Over the course of my time coaching people to alleviate migraines, it’s become clear over and over again that some doctors and naturopaths may inadvertently be causing MORE headaches and migraines through the recommendations they make – especially when it comes to management of migraines caused by digestive problems and subsequent histamine intolerance.

I’m actually very grateful that a naturopath I was seeing early on for my migraines (prior to developing the SimplyWell Protocol) prescribed an herbal remedy that contained cinnamon as its first ingredient.  I was experiencing peripheral neuropathy along with the migraines and, rightly so, she thought the increased circulation boost offered by the cinnamon would help alleviate that (actually, it was my lymph that was congested).  When the remedy made me even sicker, I took a close look at the ingredient list and through doing some online research, realized that cinnamon is a major trigger for those with histamine intolerance.  This was the clue that I needed which sent me down the path of investigating migraine through the lense of histamine intolerance, which probably wouldn’t have happened had she not suggested I take cinnamon.

This was a good lesson in realizing that all reactions to medications whether positive or negative are telling us something: even bad reactions may be helpful if we can use them as a clue to better understand what’s going on in our bodies.  Conversely, sometimes the substances that we’re taking don’t manifest as obvious problematic symptoms that we can link to them, so we may inadvertently be using supplements or eating foods that are actually causing harm without knowing it. And then there’s the problem which is all too common of taking so many supplements and medications that it is nearly impossible to know which is causing what effects, for better or worse.

Below is a rundown of the most common ways to manage migraine, usually at the advice of a holistic or conventional professional health care provider, which may be exacerbating rather than mitigating your migraines.  It helps to be mindful about these blind spots so that you can interface with your health care professional in a more educated way.  Be forewarned that many health care practitioners may not be aware of what histamine intolerance is, since it is not a formal diagnosis.  I have heard of many cases of doctors undermining or questioning the existence of histamine intolerance.  Other practitioners may be aware of histamine overload but don’t link it to migraine.  Luckily, more and more more practitioners are learning about histamine intolerance and its causes.

Blind Spot #1: Fermented Foods & Probiotics

As people wake up to the importance of good gut health and its role in basically everything, many are getting on board the fermented food bandwagon. After all, it makes sense that if your gut flora have been depleted by antibiotics and meds (which most of ours have), that replenishing them with more good flora by way of fermented foods and probiotic supplements would be beneficial.  But this is not always the case.

One of my pet peeves is to see how widespread the fervent belief in the value of fermented foods is.  Fermented foods are the holy grail of gut health right now – except that they actually make a lot of us sick. As I have explained here in this blog post on histamine intolerance, fermented foods (yes, even the beloved home-made sauerkraut, kimchi, or kombucha) become problematic for those of us who are low in the enzyme, DAO (diamine oxidase), which helps to break down histamine.  Most fermented foods as well as probiotic supplements contain a mixture of histamine-producing, histamine-neutral, and histamine-degrading bacteria. (If you do feel you need a PRObiotic, choose only those strains that are histamine-degrading, like l. plantarum, l. rhamnosus, or b. infantis).

As a result of this DAO enzyme deficiency, those with the deficiency who eat fermented foods will not be able to break the food down properly, so by the time it reaches the colon, it will start to ferment even more.  Opportunistic bacteria in the colon, many of them also histamine-producing, will also try to lend a hand in the breakdown of the food.  By this point, your serum levels of histamine are probably quite high, and symptoms of bloating, brain fog, and migraine may appear.

Let’s be clear that I am not demonizing fermented food.  Fermented foods are beneficial if you can break down histamine.  The problem is not histamine-rich foods, but the nutritional and mineral deficiencies that make it impossible for the body to produce enough enzymes.  B vitamins, in particular, are building blocks for enzymes, and many B vitamins are normally provided by our gut flora.  However, if our gut flora are depleted, we won’t have these building blocks in place.

Luckily, we have extra help from PREbiotics, which also increase healthy gut flora but are much more supportive for those with migraine. Prebiotics and probiotics are normally complimentary, so once we have stabilized with the SimplyWell Migraine Relief Protocol, we’ll find we can gradually reintroduce the wonderful and otherwise beneficial fermented foods like sauerkraut that used to give us problems.

Blind Spot #2: Bone Broth & Collagen

Bone broth and collagen are usually recommended as a means to improve the integrity of the gut lining.  Full of minerals, healthy fats, and most importantly chock full of important amino acids, bone broth and collagen at first glance appear to be really good for building gut health.  And they are – IF you have the nutritional building blocks for the enzymes needed to properly convert glutamic acid (one of the most abundant amino acids in bone broth). 

The problem is similar to that of histamine overload exacerbated by low diamine oxidase enzyme – it means that an otherwise beneficial substance becomes toxic when it is unable to be transformed or broken down due to enzyme deficiencies.  The problem is also a cyclic, chicken-and-egg problem: how do you build gut health and enzyme function if your gut health is so poor that you can’t properly absorb or assimilate the nutrients needed to make the enzymes needed for good gut health?  Because healthy gut flora normally produce many of the B vitamins that are essential for enzymatic function, consistent B vitamin and mineral supplementation is usually crucial here.

But until then, bone broth and collagen may pose some problems for those with migraine, because the glutamine and glutamic acid in it has a molecular structure very similar to monosodium glutamate (MSG) – a known migraine trigger. Despite the fact that glutamic acid is used by the body for the creation of glutathione (which is generally low in those with migraine), some caution is still in order here.  Migraineurs also have high levels of glutamate in certain parts of the brain, which leads to excitotoxicity.  Glutamine and glutamic acid are converted into glutamate.  Therefore migraineurs are best supported by avoiding substances that contribute to excessive glutamate load.

Kaayla T. Daniel, PhD, coauthor of the highly acclaimed book Nourishing Broth: An Old Fashioned Remedy for the Modern World, points out that:

The glutamine content of broth increases with cooking time as do the levels of all other amino acids. Thus long-cooked bone broth is more nutrient rich and preferable for all who can tolerate it. . Appropriate supplementation and detoxification may also help sensitive people handle glutamine. People with severe MSG sensitivity are often low in vitamin B6 or unable to convert it to the active form of pyridoxal-5-phosphate (p5p). Becoming replete in B6 and the other B vitamins may help. Glutamine sensitivity can also come from lead toxicity, widespread today due to lead contamination of our food and environment.

A separate issue in consuming bone broth or collagen if you have migraines is that of freshness and quality.  Bone broth must be made and consumed fresh because – just like any other food – bacteria start to break down broth the longer it has been around – making packaged or leftover bone broth much more of a trigger than fresh homemade bone broth.

And, as is true of all animal products we eat, any bone broth consumed must be 100% organic.  Dr. Stephanie Seneff explains how the herbicide roundup (generic name glyphosate) can contaminate many products made with gelatin:

Once you think of glyphosate insinuating itself into collagen, it’s an easy step to imagine that glyphosate would be a major contaminant in gelatin, a very common food additive and the main constituent of gelatin-based deserts. Gelatin is routinely added to marshmallows, pudding, gummy bears, yogurts, margarine, frosting, cream cheese, sour cream, non-dairy creamers and fat-reduced foods. Gelatin is typically derived from the bones joints and skin of pigs and cows. These animals are fed high doses of glyphosate in their GMO Roundup Ready corn and soy feed. The glyphosate that makes its way into their joints ends up in your gelatin dessert.

Gelatin is also the main constituent of gel caps, which have become a standard way of packaging both pharmaceutical drugs and nutritional supplements such as fish oil. I would predict that any nutritional supplement housed in a gel capsule is going to cause you much more harm than good, because whatever benefit the contents provides is more than offset by the damaging effects of the glyphosate. This also means, of course, that bone broth, a highly nutritious food, must be made from grass-fed beef rather than from the large confined animal feeding operations (CAFOs). One solution is to be sure that your supplements use vegan gel caps, which are made from cellulose, a plant-derived polysaccharide that would probably be much less at risk of glyphosate contamination. (Source)

Bummer.  Major bummer. And if that weren’t enough of a bummer, glyphosate also interferes with how the body is able to utilize glyceine, one of the other amino acids that bone broth supplies.

Takehome: if you only get migraines once in awhile, bone broth and collagen may be supportive of your healing (only if it is 100% organic due to the glyphosate contamination issue).  But if you have chronic migraines and very high histamine, and are easily triggered by food, it may be best to opt out of consuming a lot of bone broth, or only eating occasional bone broth you make yourself that has been made with short cooking times. Be absolutely sure not to buy packaged broths, and opt for supplements made with vegetable, rather than gelatin, caps.

Blind Spot #3: Methylated B vitamins

These days taking methylated forms of B12 and folate is all the rage. As more and more people do genetic testing and find they have the MTHFR gene mutation, they and their doctors may believe they need methylated B vitamins.

I was always suspicious of methyl B12 as a stand-alone supplement, because I’ve personally experienced migraines triggered by B12.  Multiple clients of mine have repeatedly mentioned that they also get migraines from methylcobalamin. I have come across some evidence that B12 can be toxic in the presence of glutathione depletion.  Glutathione is our most powerful and abundant antioxidant in the body, and migraineurs are generally low in it. (As it turns out, triptans – the most popular drug for the treatment of migraine – also cause oxidative stress in the liver and thereby deplete glutathione, at least in rats).

Not only folic acid, but also methylated forms of folate can be problematic also because they may increase glutamate and lower serotonin levels. Folic acid and folate supplementation also lower riboflavin levels – not good for those with migraine. Consider this:

The potential limitations of administering a restricted range of B vitamins are illustrated by evidence showing that approximately a third of supplementation studies to date have involved the administration of folic acid alone. . . . [F]olate and vitamin B12 are intimately interlinked within the folate/methionine cycles, and increasing the level of folate can mask the accrual of permanent neurological damage associated with a specific vitamin B12 deficiency. A striking illustration of this was provided by an epidemiological study by Morris et al. who reported that high folate status was associated with protected cognitive function, but only in those with normal vitamin B12 status, with this relationship reversed in participants with low vitamin B12 status. For this group, high folate status exacerbated the detrimental effect of vitamin B12 deficiency, increasing the risk of cognitive impairment and anaemia by a factor of five, compared to those with normal vitamin status. A further study also demonstrated that low vitamin B12 status was associated with a significantly increased decline in cognitive performance over the subsequent eight years, with this effect exacerbated in those having high levels of folate, or those taking folic acid supplements. Alongside these observations it is interesting to note that in one study supplementation with folic acid also significantly increased the proportion of participants with riboflavin deficiency. (Source)

Why not just try to get all of your b vitamins through food?  Because b vitamins from food have always been a supplemental source to begin with – adding to the b vitamins that our gut flora would normally produce for us.  That is precisely the problem: evolutionarily, we have never relied on food alone for our b vitamins.

While supplementation with methylfolate may initially give some positive results, it can also quickly backfire, especially for those with migraine.  Luckily, there are alternative ways to methylate – through the use of choline or thrimethylglycine for example.

Methylation is an extremely complex topic (one that I certainly don’t have a full grasp on) – and around which there is much confusion and many diverse perspectives even among experts. Below are a few perspectives worth considering from some of the experts on the benefit of being cautious when it comes to supplementing with methylfolate:

Chris Masterjohn:

This is not – NOT NOT NOT NOT NOT NOT all about getting methylfolate. . . . You can’t restore the normal flux of methylfolate no matter how much you eat. The RDA for folate is 400 mcg depending on your sex and life stage, and that assumes you’re going to absorb 200mcg of folate. Each molecule of folate you consume is recycled 18,00 times per day. If you consume a molecule of methylfolate the methyl group on that folate is available once, and then it has to be recycled 17,999 times. Where does that recycling come from? The carbons come from serine or glycine, but the part that MTHFR is catalyzing, the part that’s defective in someone with an MTHFR mutation, they’re coming from glucose. . . One glucose molecule, if you’re burning it for energy, supplies enough NADPH to recycle one molecule of folate one time. You’re going to need 3,00 to 6,000 molecules of glucose for every molecule of folate to get your daily methyl flux out of it. . . . But if you wanted to make up for that process by adding individual methyl groups . . . . from methylfolate that you got out of a capsule, in order to make up for that process you would have to consume an incomprehensible amount of folate: 4.5 grams of folate. You would have to consume 18,000 times the RDA of folate. I have no idea what happens to folate when you consume 18,000 times the RDA for it, I just don’t know. My guess is a lot of it winds up in your poop. But I do know that I would never advise anyone to eat 4.5 grams of folate. And that if anyone thinks that by eating super high doses of folate like several milligrams that they’re getting anywhere near inching their way towards making up for the normal flux of methyl groups through that pathway, that’s delusional. (Source).

Dr. Ben Lynch

If you know or suspect that you may be deficient in various minerals or vitamins, then it is important that you replenish many of them prior to supporting with methylfolate or methylcobalamin. Why? Because if you support with these two powerful methyl donor nutrients, it can cause a ‘clog’ in your biochemistry. This ‘clog’ may occur in how your brain chemicals (neurotransmitters) get formed and/or eliminated. Obviously, this can cause some significant issues. (Source)
Dr. Carolyn Ledowsky

A lot of information available from a variety of sources says that for those patients who have MTHFR mutations (especially the C677T MTHFR mutation) methylfolate is critical to take. And yes, for some patients, gentle supplementation via methylfolate may be all that is needed if they are otherwise healthy and have few health conditions they need to address. However for anyone dealing with allergies, inflammation, poor detoxification, hormonal imbalances or mood/ neurotransmitter imbalances – methyfolate could amplify these issues if they have not been addressed prior to engaging the methylation cycle once more. (Source)

Dr. Albert Mensah

Much discussion surrounding methylated folate comes from genetic testing and the MTHFR paradigm, which is neither an accurate assessment nor an appropriate guide for true methylation disorders. MTHFR testing is very significant in the realm of autism and in multiple sclerosis, however, in the area of mental health it is strikingly inconsistent and dubious at best.  The proof is in the pudding. People who are truly undermethylated do not do well on methylated folate after two to three months. In fact, on quite the contrary, many people report worsening of symptoms. (Source)

Marlene Merritt, LAc, DOM, MS Nutrition

Methyl groups have effects on many, many different areas of the body, INCLUDING TURNING ON AND TURNING OFF GENES and this includes tumor suppressor genes. To prevent abnormal methylation, there are seven checkpoints to prevent hypermethylation, since hypermethylation often causes cancer. So this is another reason that you not want to take large amounts folate (or any other methyl donor (ex: methyl-B12, SAMe), because you also do not want too much methylation to occur.

So then why in the world would you want to take a nutraceutical like methylfolate/5-MTHF? . . .

[L]ong term supplementation of methylfolate causes a list of side effects that rival a pharmaceutical drug: anxiety, irritability, insomnia (from changes in neurotransmitters), sore muscles and achy joints (from reduction in glutathione production), headaches and migraines (from increased nitric oxide production), nausea, palpitations, rashes and suicide, in addition to exacerbating B6 and B12 deficiencies, along with magnesium, zinc, copper, manganese and other mineral deficiencies. . . .

In preparing this article, I interviewed five biochemistry and nutrition PhD’s, all of whom categorically said that they would not take methyl folate as a supplement and considered the amounts typically prescribed as unsafe. (Source)

Blind Spot #4: Excessive Vitamin D Supplementation

Another pet peeve of mine: excessive vitamin D supplementation.  Don’t get me wrong – it appears that vitamin D3 supplementation is pretty valuable (though this may need to be reconsidered – see below).  Most people, whether they have migraine or not, are low in vitamin D.  But taking huge amounts of vitamin D is also dangerous – especially to migraineurs, since vitamin D requires magnesium for absorption.

Dr. Carolyn Dean explains:

Here’s what happens. You feel great on your magnesium and then you begin to have more magnesium deficiency symptoms after adding a high-dose Vitamin D supplement. Magnesium is required to transform Vitamin D from its storage form to its active form and for many other aspects of Vitamin D metabolism. That means if you take the extremely high doses that allopathic doctors are now recommending you can plummet into magnesium deficiency and not know what the heck is happening. In general, I don’t recommend more than 1,000-2,000 IU of Vitamin D daily for this reason. And never take Vitamin D without magnesium. (Source)

Excessive vitamin D can also deplete vitamin K stores, which are essential for helping calcium build bone.  With vitamin D excess and K depletion, calcium ends up in the wrong places. Sufficient vitamin A is also crucial if you are supplementing with vitamin D.  According to Nora Gedgaudas in her book “Primal Body, Primal Mind”, insufficient Vitamin A can lead to vitamin D toxicity.

Chris Masterjohn explains his hypothesis:

[V]itamin D increases the expression of proteins whose activation depends on vitamin K-mediated carboxylation; as the demand for carboxylation increases, the pool of vitamin K is depleted. Since vitamin K is essential to the nervous system and plays important roles in protecting against bone loss and calcification of the peripheral soft tissues, its deficiency results in the symptoms associated with hypervitaminosis D. This hypothesis is circumstantially supported by the observation that animals deficient in vitamin K or vitamin K-dependent proteins exhibit remarkable similarities to animals fed toxic doses of vitamin D, and the observation that vitamin D and the vitamin K-inhibitor Warfarin have similar toxicity profiles and exert toxicity synergistically when combined. The hypothesis further proposes that vitamin A protects against the toxicity of vitamin D by decreasing the expression of vitamin K-dependent proteins and thereby exerting a vitamin K-sparing effect. If animal experiments can confirm this hypothesis, the models by which the maximum safe dose is determined would need to be revised. Physicians and other health care practitioners would be able to treat patients with doses of vitamin D that possess greater therapeutic value than those currently being used while avoiding the risk of adverse effects by administering vitamin D together with vitamins A and K. (Source)

It’s well established that overly-high vitamin D levels are associated with frequent urination, constipation or diarrhea, hypercalcemia, headaches, increased risk of heart attack or stroke, kidney failure, and tiredness, among other things – and it is recommended that those with headaches and thyroid disorders (ie, migraineurs) supplement with vitamin D cautiously (Source).  Levels as high as 100 are above the suggested 50-80ng/ml range, and levels of 150 ng/ml and above are considered toxic.

It appears that what is often not realized by many health care practitioners is that elevated levels of vitamin D have ALSO been associated with headache and migraines.  Dr. Stasha Gominak, a neurologist specializing in alleviating migraine, improving gut health, and re-establishing sleep hygiene, believes that vitamin D supplementation contributes to B5 deficiency (and we need it for enzymatic function!).  She has put forth the hypothesis that our gut flora do not produce sufficient B vitamins in the presence of vitamin D depletion. She suggests that vitamin D should be in the range of 60-80ng/ml.

Other experts differ in their view, including Chris Kesser and Chris Masterjohn, and Amy Proal. Chris Kesser summarizes the evidence as follows:

The U.S. laboratory reference range for adequate 25(OH)D is 30 to 74 ng/mL, while the Vitamin D Council suggests a higher range of 40 to 80 ng/mL, with a target of 50 ng/mL (17).

But a large body of evidence in the medical literature strongly suggests that optimal vitamin D levels might be lower than these figures. There is little to no evidence showing benefit to 25(OH)D levels above 50 ng/mL, and increasing evidence to suggest that levels of this magnitude may cause harm. . .  Based on an exhaustive review of over 1,000 studies in 2011, the Institute of Medicine recommends a much more conservative range of 20 to 50 ng/mL. . . .

What about optimal vitamin D range from an evolutionary perspective? A study on traditionally living hunter–gatherer populations in East Africa found that the Masai and Hadzabe tribes had average 25(OH)D concentrations of 48 ng/mL and 44 ng/mL, respectively (35). These indigenous populations get a great deal of sun exposure but also have very high intakes of vitamins A and K, suggesting that these levels are probably towards the higher end of the optimal range for most people in the modern world.(Source).

And here is another very important consideration from Amy Proal explaining the cause of low vitamin D levels:

Vitamin D supplementation is routinely justified based on a plethora of studies that report low concentrations of 25-D in the blood of patients with a wide variety of inflammatory conditions. Thus far, the consensus on these findings has been to assume that the low concentrations of 25-D are driving or contributing to the pathogenesis of these diseases. However, the low concentrations of 25-D often detected in patients with inflammatory conditions may be a result of the inflammatory disease process rather than the cause of the inflammation. . . Indeed, our data suggest that under conditions of microbiome and interactome dysregulation, the body uses multiple mechanisms to naturally downregulate intracellular production of 25-D. (Source)

You can read more about alternative viewpoints and potential problems with vitamin D supplementation in the following articles: “Vitamin D: More is Not Better”, “The Evolution of Diverse D Requirements”, and “The Concept of Vitamin D Deficiency is Flawed”, “Harm from Vitamin D is Supported by High Quality Studies”, and “Vitamin D Supplements are Immunosuppressive”.

After considering these views, I no longer supplement with vitamin D.  I am currently looking into purchasing a vitamin D lamp, since I live in the Pacific Northwest. I make sure to get plenty of vitamin A from butter and beef liver pate. Getting just 15 minutes of sunlight a day should be sufficient for most people.  Sunlight is converted into vitamin D by the presence of cholesterol in skin and vitamin E.  As it turns out, vitamin E is best absorbed topically, so I like to use a sesame oil for my skin with some essential oils added as one way to boost my vitamin D production when I go out into the sun

Blind Spot #5: Insufficient or Wrong Kind of Magnesium

Magnesium is nature’s natural calcium channel blocker.  When magnesium levels are low, the voltage gated calcium channels that allow nutrients and oxygen into the cell don’t work properly.  Due to the imbalances in the ratios of our most important electryolytes – calcium, magnesium, sodium, and potassium, these channels may not be able to open and close in a balanced way.  When these channels are open, calcium floods into the cell, causing cell death (important side note: EMF – electromagnetic frequencies also cause damage by the exact same mechanism).  In order to maintain the integrity of the cell, we need the proper ratios of magnesium to calcium, potassium, and sodium.  As I pointed out above, less magnesium will be available for cellular health if it is being used up by excessive vitamin D supplementation.

One thing that I see consistently with clients is that some of them give up on magnesium if it doesn’t provide immediate or obvious benefit in alleviating their migraines.  I did this myself early on, and actually noticed a more positive immediate benefit from potassium.  Potassium deficiency, however, is usually tied to an underlying magnesium deficiency.

Magnesium supplementation can actually cause initial cleansing reactions and headaches.  A blood test for magnesium is not reflective of actual tissue concentrations of magnesium.  Therefore it is important to supplement with sufficient quantities of magnesium for the long-term.  It takes up to 4-6 months of continual supplementation to reach the right tissue concentration levels.

It is important to not only get enough magnesium (your body requires 300 mg just to maintain daily functions even without a deficiency), but to get the right kind.  Just the other day I discovered that one of my clients had been taking magnesium aspartate.  While some early studies did show magnesium aspartate to be beneficial for those with fibromyalgia, and aspartate is part of the citric acid or Krebs cycle, nevertheless it is also a neurotoxin at certain levels and when the person taking it doesn’t have the proper enzymes to convert it to a form the body can handle.  The same goes for magnesium glutamate.

Both magnesium aspartate and magnesium glutamate are often hidden in products labeled “magnesium chelate.” Dr. Russel Blaylock, a neuroscientist, explains this at length in his book Excitotoxins: The Taste that Kills.  Because those with migraines already have very high levels of inflammatory neurotoxins including glutamate and CGRP, and are already sensitive to glutamate-containing foods and supplements, it’s crucial to avoid magnesium glutamate, as well as aspartate, for optimal brain health.

Those who are constipated or who have oxalate sensitivity issues may benefit from magnesium citrate, as this form helps to flush out oxalates from the body (and may cause some cleansing reactions).  Magnesium citrate also supports the citric acid or Krebs cycle, which brings oxygen into the cell to create ATP, or cellular energy.  Magnesium malate is also supportive of the citric acid cycle and generally doesn’t cause loose stools as the citrate form does.

Those who already have loose stool should avoid the citrate form.  The glycinate form is great because not only is it well tolerated, but it also lends a glyceine amino acid, the smallest and most versatile amino acid.  (The receptor sites on cells often get blocked for this amino acid, incidentally, by the presence of glyphosate, or roundup contamination in food – which seriously messes up enzymatic function).

Magnesium chloride can be easily absorbed as bath salts or through the skin, though magnesium oil is sometimes very itchy.  This form of magnesium is mined in ancient deposits, so sourcing is important.  The benefit of magnesium chloride is that the chloride portion of this molecule can be used by the body to produce stomach acid for those low in stomach acid.  Chloride is also important for the cellular receptor sites for diamine oxidase (DAO), meaning that it helps to metabolize histamine.

I always take a minimum of 800 mg total of magnesium daily. I like to use a combination of magnesium chloride (the kind sold as “magnesium oil” in my water, along with other minerals I add to my filtered water), and a magnesium glycinate as well as magnesium malate supplement.

Blind Spot #6: Ingestion of Cinnamon

Cinnamon is without a doubt an incredible healing plant ally.  It is warming, pungent, and therefore dispersing of stagnation, which is one reason why cinnamon may be suggested by holistic health care practitioners to improve circulation.  Cinnamon especially is also a powerful antiviral and antibiotic as well as a mast cell stabilizer.

It is not totally clear why cinnamon triggers migraine, but it has been observed repeatedly that it does in those with histamine overload.  Cinnamon does contain histamine, but most likely, histamine triggers caused by cinnamon are due to the fact that sodium benzoate (NaB) produced by cinnamon is a DAO inhibitor and will therefore impair histamine degradation. 

It must also be noted that there are different kinds of cinnamon, and the coumarin in cinnamon may be the culprit, as it is hard for the liver to process (and could therefore trigger migraine in someone who already had compromised liver detoxification).

There are big differences between the main forms of cinnamon, cassia, and Ceylon. If you ingest cinnamon as a spice or take it in supplement form, you want to make sure that it is produced from Ceylon cinnamon. Both forms of cinnamon contain coumarin, which is a natural blood-thinning agent but is hepatotoxic. Ceylon cinnamon contains minute amounts of coumarin compared to cassia cinnamon. Coumarin detoxification requires proper liver function and activation of the cytochrome P450 gene CYP2A6. If you have a polymorphism in CYP2A6, you need to avoid cassia cinnamon if all possible. Proper detoxification of coumarin will be lessened, and increased risk of liver damage may occur. (Source)”

Side note: I’ve made an analgesic salve available in my shop that does contain cinnamon along with cayenne for rubbing on the temples and intranasally to dissolve migraine – but, as explained above, topical application has very different effects than ingesting it does!

Blind Spot #7: Ingestion of Cayenne or Chili

As for chili, it can definitely add to your overall histamine load.  Cayenne as well as most spicy chilis, especially their seeds, contain a powerful compound called capsaicin.

How capsaicin is administered makes a difference in its therapeutic effects (or lack thereof).  Because cayenne (and capsaicin) thins mucous, consumption of cayenne may be more applicable for those with sinus headaches than with migraines caused by digestive upset and histamine overload. This mechanism makes sense when you consider that those who experience relief from capsaicin get it when they take capsaicin in a drink (where it gets exposed to the nasal sinus) but don’t when they take it in capsule form.

Capsaicin has been shown to inhibit CGRP (Calcitonin Gene Related Peptide), a potent vasodilator implicated in migraine. However, again, in this study the capsaicin was administered through the nose (Source). Intranasal exposure to capsaisin numbs and desensitizes the cranial nerves. Note that Lundberg and coworkers found that CGRP was inhibited (in guinea pig lung) only when small concentrations of capsaicin were used, but not when high concentrations were (Source). Capsaicin seem to contribute to migraine by way of neurogenic inflammation on a cellular level caused by a sudden influx of calcium into the cell followed by cell death (Source).

For those with histamine intolerance, ingesting cayenne must be avoided, because capsaicin not only contains histamine but also is a potent vasodilator itself (source).  It is a very potent trigger. If you’re going to take it, take it up the nose.  Otherwise – avoid!

Side note: I’ve made an analgesic salve available in my shop that does contain capsaisin in cayenne for rubbing on the temples and intranasally to dissolve migraine – but, as explained above, topical application has very different effects than ingesting it does!

A Final Note About “Triggers”

I just want to briefly point out that when we speak about histamine intolerance and its associated food “triggers”, that it is the amount of pre-existing histamine in the body that determines whether a food with more histamine will act as a trigger or not.  This makes it a little tricky because it means that depending on the person’s histamine level at the time, they will get different responses from the same kind of food and may therefore think that something like chili, sauerkraut, or chocolate isn’t an issue because it doesn’t cause a migraine every time it is consumed.  Again, histamine intolerance is an issue of histamine overload, not an immediate, anaphylactic allergic response.  So the word trigger may be misleading.  What we are talking about here is problematic foods that increase histamine and add to the overall load, which will sometime mean that that food acts as the trigger because the histamine bucket “tipped over” into migraine.