Once again, for those that know me well, it is a clear rule in my house that one should not speak words until I have had my first sip of that loving, steaming cup of coffee. When I get a chance, I enjoy the ritual of cradling the cup in my hands and enjoying an old rerun (typically of The Golden Girls) in the morning. This blog post is not here to take that away from you. I promise. I would cry for you and me. However, you do need to realize that too much caffeine can be a bad thing.
Caffeine’s effects on your brain vary dramatically based on how frequently you consume it. This is why you may hear that caffeine can help treat a headache but too much of it will result in more headaches. A very tricky spot to be in as a caffeine-loving migraineur. Daily or near-daily use can lead to developing a tolerance for caffeine. When the regularly scheduled ingestion of caffeine does not occur, then a withdrawal syndrome begins. And, guess what the main symptom is? You got it, a headache. The withdrawal also leads to increased blood vessel diameter which aids the onset of the headache. This type of tolerance can develop in as little as 7 days and with a very small amount of caffeine.
This withdrawal is likely related to the effects of adenosine in the brain. Warning, big science nerd alert here. Caffeine can affect the function of adenosine and it is known that adenosine is increased during a migraine attack. Not to mention, if adenosine is injected (in rats, of course) it can trigger a migraine by itself. We do not completely understand all of the functions of caffeine in the brain and its targets including all of its interactions with adenosine, but this seems to all start to tie together.
Now, I said I would not take away your caffeine. True, a chronic migraine sufferer or daily headache patient should avoid caffeine as much as possible at least until the headaches are a little better controlled. So, I may ask for a temporary break, but will certainly allow a return in moderation. There is that word again, moderation. For some it is not a factor as much; and if there is no improvement, we might let you back on caffeine regardless. It is important to try to address your triggers as much as you can but we will do our best to let you enjoy your life! To the café!!