The Caffeine And Migraine Relationship: What You Need To Know

Fact: Caffeine can relieve migraine and make pain medicine work more effectively. Yet, caffeine––or the lack of it––can also trigger a headache. How can both of these things be true at the same time? For those of us who perk up around the aroma of freshly-brewed coffee, these contradictions might leave us confused. Is caffeine okay or not for people with migraine? Let’s take a closer look at the relationship between caffeine and migraine.

Caffeine And Migraine: The Stimulant That Helps Pain Go Away

Caffeine has well-known pain-relieving properties. Studies have found that doses of 200 mg can help reduce tension-type and migraine headaches. Painkillers with caffeine (Anacin, Excedrin Migraine, Excedrin Extra Strength, Vanquish) are remarkably effective as quick-fixes. Even a cup of coffee can reduce head pain.

Caffeine inhibits adenosine receptors in the brain. Adenosine is a neurotransmitter, which promotes pain and inflammation in the brain. Caffeine inhibits adenosine from doing its job. In addition, when adenosine is blocked, the brain chemical dopamine becomes more plentiful–– which gives us a feeling of pleasure. Between stopping pain and allowing more dopamine to flow, it’s no wonder caffeine helps to relieve head pain. 

Caffeine also helps other pain medicines work better. It increases the activity of acetaminophen and aspirin in the body and decreases their clearance, so they work longer on treating pain. Studies have shown that adding caffeine to other pain medicines decreases the dose of the pain medicine required to achieve pain relief.

And yet…

Caffeine Can Help Create Pain

Some people tolerate caffeine better than others. If you’ve ever taken a home genetic test, you may have seen we have a genetic marker for the body’s ability to metabolize caffeine (the genes XYP1A2 and AHR). It means that for some, caffeine is quickly processed out of the bloodstream, but for others, it lingers longer. People who are more sensitive to caffeine appear to be more vulnerable to it contributing to an attack. In these people, the relationship between caffeine and migraine is actually a negative one.

Caffeine withdrawal hurts. Anyone who has skipped their regular morning cup is familiar with a caffeine headache. Some call it the “weekend migraine,” because people tend to sleep later on the weekend, pushing back the time of their morning cup. Caffeine withdrawal is thought to contribute to migraine attacks.

• • If you’ve been using more than 200 mg per day, you’re more likely to notice withdrawal symptoms. The severity of your symptoms (fatigue, mood changes, poor concentration, nausea, muscle aches, runny nose) depends on how much caffeine you’ve been consuming and your own ability to process caffeine.

• • If you’re going cold turkey, caffeine withdrawal may last up to ten days. Caffeine pill packs can help you avoid withdrawal symptoms by gradually decreasing the dosage.

Links to rebound headache syndrome. When medicines with caffeine are taken more frequently than directed, they’re known for leading to rebound headache syndrome (also called “medication-adaptation” headache). That’s when the body develops a dependence on and craves more of the drug once the medicine has left the system. It signals that need with head pain. To avoid this syndrome, be mindful of your caffeine intake, whether in your pain-relief medicine or food and drink. Try not to use caffeine more than once a day––or pain medicine more than ten days a month.

So What’s The Final Answer On Caffeine And Migraine?

The science is inconclusive about whether caffeinated beverages can kickstart a migraine attack. What’s clearer is that some people are more susceptible to the effects of caffeine than others. So, if you’re someone who consumes caffeine, monitor your dosage.

Be consistent in your caffeine consumption. Experts recommend having the same amount, same time of day, and no more than 200 mg per day. Don’t forget to have some on the weekends if you drink it during the week. The migraine brain does not like change.

Limit pain relief meds with caffeine. Experts recommend using them no more than twice a week. Above that limit, you are at risk for rebound headache syndrome. 

Now that you have the facts, your caffeine intake is an aspect of migraine management that is well within your control. A little bit of trial and error will help you find the caffeine balance that’s right for you.