How Does Caffeine Affect Headaches & Migraines? - Lauren Natbony, MD
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How Does Caffeine Affect Headaches & Migraines?

How Does Caffeine Affect Headaches & Migraines?

1. Regular caffeine consumers can get caffeine withdrawal headaches when they cut it out due to the abrupt cessation of the caffeine.  The body gets used to the effects of caffeine that, when it’s not consumed, there is withdrawal.  Headache is just one of the symptoms.  Withdrawal headache can happen with regular caffeine consumption even as little as a cup of coffee per day.  However, there seems to be a dose-dependent relationship and we think that the less caffeine consumed and the less frequently it is consumed, the less likely a person is to have a withdrawal headache. The threshold appears to be around 200mg of daily caffeine. Doctors, therefore, recommend that patients with migraine limit caffeine to 2 beverages daily or 200mg caffeine.

The reason why a headache occurs might be due to one of the pharmacological effects of caffeine – constriction of blood vessels in the brain. Thus, when caffeine is not consumed, the result is that blood vessels dilate too much which causes a headache. Caffeine may also have effects on neurotransmitters involved in head pain but the data on this is limited.

The best way to minimize withdrawal headaches is to stop caffeine gradually, cutting down by about 25% per week.  Those with frequent headaches should consider avoiding caffeine completely.

2.  We do not think that caffeine acts to prevent migraines. If caffeine is consumed daily, especially in combination with other analgesics such as acetaminophen, ibuprofen, etc. it can actually cause a medication overuse headache leading to more frequent headaches. Yes, headaches may improve and temporarily resolve when consuming caffeine at the moment. However, the cause of headache is the caffeine itself and must be stopped in order for headache frequency to decrease in the long run.

3. Caffeine withdrawal headaches tend to occur in the morning and abate with consumption of caffeine usually within 30 to 60 minutes. The headache is usually described as diffuse and throbbing.  It is a common cause of weekend headaches in those who consume caffeine during the workweek only. Withdrawal headaches usually resolve within seven days of stopping caffeine. However, those with daily headaches and those who consume excessive amounts of caffeine may take longer to see improvement.

4. While caffeine, in general, is thought of as a migraine trigger, it is not a trigger for everyone.  Triggers are very independent to the person and what is a trigger for one person may not be a trigger for another. Caffeine’s effects on a specific individual may, for example, depend on how much water one drinks as caffeine can cause dehydration.  

Caffeine can work as treatment for a headache usually when combined with analgesics such as acetaminophen or ibuprofen due to improved absorption of these pain relievers. It can also work on its own to relieve a headache however this is not universal.  It appears that those who suffer from less frequent headaches and are not regular caffeine consumers tend to respond better to the effects of caffeine.