What is it?: a natural chemical that acts as a central nervous system stimulant
Where is it?: coffee, chocolate, sodas, some pain relieves like Excedrine
Is it a common trigger?: yes – and a common treatment!
Caffeine is a central nervous system stimulant and has multiple effects on your body and mind.
It causes alertness, which is undoubtedly why most of us enjoy it as part of our daily routines.
The other effects of caffeine include temporarily increased blood pressure and heart rate, stimulation of the bowels (aka makes you poop), increased acidity in the stomach that can lead to heartburn, and interestingly enough a decrease in the risk of Alzheimer’s, dementia, and oral cancer.
When you have caffeine – let’s say a cup of coffee – that caffeine makes its way to your brain and shoos away a chemical called adenosine, which is responsible for making you sleepy.
The caffeine takes the place of adenosine in your brain, but that adenosine doesn’t go anywhere – it sticks around and waits for the caffeine to wear off, and when it does, adenosine swoops in with a vengeance.
This explains that lovely crash you experience once caffeine wears off.
Many people who have plain old headaches notice that caffeine can often get rid of their pain – but for people with migraine, it’s not quite as straight forward.
Before a migraine episode your blood vessels enlarge, and caffeine can reduce that action – helpful!
But if you’re dependent on caffeine, the withdrawal you experience once it wears off can actually trigger a migraine episode – not so helpful!
Caffeine can also increase stress and anxiety in sensitive people – also not helpful for migraine, as you know.
So what to do about caffeine? Enjoy it to your heart’s content or cut it out altogether?
The most helpful place to start with caffeine is to drink it on a consistent schedule.
That means figuring out how much caffeine you like to have every day and when you like to have it, and sticking to that schedule every day.
Personally, I like to have a cup of coffee in the morning as soon as I wake up, and another cup after lunch around noon.
I do this every day, pretty much without fail, and it works pretty well for me!
Your migraine brain likes consistency in all things, and that includes your caffeine intake.
If you’re looking for a specific amount of caffeine to shoot for, research tells us that 200mg seems to be a good amount for most women with migraine.
That equals about 2 home-brewed cups of coffee per day – but we’ll go over other sources of caffeine at the end of this lesson if you prefer other types of caffeinated drinks.
If you have trouble sleeping, try cutting your caffeine intake off at 3pm – and if that doesn’t help, move that time back to noon.
When to cut back or quit
You can use your body-connection superpowers to help you figure out if you need to cut back on your caffeine or quit altogether.
Notice how you feel when you have a cup of something caffeinated:
- Warm? Alert? Energized?
- What about jittery? Anxious? Sweaty?
Caffeine shouldn’t make you feel like you’re running a marathon or taking a high school exam – if it does, it’s probably a good sign that you’re caffeine sensitive and may want to consider cutting back.
Another reason you may want to cut back is that you’re caffeine dependent.
How do you know if you’re caffeine dependent? You experience a migraine episode when you skip your morning coffee or afternoon soda.
I’ll be totally transparent with you – I’m caffeine dependent! But I’m also in love with my daily cups of coffee. They’re part of my daily ritual and bring up warm, fuzzy memories. I’m also not caffeine sensitive – coffee doesn’t make me jittery or anxious when I drink it in reasonable amounts, and it doesn’t trigger my migraine (unless I skip it, of course).
If you’re caffeine dependent but not caffeine sensitive, you have two options:
Prioritize caffeine consistency – this is what I do.
Wean yourself off caffeine completely. This will allow you to reset your dependence on caffeine, and at some point you should be able to reintroduce it but in smaller amounts to prevent redeveloping dependency.
The choice is up to you! It all depends on how attached you are to your caffeinated beverage of choice and how it makes you feel.
There is no wrong answer here – but if you’d like to try weaning down the amount of caffeine you drink or cutting it out completely, I’ll tell you how I’ve done it in the past below.
Reducing Caffeine Intake
The first step is to be caffeine consistent without changing the amount of caffeine you’re consuming – aka drink the same amount of caffeine at the same time of day, every day.
Do this for about a week or so and see how you feel – if you like how you feel, stop here!
The next step is to make your last caffeinated beverage of the day half caf – so if that’s coffee, order a half caf; if that’s soda, choose a drink that has less caffeine or mix your regular soda with a decaffeinated version.
Do this for another week and see how you feel – again, if you like how you feel, stop here!
Next, try eliminating that last caffeinated beverage altogether or making it decaf. Try this for a week and see how you feel.
You can continue in this pattern with each of your caffeinated beverages throughout the day, always starting with your last drink. Do this until you find your personal caffeine sweet spot!
The method I use for cutting out caffeine is the same as the one we just discussed, except you continue on until all caffeine has been eliminated.
I find that it’s particularly important to replace those caffeinated drinks with something else when you’re eliminating caffeine so you don’t feel deprived. Choose any decaffeinated drink that satisfies you, whether that’s tea, decaf coffee, seltzer water, whatever!
One note about decaf coffee:
When possible, choose brands that decaffeinate their coffee using the swiss water processing method or the CO2 method.
These processes do not rely on chemical methods to remove the caffeine, which is good news if you’re particularly sensitive to additives in food.
Atlanta, GA·Updated Wed, October 7, 2020
Hey friends! I’m Kelli, your favorite dietitian and trusty migraine guide.