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Food triggers: Elimination diets

What’s an Elimination Diet and How Do I Manage One?

The term “elimination diet” sounds like you’re eliminating certain foods from your diet. Period. It actually means that you temporarily eliminate certain foods, then test to see which foods are problematic for you. It is not intended as a permanent change to your diet. Here’s what you need to know before you embark on an elimination diet.

An elimination diet is an experiment. You remove certain foods or food chemicals from your diet for a short time. After you’re symptom-free (or have reduced symptoms) for a while, you slowly add foods back in to see if they trigger a migraine. The recommended time to wait before reintroducing a food varies from several weeks to four months; in my experience, about six weeks is sufficient. Once you’ve determined a food or food chemical isn’t a trigger, it can go back in your diet. (“Food chemical” doesn’t necessarily mean something artificial added to foods. All foods are made up of naturally occurring chemicals and some have artificial chemicals added to them. Migraine trigger foods are generally from a wider category of naturally occurring food chemicals, like tyramine, nitrates/nitrites, or sulfates/sulfites. The next article will address this in detail.)

Elimination diets can be overwhelming and frustrating at first. There’s a lot of confusing information and food lists to reconcile. It can take time to settle into a rhythm and, even then, you’ll probably resent the restrictions. You will get fed up and wonder if there’s any use to it. You will make mistakes. You will sometimes decide that it’s more important to eat your favorite food than it is to stick to the diet. All these things are almost inevitable. It’s important to go easy on yourself and remember that you’re learning something entirely new. You wouldn’t expect a child to ride a bike the first time they saw one; doing an elimination diet isn’t all that different.

“If I cut out all those things, there’s nothing I can eat!” is a nearly universal reaction. No matter what the elimination diet, most people look at the restricted foods and think they’re nothing they can eat. While it seems that way at first, there’s actually quite a bit of leeway, though you may have to get creative or go outside your comfort zone. You may even discover new foods you love or that you like foods you previously disliked (mango, persimmons, teff, and fennel are all on that list for me). You can choose to stick with a repetitive diet for a few months, just make sure you’re eating lots of vegetables, fruit, lean protein, and whole grains so you stay healthy.


Good nutrition is still possible with the standard migraine elimination diet. As I mentioned above, be sure you eat plenty of vegetables, fruit, lean protein, and whole grains – all part of any healthy diet – and you should do just fine. If you’re nervous, you can enter the foods you eat into Self’s nutrition database to see if you’re meeting all your nutrition requirements. You can also ask your doctor for a referral to a dietician. Even if the dietician isn’t familiar with migraine, you can present them with the foods and food chemicals you’re trying to avoid and they can help you develop a nutritious diet.

Elimination diets require time and attention. If you already make most of your food from scratch, you’ll have a bit of a learning curve to figure out what you can and can’t eat, but the cooking won’t be much of an additional time commitment. If you rely on a lot of convenience foods or eat out a lot, you’ll probably spend a lot more time on food. You’ll need to read labels at the grocery store and spend more time preparing food or cooking. It helps to think of this as a time-limited project. You’re doing an experiment to see which foods are problematic for you, not revamping your diet for the rest of your life.

Keeping the potential outcome in mind is helpful. For someone who has food triggers, determining what those triggers are is freeing and instills a sense of control over migraine attacks. It can reduce the number of medications and supplements you take or eliminate them entirely. There aren’t enough adjectives to describe how great this is. Even if you’re unable to find food triggers from this particular elimination diet, you’ll have more information about your migraine triggers than when you started.

The next article in our food trigger series will address which foods you should avoid during the first stage of a migraine elimination diet.

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

Comments

  • Kim
    4 years ago

    I think where people get confused with elimination diets is in thinking that you need to eliminate all foods at once. Like cutting yourself back to chicken, rice and water and living like that. Not so. I have had migraines since I was a kid, but when I started getting them non-stop, I had to do something. I once again looked at that long list of things were *supposed to* not eat as migraneurs and ticked off the list anything I knew was safe. I looked at anything I might have added in recently as well. I eliminated about 8 things and after a few days my head started to feel less painful. It took a while to get back on an even keel, though. Once I had felt that sufficient time had passed, I braced myself for a test of items one by one to see if I had a reaction. Two items – sorbitol from my flavored water tablets and the MSG in my seasoning salt – were the blue ribbon winners. I have also discovered that I need to limit the amount of sugar I eat – I thought that an odd one. But it was well worth the time and effort put into the experiment because it stopped the cycle. I still have migraines but they are back to what I consider a manageable level. (Sad what I consider manageable, but there you have it.) I would highly recommend anyone try at the very least eliminating new items from their diet if they find they are experiencing an increase in daily migraines. Keeping a food diary is always helpful in any case.

  • RecipeRenovator
    4 years ago

    Kerrie, thanks so much for shedding light on this topic. I found the whole process so incredibly confusing that I am writing a step-by-step book on the subject. I have found a lot of success but it’s really hard with no guidance. I know you are helping a lot of people here.
    Stephanie Weaver

  • thisisendless
    4 years ago

    I did the “Heal Your Headache” diet by Dr. Bucholtz for about 8 months when my migraines started. (PLUS gluten free for awhile) It did not make any difference, but drove me crazy because I worked at a restaurant at the time so I could never be sure what was in anything. There was like ONE thing I could be sure of so I had to eat it every day.

    I was SO grateful when I found my current neurologist, who told me that triggers would happen in a few hours and I didn’t need to be on the diet. I immediately when out and bought a loaf of bread and put peanut butter on it. I was SOOOOooo happy. That may not be the case for everyone, but for me it just put me through months of misery with no result.

    We have finally found a preventative that has been working for a couple of months. My doctor didn’t think I had food triggers though, since I never got migraines until about a year and a half ago.

  • pam bitterman
    4 years ago

    Me too, Kerrie! I did the hormone test, acupuncture, Delayed Hypersensitivity Test, and sooo many more. Most seemed to help a little. Then I read that 75% of migraine sufferers experience some relief when they eliminate gluten. As I have been a practicing vegetarian for over 40 years and have already eliminated foods indicated as triggers (not gluten!) from other test results, I was skeptical, especially since organic whole grain products make up a large part of my healthy diet. But I decided to give it a go! And I have seen a significant improvement! I just hope it lasts…

  • Debbie
    4 years ago

    Kerrie, thanks so much for writing about this. A couple of months ago. I cut out sugar and gluten and eat only whole foods with no added ingredients. I’m still not perfect with it yet and haven’t added anything back in, but I have noticed that my migraines are much better than before. I also have much more energy and less brain fog. I do spend more time shopping and cooking for food but I don’t mind as much as I thought I would since I feel so much better! I’m looking forward to your other articles in this series.

  • Janet
    4 years ago

    I was put on a ketogenic meal plan last April…I had medium hopes as disappointment comes so often…as with any elimination diet there is the period of withdrawal that gives you a migraine. Sugar free..gluten free..nothing from a box, can, package (well I haven’t eaten things like that in my ver 30 years) but sugar is in so much..fruits…so finding low sugar fruits that aren’t migraine triggers brought me to strawberries, blueberries, blackberries..the end of the list..low carbs..I believe that was a good idea..but no a limit of 20!!!!!my brain stopped working and I could barely walk..I agree with high protein and decided this neurologist/headache specialist/author’s ketogenic diet didn’t cure me like it did for the bulk of his patients…I am now tweaking the diet…but have a huge speed bump as I had major surgery to teeth and gums last week causing a migraine marathon and nothing for the pain…I eat baby food now..clear broth and teas..trying juicing a little…down to 87 pounds and waiting to turn the corner. Mouth pain for me has always been a migraine trigger so elimination dieting is a long process and so hard to know what exactly was or is working..I feel I know my body and head better than anyone now and will trust my instincts for awhile before I can trust yet another headache specialist…I’m a bit negative right now as I’m in unbelievable pain…been absent from migraine.com and posting mostly for the reason of complete frustration of stil being misunderstood by the ones I love most. I have begun therapy and when I can move my mouth and speak..I will return to this very compassionate therapist who was willing to read all the articles written by so many of the migraine.com staff that I printed out…I think I’ve at least found someone who will validate my pain and not tell me how to feel.

    Blessings
    Janet

  • Sandy
    4 years ago

    Thank you. Dx with egg and wheat intolerance. Cleared my system when first dx of wheat, egg, and yeast Under dr order care. Slowly added stuff back. It was very hard. Waiting to read all of ur articles and talk to my new nneurologist before eliminatination diet. Obviously wheat and egg free not the only triggers.

  • Luna
    4 years ago

    I tried a couple of elimination diets for a short time but the limited variety caused digestive difficulties. My doctor didn’t think that the restrictive diets were good for my overall health either.
    Then I just started not eating any processed foods, no animal products, no sugar, no simple carbs. Whole foods plant based simply prepared. I’ve tried gluten free and have eliminated one or two foods at a time. This is a long process but the best way for me. Every body is different as we all know. Haven’t found anything that really makes a difference but suspect a few things to not eat in excess or too often.
    I encourage others to try but if the full elimination diet doesn’t work modify it to what works for you. Courage.

  • BeverlyA
    4 years ago

    I started my elimination diet 4 weeks ago and got sick with acute tonsillitis the very same day. It got a LOT getting used to but I’ve been migraine-free for more than a month now. I’ve started slowly adding things back in but I have the feeling pork and sugars (they’re in everything!)are the culprit. It’s kinda fun being like a detective and I’ve found my tastebuds have changed. Unsweetened applesauce is actually very sweet and I love spaghetti squash.

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