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Hidden sources of dietary triggers

We recently received a comment from one of our Facebook visitors informing us that this year’s influenza vaccine contains MSG. This is a pretty serious concern for migraineurs. On the one hand, no one wants the flu. It can be especially difficult for migraineurs because viral and bacterial illness often trigger a long and difficult round of migraine attacks.  Not wanting to be an alarmist, I went straight to the source. I found a list of all available flu vaccines at the CDC1 which confirmed that at least one brand, FluMist, does contain MSG.  If MSG is a trigger, you might want to talk to your doctor about using one of the other brands.

This is not the first time I have heard about medication containing potential migraine triggers. Even migraine medications sometimes contain triggers. For example, Zomig ZMT contains the artificial sweetener, mannitol3. For this reason, it is especially important to know your triggers and read all labels. Sometimes it’s not so easy though.  MSG can be listed by other names or it can be one of many ingredients within a labeled ingredient. If MSG is a trigger and you’re serious about trying to avoid it, you need to know all the ways that MSG can hide in foods2.

Definite sources of MSG

Ajinomoto Any “hydrolyzed protein” Anything with “enzymes”
Anything containing “protease” Anything “enzyme modified” Anything “fermented”
Anything “hydrolyzed” Anything “protein fortified” Anything “protein”
Autolyzed yeast Calcium caseinate Calcium glutamate
Gelatin Glutamate Glutamic acid
Malt extracts Maltodextrin Magnesium glutamate
Monoammonium glutamate Monopotassium glutamate Monosodium glutamate
Natrium glutamate Potassium aspartate Potassium citrate
Potassium glutamate Smoke flavoring Sodium caseinate
Soy protein Soy protein concentrate Soy protein isolate
Soy sauce Soy sauce extract Textured protein
Torula yeast Umami Vetsin
Whey protein Whey protein concentrate Whey protein isolate
Yeast extract Yeast food Yeast nutrient


Use Caution:

Any “flavors” or “flavoring” Anything “ultra-pasteurized” Barley malt
Bouillon and broth Brewer’s yeast Carrageenan
Citric acid, Citrate Malt extract Malted barley
Maltodextrin Natural flavor Oligodextrin
Pectin Seasonings Stock


Suspicious foods and ingredients:

Annatto anything “enriched” anything “pasteurized”
anything “vitamin enriched” Balsamic vinegar Brown rice syrup
Corn starch Corn syrup Dextrose
Lipolyzed butter fat Milk powder Modified food starch
 “low fat” or “no fat” Reduced fat milk Vinegar


Special Notes

Citrate, aspartate, and glutamate are used as chelating agents with mineral supplements. Binders and fillers in supplements and medications may contain MSG, too. If you are highly sensitive to MSG, you may also react to these ingredients. Also disodium guanylate and disodium inosinate work with MSG. If they are disclosed, assume that some form of MSG is also in the food even if not labeled.

Counteracting MSG

If you suspect you have been exposed to MSG by accident, there are some things you can do to counteract its effects.  Supplemental Vitamin B6 can help reduce your reactivity to MSG. Both Benadryl and Hydroxyzine can reduce the symptoms of an MSG reaction. Vitamin B6 and Bendaryl are available over-the-counter. Hydroxyzine requires a doctor’s prescription. Please discuss these with your doctor before making any changes to your treatment regimen.

Sugar substitutes

If you are sensitive to MSG, you may also have problems with sugar-substitutes. This can be very difficult for those who must also watch their sugar intake. In that case, you are better off avoiding anything that isn’t naturally sweet.

Sugar-substitute brands

Equal NutraSweet
Sweet-N-Low Splenda


Artificial sweetener ingredients to watch for

Acesulfame potassium Alitame Aspartame
Aspartic acid Cyclamate Erythritol
Isomalt Lactitol L-cysteine
Maltitol Mannitol Xylitol
Neotame Saccharin Sorbitol
Sucralose Neohesperidine dihydrochalcone

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Centers for Disease Control, Provider Information: Influenza VISs , retrieved online from on 10/13/2104.
  2. Truth in Labeling, Hidden Sources of MSG, retrieved online from on 10/14/2014.
  3. AstraZeneca, Zomig Prescribing Information, retrieved online from 10/14/2014.


  • jayM
    2 years ago

    Definitely MSG trigger and a big one. Anything “Chinese” and any spice mix sold have MSG, salad dressings, soy sauce and other sauces. Be very careful with any type of “spice mix” made in any country (i.e. curry mixes or similar)

  • LAnnSmith
    5 years ago

    Hi Tammy,
    Do the Maxalt MLT pills contain an artificial sweetener or some other trigger?
    I can’t take them because they send me almost immediately into visual pain spirals and vomiting. I use the regular Maxalt pills and sumatriptan injections instead, which really puzzles my neuro. None of his other patients have my reaction.


  • LAnnSmith
    5 years ago

    I went to and found my own answer. The MLT version of Maxalt has two of my major triggers: aspartame and peppermint. Maybe mannitol is also trouble. Now I understand why it makes me so sick!

    Here is the list of ingredients in MLT (in addition to those in the regular pill)
    “Each lyophilized orally disintegrating tablet contains the following inactive ingredients: gelatin, mannitol, glycine, aspartame, and peppermint flavor.”

    Thank you for writing this article, even though this is about dietary triggers it sent me to medication triggers. Without this it might have never occurred to me to look up the ingredients on my meds. You’ve given me a new tool!

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