Does caffeine help migraine or worsen it?

Woman migraine due to caffiene Caffeine migraine (Image: Canva)

The other day at a cafe, my friend asked me what my choice of beverage was, coffee or tea? Without missing a beat, I said: “Anything is fine as long as there’s caffeine in it.” You see, caffeine is more than just a habit for me. Over the years, it has become the pivot of my existence. Without a cup of coffee or tea in the morning, I will be left with a debilitating headache. There are scores of others like me who are at the mercy of the brown beverage in the morning. Yet, the caffeine-migraine link is still a mystery to many.

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Migraine has been a persistent health problem for me since my teenage days. By now, I am fairly good at understanding the triggers and consciously sidestepping them. Ensuring that I am thoroughly caffeinated first thing in the morning is a handy tip I live by.

I know that caffeine comes with its own set of side effects. And I’ve been trying to get on an anti-inflammatory diet for endometriosis for a while now. But the withdrawal may make things worse and leave me with another one of those awful migraines.

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But the connection between caffeinated beverages and migraine is convoluted. Because what caffeine giveth, caffeine taketh away. Your favourite ginger tea may seem like a migraine killer in a cup. However, did you know that it can also be causing a headache in the first place?

What is caffeine?

Caffeine is a naturally-occurring central nervous system stimulant found in coffee beans, cacao beans, kola nuts, tea leaves, yerba mate and the guarana berry. It’s also the commonest psychoactive stimulant in the world, in almost 80% households, to battle fatigue and drowsiness.

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Caffeine works by blocking the effects of adenosine, a compound in the body that promotes relaxation and sleepiness. That’s why you feel awake and alert after a cup of joe in the morning.

In small doses, it can promote a feeling of happiness and wellness. But larger doses can make hell break loose with increased heart rate, anxiety, stomach troubles and general restlessness.

Does caffeine reduce or worsen migraine?

Caffeine is a double-edged sword as it happens to be a vasoconstrictor and a vasodilator. In simple terms, it can dilate your blood vessels as well as constrict them.

One of the things that worsen migraine is the flow of excessive blood to the brain also known as Cerebral Blood Flow.¬†Caffeine in your tea or coffee can worsen a migraine by restricting the flow of blood, trapping it in the head. Similarly, it can also relieve pain by dilating the blood vessels, easing blood flow. So, while caffeine may work as a wonderdrug for many with migraine, for others, it’s a trigger.

But imagine you one day decide to forego caffeine for good…like moi. Be prepared for the terrible withdrawal phase, which will have you back on the caffeine carousel in no time. What follows is more migraine, fatigue, drowsiness, mood changes, nausea and muscle stiffness.

Dr Rahul Chakor, Professor and Head of Neurology Department at Nair Hospital, Mumbai, sums it up, “Caffeine withdrawal can precipitate migraine attacks in habitual coffee drinkers. In fact, any change in the routine schedule can precipitate migraine. Like not getting up on the usual time on the weekend and not having coffee at the time you have on weekdays.”

What can you do about caffeine migraines?

If you are someone who suffers from frequent migraines, caffeine reduction, in the long run, may help. A 2020 review in the journal Nutrients gives us some pointers to remember.

Be mindful of your caffeine consumption. Get a fair picture of all the caffeinated products you consume throughout the day. Sometimes, there may be a lot of it in energy drinks, soft drinks and even in the medicines you consume.

Be consistent in your caffeine consumption if you want to keep your coffee/tea-drinking habit. Don’t deprive your body of caffeine one fine day.

But if you wish to cut down on caffeine and kick the habit to a curb, taper your intake over several weeks. Reduce 14 cups a week to 7 to 4 to 2 to none.

Stick to 200mg a day, which is about two servings of a caffeinated beverage.

Avoid sleeping longer on weekends to prevent an episode of caffeine withdrawal, especially if you are used to drinking tea or coffee first thing in the morning.