A study carried out by BIDMC (Beth Israel Deaconness Medical Center), Brigham and Women’s Hospital and HSPH (Harvard T.H. Chan School of Public Health) and published in the American Journal of Medicine examined caffeinated beverages as the possible causes of migraine.
In the research led by Elizabeth Mostofsky, ScD, of BIDMC’s Cardiovascular Epidemology Research Unit and HSPH’s Department of Epidemiology, it was found that in case of patients suffering from episodic migraine, one or two doses of caffeinated beverages a day do not cause a headache, however, drinking three or more of these raises the risk of migraine attacks on the given day, or possibly the day after.
The research revealed that while most of the causes of migraine attacks – such as sleep deprivation – only raise the risk of migraine, the role of caffeine in this field is complex because it may trigger the pain on the one hand, but on the other hand, in some cases, it may even help in treating the symptoms of migraine. The effect of caffeine depends on its quantity and its frequency, however, since few prospective studies have been conducted about the immediate risks of migraine headaches after the intake of caffeine, there is only a restricted amount of evidence available for making dietary recommendations for patients suffering from migraine.
In the prospective cohort study, 98 adults suffering from frequent episodic migraine filled out an electronic journal for a period of 6 weeks. The participants of the study reported about the quantity of caffeinated coffee, tea and energy drinks they consumed each day; furthermore, they completed a report about their headaches twice a day, which presented the headache in a detailed way: its length, its intensity and the medications applied since the last journal entry. The participants provided detailed information about other frequent causes of migraine as well, such as the use of medications, the consumption of alcohol, the level of physical activity, symptoms of depression, psychic stress, sleeping habits, as well as their menstrual cycle.
To assess the connections between the consumption of caffeinated beverages and the migraine headache experienced in the same day or the day after, Mostofsky, Bertisch and their colleagues applied an analysis in which they compared the daily occurrence of each participants’ headaches with the quantity of the caffeinated beverages they consumed, as well as the occurrence of the same participants’ headaches on the days when they did not consume any caffeinated beverages at all. This method eliminated the possibility of the confusion of the results by different variables, such as gender, age, and other demographic, behavioral, or environmental factors. The researchers also examined the results in accordance with the days of the week, thus, eliminating the differences between weekday and weekend habits, which may also influence the occurrence of migraine. Furthermore, this method made it possible to distinguish between the caffeine doses of different caffeinated beverages.
One dose of caffeine is usually determined as eight ounces or one cup of coffee; this quantity is the same as six ounces of tea and two ounces of energy drink. These doses contain between 25-150 milligrams of caffeine, therefore, it is not possible to determine the exact quantity of caffeine that increases the risk of migraine. However, in this study, the participants had to be consistent in choosing their caffeinated beverage throughout the six-week-long period.
All-in-all, the researchers did not find a correlation between the consumption of one or two doses of caffeinated beverages and the risk of headache occurring the same day; however, the occurrence of headache had a bigger probability when three or more doses of caffeinated beverages were consumed. Nevertheless, in case of people who rarely consume caffeinated beverages, even one or two doses increased the risk of headache.
Despite of the frequent occurrence of migraine and its serious symptoms, the prevention of migraine is still an unresolved issue for many patients. This study explores a new point of view in the field of examining the short-term effects of caffeine consumption concerning the risks of migraine headaches. Interestingly, despite some patients suffering from migraine believe they have to avoid caffeine, this study shows that the consumption of one or two doses a day does not imply a higher risk of headache. Of course, further studies are necessary to confirm the previous findings but these results definitely mean remarkable new knowledge in the field of migraine treatment."