Migraine sufferers reveal what is the most common drink to trigger an attack

Red wine was the most common drink to trigger a migraine, sufferers said.

Alcoholic drinks were blamed for triggering migraine attacks in over a third – 35.6 per cent – of sufferers questioned.

Wine, especially red wine, was identified as the most common trigger among the drinks by three quarters – 77.8 per cent.

However a new study found red wine consistently led to an attack in only 8.8 per cent of participants and questioned whether it was really a trigger.

It did note the time of an onset of an attack was rapid in less than three hours in one third of patients.

And almost 90 per cent had an onset in under 10 hours independent of the type of alcoholic beverage consumed.

And because drinking has linked to migraine attacks, a quarter had given up boozing all together.

Associate Professor of Neurology Dr Gisela Terwindt, of the Leiden University Medical Center, in the Netherlands, explained: “Susceptibility for migraine is thought to be determined by a combination of non-modifiable genetic factors and modifiable internal (hormonal fluctuations and comorbid diseases) and external (sleep pattern, alcohol, fatigue and food consumption) risk modulation factors.

“Patients strive to get a sense of personal control over their attacks.

“Identifying and modifying or avoiding external risk modulation factors, also called trigger factors, could potentially prevent attacks.

“Alcoholic beverages a trigger factor that may be avoided, are frequently reported in the top 10 trigger factors.”

But until now previous studies have been small and looked at all drinks, although red wine studies “in particular was suggested as a trigger factor, with rapid onset of headache after consumption.”

So the new study questioned 2,197 migraine sufferers to see which drinks were reported as a trigger, how fast a migraine attack came on and whether sufferers then avoided a particular drink.

Prof Terwindt said: “In order to identify if ethanol in general or certain specific beverages were responsible for this effect, we presented patients with a list composed of seven different beverages.

“Wine, especially red wine, was recognised as the most frequent migraine-provoking

“These results are consistent with previous findings, with wine being regarded as a migraine trigger factor for decades.

“In Europe, results differ between countries, with red wine being reported most often in the UK and white wine most often in France and Italy.

“This inconsistency has been speculated to be caused by differences in the popularity and availability of particular beverages across countries.

“Vodka was identified as the least frequent migraine-provoking beverage but this might be because wine is consumed on a more regular basis compared with vodka.

“This is certainly true for our cohort.

“Other studies also report a low triggering potential for vodka or other spirits.

“It has been suggested that this might be due to certain biochemical compounds being present in wine and not in other beverages, which would imply that ethanol is not the main culprit.

“Various compounds such as histamine, tyramine, phenylethylamine and flavonoids have been suggested, however, results are inconsistent and remain to be studied in more detail.

“On average, patients report relatively few standard glasses of between one to three glasses for red wine to be consumed to provoke an attack.

“This may be a reflection of a common number of glasses consumed over dinner or at a party, suggested by the two glasses that the total population drinks on average.

“A similar amount (two standard glasses) was used in the earliest provocation experiments with alcohol.”

But the quick onset of an attack meant it could not be linked with a handover headache.

Prof Terwindt said: “Alcohol-triggered migraine occurs rapid after intake of alcoholic beverages, suggesting a different mechanism than a normal hangover.

“The low consistency of provocation suggests that alcoholic beverages acting as a singular trigger is insufficient and may depend on a fluctuating trigger threshold.

“It can be debated if alcohol is a factual or a presumed trigger.”

The NHS said migraine is a common incurable health condition, affecting one in every five women and one in every 15 men in the UK. They usually begin in early adulthood.

The exact cause of migraines is unknown, although they’re thought to be the result of temporary changes in the chemicals, nerves and blood vessels in the brain.

About half are thought to be genetic while some people find migraine attacks are associated with certain triggers, which can include starting their period, stress
tiredness or certain foods or drinks

The study was published in the European Journal of Neurology.


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