The Heal Your Headache diet by Dr. David Buchholz is meant to be a migraine elimination diet, which means you’re strict about it for a period of time with the intent to re-introduce foods when you feel better. The reason for this is not only to discover if you have any migraine food triggers, but also to lower your migraine threshold.
How to Increase Your Migraine Threshold
Increasing your migraine threshold can be done in a number of ways. Migraine Strong likes to call this the Treatment Pie, where you combine pieces of exercise, medication, supplements, hydration, sleep schedule, therapy, diet, and whatever seems to help you best into your treatment plan. These pieces stack on each other to increase your overall threshold for getting a migraine attack. For this particular pie, we want it to be a deep dish and not thin crust...luckily you’ve reached the point where you can start to think about eating lots of pizza, right?!
Another reason to increase your migraine threshold is to allow your brain some time to calm down. It’s been in hyperdrive with attacks and every little thing seems to set you off. Taking potential food triggers out of the mix can aide with this process over the course of a few months. So even if you don’t discover a bunch of massive food triggers, you can still be helping yourself improve by following the diet.
Why Be Strict on a Migraine Diet?
If you’re not strict and eliminating everything on the plan, you may be allowing that threshold to lower, even just a bit. This opens yourself up to being triggered more easily by bright lights, loud noises, movement, etc. Also if you’re eating something every so often that’s actually a trigger for you, it’s difficult to see if you’re also having symptoms daily. Some people have a spike in symptoms that are even worse than what they experience daily, others just can’t tell.
Being strict takes out any guesswork. You don’t have to wonder if it’s the chocolate you had last night or the wine you had this morning…what? Maybe I should flip that…
Having a set plan and testing foods in a controlled setting will make it obvious what your food triggers are.
When Do I Reintroduce Foods After an Elimination Diet?
Eileen from Migraine Strong wrote a great article about recognizing “baseline”, which means a reduction in severity and frequency of attacks. This can be different for everyone. For me, personally, I waited till I was having a good amount of totally dizzy free days to reintroduce foods.
When I began the Heal Your Headache diet, I was still having 24/7 dizziness, lightheaded symptoms. I had been on medication and supplements for about 4 months and was feeling a bit better without severe vertigo, intense disequilibrium, or dissociative vestibular migraine symptoms. Occasional I would have the walking on marshmallows feeling and pretty bad light and sound sensitivity. I literally did a migraine diet and cooked at home for months so I COULD actually go out and enjoy a restaurant without wearing sunglasses and wanting everyone in the room to shut up. A part of me figured, it has to get better than this.
Changes at 2 Months, 4 Months, and 8 Months
About 2 months in I wasn’t noticing a huge change in my symptoms. I still had daily dizziness and I was very frustrated I was putting in all this work for zero changes. That night I tried tzatziki with my lamb dish, which contains yogurt. Yogurt was an item I used to eat daily for breakfast and I never noticed that it spiked my symptoms at all. Within 30 minutes, the table felt like it was moving on me and I experienced a really severe attack, similar to what I used to go through before taking medication and supplements. I decided there must be something to this and I should stick with it a little bit longer.
About 4 months in I was feeling better and started having actual breaks in my dizziness, but was still experiencing symptoms daily. So I stayed the course.
Finally around 7-8 months I felt comfortable reintroducing foods. I was having actually dizzy free days, or the dizziness would be so light it really wouldn’t bother me. I could exercise, travel, and drive again without being nervous at all. This was my “baseline”.
How to Reintroduce Foods on a Migraine Elimination Diet
The best way to do this is to test them in a controlled setting. It shouldn’t be over your period, during final exams, when your in-laws are visiting (unless you love yours like I do), during crazy weather changes, etc.
Test one food for 3-5 days. They say food triggers can show up 2 days later, but I think that’s a little extreme. Most of mine were within 30 minutes to a day at the most. They were also pretty obvious. I’d have a noticeable spike in symptoms. And this is why it’s easier to wait till you’re having symptom free days.
If you start to get really bad symptoms and don’t think you can continue for the whole time, I like to write that food down and keep it in my memory. Continue to eliminate it and try to reintroduce later.
For tips on bringing red wine back into your diet, see this post.
My 5 Tips for Reintroducing Foods on Heal Your Headache
- Start with the foods you miss the most. This could be foods just love or it could be the foods that cause a total pain for you to not eat – like onions or citrus. I started with onions, citrus, and avocado. I love avocado, but being able to eat citrus and onions really opened some doors for ordering out. Especially with salads.
- You don’t have to reintroduce everything. There are some foods I don’t love and never reintroduced. For instance, I never did an official re-introducing of peanuts because I found I loved sunflower seed butter so much more. I’ll eat it here and there at restaurants and it doesn’t seem to bother me, but I overall I just don't really care to bring them back in. And things like MSG and additives, my life is just better without. I personally love reading labels now and choosing the best options for my health.
- Food triggers aren’t necessarily triggers forever. Just because something triggers you now, doesn’t mean it will a year down the road. As you begin to feel better, it’s sometimes easier to tolerate more. This was definitely the case for me! Things like avocados and cashews used to bother me, but now I tolerate them fine.
- Be patient. This process does take time. I know when you’re feeling better all you want to do is eat all the foods, but going off the deep end may end up in a few unexpected attacks or decrease that threshold real fast.
- Don’t let others influence you. My big triggers are yogurt, most nuts, and caffeine. It doesn’t really make sense and I can’t draw a conclusion as to what I’m reacting to as far as tyramine or histamine, but at the end of the day, it doesn’t matter. Those just make me feel like garbage. I’m automatically dizzy and out for the rest of the day. I’ve had so many people try to tell me a migraine diet is BS and that nuts are good for me or I need the probiotics. You know your body best. Don’t let anyone else tell you what it needs.
Having so much fun eating onions in my salsa again.
The Willy Nilly Approach
I’m going to be honest, I wasn’t perfect on my reintroduction of every little thing. I was one of the impatient people I tell you not to be above. Now I didn’t go crazy for days, but I did go out to eat and enjoy myself a little bit more. I was feeling good! And reintroduction the "good old boy" way takes a really long time. I always tried to stay away from my big, known triggers, but I didn’t grill the servers about what is in everything I might be ordering. There were times it lashed back on me and I couldn’t pinpoint a source. It’s easy to blame food, but it could have been the candle flickering or the loud noises combined with potential food triggers.
Sometimes I could draw a connection. Like in Burgundy when we had a dish full of walnuts and I felt so dizzy the rest of the day. It really raised a red flag. I do believe you can kind of gauge triggers this way if you’re really in-tune with your body. It’s certainly not the recommended approach, but we’re all human.
This is actually how I discovered almonds were a trigger of mine. I didn’t officially test them, but my local grocery was out of Oatly oat milk and I thought I would give the Malk Almond Milk a try. Almost instant dizziness, just like caffeine. The same thing would happen if I went out and had a dish with a lot of almonds in it. I eventually pieced all of this together to decide it was a personal trigger.
So are you ready to re-introduce some foods?! If there’s anything you’d like to know more of, just ask below in the comments!
For more information on reintroducing foods for Heal Your Headache, see this article .
My headaches seemed to have turned a corner. It has given me great hope. Alicia's info built on the heal your headache info, along with prayer are what I recommend!
I was diagnosed with VM in August 2020. My world was turned upside down for a while! I kept saying, "WHAT"!! I'm still learning and until an hour ago I had NO idea there WAS this much information about it. I applaud you and thank you from the bottom of my heart. My family has been searching for answers along with me and coming up with not much. Your article is very comprehensive. I will pass it on to my daughters who are trying to help me. Thank you so much for all you have done for us who have VM!!!! Andrea
I understand the wealthy investor part! I am assuming you are juggling family and everything else but... reaching out to some of those services already in existence to carry the "Alicia head ache diet" within their infrastructure sure sounds interesting? Many of my clients say the best business deal is a licensing arrangement. Keep up the good work. On a personal level I have hit a bad stretch. I have eliminated all recommended triggers but still getting them. I am about to concede Imitrex when they come and hope staying on the diet means they come less? Those 24 hour zombie sessions are getting hard to justify to hope the pills are not causing rebounding???
Alicia, After reading Heal your Headache I bought Your cook book and have been signing up for everything I can that you are putting out. I think you are doing a great job and have given me new hope. My headaches have improved. The information you share about triggers is as valuable as the recipes. It seems like Dr Buchholz went dark after the book? I think of you as our leader in continuing his school of thought. My comment is I sure wish you could put out some kind of meal program like Blue Apron, HelloFresh etc. with your recipes. I am beginning to think that "unfortunately" there is a huge universe of us. One of the good things of social media seems to be connecting these kind of groups. I have to think there are many of us that would really buy into a meal service with your recipes. I also really encourage you to monetize wherever possible all the information you are providing. I would gladly pay any kind of subscription service to help you continue. Keep up the good work!
Hey Matt, Thanks for the compliments. I'm so happy you've seen such an improvement. I would love to! Unfortunately we would also have to think of the build up of tyramine when shipping these products. It's a really great idea - I wish more people were interested in a migraine diet or had a wealthy investor! Dr. Buchholz just retired this past year. We had a big conference planned last September in Baltimore, but unfortunately that got cancelled with COVID. We will reschedule one of these days.
Hi. After 2.5 months, it was time to introduce items. I map everything on an Excel charrt. Chocolate was fine, and pumpkin isn't on the migraine diet -yet I started having intense attacks again after eating both of them, which was the first time I'd had one in 2 months. (9/17). Prior to that one, I'd been intense episode free for weeks. I went off both 3 days ago. No change . It's back to living on the first floor. How long does it usually take until I know it's not the chocolate/pumpkin and must be another cause? Thanks, y'all!
Hey Rachel, 2.5 months is actually a really short amount of time! That's amazing you saw results so fast. Do you think you're trying to reintroduce things maybe a little too soon? The only way to know is once you feel better you would try to reintroduce them again (separately). If you continue to notice a correlation, it would be a trigger food. I'd make a note in a journal so you can remember. Also write down what was happening the day you tested - was there a weather change? Were you stressed? Did you start your period? All these things can contribute to a lowered threshold as well.
Three years in and this inspires me to reintroduce some things I miss like oranges and Avocados. I found mushrooms to be ok after a while. I should try walnuts too, I used to eat them daily and miss them. The hyh diet hasn’t been too hard, probably miss citrus the most. I did discover many new spices, like sumac and leeks as a result.
I missed citrus the most too and I'm so happy I tested it out now..I hope you'll be able to add it back in too. But you're right, there is a positive to expanding what we shop for a bit!
Hey Alicia, amazing post. I have migraine but I was never aware about that headache can be healed through foods. I was only dependent on medicines. But after reading your blog I feel like everything can be cured with good food and a healthy diet. Thanks for sharing such a helpful post.
What are your thoughts on IgG or IgE testing for food allergies (possible triggers for migraines)? Do you find them accurate? I was on HYH diet for a year and got tested because I was still having migraines. Sure enough, eggs and dairy were major triggers for me (along with 12 other food items). Avocados, bananas, raspberries and coffee (all high tyramine/histamine foods) didn’t show up but I know coffee is a major trigger for me. However, I now avoid eggs and dairy and that has helped a lot.
Hey Nic, I think some people do find them accurate, but what I've learned from my RD friend at Migraine Strong is it measures your bodies response to the food, but doesn't take into account if it's actually a negative response....so kind of pointless. Here's some info on this. She prefers MRT testing which is a lot more accurate as far as pinpointing triggers go. I'd be happy to put you in touch with her if you're interested.
This is such a fantastic explanation of how to go about the migraine diet. My experience is similar to yours. In my case I gave it 6 months and then slowly reintroduced (although I wasn't great about staying away from chocolate all the time). I was fine introducing coffee back for a few months and then BAM attack, so goodbye to that. I certainly love avocados, cashews and bananas! I'll be sharing this post with many because you answer some of the top questions I often get!
I'm curious how avocados, cashews and bananas were for you Em. Those are my favorites and I"m at the beginning stages of the migraine diet.
My body is happy eating avocados, cashews and especially bananas- I probably eat 3-5/day in smoothies. Of course we're all different but that's what works for me now! Wish you the best on your journey and feel free to reach out 🙂
I’ve been on the headache diet for about 9 months now. I too had chronic vestibular symptoms that went on for months. Medication (verapamil) got me to the point of being able to function but still with symptoms more days than not. After the first few months, on the diet, I was feeling deprived but it was working and my symptoms were reduced. So, decided I would eat what I wanted without worrying too much about the diet when I ate out (only a couple of times a month) and stick with it at home—that has worked pretty well for me.
So glad you were able to find what works best for you! I was able to get away with it a little bit too, but I know others who have to be totally strict all the time. I think we got lucky. 🙂
What happens when you feel like almost every food gives you a reaction. Every time I test, I have an issue but then I think, I can't have an issue with every food, right? Or I eat the same food and day 3 I feel awful.....maybe it's that I can tolerate it mildly and not for days on end.....not sure. Then I am afraid to try again for a while and I give up. I have been living on the migraine diet for close to 2 years. Actually, it doesn't bother me much but it would be nice to know my triggers for vacations, eating out and living life. Thanks in advance for any suggestions.
Hey Heather, I was much more sensitive when I first reintroduced foods compared to now. It may be exactly as you said or you have other triggers that are helping it stack up like stress, weather, hormones, etc and that food is just tipping you over the edge. Perhaps focusing on another area may help you raise your threshold a little more so food doesn't seem as triggering - something like mindfulness, maybe increasing magnesium, adding in CBT or looking at other meds. I do know some people who just feel better on it in general and there's nothing wrong with that either. Usually on vacations my stress level is low, so I can get away with a little more than I would at home. Maybe you can try the "Willy Nilly" approach when you're on your trips if you think that might be helpful.