If aspirin helps with a migraine, should salicylates in food be eliminated in the diet trial?
Someone may report that having an aspirin helps reduce a migraine, especially if they judge the time as the migraine is coming on. If this does, in fact, solve the migraine then there is no need to use diet. But most often it does not, and taking aspirin does not help you know what is causing the migraine. How can we think through what to do?
If someone drinks too much alcohol they have a hangover. That person may say that having another drink will make the hangover go away. This is true. We call this having “the hair of the dog” and we know that having more drinks will only be a temporary solution and cause another hangover the next day. The biochemical changes in food sensitivity are similar. Having more of the suspect chemicals does decrease the symptom. I have had patients say that in their family they have learnt to have a strong cup of tea as they feel the migraine coming on. That family may even insist on a particular brand of tea drunk at a particular time as the migraine comes on. Others report peppermints used the same way. The problem is that in their normal diet they may be eating variable amounts of other high salicylate foods: spicy foods, tomato-based foods, acidic fruit, and so having the tea, mint or aspirin are not enough to contain the migraine. This is when it is worth running a diet trial.
There is not one particular diet just for migraines. Some people are fairly certain that chocolate, red wine or rich meals, which all contain amines, cause migraines. Others suspect strong smells, especially diesel or paint fumes. If it was clear what foods caused migraines we would not need to run an elimination diet to find out what is the problem. Few people are lucky enough to be only sensitive to a couple of foods. Most are sensitive to many, and they only have a migraine if the amount of all the suspect foods add up over time and a migraine comes on.
“But, Joan, I really like spicy meals, Italian foods and they don’t cause my migraines” they say. Many people go for years thinking about what food they feel like when they feel a bit “off”. They just feel like a curry, and the next day they feel like a pizza, and the next day some chocolate cake, and the next day some mint lollies, or a “sugar hit” from coloured lollies. But there comes a time when doing this doesn’t work any more and the migraines are worse but no food seems directly linked to the migraine.
The right diet is not some “migraine diet”. It is the diet that is right for that individual person. We can say the diet is in the person, not in the diagnosis. Additives, and smells have a similar in chemical structure to salicylates so they are worth taking out at the same time, and amines are often a problem. Glutamates are still a problem to some, so the Low Chemical Diet, which lowers all the suspect food chemicals, is the way to start the porcess.
Reading Are You Food Sensitive? preferably with the help of an accredited practicing dietitian guides you through the process. See https://foodintolerancepro.com/buy-food-sensitivity-products/
Many patients may not have a strong family history of symptoms but even just a few symptoms in the person or in close relatives supports a diet trial. In a lifetime of migraine it is worth spending a few months really clarifying if diet has a role, as if it does, it can make a huge difference in the quality of life. Strong coffee is a problem to some but a weak good quality coffee, perhaps decaffeinated is often tolerated. Once on the diet an occasional hint of a migraine can be helped by using a pain killer like Panadol rather than muddling the diet with tea or a mint. Patients report Panadol not working for at least 20 minutes in most, or any time up to one hour in others.