted - or in other words, when a person sleeps in and misses their 6am, 7am and 8am cups of coffee. The body goes into withdrawal mode, and a migraine begins. The headache clears after the caffeine ingestion.

A study on the subject at the Princess Margaret Migraine Clinic, London in 1992, concluded that amongst a chosen group of migraine sufferers, there was a noticeable tendency towards high caffeine consumption during the week. Among the 151 patients, 33 were identified as having weekend migraine. Of these, everyone reported sleeping in late on weekends; with a subsequent average consumption of 734 mg. per day of caffeine.

In contrast, of the remaining 118 patients only 43% slept late on weekends, and of these the average caffeine was only 362 mg/day(2). This lends credence to the idea that it is the withdrawal from dependency that is the trigger rather than the coffee or tea being the cause.

Soda seems a slightly different story - a study done on adolescents who drank a liter of cola a day and suffered from daily migraines showed a marked improvement across the board when cola was cut from the diet. This led to the recommendation that children with daily recurring headache be researched as to caffeine intake(3).

The scientific studies are fascinating and useful, but however much we enjoy it, caffeine is a substance we can live without. The simple way to discover if it's a problem for you is just cut it out for a few weeks. If you suffer enough with your migraines, you might find the exclusion brings relief. However, be aware that there will be a tendency to suffer an initial increase in headaches, due to the possible "withdrawal syndrome" as discussed above. Consult your GP or health professional if you are concerned.

For coffee, tea and cola drinkers, instead of complete elimination, a gradual lessening of daily caffeine consumption may be the best way to remove the possibility of the excess or lack of it triggering a migraine. On a personal note, I was a heavy coffee consumer and suffered severe and regular migraines. I rarely get a migraine now and enjoy one cup of coffee per day, having found this an acceptable level which doesn't cause any me problems.

(1) Stephen J. Peroutka; James A. Lyon; James Swarbrick; Richard B. Lipton; Ken Kolodner; Jerome Goldstein Headache: The Journal of Head and Face Pain, Volume 44, Number 2, February 2004 , pp. 136-141(6)

(2)EGM Couturier, R Hering, and TJ Steiner, Weekend Attacks in Migraine Patients: Caused by Caffeine Withdrawal? Cephalalgia 12(2):99-100 (Apr 1992)

(3) Hering-Hanit R, Gadoth N. Caffeine-induced headache in children and adolescents. Cephalalgia 2003;23:332-335.