Vertiginous migraine, also known as vestibular migraine, is a type of migraine that affects the vestibular system, which controls balance and a person’s sense of positioning in space, or proprioception. People experiencing a vestibular migraine may experience vertigo or dizziness. They may also have trouble with balance or feel uncertain on their feet. This can cause a person to feel dizzy, off-balance, or uncertain of their movements. There is a significant overlap between vertigo, which is a feeling of dizziness, and migraine. The Vestibular Disorders Association estimates that about 4 in 10 people with migraine develop vestibular symptoms such as dizziness. When they strike, they might inconvenience an hour, wipe out an entire day, or in cases of migraine, especially vestibular migraine, they can negatively impact quality of life. More than 17 percent of women and nearly six percent of men suffer from migraines, and about three percent of adults experience the less common, but no less severe, vestibular migraine. Symptoms may not resemble typical migraine headache, such as moderate to severe pounding or throbbing. In fact, it may not involve headaches at all, but rather vestibular (affecting one’s sense of balance) symptoms, such as vertigo, imbalance, nausea, and vomiting. If you’re one of those suffering from vertigo, it’s appropriate to say that your world is spinning, at least during an attack. Vestibular migraine can cause spontaneous and recurrent vertigo episodes. If you’re one of the three percent of the adult population affected by vestibular migraine, you know how debilitating its symptoms, such as vertigo, can be. The constant feeling of dizziness and spinning on top of balance issues and motion sensitivities can make it difficult to function and fulfill your daily routine. There is no cure for vestibular migraine yet, so many patients learn to find ways to manage their triggers to live a normal life. One way is to make specific dietary changes to lessen the frequency and severity of attacks linked to your diet. This can also potentially reduce your urge to come rushing to a chiropractic office in Oklahoma City every time an episode happens.
No single specific diet can prevent vestibular migraine. However, many people have dietary triggers. Identifying and then avoiding these triggers may help reduce the frequency of a person’s migraine attacks. Some research suggests that tyramine, which is present in foods such as fermented foods, aged cheese, and nuts, may contribute to an increase in headaches and migraine. This article explains how diet may affect vestibular migraine and provides a guide for dietary changes to help reduce symptoms.
The Connection Between Diet and Vestibular Migraine
Some conditions, such as diabetes, respond directly to diet. High-sugar foods cause blood sugar to go up, and avoiding them can help control blood glucose. The link between diet and vestibular migraine is more complicated. Food on its own does not cause migraine, and most people can eat migraine-triggering foods without experiencing a migraine. But people with migraine can have a variety of triggers, many of which are foods. A number of studies suggest that tyramine can trigger migraine. Researchers do not fully understand this phenomenon, but it may be because of the effect tyramine has on the nervous system. It can cause blood vessels to constrict and change the way the body releases chemicals such as adrenaline.
The causes of migraine, including vestibular migraine, are not completely understood and symptoms can vary greatly. Evidence suggests that dietary factors may play a role in several of the triggering mechanisms. According to a review of studies, the most commonly reported foods and drinks that have been identified as migraine triggers include chocolate, cheese, nuts, citrus fruits, processed meats, monosodium glutamate (MSG), aspartame, fatty foods, coffee, and alcohol. While it is generally accepted that migraines are sensitive to diet and that diet may trigger migraine attacks, there is no definitive list of these foods. According to a study published in the journal Nutrients, the following foods have been noted in the scientific literature as potential contributors to migraine:
- Chocolate
- Citrus fruits
- Nuts
- Ice cream
- Tomatoes
- Onions
- Dairy products
- Alcoholic beverages
- Coffee
- Caffeine
- Monosodium glutamate (MSG): commonly found in fast food, chips and snack foods, seasoning blends, frozen meals, canned soups and soup and noodle mixes, processed meats, and condiments
- Histamine: found in alcohol and other fermented beverages and foods, like yogurt and sauerkraut, dried fruits, avocados, eggplant, spinach, processed meats, shellfish, aged cheese
- Tyramine: found in aged cheese, cured meats like salami and pepperoni, pickled and fermented foods, dried fruits, alcoholic beverages
- Phenylethylamine: found in chocolate, wine, natto, eggs, some nuts and seeds like almonds, walnuts, and flaxseeds, and some beans like soybeans, lentils, chickpeas, and green peas.
- Nitrites: added to foods such as cured deli meats, bacon, and sausage.
- Aspartame: artificial sweetener added to some sugar-free sodas, ice cream, gum, yogurts, dressings, etc.
- Sucralose: sweetener that may be found in packaged baked goods, beverages, chewing gum, frozen dairy desserts, etc.
- Gluten: found in beer, breads, cakes, candies, cereals, cookies, crackers, muffins, pancakes, etc.
Research has also suggested that it can take high amounts of some of these foods to trigger a headache, withdrawal from some of these foods, notably caffeine, or fasting. According to one systematic review, fasting was shown to be a migraine trigger for 44 percent of people.
Read also: Comprehensive Guide to Migraine Diet
- Eat regularly, and on time
- Reduce carbohydrate intake
- Reduce fat intake
- Work with dietitians and nutritionists
This is the first step we recommend, as it can get you a better start in knowing what you need to improve. Next, keep track of your food and drink intake. We highly discourage you from skipping meals. Irregular eating habits can bring harmful effects on your overall health. Skipping meals can also worsen your vestibular migraines because of the lack of nutrients absorbed by the brain. People with vestibular migraine may experience more attacks due to consuming too many carbs. This is because of the sudden increase in your blood sugar level. When eating carbs, make sure you do so only in small amounts per meal to avoid fluctuations in your blood sugar levels. A small amount of fat is essential to keep a balanced diet. Hence, we recommend not eliminating it from your diet but switching to a low-fat diet. Maintaining an ideal weight and eliminating food products that contribute to your weight problem may be necessary. Watch out for foods that are high in saturated fat. A balanced diet is necessary to keep your body healthy. This is because your food intake helps provide nutrients to your body for its parts to function well. Attempts to remove a specific food product from one’s diet to lessen vestibular migraine episodes may not work for every patient. Dehydration can worsen symptoms of vertigo, so it’s essential to make sure you’re drinking plenty of fluids throughout the day. Drinking enough water daily can also help clear your organs of toxins that may affect several body parts, including your vestibular system.
Identifying Trigger Foods: The Elimination Diet
People who want to try a diet for vestibular migraine must first identify foods that trigger their migraine. One way to do this is via an elimination diet. An elimination diet begins by eliminating foods a person thinks may be causing their symptoms. If symptoms improve, this suggests that one or more of the eliminated foods is likely causing the migraine. A person then tests which food is the culprit by slowly reintroducing each food and waiting days to weeks before adding another food. If symptoms reappear, this suggests the food the person reintroduced is a trigger. It can be helpful to work with a dietitian or doctor to determine the right timeline and ensure a person gets adequate nutrition. Pregnant and breastfeeding or chestfeeding people, individuals with a history of eating disorders, and people with special nutritional needs, such as those who have diabetes, should not try an elimination diet before talking with a doctor.
An elimination diet is the only official dietary guidelines for vestibular migraine. A vestibular migraine diet identifies and avoids food triggers while incorporating anti-inflammatory, blood sugar-stabilizing foods. Elimination diets and lifestyle changes, such as stress reduction and hydration, can help reduce migraine symptoms.
A migraine elimination diet involves temporarily removing common dietary triggers and gradually reintroducing them. This trial-and-error method helps identify foods that contribute to migraines. Usual culprits include aged cheeses, processed meats, chocolate, and artificial sweeteners. But everyone’s body reacts differently.
The elimination diet is considered the gold standard for pinpointing specific food sensitivities.
Read also: Understanding Keto for Migraine
Steps to follow:
- Remove known migraine triggers such as aged cheeses, fermented foods, artificial sweeteners, and alcoholic beverages for four weeks.
- Track food and symptoms daily, noting when you experience dizziness, nausea, head pressure, or other symptoms or how long you’ve been symptom-free.
- Reintroduce one food at a time every 3-5 days and note any increase in migraine symptoms.
Working with a dietitian or provider who understands vestibular disorders can help you navigate the process safely and effectively.
Currently, there are no official dietary guidelines for vestibular migraines. Consider whether certain foods, such as the foods that are known to be migraine triggers, have been associated with your migraines. You can start by eliminating that specific food to see whether that affects your migraine frequency. If you can’t identify a dietary trigger, an elimination diet might be an approach you can take. With this approach, you remove foods you suspect may worsen your symptoms. Because people respond differently to foods, elimination diets are personalized for each individual. You then reintroduce these foods at a later date, group by group, to determine whether any food or food group triggers your symptoms. An elimination diet typically lasts 5-6 weeks. It should only be done under the supervision of a health professional like a dietitian or doctor, as it increases your risk of a nutritional deficiency if followed incorrectly or for too long. Bear in mind that vestibular migraine is a complex condition, and you may find that dietary changes don’t affect your symptoms.
An elimination diet is divided into two main phases - elimination and reintroduction.
The elimination phase
During this phase, you avoid foods that may trigger vestibular migraine symptoms. You can then tell whether diet plays a role in your symptoms because you’ve eliminated nearly all possible trigger foods. This phase typically lasts 2-3 weeks.
The reintroduction phase
During this phase, you slowly reintroduce the eliminated foods or food groups. Each food group should be introduced individually over 2-3 days while you record how it affects your vestibular migraine symptoms. If you find that reintroducing a food or food group doesn’t worsen your attacks, it’s likely safe to eat. Yet, a food that triggers symptoms may need to be cut from your diet indefinitely. The reintroduction phase takes another 2-3 weeks depending on how many food groups you eliminated initially, though it may last longer if your health care professional recommends it.
Read also: Comprehensive Migraine Diet
An elimination diet targeting migraine trigger foods may help reduce vestibular migraine symptoms. This diet has two main phases - elimination and reintroduction - and usually lasts 5-6 weeks.
An elimination diet for vestibular migraine should remove foods linked to migraine symptoms, such as:
- aged cheeses
- alcohol (particularly red wine and beer)
- aspartame, an artificial sweetener
- chocolate
- processed meats like bacon, sausages, salami, and cured meats
- monosodium glutamate (MSG)
Caffeine intake has a major impact on migraines. If you regularly drink caffeinated beverages, you might get a migraine just by reducing or increasing the amount. So you should not make changes in your caffeine intake while you are trying an elimination diet.
Other foods that may worsen symptoms but have less supporting evidence include:
- citrus fruits
- tomatoes
- onions
- beans and lentils
- nuts and seeds
- pickled and fermented foods
- organ meats, such as beef and chicken livers
- salted, smoked, and dried fish
- dairy products like milk, cheese, cream, ice cream, and yogurt
- canned soups, soup cubes, and bouillon cubes with MSG
- fruit juices and carbonated sodas
- bottled salad dressings and packaged dips
- vitamins and herbal supplements, especially those containing caffeine
If you suspect that other foods not listed above may trigger your vestibular migraine symptoms, you should consult a health care professional and consider removing them as well. Discuss which foods you should eliminate with your doctor, as well as the duration of each phase, before you start any elimination diet. Keep in mind that these food groups should only be avoided during the elimination phase, as they’re reintroduced later on.
Foods That Are Usually Safe to Eat
During the elimination phase, you’re still able to enjoy plenty of healthy, delicious foods, such as:
- Fruits: most fruits, excluding citrus and tomatoes
- Vegetables: most vegetables, excluding onions, beans, and lentils
- Grains: all grains, such as rice, quinoa, couscous, and oats
- Meat, eggs, and fish: all fresh meats, such as chicken, beef, turkey, lamb, eggs, and fish - though not processed or boxed meats and fish
- Dairy substitutes: nondairy milk, such as coconut and oat milk
- Fats: healthy fats like olive, flaxseed, and coconut oils
- Beverages: water and decaffeinated herbal teas
- Spices and condiments: all fresh herbs and spices, plus most homemade condiments (no store-bought dressings or dips)
If you’re struggling to stay motivated during this phase, try experimenting with a variety of herbs and spices to flavor your dishes.
A person should not eat any foods that they believe may be triggering, even if they are on this list. The National Headache Foundation recommends avoiding the following:
- dried, aged, fermented, or salted foods
- mincemeat pie
- aged cheeses such as blue cheese and brie
- pickles, olives, and sauerkraut
- snow peas
- fava and broad beans
- monosodium glutamate (MSG) in large quantities
- alcoholic beverages
- all nuts
The following foods are usually safe to eat in small quantities, but a person should try to limit them:
- chocolate
- foods with autolyzed or hydrolyzed yeast
- caffeinated beverages (no more than two servings per day)
- dried fruit, papaya, avocado, raisins, and figs
- Parmesan and Romano cheeses
- sourdough bread
- home-leavened bread
- raw onions
- citrus fruits such as oranges and pineapples
Sample 3-Day Vestibular Migraine-Friendly Meal Plan
This 3-day outline avoids common triggers and supports nutrient needs. A registered dietitian can offer personalized guidance, including portion sizes and modifications based on your dietary needs.
Day 1
- Breakfast: Oatmeal with flaxseed, blueberries, and almond milk
- Lunch: Grilled chicken, quinoa, zucchini, and spinach
- Snack: Apple slices with sunflower seed butter
- Dinner: Baked salmon, brown rice, and asparagus
Day 2
- Breakfast: Smoothie with protein powder, banana, spinach, chia seeds, and coconut milk
- Lunch: Veggie soup with an olive oil-dressed salad
- Snack: Carrot sticks with hummus
- Dinner: Ground turkey and sweet potato hash
Day 3
- Breakfast: Scrambled eggs, avocado, and roasted zucchini
- Lunch: Grilled shrimp salad with cucumber and olive oil
- Snack: Rice cakes with cream cheese
- Dinner: Roasted chicken, wild rice, and cauliflower
Quinoa Bowls: Create a base of quinoa or brown rice and top it with lean proteins like grilled chicken or roasted chickpeas. Simple Proteins: Stick to fresh fish or lean turkey cooked with olive oil. Small snacks throughout the day help to prevent hunger and potential triggers.
Potential Risks and Benefits of Dietary Changes
The main benefit of using a migraine diet to reduce or manage migraine is that a person may have fewer migraines. In some cases, the diet may also reduce the need to use migraine medication and enable a person to live a fuller life with fewer migraine-related interruptions. If dietary changes do not reduce a person’s migraine frequency, there is no benefit to continuing these changes unless the person has another medical condition necessitating such changes.
The main risk of dietary changes is that a person may miss out on important nutrients. For people who already have restricted diets because of diabetes, vegetarianism or veganism, or other nutritional needs, it may be especially difficult to get all of the nutrients they require. Restrictive diets can sometimes lead to an eating disorder or be a symptom of one. People with a history of disordered eating may have a higher risk of relapsing on a migraine diet or any other restrictive diet.
While an elimination diet may help reduce vestibular migraine symptoms, it has several potential downsides. It can be tricky to adjust to an elimination diet. You shouldn’t follow it for an extended period without the supervision of a health professional, such as a doctor or dietitian. Restricting multiple food groups for too long increases your risk of nutrient deficiencies. Furthermore, it’s important to note that eliminating trigger foods may not work for everyone, as diet may not play a role in everyone’s vestibular migraine attacks. What triggers one person’s symptoms may not trigger another’s. If you don’t seek professional guidance, a vestibular migraine diet may increase your risk of nutrient deficiencies. In some cases, this diet may not help treat your symptoms.
Beyond Diet: Additional Lifestyle Changes
While dietary adjustments are crucial for managing vestibular migraine, incorporating other lifestyle changes can further enhance the effectiveness of these dietary measures.
Combining your migraine-safe diet with these lifestyle habits can further mitigate symptoms:
- Focus on managing your stress with meditation, yoga, or journaling. This can help reduce inflammation and promote healthy blood flow throughout your nervous system.
- A good sleep routine supports brain health and can help prevent migraines.
- Hydration is a non-negotiable. Make sure you’re drinking plenty of water throughout the day.
- Avoid skipping meals, as stable blood sugar reduces migraine risk.
- Consider supplements like magnesium, but consult a healthcare professional before starting any new regimen.
Lifestyle changes, like revamping your diet, can make a significant difference in managing vestibular migraines.
The Role of Hydration
Dehydration is a known migraine trigger. Prevents Dehydration: Dehydration is a known migraine trigger.
Stress Management
Chronic stress is a common trigger for migraine. Reduces Trigger Frequency: Chronic stress is a common trigger for migraine.
Moderate Exercise
Moderation: Avoid overexertion, which can sometimes trigger migraine.
Supplements for Migraine Prevention
Beyond food triggers, there are ways to nutritionally support your body. Some people benefit from adding magnesium, riboflavin (vitamin B2), or coenzyme Q10 to their routine.
For those who need additional magnesium support, supplements can be a convenient solution. Potter’s House Apothecary offers supplements for adding nutrition to your routine.
Managing Vestibular Migraine: A Multifaceted Approach
Effective treatment for vestibular migraine often involves a combination of lifestyle modifications, dietary changes, medications, and vestibular rehabilitation therapy. Identifying and avoiding triggers is crucial, as is maintaining a consistent sleep schedule, staying hydrated, and managing stress. Managing vestibular migraine requires a multifaceted approach that combines medical treatments, lifestyle modifications, and alternative therapies.
Medical Treatments:
- Triptans: Effective for acute migraine attacks.
Vestibular Rehabilitation Therapy:
- A type of physical therapy designed to improve balance and reduce dizziness.
Alternative Therapies:
- Acupuncture: An ancient Chinese practice that involves inserting thin needles into specific points on the body.
Seeking Professional Guidance
No specific diet can guarantee a reduction in migraine, and diets will not cure the underlying neurological issues that cause migraine. However, it is important to identify migraine triggers, including triggers in a person’s diet. In so doing, a person may gain more control over their migraine. People who need support to manage migraine should consult a doctor or ask for a referral to a neurologist.
Diet changes can be drastic and difficult for some people, but they can slowly help manage your symptoms and benefit your overall health. But if you’re looking for a natural yet effective approach to deal with your vertigo and other symptoms related to vestibular migraines, you might want to explore upper cervical chiropractic care. Upper cervical chiropractic is a go-to and proven remedy for chronic vertigo attacks due to conditions including vestibular migraines. It involves identifying upper cervical bone misalignments that might contribute to your vestibular migraine’s development. Correcting the misalignments through gentle adjustments can potentially reduce the occurrence and severity of your vestibular migraine attacks. That’s because correcting and restoring your upper spine’s bones’ proper alignment relieves the pressure on tissues like the brainstem and vestibulocochlear nerve. To know if a misalignment is linked to your vestibular migraine, you will need to consult with an upper cervical chiropractic doctor.
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