Can Beer Trigger Migraine Attacks?
When you’re living with migraine, you may have to give up a lot of things you love. Triggers may include staying up late, favorite foods, sunbathing, workout routines… and often, alcohol. But what if you’re craving a cold brew at the end of a warm spring day?
Every person with migraine is different. For some, an occasional ale is no big deal. For others, drinking beer is guaranteed to bring on symptoms. If you’re somewhere in the middle, here are a few key things to know.
The relationship between alcohol and migraine is highly individualized and is still being studied.
A 2018 study of almost 2,200 migraine patients found that more than a third of them — 35.6% — reported that alcohol was a migraine trigger. Red wine was named as the most common trigger among alcoholic beverages. Beer ranked fourth, after white wine and champagne/sparkling wine. Vodka was the drink least likely to trigger a migraine.[i]
Because vodka contains almost no ingredients beyond ethanol and water, “this implies that ethanol is not the main culprit, but other compounds in wine such as histamine, tyramine, phenylethylamine, and flavonoids, which have also been suggested by other studies,” the study authors told Neurology Advisor. These compounds also can be present in beer.
Alcohol-triggered migraine attacks are not hangovers.
Migraine symptoms are triggered by alcohol within a few hours of consumption, while a hangover typically happens much later. Migraineurs are more susceptible to hangover symptoms than people without migraine, however.[ii] So it’s wise to stay hydrated and not overindulge, no matter what you’re drinking.
To figure out if beer triggers your migraine attacks, keep a headache diary.
Another interesting finding from the 2018 study is that alcoholic drinks aren’t predictable migraine triggers. Red wine, for instance, consistently triggered an attack in just 8.8% of participants. Other people surveyed said that red wine sometimes caused symptoms and sometimes didn’t.
Track your symptoms in a migraine diary to see if you can detect patterns in triggers and treatments. You might notice that a specific brand or type of beer is more likely to cause a migraine attack. Record your number of drinks, too, as well as other possible triggers: the food you ate, the time you went to bed, etc. If you take medication for migraine, ask your healthcare provider if you should avoid alcohol because of potential harmful interactions.
Try different types of beer to see what you can tolerate.
If you enjoy beer, but you find that it’s sometimes a migraine trigger, then it may be worth doing some detective work by (cautiously) trying certain beers to identify which ones work for you. Is a lager better than an IPA? Is light beer less likely to trigger migraine? Some people do well with beer that’s low in hops, such as Guinness.[iii] For others, sulfites or histamines are the problem; filters designed to remove these compounds might help.
Beer often contains tyramine, a compound produced from the breakdown of the amino acid tyrosine.[iv] Tyramine occurs naturally in fermented and aged foods and beverages. All beer is fermented, but levels of tyramine vary.
To reduce tyramine intake, a beer expert in Brew Your Own magazine advised choosing bottled and canned varieties that are pasteurized, a process that kills the lactic-acid bacteria that produce tyramine. Draft beer and home-brewed beers should be avoided, he said, especially because dirty draft lines may contain high levels of these fermenting bacteria.[v]
It’s probably best to skip the green beer.
The most famous beer-drinking holiday is, of course, St. Patrick’s Day. So people with migraine want to know: Is it safe to drink the green beer?
Not to be a buzzkill, but we suggest avoiding it. One, the green beer that bars serve on St. Paddy’s usually comes from a keg. Two, green food dye contains Yellow No. 5, which is a migraine trigger for some.[vi] So if you’re imbibing on March 17, don’t take a chance — stick to a drink you know is migraine-friendly. Sláinte!
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Reviewed by: Deena E. Kuruvilla, MD, a board-certified neurologist and the director of the Westport Headache Institute, where she employs a holistic biopsychosocial approach to diagnosis and treatment. She held clinical appointments at the Yale University School of Medicine prior to starting her own practice and has authored many articles, book chapters, and research publications.
- [i] Onderwater GLJ, van Oosterhout WPJ, Schoonman GG, Ferrari MD, Terwindt GM. Alcoholic beverages as trigger factor and the effect on alcohol consumption behavior in patients with migraine [published online December 18, 2018]. Eur J Neurol. doi: 10.1111/ene.13861
- [ii] Zlotnik Y, Plakht Y, Aven A, Engel Y, Am NB, Ifergane G. Alcohol consumption and hangover patterns among migraine sufferers. J Neurosci Rural Pract. 2014;5(2):128-134. doi:10.4103/0976-3147.131652
- [iii] https://www.peoplespharmacy.com/articles/is-there-a-beer-that-wont-cause-headaches
- [iv] https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/maois/faq-20058035
- [v] https://byo.com/mr-wizard/how-does-tyramine-in-beer-affect-people-taking-maoi/
- [vi] https://www.health.harvard.edu/blog/food-and-migraine-a-personal-connection-201104052222