With rheumatoid arthritis and irritable bowel syndrome, we were able to present another scientific trial that failed to find any response to elimination diet. As far as we know, there has been no such trial with migraine. Paradoxically, the fact that foodstuffs already have an accepted role in the orthodox view of migraine is partly reponsible for this. Certain foods, such as chocolate, cheese, red wine and citrus fruits are well-known migraine triggers. They are thought to spark off migraine attacks because they contain chemicals known as ‘vasoactive amines’ that can have a drug-like effect on the blood vessels.

Other trigger factors, such as bright lights, television screens, or emotional scenes, still have to be avoided, and some migraines are experienced regardless of all these precautions. This is an important difference between the chocolate/cheese/red wine sort of food response and the intolerance of commonly eaten foods such as wheat and milk, diagnosed by elimination diet. When foods are identified by elimination diet and then avoided, it is common for migraines to disappear altogether – non-specific triggers such as bright lights no longer seem to be a problem. This was noticed in the Great Ormond Street study, and is commonly reported by other doctors treating migraine with elimination diets.

In the orthodox approach to migraine, getting patients to avoid specific high-risk foods such as chocolate, and then record any reduction in their attacks is a standard part of treatment. Unfortunately, as ideas about intolerance of everyday foods has filtered through, this same method has been extended to those foods. So patients who enquire if commonly eaten foods might cause their symptoms are told to omit wheat for a couple of weeks, then milk for a couple of weeks and so on. The collective experience of all those treating food intolerance is that this approach simply does not work. The majority of people, if they are sensitive to any foods, are sensitive to more than one, and it is only if all are withdrawn at the same time that any improvement is noticed. This is why a proper elimination diet is necessary to detect this sort of food sensitivity. Yet the majority of migraine specialists dismiss the idea of food intolerance as a major, fundamental cause of migraine – and they do so on the basis of having asked patients to exclude foods from their diet one at a time.


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