A diagnosis of “migraine” is often frustrating for the patient because there are probably as many causes of migraine as there are migraine sufferers. Add to that the fact that migraines rarely result from a single factor and you have a difficult malady to manage. For instance, a female migraine patient may be able to predict that she will be more likely to have a migraine during menses or at ovulation, but she may not have her usual migraine in a given month, or she may have a migraine outside of the usual time. Sometimes female migraine sufferers find relief with pregnancy and lactation; sometimes they don’t; sometimes the migraines get worse. Some migraines can be allergy related, be it a food allergy or an airborne allergy. Some migraines can be related to sleep deprivation, hunger, poor posture, or poor eyesight. For some people, migraine medicines that contain caffeine or caffeine-like substances bring relief, but in reality a life style change that involves eliminating caffeine may be what the migraine sufferer really needs to stop the headaches.
Migraines are not simple problems with simple solutions. Add to that the volume of information, single studies, and individual case reports that seem to contradict one another, and trying to figure out how to treat migraine is enough to give a person a headache.
One of the food additives that has been in and out of the spotlight in the migraine debate is monosodium glutamate (MSG). MSG is the sodium salt of the amino acid, glutamate. Glutamate, in addition to serving as one of the amino acids found in proteins, is also an excitatory amino acid. When glutamate binds to glutamate receptors on neurons, such as the NMDA receptor, it activates (excites) the nerve cell. Glutamate has been implicated in exicitotoxicity associated with stroke, ALS and other neurodegenerative diseases (1). It has even been implicated in epileptic seizures, which is particularly interesting, since many migraine sufferers get relief through prophylactic treatment with anti-seizure medications such as topiramate (2).
Many migraine sufferers have linked migraines to eating foods that contain MSG (sometimes called Chinese restaurant syndrome). Indeed, in my own journey to manage migraines, a retrospective study of my personal journal entries, which spanned several years, revealed that I often had migraine with nausea and vomiting after eating at restaurants noted for using a great deal of MSG in their cooking (usually not Chinese restaurants, interestingly) or processed foods known to contain MSG (like yellow rice). However, many people argue that MSG does not cause headaches, and truthfully, most of the evidence linking MSG to migraine (like my own) is anecdotal.
Baad-Hansen et al. report on a small (n =14), double-blind study of healthy men who received an oral administration of either MSG or placebo. After receiving the MSG, the men were asked to report effects such as muscle pain, headache or other side effects. Additionally blood pressure, plasma glutamate levels and pain and pressure thresholds for specific facial muscles were recorded. While no statistically significant changes in pain thresholds were detected, there was a significant increase in reports of headache and self-reported muscle tenderness after MSG administration (3).
Admittedly the Baad-Hansen study is a small one. Further, it only involved healthy men. Migraine is a more common diagnosis in women, and it may be that people carrying certain genotypes may be more susceptible to pain triggered by MSG. But, the Baad-Hansen study does suggest that something may be happening with MSG and pain, and perhaps several, independent large-scale, double-blind, placebo-controlled studies are warranted. Such studies, taken in context with the larger body of literature in molecular neuroscience, may begin to answer questions about how compounds like MSG affect certain individuals. Science is an incremental process, and there is almost always a larger truth waiting to be revealed by more work and additional study, particularly on complex problems like migraine headaches.
Baad-Hansen, L., Cairns, B.E., Ernberg, M., & Svensson, P. (2009). Effect of systemic monosodium glutamate (MSG) on headache and pericranial muscle sensitivity Cephalalgia, 30 (1), 68-76 : 10.111/j.1468-2982.2009.01881.x
- Beal, M.F. (1991) Mechanisms of Excitotoxicity in Neurologic Diseases. FASEB J. 6, 3338–44.
- Rogawski, M.A. (2008) Common Pathophysiologic Mechanisms in Migraine and Epilepsy Arch. Neurol. 65 (6): 709–714.
- Baad-Hansen, L. (2009) Effect of systemic monosodium glutamate (MSG) on headache and pericranial muscle sensitivity. Cephalagia. 30, 68–76. (doi: 10.111/j.1468-2982.2009.01881.x)
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