Is Caffeine Good or Bad for Migraine? It's Complicated.

January 26, 2024
May 26, 2021
Is Caffeine Good or Bad for Migraine? It's Complicated.

Is Caffeine good or bad for migraine?

Caffeine has a strange relationship with migraine.  On the one hand, it is a common ingredient in many over the counter, and even prescription, migraine medications.  On the other hand, people with migraine are frequently told to avoid caffeine.  The truth is somewhere in between. 

Caffeine as a treatment for migraine

The reason why so many medications for migraine contain caffeine is because it definitely is an effective treatment for migraine.  Caffeine can be added to many acute treatments for migraine to increase effectiveness, and caffeine may be recommended by your doctor as a treatment for migraine in pregnancy.  

During migraine, some of the neurotransmitters released by the sensory system of the brain cause vasodilation.  Caffeine is a vasoconstrictive agent, and can decrease one of the effects of those neurotransmitters.  This in turn decreases the sensitivity of many of these nerves, and can shorten the duration and severity of a migraine attack.

A number of other headache disorders can also be treated with caffeine.  “Spinal” headaches, or headaches that are due to a leak of the spinal fluid, can improve with caffeine, because caffeine can help with regulation of the areas of the brain that control production of the spinal fluid.  A rare headache called Hypnic Headache (also known as “alarm clock headache” because it wakes you up at the same time every day with headache pain) is also treated with caffeine - but you actually have to drink before you go to sleep.  

Why caffeine isn’t so great for migraine

Although caffeine can help migraine, excessive caffeine can interfere with your mood, sleep, and appetite, and make those triggers more likely to lead to a migraine.  Excessive caffeine is typically defined as more than 100 mg of caffeine daily - about 3 cups of coffee.  Coffees and teas definitely vary, and each kind of roast and preparation can have varying amounts of caffeine. 

Like most other treatments for migraine, you can definitely have too much of a good thing.  Almost all treatments for migraine will have a limit - a maximum amount that you can use per week, beyond that amount you are at risk to develop more frequent and severe migraines.  This is called medication overuse headache, or “rebound” headaches. This is why you should keep track of how often you use each kind of acute medicine for migraine, and why you should know if caffeine is an ingredient in what you are using.  You might be using multiple medications with caffeine and inadvertently worsening your migraine. 

Caffeine withdrawal is a common trigger for migraine as well.  If you are used to drinking a specific amount of caffeine and you are now decreasing or stopping it completely, you might also precipitate a headache.  There are strategies that your doctor can recommend that might help you get off of caffeine more easily, and without triggering headaches. 

In conclusion, caffeine and migraine have a complicated relationship.  Caffeine can help migraine (and other headaches), but also worsen it.  Caffeine doesn’t have to be avoided if you have migraine, instead just make sure you are consistent with when you drink caffeine (to avoid withdrawal) and don’t drink it to excess. Always remember to listen to your body and try to track your body's reaction every time you consume caffeine.

If you are not sure how caffeine affects your body, download Neura Health app and get more information on how to track your triggers and what you should do to avoid them. And if you'd like to speak with a neurologist specializing in headache and migraine about your condition, join Neura today!

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Thomas Berk, MD FAHS
Thomas Berk is Medical Director at Neura Health, where he treats Neura patients via video visit. He is a former Clinical Assistant Professor at the Department of Neurology at NYU Grossman School of Medicine.
About the Author
Thomas Berk, MD FAHS is Medical Director of Neura Health and a neurologist and headache specialist based in New York City. A former Clinical Assistant Professor at the Department of Neurology at NYU Grossman School of Medicine, he has over 12 years of clinical experience. He graduated from the NYU Grossman School of Medicine and completed his neurology residency at NYU as well. He completed a headache fellowship at the Jefferson Headache Center in Philadelphia. He is a Fellow of the American Headache Society and has been on the Super Doctors list of rising stars for the past five years.

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