Dark chocolate, caffeine, and migraines

I don’t like dark chocolate and I don’t really suffer from migraines. But, I have heard enough people make the connection between chocolate and migraines and caffeine and migraines that I decided to do some investigation.

What intrigued me from the start is that a number of headache medications use caffeine as an active ingredient. It is not unheard of for something to be a trigger in some people and a treatment in others but what does caffeine do and how does that relate to migraines?

Apparently, caffeine increases the effectiveness of many common pain relievers by up to 40%. The reason caffeine is added to medications then is to reduce the amount of medication an individual has to take. This reduces the chance of habitual or addictive use. It also reduces the likelihood of side effects. (Cleveland Clinic).

At the same time, there are indications that excessive caffeine, or caffeine withdrawal can both lead to migraines. High caffeine consumption is moderately linked to the likelihood of daily headaches of all kinds in adults (Scher, Stewart, & Lipton, 2004) and children (Hering-Hanit & Gadoth, 2003).

So don’t drink too much caffeine, but it can be an effective treatment in small doses, with other pain killers. What about dark chocolate?

People will swear that chocolate, and particularly dark chocolate, can be blamed for at least some migraines, but the research is quite controversial. Marcus, Scharff, Turk, and Gourley (1997) tried to replicate a study that found a significant difference in the ability of chocolate and carob to trigger migraines. They found that there was no statistical difference between the two substances. Kelishadi (2010) also reported mixed findings regarding cocoa and headaches, highlighting the possible placebo effect – where something that is inactive has an effect because the person expects it to – as a potential cause.

Of course, there is some caffeine in dark chocolate, but it is generally less than a cup of coffee. So, as long as you are not spending your day consuming dark chocolate and other caffeinated products there should not be a biological link. Of course, psychology is powerful so if you believe there is a link there may be one, for you.

Hering-Hanit, R. & Gadoth, N. (2003). Caffeine-induced headache in children and adolescents. Cephalalgia, 23(5): 332-335.

Kelishadi, R. (2010) Cacao to cocoa to chocolate: Healthy food? ARYA Atherosclerosis, 1(1): 28-34.

Marcus, D., Scharff, L., Turk, D., & Gourley, L. (1997) A double-blind provocative study of chocolate as a trigger of headache. Cephalalgia, 17(8): 855-862.

Scher, A., Stewart, W., & Lipton, R. (2004). Caffeine as a risk factor for chronic daily headache: A population-based study. Neurology, 63(11): 2022-2027.