David PerlmutterPresident,, Perlmutter Health Center · Board-Certified Neurologist | Functional Medicine Pioneer | #1 New York Times Best-Selling Author | International Speaker | Host of The Empowering Neurologist Podcast

Understanding Headaches

31 Jul 2017 · 2 min

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1:33

In this educational talk, Dr. David Perlmutter explains that migraine headaches are a major source of disability and lost productivity in Western societies. He critiques the prevailing medical model that relies primarily on abortive pain medicines and prophylactic drugs such as beta‑blockers, arguing that this approach often overlooks the pivotal role of lifestyle factors. Perlmutter highlights insufficient sleep and specific food sensitivities as major headache triggers. He details three categories of dietary triggers: nightshade vegetables (eggplant, white potatoes, tomatoes, and even tobacco), tyramine‑rich foods (aged cheeses), and gluten sensitivity, citing published research linking gluten to headaches. He urges clinicians and patients to assess and modify these lifestyle elements before defaulting to prescription medication.

Chapters

Headaches, and specifically migraine headaches, are extremely common now in Western societies and represent a really significant amount of disability and loss of work productivity. And it turns out that, you know, most mainstream treatment for headaches is centered on pain medication or abortive medication to treat a headache once it starts Or what is called prophylactic medication like beta blockers, for example, that people will take all the time in hopes of keeping those migraine headaches from happening. But unfortunately, the notion that lifestyle factors play such an important role in terms of headaches is oftentimes overlooked. Not getting enough sleep, certain food sensitivities play huge roles in causing headaches, and my thought is that this is where we should be looking first. Some individuals are sensitive to, for example, the nightshade vegetables— eggplant, white potatoes, tomatoes, and even tobacco, a nightshade vegetable— that can bring on headaches. Other people are sensitive to tyramine, and foods like aged cheeses, for example, are high in tyramine, and this can lead to headaches. We have even seen and published research which connects headaches to gluten sensitivity. So I think these things are all important to look at in terms of how we approach individuals with headaches rather than just Just jumping on the prescription pad as the best and, and first choice.