Hey Migraine Mentees 👋 

Today’s newsletter takes another 5 minutes to read—so if you’ve only got 60 seconds, here’s what you need to know:

• For acute migraine attacks, consider the listed evidence-based combination options that include caffeine (acetaminophen + aspirin + caffeine) rather than just consuming caffeine alone…

• Keep daily caffeine consistent. Large spikes (≈≥3 servings/day) increase migraine odds for many, while steady intake has been deemed far safer overall…

• If you want to reduce caffeine intake, gradually taper your dose to avoid withdrawal headaches and migraines triggered by abrupt caffeine withdrawal…

• Avoid late-day caffeine intake (no later than 12 PM), as this can impair sleep, which is a well documented migraine amplifier…

☕️ This week’s edition is all about the upside down world of caffeine, so grab your favorite caffeinated beverage (or don’t, depending on your tolerance…), cozy up in a blanket, and let’s dig into the twisted story of caffeine and it’s impacts on migraine…

🧠 The Migraine Mentors

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In This Week’s Edition…

• 🥡 Weekly Take-Out

  • Meme of The Week - ☕️ Hello Dark Roast…

• 🔈️ The Migraine Mentors Minicast - Podcast Series

  • How Caffeine Impacts Migraine (For Better, For Worse)

• 📜 This Week’s Top Article

  • Caffeine & Migraine - Friend, Foe, or Both?

• 🍴 Migraine-Friendly Recipe of the Week

  • Rice Noodle Bowl with Bok Choy, Carrots & Ginger Broth

• 📸 Weekly TikToks

  • The Truth About Migraine Triggers…

  • 3 Migraine Tips…

🥡 WEEKLY TAKE-OUT

Meme of The Week

🗞️ MIGRAINE MINICAST

🎧 How Caffeine Impacts Migraine (For Better, For Worse)

🥡 Caffeine can calm a migraine—or kick one off—depending on dose, timing, and how steady your daily habits are.

And when you understand caffeine’s thresholds and patterns, you can start to enjoy your cup of joe without inviting a nasty migraine attack to join you…

🧠 In this week’s Migraine Mentors Minicast, we unpack the following:

• How caffeine works in the brain and why it’s matters during an attack…

• When caffeine helps vs. hurts…

• The differences between caffeine-withdrawal headaches vs. true migraines…

• A practical plan to using caffeine to your advantage…

• A 7-day self-experiment to track dosage, timing, and symptoms so you can find your personal threshold…

💬 Caffeine isn’t the villain or the hero—it’s a tool!

🛠️ And a good carpenter never blames their tools… They just know exactly when/where to use them.

👇 Tap below to listen now! 👇

📜 TOP ARTICLE

Caffeine & Migraine - Friend, Foe, or Both?

Depending on who you ask, caffeine is either the devil or a girl’s best friend in the realm of migraine attacks…

So what’s the deal?

Caffeine has the capacity to both soothe and stir up migraine symptoms. Generally speaking its impact depends on dose, timing, and your baseline habits.

☕️ First, Why Caffeine?

As an adenosine-receptor antagonist (meaning it blocks receptor sites, like a broken key stuck in a lock), caffeine can boost the effects of common OTC pain relievers during an attack, making it a secret weapon for pain management.

But as great as that sounds, abrupt changes in caffeine intake (too much or sudden none) can also trigger migraine attacks.

It seems like too much of a good thing can be a bad thing…

So how do you decide what works best for you?

❤️‍🩹 When Caffeine Helps Migraine

Fixed-dose migraine medication combinations that include caffeine have randomized, placebo-controlled (RCT) evidence for acute migraine relief. Keep in mind that RCT’s are the highest quality study one can perform, which means that the data is usually

In three RCTs of 1220 patients, acetaminophen + aspirin + caffeine outperformed placebo for pain and migraine symptoms with good tolerability.

And head-to-head trials in patients with severe migraine found this combo was as fast and/or faster than ibuprofen alone, with findings showing this combination was superior on several outcomes…

A crossover RCT back in 2012 also showed 1000 mg of paracetamol (Tylenol) + 130 mg of caffeine provided similar 2-hour pain relief to 50 mg of sumatriptan in patients having active migraine attacks.

Lastly, guideline reviews from the American Headache Society (we know, we know… migraine isn’t just a bad headache!) list caffeine-containing combination analgesics as evidence-based options for acute migraine attacks.

As you can see, there’s clearly enough evidence to support the use of caffeine before and during a migraine attack, but as with everything in life, there’s always exceptions to the rule…

⚡️ How and When Caffeine Triggers Migraine Attacks

In a 2019 prospective cohort study of adults with episodic migraine, consuming ≥3 caffeinated servings in a day vastly increased same-day migraine odds, while 1–2 servings generally did not raise risk, on average.

Another prospective cohort study in 2024 in people with episodic migraine found habitual caffeine intake was not linked to attack frequency, duration, or intensity—suggesting that deviations from your personal baseline, not steady use, may be the problem.

It seems as though caffeine has a threshold of benefit, with tolerance being a major driver in outcomes…

💢 The Differences Between Caffeine Withdrawal Headaches vs. Migraine

“Caffeine-withdrawal headaches” are a separate diagnosis in the International Classification of Headache Disorders and can occur in anyone who stops caffeine abruptly…

As one can assume, this is not a classic migraine.

Interestingly though, a 2020 randomized, double-blind controlled trial in people with migraine showed that abrupt caffeine cessation triggered severe migraine attacks in most participants, whereas continuing caffeine did not.

TLDR - If you live with migraine, sudden changes (to zero or big spikes) can provoke migraine, not just a generic withdrawal headache…

For those of you who are coffee lovers out there, we’re sure a withdrawal headache would just be a walk in the park compared to a full blown migraine attack!

🗒️ How To Drink Coffee & Not Be In Pain…

• For acute migraine attacks, consider the previously listed evidence-based combination options that include caffeine (acetaminophen + aspirin + caffeine) rather than just consuming caffeine alone…

• Keep daily caffeine consistent. Large spikes (≈≥3 servings/day) increase migraine odds for many, while steady intake has been deemed far safer overall…

• If you want to reduce caffeine intake, gradually taper your dose to avoid withdrawal headaches and migraines triggered by abrupt caffeine withdrawal…

• Avoid late-day caffeine intake (no later than 12 PM), as this can impair sleep, which is a well documented migraine amplifier…

☕️ Caffeine is the most widely used drug in the world, and for most of us who drink it, it seems to just make the world a better place…

If, and only, if, it doesn’t result in a full blown migraine attack.

👉️ Now that you know better, you can do better…

This was a fun one to dive into, so let us know what you want us to write about for next week’s newsletter!

📩 Submit your comments and feedback through the poll or email us directly. We read every submission you send our way!

🧠 The Migraine Mentors

🍴MIGRAINE-FRIENDLY RECIPE

Rice Noodle Bowl with Bok Choy, Carrots & Ginger Broth

🍜 Ingredients (2 servings)

• 4 oz rice noodles (thin or medium)

• 4 cups low-sodium chicken or vegetable broth (homemade or a clean, additive-free version)

• 2 small heads baby bok choy, chopped

• 2 medium carrots, julienned or thinly sliced

• 1 inch fresh ginger root, sliced

• 1 tbsp olive oil

• Sea salt, to taste

• Optional: fresh parsley or cilantro (if tolerated)

✅ Instructions

1. Prepare the broth

   • In a medium pot, warm the olive oil. Add sliced ginger and sauté for 1–2 minutes until fragrant. Pour in broth and let simmer gently for 10 minutes to infuse.

2. Cook noodles

   • In a separate pot, cook rice noodles according to package directions. Drain and rinse with warm water.

3. Add vegetables

   • Add carrots and bok choy to the simmering broth. Cook 3–4 minutes until just tender but still bright.

4. Assemble bowls

   • Divide noodles into two bowls. Pour broth and vegetables over the top.

5. Serve!

   • Garnish with a few fresh herbs if tolerated. Enjoy warm and fresh.

🧠 Why It’s Migraine & Histamine-Friendly

• Rice noodles → Naturally gluten-free, bland, and non-triggering for most people with migraines or histamine intolerance.

• Bok choy → A fresh, non-aged leafy green, rich in nutrients without being a known migraine trigger like spinach.

• Carrots → Gentle, low-histamine vegetable that adds sweetness and fiber.

• Fresh ginger → Supports digestion, reduces nausea, and is well-tolerated in migraine-friendly diets.

• Fresh broth (not aged/fermented) → Using homemade or carefully chosen broth avoids histamine build-up found in long-simmered or processed stocks.

• No aged, cured, or fermented ingredients → Keeps the dish safe for both migraine and histamine-sensitive patients.

💡 The freshness of ingredients is key - avoid long storage, leftovers beyond a day or two, or pre-packaged flavor enhancers (like soy sauce or bouillon cubes), which often contain glutamates or histamine triggers.

🥡 WEEKLY TIKTOKS

The Truth About Migraine Triggers…

@migrainebabe

#stitch with @Joshua Smith, PA-C Triggers did not cause your migraine—a whole mess of genetic mutations did. But while on the topic of tri... See more

3 Migraine Tips…

@doctor.sina

Don’t miss these simple tips for migraine prevention #migraine #migrainerelief #headache #healthtips