CAUSES OF HEADACHES: FOOD

Food can cause headaches in a number of ways. Food sensitivities are however a very complex topic and I will only summarise the role of food and additives here, in order to set them in the wider context of chemical sensitivities.

Like any other chemical substance, food can cause problems in two ways. Firstly, there is a pharmacological reaction – where a substance in the food has a direct effect on the body’s cells. A pharmacological reaction like this is always dose dependent – the more you take in, the bigger the reaction (at least, up to a point). The other way foods can cause trouble is when the body has become allergic to a specific foodstuff; when the food is eaten, the body recognises it as a potential ‘foreign’ agent, and mobilises the immune system to try to deal with it. Allergic reactions like this tend to be much more like an on-off switch – they trigger off a maximal reaction at very low doses.

As an example of the two ways in which foods can react, tyramine is a constituent of chocolate and cheese, and in certain people can cause migraines via the direct pharmacological route. Reducing the level of tyramine in your diet will reduce the migraines. On the other hand, some people are allergic to various foodstuffs; they may also get migraines, but the migraines are triggered in a different fashion and usually require much smaller doses to start them off. Many different types of foods can cause migraine like this and the tendency to react to a particular food depends if you’ve been sensitised (become allergic) to this food. In turn, this relates more to the individual’s exposure to that food in the past, rather than to any specific chemical constituents of the food itself.

Food additives can cause problems in exactly the same way as foods.

Some foods and additives are much more potent than others in causing headaches. There is even the ‘Chinese restaurant syndrome’ – pressure in the face, pain in the chest and a burning sensation in the head and chest. This seems to be related to eating certain types of Chinese food, Wonton soup, in particular, especially when taken on an empty stomach. Only a certain group of people seem to be sensitive in this way; the offending agent is thought to be monosodium glutamate, which is often used in Chinese cooking. However, it may not be monosodium glutamate on its own that causes the problem; there may well be an interaction with other constituents of Chinese food.

Another food additive which can cause problems is sodium nitrite, which is used in cured meat products such as Frankfurter sausages, and luncheon meats. In some people, sodium nitrite can produce a similar headache, together with flushing and redness of the face.

The pattern of meals can also affect headaches. Some patients with migraine find that low levels of sugar in the blood can trigger off an attack, and so going without a meal may be hazardous. Note, however, that a migraine caused by the absence of food can also be caused by a food allergy; there is a distant relationship between food addiction and food allergy, and patients who are allergic often get withdrawal symptoms when they initially omit a food to which they are allergic from their diet. Therefore, a migraineur who develops an attack every time he misses breakfast may be triggering the attack by low levels of sugar in the blood, but it might just be that he’s allergic to milk (or tea, or coffee, or marmalade, or pork or eggs) and is having withdrawal migraines as a result of not eating any for some time.

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HEADACHES IN WOMEN

Some types of headaches occur only in women. These are headache: caused by the contraceptive pill; from toxaemia in pregnancy; and related to the menstrual

cycle.

A number of types of headache occur more frequently in women than in men -sub-arachnoid haemorrhage and migraine, for example. Other types attack men more often than women – such as cluster headache. And, of course, there are a large number of types of headaches which affect both sexes equally.

The female reproductive system is controlled by many different hormones. Each month during the fertile part of a woman’s life, they cause a single egg to complete its development in one of the ovaries, and to be released into the Fallopian tubes which eventually lead to the womb. Two of the main female hormones, oestrogen and progesterone, are made in the ovary. Oestrogen is created by cells which surround the developing egg, while progesterone is released from the region formerly inhabited by the egg, after it has been released.

The whole cycle is under the control of hormones produced by the pituitary gland. One of its hormones, follicle-stimulating hormone (FSH), causes the egg and its surrounding cells to begin maturation. The female hormones are low in childhood, rising as puberty commences, and then (unless interrupted by pregnancy) continue to vary in a monthly cycle until the menopause. The time of the menopause is determined by the number of eggs left in the ovary ready to develop; when these run out, the ovary is unable to produce oestrogen and progesterone as it previously did, and the levels of these hormones begin to fall.

However, from time to time, hormone imbalances can occur. These can cause a variety of diseases, including abnormal monthly bleeds, pre-menstrual syndrome (PMS) and menopausal problems. Pre-menstrual syndrome and menopausal problems both include a wide variety of symptoms, including headaches.

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WORK-RELATED HEADACHES’ CAUSES: THE ‘SICK BUILDING’ SYNDROME

Reaction to synthetic fabrics and petro-chemical fumes lighting flicker, allergy to fungi, and sensitivity to positive ions in the air can Individually produce headaches in susceptible people, but more commonly one, two or more of them act together. A recently labelled condition is the ‘sick building syndrome’, in which people in a particular office find that just attending work makes them ill, with headaches, a feeling of malaise, sniffles, and maybe even a slight temperature.

Sick building syndrome has a very loose definition, but quite a number of problems are relevant: poor ergonomic design of the computers and office furniture; fungal spores in the air-conditioning system; windows that won’t open so there are lots of positive ions inside; offices lit exclusively by fluorescent lighting; newly painted walls and new carpets that are giving off chemical vapours; and duplicators and photostat machines that exude chemical solvents. And, of course, it’s made worse if some of the employees smoke.

The cure for ‘sick building syndrome’ is to remove as many of the unwanted sources of stimuli as possible – cleaning up the air humidifying system using antifungal agents; fitting non-flicker fluorescent lights; and making sure that windows can open to let fresh air in from the outside, both to provide more negative ions, and also to blow away petro-chemical fumes, fungal spores and tobacco smoke.

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MISCELLANEOUS CAUSES OF HEADACHES: EXERTION HEADACHE

Exertion headache is a throbbing pain which can be brought on by exercise – such as running, swimming, sexual intercourse or sometimes even by sneezing and coughing. It particularly effects men over the age of forty. The headache is usually throbbing, extends over the whole of the skull, and lasts for a few hours. It is often associated with nausea – and sometimes even vomiting – and the need to avoid bright lights (photophobia), which are painful.

Exertion headaches may actually be a rare form of migraine. Very rarely they can be associated with tumours or abnormal blood vessel formations inside the brain, and because of this it is wise for a full set of investigations to be carried out.

Treatment of exertion headaches can be surprisingly simple. For some reason indomethacin, one of the non-steroidal anti-inflammatory drugs (NSAIDs) seems to be very effective in removing the pain; aspirin can also be used. Beta-blockers, such as propranolol, may also help. In those cases caused by blood vessel abnormalities or tumours, surgery may be necessary.

Complementary treatment

Lavender oil, applied neat to the nostrils can have a powerful effect on exertion headaches, or try a tiny valerian tablet.

Exertion headache shares a lot of similarities with migraine and may be a rare form of it; it is also identical to true coital headache.

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HEADACHES DURING SEX: WHAT GOES WRONG?

Where the pain is a tension headache made worse by intercourse, the underlying causes are the same as for ordinary tension headaches. They are at least partially due to relaxation of the muscle in the walls of the arteries, which allows a higher blood pressure to be transmitted through to tissues which normally aren’t accustomed to such high pressures.

With a headache from a sub-arachnoid haemorrhage, caused by a ruptured berry aneurysm (a balloon-like weakness or bulge in the blood vessel), the escape of blood into the area surrounding the brain, and the pressure it develops locally, are the root causes for the pain.

In the third type, true coital headache, no one is really sure what happens. There is a definite association of true coital headache with migraine, so it’s quite possible that there is a common factor; blood vessels in the brain which are abnormally responsive in migraine may also be reacting too quickly to changes in body chemistry that occur during intercourse. (‘True coital headache’ and ‘exercise headache’ may both be just variants of migraine.)

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