Thank you so much for joining me throughout 2023! I haven’t been able to post as much as I have in past years, but I’m still here. 🙂 I’m also still posting at least daily on Facebook and X, so you’ll want to check that out for a review of past articles, current news, and clinical trials you can be involved in. (I know we’ve had some technical problems at Facebook – hopefully everything is posting now!)
Here are the top 10 posts from this past year that I would especially recommend you check out. Pass them on if you think they’ll be a help to someone you know! And let’s keep fighting back against migraine and headache in 2024!
Have we finally explained the “red wine headache”? Well, not exactly. However, a new study has been making the news rounds that introduces a new piece to the puzzle.
The study, published in Scientific Reports, sought to estimate the effect of quercetin glucuronide in red wine on the body, compared to the effects of quercetin glucuronide in other foods. However, the effects were lab-tested and not tested on humans.
Quercetin comes from many foods and drinks, and is popular in supplement form as an anti-inflammatory, helpful for heart health and even a cancer-fighter (read more here). But this study does not suggest that taking a quercetin supplement or even getting quercetin in foods and drinks will trigger a headache. They’re only saying this:
Thus, we propose that quercetin-3-glucoronide, derived from the various forms of quercetin in red wines inhibits ALDH2, resulting in elevated acetaldehyde levels, and the subsequent appearance of headaches in susceptible subjects. Human-subject testing is needed to test this hypothesis.
So this is a possible mechanism that contributes to “red wine headache” in some people. But it’s only the quercetin+alcohol – not quercetin in other forms.
Remember, we’re not talking about a hangover here. We’re talking about headaches triggered after drinking a glass or two of red wine, not what may come the next day.
We’ve discussed red wine headache a lot, and it seems that it may not deserve the notoriety that it has. That’s not to say it’s not a problem for some people – as the researchers in this study say, it clearly is. But It seems to be much more rare that red wine alone, as opposed to other alcoholic beverages, consistently triggers migraine (see Red Wine a Possible Trigger? Yes, but…). Let’s put it this way, most often:
It’s red wine + other factors that trigger the headache
It’s red wine or other alcoholic beverages that trigger headache
It’s sometimes red wine that triggers headache in some people
To make it even more complicated, the researchers noted that not all red wines are alike, even when it comes to quercetin. So now we also have:
Some red wines may trigger headache in some people sometimes
So although this is an interesting step toward further understanding how some red wines affect the body, it doesn’t give you personally much more information about whether or not you should reach for that glass of red wine (or which wine). Your own experience is a much more accurate measure. (See also Wine & Headaches: Why We’re Still Confused.)
If there’s anything practical that comes from this study, it’s this – don’t worry about quercetin (unless it’s mixed with alcohol).
The best advice remains the same as before – be cautious of alcohol in general. Listen to your body, and try drinking less, or none, and see how your body responds.
A new book is not only reminding us that we’re not alone, but also being used to raise money to fight migraine.
It’s not the only one of its kind, but let’s face it, it’s been a full 15 years since the beautiful Migraine Expressions was published (a book I would still recommend, by the way!). It’s certainly time for another chapter in the story.
This book comes from a different source – our friends at Miles for Migraine. You’re probably familiar with the Run/Walk/Relax events that has made Miles for Migraine famous for raising awareness and raising funds. If there’s a season for these events, it tends to be more February to April, with a few other events later on. But the organization has expanded quite a bit in recent years, offering many other events and support groups online and offline, as well as resources and training. All the while, they help provide funds for migraine treatment and research.
But off-season or not, this is the season for giving, and the new book Dear Migraine: Migraine and headache inspired essays, poems and art is out just in time for Christmas. You might want to get it for a migraineur, or perhaps for a close friend or family member, to help them understand. As it says in the official promo:
Inside these pages you will find works that illustrate pain and struggle, but also laughter, insights, and inspiration. The words and visuals in this book are by 64 contributors who have all been affected by migraine and headache diseases.
But besides the value of the book itself, proceeds from the sales will go toward the work of Miles for Migraine. That’s how you give twice! Give through the links in this post, and you’ll also support the work of this website. That’s giving three ways at once! I think that’s the best I can do for today. 🙂
A study published last month in the journal Nutrients showed some positive results for migraine patients on keto. But it’s not that simple, so let’s take a closer look.
It’s tempting to come up with a headline such as “Keto Diet shown to fight Migraine Symptoms” – but we have to be careful here. It is notoriously difficult to do studies on diet, because diet is so complex. If a patient shows improvements, what part of the diet was really the “cause”? Or was it a combination of things? Or, in some studies, patients who eat a certain way also tend to do other things in life differently.
The other challenge here is that there is no “THE Keto Diet” – in spite of what promotions and labelling may make you think. Yes, “keto” does refer to a specific, measurable thing – it puts your body in a metabolic state called “ketosis”. But of course this can be done using very different diet plans. And the very vague “low-carb diet” may not be keto at all.
The authors of this study are well aware of these and other limitations. They’ve done their best to be very specific about the diets they used. You can read the study yourself using the link below, but let’s look at a quick summary.
The study used three very specific keto diets for at least three months. The specific ratios in the diets (e.g. calories, protein) were adjusted depending on body mass index and general physical activity.
Patients were then monitored for migraine frequency and intensity – but fatigue was also a very important part of the study. All three were measured with recognized metrics.
In the end, there was significant improvement in all three metrics. Migraine attacks were less frequent and less severe, and patients experienced less fatigue.
How all these things were related is difficult to say. Did less intense migraine attacks simply result in more energy in general? What part did weight loss play?
And importantly, what about other diets?
The study authors do look at how this study relates to other studies. This isn’t the first time, by any means, that keto has been indicated as a migraine-fighter, both from anecdotal evidence and scientific studies. So this study does seem to further confirm that keto can be a help. But as the authors note:
Snetselaar et al. conducted a systematic review examining 12 randomized trials evaluating the effectiveness of different types of diets in patients with multiple sclerosis. Eight dietary interventions were compared: low-fat, Mediterranean, ketogenic, anti-inflammatory, paleolithic, fasting, calorie restriction, and control (usual diet). Paleolithic, low-fat, and Mediterranean diets showed greater reductions in fatigue than the control. Considering these results, in the future, we could compare the effectiveness of the KD on curbing fatigue in migraine patients compared with other dietary regimens.
Sometimes “contradictory” diets all help fight migraine – perhaps because most tend to cut down on processed foods and sugar. But that doesn’t mean all diets are equal – we keep researching to find which may be the better migraine-fighter, and perhaps the real question is which is best for you. However, so far, some keto diets do seem to be on the top tier of diets to try.
This quick little interview by the Guardian has a title which is basically clickbait. However, it’s a nice little overview of some common information about migraine, and a look into what researchers are looking forward to.
It’s less than 17 minutes long. Give yourself a quick refresher on the basics. It is good to see migraine getting some attention in the UK.
