Caffeine and Headaches

Caffeine is included in many over-the-counter and prescription medications. It helps relieve migraines by constricting blood vessels and by directly relieving pain. However, caffeine is also a major cause of headaches, especially in the difficult-to-treat chronic migraines. People consuming large amounts of caffeine develop headaches not from caffeine, but due to caffeine withdrawal. This fact was confirmed by a double-blind study published in the New England Journal of Medicine. Half of the group of people, who normally did not suffer from headaches and were consuming only about 2 and 1/2 cups of coffee a day were switched to decaf. More than half of the people switched to decaf developed a headache, while the control group did not. Those people who are prone to having headaches are also much more prone to having caffeine-withdrawal headaches. The fact that caffeine causes headaches often comes as a surprise since many sufferers feel that caffeine in coffee, soda or medications actually makes them feel better. What they often don’t realize is that they are just adding fuel to the fire. Patients who start taking Excedrin or another drug find that with time¬†they need to take more and more of the medication with less and less relief. The only way to stop headaches in these patients is by stopping caffeine.Often it is not easy to do because headaches will first get worse before they get better. A physician can prescribe medications to relieve pain during the period of caffeine withdrawal, but usually after a few days headaches improve and no medications are needed at all. If headaches persist, a preventive medication, biofeedback or Botox injections can be used. Excedrin, Fioricet and other caffeine-containing drugs sometimes can be very effective, but to avoid caffeine-induced or, so called rebound headaches not more than 15-20 tablets should be taken each month. Caffeine has many other negative effects on some people. It can heighten anxiety, cause insomnia and has been reported to promote cyst formation in ovaries and breasts. Obstetricians advise pregnant women not consume caffeine because of its possible, although not definitively proven deleterious effect on the fetus. The following article from The New York Times suggests another negative effect of caffeine on the heart, which may also occur in the brain. VITAL SIGNS Advice on Racing to a Starbucks in Denver By NICHOLAS BAKALAR Published: January 24, 2006 In a small study, researchers have found that the caffeine equivalent to two cups of coffee appears to reduce significantly the body\’s ability to increase blood flow to the heart in response to exercise. The effect was especially strong when volunteers exercised while breathing air that simulated the oxygen levels at high altitudes. Eighteen regular coffee drinkers who had refrained from drinking coffee for 36 hours exercised on a stationary bicycle to establish normal levels of blood flow to the heart. Each then swallowed a 200-milligram caffeine pill. After 50 minutes of rest, enough time to allow the caffeine to attain its peak level in the blood, they performed the same exercise again. While caffeine did not affect blood flow at rest, it produced a 22 percent reduction of blood flow with exercise at 1,500 feet above sea level, and a 39 percent reduction at the equivalent of 15,000 feet of altitude. The results were reported in the Jan. 17 issue of The Journal of the American College of Cardiology. Dr. Philipp Kaufmann, the lead author on the study and a professor of cardiology at University Hospital in Zurich, said that while the risks for healthy people were minimal, those with coronary artery disease might be at considerably greater risk. He is not, however, prepared to recommend that healthy people forgo coffee before exercise. “In view of the fact that millions of people drink coffee before doing ordinary exercise and experience no health problems,” he said, “I do not think that we should expand our advice to the whole population.” But, he added, “Before doing high-level exercise, and particularly at high altitude, coronary artery disease patients should probably avoid caffeine.”