When you’re living with migraine, you may have to give up a lot of things you love. Triggers may include staying up late, favorite foods, sunbathing, workout routines… and often, alcohol. But what if you’re craving a cold brew at the end of a warm spring day?
Every person with migraine is different. For some, an occasional ale is no big deal. For others, drinking beer is guaranteed to bring on symptoms. If you’re somewhere in the middle, here are a few key things to know.
The relationship between alcohol and migraine is highly individualized and is still being studied.
A 2018 study of almost 2,200 migraine patients found that more than a third of them — 35.6% — reported that alcohol was a migraine trigger. Red wine was named as the most common trigger among alcoholic beverages. Beer ranked fourth, after white wine and champagne/sparkling wine. Vodka was the drink least likely to trigger a migraine.[i]
Because vodka contains almost no ingredients beyond ethanol and water, “this implies that ethanol is not the main culprit, but other compounds in wine such as histamine, tyramine, phenylethylamine, and flavonoids, which have also been suggested by other studies,” the study authors told Neurology Advisor. These compounds also can be present in beer.
Alcohol-triggered migraine attacks are not hangovers.
Migraine symptoms are triggered by alcohol within a few hours of consumption, while a hangover typically happens much later. Migraineurs are more susceptible to hangover symptoms than people without migraine, however.[ii] So it’s wise to stay hydrated and not overindulge, no matter what you’re drinking.
To figure out if beer triggers your migraine attacks, keep a headache diary.
Another interesting finding from the 2018 study is that alcoholic drinks aren’t predictable migraine triggers. Red wine, for instance, consistently triggered an attack in just 8.8% of participants. Other people surveyed said that red wine sometimes caused symptoms and sometimes didn’t.
Track your symptoms in a migraine diary to see if you can detect patterns in triggers and treatments. You might notice that a specific brand or type of beer is more likely to cause a migraine attack. Record your number of drinks, too, as well as other possible triggers: the food you ate, the time you went to bed, etc. If you take medication for migraine, ask your healthcare provider if you should avoid alcohol because of potential harmful interactions.
Try different types of beer to see what you can tolerate.
If you enjoy beer, but you find that it’s sometimes a migraine trigger, then it may be worth doing some detective work by (cautiously) trying certain beers to identify which ones work for you. Is a lager better than an IPA? Is light beer less likely to trigger migraine? Some people do well with beer that’s low in hops, such as Guinness.[iii] For others, sulfites or histamines are the problem; filters designed to remove these compounds might help.
Beer often contains tyramine, a compound produced from the breakdown of the amino acid tyrosine.[iv] Tyramine occurs naturally in fermented and aged foods and beverages. All beer is fermented, but levels of tyramine vary.
To reduce tyramine intake, a beer expert in Brew Your Own magazine advised choosing bottled and canned varieties that are pasteurized, a process that kills the lactic-acid bacteria that produce tyramine. Draft beer and home-brewed beers should be avoided, he said, especially because dirty draft lines may contain high levels of these fermenting bacteria.[v]
It’s probably best to skip the green beer.
The most famous beer-drinking holiday is, of course, St. Patrick’s Day. So people with migraine want to know: Is it safe to drink the green beer?
Not to be a buzzkill, but we suggest avoiding it. One, the green beer that bars serve on St. Paddy’s usually comes from a keg. Two, green food dye contains Yellow No. 5, which is a migraine trigger for some.[vi] So if you’re imbibing on March 17, don’t take a chance — stick to a drink you know is migraine-friendly. Sláinte!
Why Does Beer Give Me Headaches?
Everyone gets migraines for different reasons, regardless of the drinks involved. As research on alcohol and migraine develops, many are left to wonder why beer specifically gives them headaches. Some suggest that the alcohol content itself is a trigger for migraine, whereas others are investigating the other ingredients.
Beer is a diuretic, which dehydrates drinkers throughout a night of casual consumption. Dehydration alone is a migraine trigger for many. Beer’s ingredients — like tyramine, histamine or tannins — may be an equal problem for others. However, researchers are conflicted about the link between these ingredients and migraine. For some, the byproduct of beer’s fermentation process may be enough to trigger migraine.
Understanding your triggers can help you prevent or mitigate migraine in the future. As we learn more about beer’s relationship to migraine, you can do your own “research” by keeping a personal record of your attacks. The CeCe migraine management app allows you to keep a real-time diary right on your phone. You may learn that certain types of beer create more of a reaction than others.
How to Avoid Migraine Without Skipping Happy Hour
Living with migraine is all about balance. Depending on the severity and consistency of your migraine attacks, you may be able to enjoy a drink from time to time without symptoms. For some, a migraine diary is enough to understand the consequences of each drink. For others, it may be best to eliminate drinking until researchers know more about why alcohol triggers migraine.
If you plan to continue drinking, keep these tips in mind to reduce the risk of migraine:
- Choose brands you know: If you tend to be sensitive to different types of alcohol, you may want to skip the drinking tour. Stick to the brands and types of alcohol you’ve tolerated in the past.
- Drink in small quantities: Keeping your drinking to a minimum prevents excessive dehydration and helps your body mitigate triggers.
- Stay hydrated: Drinking alcoholic beverages actively dehydrates your body. We recommend having one glass of water per drink to replenish your body.
- Control other triggers: Stress, lack of sleep, skipping meals and menstruation can all be migraine triggers. Pass on the bottomless mimosas when you’re not feeling your best, and you can potentially avoid migraine.
How to Treat Migraine After Drinking
Let’s say you do everything listed above, and you still feel migraine symptoms after drinking. It happens! When you feel an oncoming migraine, there are many steps you can take to treat symptoms. Follow these tips to relieve your migraine:
- Stop drinking: Though alcohol may not be the only trigger, it’s best to put the drink down before your symptoms get any worse.
- Hydrate: If you haven’t already, start drinking water to rehydrate your body.
- Avoid prescription medication: Most pain relief meds are dangerous to take with alcohol. Check your prescription for guidance.
- Lie down and rest if needed: You can begin to calm your body and mind by taking a moment to rest if possible.
- Use CEFALY: Attach a CEFALY device to your forehead, and relax as small electrical pulses reduce your migraine symptoms in less than an hour.
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