Don’t eat that chocolate, it will give you a headache! If you suffer from migraines, you’ve probably been given this advice, at least once or twice, by a well-meaning aunt or friend. Maybe you’ve read it on the internet or in a natural healing book that promises to cure your migraines with a clean diet and the right oils.
I’m going to let you in on a little secret: there’s no clear scientific evidence that chocolate causes migraines or makes them worse. If you love and enjoy chocolate, like I do, you may not need to give it up completely in order to manage your migraines. Don’t develop a 5-a-day Hershey Bar habit — that’s unhealthy for a whole host of other reasons — but don’t feel bad if you enjoy a square of dark chocolate after lunch. It most likely won’t give you a headache, and it will benefit you in other ways.
There are a lot of anecdotes from people who claim that they get migraines after eating chocolate. These stories are not lies, but the mistake is concluding that the chocolate causes the migraine. In many cases, one of the two following things are happening.
1. Patients are craving chocolate prior to a migraine. Specific food cravings can be a symptom of a migraine. Some people crave cheese, salty snacks, or sweets a few hours before their headache begins. Others crave chocolate. When they crave chocolate, they reach for some — and then when they get a migraine, they make the mistake of assuming the chocolate caused the migraine. Really, the migraine caused the (craving for) chocolate!
2. Cravings and migraines come at the same time of the month for women. Many women experience migraines right before their period due to a change in hormone levels. This also happens to be a time when women tend to crave chocolate. Some patients mistakenly assume that eating chocolate causes the migraine when really, migraines and chocolate cravings have the same cause — a sudden drop in estrogen levels.
People who eat chocolate then have a migraine share their experience with others. They tell other migraine patients to avoid chocolate, and the story spreads — until everyone is avoiding chocolate.
Some studies have found an association between chocolate and migraines. However, these studies are not always set up in a way that allows the researchers to conclude that the chocolate really caused the migraines. What they could sometimes be seeing is the relationships discussed above — chocolate cravings as a symptom prior to migraine or due to hormonal fluctuations that also cause migraine.
Other studies have found no causal relationship between chocolate and migraines. In one study, patients who were given chocolate were no more likely to develop a migraine than those given a placebo. Other known migraine triggers, like alcoholic beverages and fasting, definitely did increase the frequency of migraine beyond that seen with a placebo. Based on these results, it seems unwise to lump chocolate in with other migraine triggers.
When you give up alcohol, fasting, or high-stress environments because they’re giving you migraines, that’s fair — those are unhealthy habits and there’s real evidence they can trigger migraines. When you give up chocolate, and dark chocolate in particular, you’re giving up something that can be beneficial, and there’s just no evidence that doing so is necessary. The science is mixed, and chocolate might be a trigger for some patients, but recommending that all migraine sufferers avoid chocolate is quite a reach based on the current science.
Caffeine is a known migraine trigger. It blocks the action of a neurotransmitter (brain chemical) known as adenosine, which has an impact on blood vessel dilation. It seems that for most patients, it’s caffeine withdrawal that’s most likely to trigger a migraine. You’re used to consuming caffeinated beverages every day, and then suddenly you don’t, and you develop a migraine.
The common recommendation is that migraine patients avoid caffeine so they do not build a dependency and then suffer migraines when they withdraw from the substance. But how much caffeine does it take to build dependence? Is there enough caffeine in dark chocolate to trigger this response?
A standard, 8-ounce cup of coffee contains between 50 to 90 mg of caffeine, and most people drink more than 8 ounces in one shot. This is not a good idea for migraine sufferers — dependency develops quickly at these levels of caffeine intake. The average dark chocolate contains 12 mg of caffeine per ounce. A Ghirardelli square weighs 14 grams, which is about a half ounce, which means one of these squares contains about 6 mg of caffeine. That’s less than the 15+ mg of caffeine found in some decaffeinated coffee drinks.
So is the 6 mg of caffeine found in a 1/2 ounce square of dark chocolate enough to trigger a migraine? Probably only in the most sensitive of patients. Only about 30% of patients can feel the effects of less than 18 mg of caffeine, and dark chocolate contains far less than 18 mg per serving. If you are able to drink decaf (which does still contain some caffeine) you should be able to indulge in some dark chocolate without worrying about the caffeine content.
Beyond tasting delicious, there’s another reason not to exclude dark chocolate from your diet as a migraine sufferer. When enjoyed in moderation, dark chocolate has a whole array of health benefits — some of which might even help prevent migraines in a round-about way.
Several studies have found that eating cocoa-containing foods helps lower blood pressure, which is important to note since high blood pressure is linked to migraines. Chocolate, when consumed in moderation, seems to be good for cardiovascular health in general. Dark chocolate also appears to increase insulin sensitivity, which indicates it could help reduce the risk of diabetes.
Another benefit of dark chocolate is that it’s really high in certain minerals, including iron, copper, magnesium, and zinc. Many of us do not get enough of these minerals in our diet.
Of course, to experience these health benefits, you need to be buying the right chocolate. Look for dark chocolate that is at least 70% cocoa. The higher the cocoa content, the more flavanols the chocolate contains — and flavanols are responsible for most of the chocolate’s health benefits.
Where does this leave us? Basically, there’s no solid evidence that chocolate triggers migraines. It may trigger migraines in some patients, but probably not in most. If you love chocolate, you don’t have to give it up — and continuing to eat a little is good for your health.
Focus on eliminating other more likely triggers before you come down hard on your chocolate habit. If you need help identifying those triggers and otherwise treating your migraines, schedule a consultation with me, Dr. Risa Ravitz. I offer personalized, one-on-one virtual appointments from the comfort of your own home.