What Is The Heal Your Headache Diet?

12 types of food you should eliminate if you get migraines

When I first began researching migraine and the migraine diet more in depth, I found everyone kept recommending the Heal Your Headache migraine diet from this book, Heal Your Headache – The 123 Program for Taking on Your Pain. I finally ordered it on Amazon and it was 10x more helpful than the majority of doctor visits I had experienced over the past year. Dr. David Buchholz from Johns Hopkins University School of Medicine is the author and he is endorsed by many of the top migraine doctors like Robert B. Daroff from the American Headache Society and Ronald J. Tusa from the Dizziness and Balance Center at Emory University. In the book he gives a plethora of helpful information you won’t necessarily get from your personal physician. This isn’t just a book about headaches, it’s a thorough overview of all types of migraine. It will show you how to find and avoid your potential triggers, including foods that trigger migraine attacks.

About Heal Your Headache

There are 3 sections to the book – avoiding the quick fix, reducing your triggers, raising your threshold. “Avoiding the quick fix” is about the standard migraine “abortives” that are widely available such as triptans (Imitrex, Relpax, Zomig), caffeine containing analgesics (Excedrin, Vanquish, Midol, etc.), and opioids and how they can cause rebound if used several times a month, perpetuating the migraine cycle.

“Raising Your Threshold” is about incorporating a daily preventative if you cannot get enough relief from the elimination diet and eliminating rebound migraines. “Reducing Your Triggers” focuses on the Heal Your Headache, or HYH diet, and how eliminating certain trigger foods can help to lower your overall threshold. By lowering your migraine threshold with the diet, you can experience unavoidable migraine triggers such as stress, bright lights, loud noises, and weather changes without them always triggering a migraine. This is the section I will focus most on because, as Dr. Buchholz states clearly, “If your goal is to control your headaches (or migraines) – and take as little medication as possible – the diet is the most valuable tool you have”.

The Heal Your Headache Migraine Diet

The Heal Your Headache migraine diet is tough to follow in the beginning because you must “strictly avoid all potential dietary triggers”. I even cried in the first two weeks because I was so upset and frustrated. I believe once you focus on all the things you cannot have, which usually lasts for about a month, you begin to focus on what you can have all the great substitutions that are available. Plus it may take a few months to truly notice a difference, which adds to the initial frustration. I remember a month or two in thinking this diet was silly and I was going to try a little bit of yogurt. After all, I had eaten it almost every day for years before being diagnosed with vestibular migraine. What would it really do if I just had a dollop of tzatziki with my lamb? A few minutes after trying the yogurt, I felt like everything was moving at the dinner table. My vestibular migraine was back in full force and triggered almost immediately by the yogurt. Sure enough from then on, I stayed on the diet!

The Importance of High Tyramine and Histamine

Lets talk about the triggers. Some of these you hear as common triggers – caffeine, red wine, chocolate, but some are lesser known like lemons and nuts! This list was compiled based on years of research from Dr. Buchholz patients. Most contain some form of tyramine (aged or fermented foods) or histamine (citrus, nuts, aged cheese). According to WebMD “tyramine can cause nerve cells in your brain to release the chemical norepinephrine. Having higher levels of tyramine in your system — along with an unusual level of brain chemicals — can cause changes in the brain that lead to headaches.”

Histamines, according to MBG Health,“cause your blood vessels to swell, or dilate, so that your white blood cells can quickly find and attack the infection or problem. The histamine buildup is what gives you a headache and leaves you feeling flushed, itchy and miserable. This is part of the body’s natural immune response, but if you don’t break down histamine properly, you could develop what we call histamine intolerance.” 

The following are triggers according to the Heal Your Headache migraine diet:

Caffeine – coffee, tea, sodas. Unfortunately decaf coffee and tea should be avoided as well since most contain chemical triggers and are not fully decaffeinated . The best substitute you can find are CO2 or Swiss Water Processed decaf coffees which are naturally processed and 99.9% caffeine free.

Chocolate – this includes organic dark, cacao nibs…anything you might think is “healthy chocolate”. White chocolate is allowed as long as it does not contain additives. It’s not actually chocolate!

Carob is considered “questionable” according to Dr Buccholz.

Monosodium Glutamate (MSG) – I know you think you don’t eat MSG. It’s not on any of your labels! What you may not know is that it’s actually considered a natural flavoring. It can be labeled as hydrolyzed vegetable protein, autolyzed yeast, hydrolyzed yeast, carrageenan, yeast extract, soy extracts, and protein isolate. See the chart for all the names.

A list of hidden msg names

Processed Meats and Fish- Canned, aged, cured, fermented, smoked, tenderized, marinated meats and fish. Most contain nitrates or nitrites as preservatives. These include hot dogs, ham, jerky, sausage, pepperoni, most deli meats, smoked or pickled fish, bacon, and anchovies. Beef or chicken livers also contain a high amount of tyramine.

Aged Cheese and Dairy Products – “The more aged, the worse” according to Buchholz. This includes gouda, parmesan, cheddar, brie, manchego, swiss, blue…all the good stuff. However, there are some fresh cheeses you can still have as long as they don’t have additives. FRESH mozzarella (not aged or smoked), ricotta (beware of carrageenan here), cream cheese, cottage cheese, boursin, and good quality American cheese. Yogurt and buttermilk should also be eliminated. Organic milk and cream, hemp milk, rice milk, and oat milk are all OK. Watch for additives in these. Carrageenan is a definite no, but gellan gum is allowable if there is no cleaner alternative. Update – I’ve seen a lot of people using sour cream and creme fraiche. Don’t do it! Creme fraiche is usually part buttermilk that’s fermented with cream. 

Nuts – All kinds must go, including nut butters. Peanuts, which are legumes but fit well in this area, are also to be eliminated. Good substitutes that are allowed are sunflower seeds and sunbutter, tahini (sesame seed butter), and pumpkin seeds. All seeds are allowed on the HYH diet.

Buchholz includes coconut under nuts, but coconut can technically be classified as a drupe fruit, nut, or seed! The other confusing part is coconut is allowed on another, more strict migraine diet, The Charleston Diet, from the Charleston Headache and Neuroscience Center. From what I have seen, it seems many on HYH can tolerate coconut. Because of this, and because it doesn’t seem to be a huge trigger for many, I will include it in some recipes. If you are just beginning the diet or if you find it is a trigger for you, you should definitely eliminate it.

Alcohol and Vinegars (except distilled white) – “Especially red wine, champagne, and dark or heavy liquors” says Buchholz. Vodka is best tolerated as well as clear distilled liquors and organic white wines, but these should be eliminated at the beginning of the diet until a steady place is found. This has to do mostly with the aging processes and fermentation, however some wines do contain added chemicals that appear to affect migraines even more than sulfites. Clear, distilled white vinegar is allowed, but other vinegars, like balsamic, are not.

Certain Fruits and Juices – Citrus fruit such as lemons, limes, grapefruit, and oranges etc. Bananas, pineapple, raspberries, red plums, papaya, passion fruit, figs, dates, and avocados should all be eliminated. Raisins and dried fruits with sulfites must be avoided. Once you are feeling better you can incorporate organic dried fruits that have no added sulfites (check labels).

Onions, Pea Pods, and Certain Beans – Broad italian, lima, fava, navy, and lentils should be eliminated due to high tyramine. Garlic, spring/green onions, shallots, and leeks are allowed and good substitutes for all onions. Sauerkraut and kimchi, since they are fermented, are off limits.

Fresh Yeast-Risen Baked Goods – This includes all baked breads less than one day old, especially sourdough due to the fermentation. Bagels, donuts, pizza dough, pretzels, muffins, etc. You can bake or buy all of these things and let them sit 24 hours for them to be safe to eat. Even if not a day old, look for additives like “malted barley flour” as that should be avoided because of glutamic acid. Pre-made naan is great for making pizzas, but watch for yogurt in it.

* There is no indication in Heal Your Headache that gluten is a definite trigger. If you would like to eliminate gluten because you think it may be a problem for you personally – go for it! I personally tried Gluten Free after my first few months of HYH to see if it would make an impact on my symptoms, but had a lot of success before I added it. Just be wary of additives. Sometimes I find gluten free foods actually contain more migraine trigger ingredients than fresh breads from your local baker.

Aspartame (Nutrasweet)– Saccharin (Sweet N Low) can sometimes trigger. Sucralose (splenda) and stevia (Truvia) should be ok, but would avoid if you can at first.

Soy products – Miso, tempeh, soy protein isolate, soy sauce. Soy milk and flour are less risky, but should be avoided in the beginning, and soy oil is safe.

Leftovers that have been in the fridge a couple of days – This one is based on the build up of tyramine that can occur in “safe” foods over time. I find that this is highly specific to the individual. I can usually tolerate foods that have been left in the fridge a max of 2-3 days, but I have also seen people who cannot even tolerate crockpot meals or broth that has been simmered for several hours. If you do have leftovers, it’s a good idea to freeze them right away and then thaw as needed.

Other potential triggers include tomatoes and mushrooms…or a number of other things that are completely individual – While mushrooms and tomatoes aren’t on the “no” list, they could be triggers for you based on them being a more common trigger for others. If you haven’t eliminated them and are not feeling better after 2-3 months, consider adding them to the “no” foods from the HYH diet. I will cook with these in recipes, but I will also try to give you substitutes or allow you to eliminate them if possible. I’ve also seen people with seemingly random triggers such as cinnamon, spinach, strawberries, or shellfish. These could potentially indicate a higher intolerance to histamine, in which case you could further eliminate more foods high in histamines.

Before you start feeling depressed that you can’t eat anything you love, please read this post about things you CAN eat. There’s actually quite a bit!

While Buchholz is very clear that diet alone will not eliminate your migraines, myself as well as many others have had great success with raising our overall thresholds for developing a migraine by following the diet closely. You should eliminate all the “no” foods for at least 3-4 months depending on how you are feeling. If you begin to feel better and notice your migraines are under control, you can begin to introduce some of your favorite “no” foods. I would personally begin with the things you are REALLY craving (I’m looking at you, avocados).

The idea is to test the potential trigger food for 4-5 days in a row to see if a migraine presents itself. This can be tricky because one day your threshold for a migraine could be much lower due to stress, weather, hormones, etc. and you could instantly get a migraine, whereas on good days where your threshold is higher, you could eat the trigger food and get by with it, not even realizing it’s a trigger. Also some trigger foods can produce a migraine as much as 24-48 hours later, allowing you to blame incorrect foods for the migraine. This is why it’s a good idea to keep a journal of what you ate and any outside triggers that occurred that day and test potential trigger foods on several different days.

Looking for a good place to start? Check out this easy 5 day meal plan with a grocery list included! It covers all your breakfast, lunch, snack, and dinner needs!

The Heal Your Headache book on a white background

The 12 types of foods you should eliminate on a migraine elimination diet according to Johns Hopkins and the Heal Your Headache diet #lowtyramine #migrainediet #migraineremedy #migrainetreatment
Get migraines? These are the 12 biggest trigger foods you need to eliminate to heal your migraines naturally. #migraineremedies #migraine #healthydiet
What is the Heal Your Headache HYH Migraine Diet?
Do you know all the names MSG can go by? Look for these in your food labels next time you shop - they are everywhere! #migraineremedies #migraineprevention

Alicia was diagnosed with Chronic Vestibular Migraine in 2016 and has been able to successfully manage her symptoms through medication, supplements, lifestyle changes, and the Heal Your Headache Diet by Dr. David Buchholz from Johns Hopkins. She's the owner of The Dizzy Cook.

110 comments

  1. Myfanwy

    Thank you very much for all the useful information you have posted here. I am suffering badly from migraines and although I’m taking medication I’m still getting two a week. It’s better than one every two days but I think I need to try the diet. I’m just finding it challenging as I eat low carb for diabetes and when I have a headache, it all feels overwhelming.

    Reply

  2. Brad

    Were you ever able to tolerate avocados?

    I’m in a little bit of denial this week. Like several others who have let comments, my VM started about 2 years ago while I was under a great deal of stress. I actually, which sounds similar to you, encountered two problems at the same time; VM and SIBO/IBS. I’ve done a lot of work on my IBS and am in a much healthier place with that now but the VM comes and goes. Like others also mentioned, which I find curious, when the VM first started I also got tinnitus which is still with me today, 2 years later.

    I think what I’m having the most trouble with right now is caffeine. I quit caffeine for a few months; once the VM was manageable I started back with decaf coffee. I was able to drink regular decaf coffee without many flare ups for about a month. I then started drinking regular coffee, intermittently, and was still okay for another month. Finally after about 3 months the VM came back with a vengeance and I’ve thrown my hands up in disbelief. It was at this time that I first learned of the HYH diet, and came across your website.
    I’m having a very hard time finding motivation without caffeine. I went about two weeks without and tried a cup of decaf today; needless to say I’m feeling sluggish and tired afterwards which is not the response I was hoping for. It did taste delicious though.

    Sorry for the long post but I wanted to know if you were ever able to tolerate avocados, almonds, or Swiss Water processed Decaf? Thank you!

    Reply

    1. Alicia

      Hey Brad,

      Yes! I do eat avocados often now. At first when I reintroduced them, they proved to be a low grade trigger. As I continued to heal, I can tolerate them just fine now. I still try to be careful though if I have a lot of outside triggers going on – stress, messed up sleep schedule, travel, etc.

      Almonds I can do in very small amounts, but I can no longer drink almond milk. To be honest, I don’t miss them that much. I think oat milk is much better and prefer seeds now. I think you’ll do well with Swiss Water Processed Decaf. Here’s a post on coffee and VM.

      I could never reintroduce caffeine and just stick with SWP. Even regular decaf makes me dizzy. I do miss caffeine, but I also like not being dizzy!! A few ways I get some energy and mental clarity.

      Magnesium Threonate – people tell me this is like having a cup of coffee for them. It’s helped with my brain fog immensely. Take in the morning.
      B vitamins, like B2.
      – A little bit of exercise.
      – Sparkling water – I’m not sure why, but this sometimes helps wake me up in the afternoons.

      Usually between these 3 things I can get enough energy to not miss caffeine too much. I wish you the best!

      Reply

      1. Brad

        Thank you Alicia, that gives me hope 🙂
        And thank you for creating this site and sharing. Similar to you I waited for 10 months to see Dr Beh. In the interim, someone I met in a group referred me to a Neurologist in Southlake who also focuses on headaches/migraines. He was a life saver and got me started on my wellness journey. I eventually got into see Dr Beh and am thankful to be in this area where we have access to these doctors; that said the wellness journey does not end with the doctor so I really appreciate you creating this space to share your journey that will no doubt help others who are struggling and looking for answers.

        Reply

  3. Jill

    Hi Alicia,
    I notice Brad mentions tinnitus. Uneven loss of hearing plus tinnitus has been my most persistent symptom apart from dizziness. And it doesn’t seem to have improved. Do you have any experience of this or have you heard of others with this difficulty, or anyone for whom this has improved over time?

    Also, I wondered if you have tried Craniosacral Therapy?

    Reply

  4. Lisa

    How does your diet work for people with hemiplegic migraines ? My son gets about currently get 15 a month

    Reply

    1. Alicia

      Hey Lisa – This diet actually works for all types of migraine. I’m sure that’s terrifying for both you and him, so I would say it’s definitely worth your time to read the book and see if he will make the effort to give the diet a try. 🙂

      Reply

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