I have had clusters for 20 years and learned quickly that alcohol was a trigger. This past weekend I had 2 that I think were brought on by chocolate bars. Does anybody else avoid chocolate while in a cycle?

When in cycle the fear is so strong I just can't be assed to do the triggers/ doesnt trigger test on all foods, I just live by water and bread literaly, and chicken/beef, very careful with veggies/spices and so on, not even touching ice creams/chocolate and pre-made products from shop, all I eat is raw and made by myself.

I know that ale is trigger for me, not sure about anything else.

Not for me, just alcohol, sleep cycle disruptions, extreme hunger and sustained stress.

Joe

In general I don't drink, smoke, and I avoid caffeine.  The only thing that seems to be a trigger for me is lack of sleep.  I've never felt that there was any food that was linked or anything that I could avoid to keep it from happening or reduce it.

I would be happy to eat your share of chocolate bars so the industry doesn't feel the impact while you're cycling.  1 a day is it?  I'm on it.

I am am not sure if it was the chocolate or not. It could just be a coincidence. I am getting hit between 4 and 8 times a day. I have only been getting hit at night till yesterday when I had 3 at work. I will vouch that slugging down a monster drink knocked out one ch.

chocolate is most certainly a trigger for me.

My triggers are: cigarettes or smoke or sleeping disorder. But lately i did ate some chocolate and the i got the attacks, but i'm not sure that the choc. is the cause.
As i wrote in my msg i have 3 month old baby so i don't sleep enough. 

Heck yes it is for me too. And i struggle hard with this one.

For CH chocolate has zero impact, but for migraines it's a different story.

Nope.  Just alcohol for me.

Never paid attention to this as a trigger as I rarely eat chocolate.

-Gregg in Las Vegas

I really dislike chocolate, so I can't say for sure. (I always get sh*t for hating chocolate. It's not socially acceptable. LOL.) But choc has a lot of interesting compounds that could affect CH regardless of the caffeine content. Theobromine comes to mind.

chocolate is certainly one of my triggers

I would say chocolate is a trigger for me, although I have eaten some this cycle and was not hit one time but was another.

My son, who is 40, has had CH's for the last 7 years. His CH's start in Jan and end in April. He has discovered that dark chocolate helps stop his pain. He now makes a strong cup of dark roasted coffee mixed in with double mocha cappuccino and sugar. He takes this when he feels a Ch coming on and this mixture either reduces or stops the pain. So I researched what is in common between coffee and chocolate and found that both have high concentrations of caffeine and theobromine. Theobromine is a natural stimulant and does not stimulate the central nervous system. So he gets a double dose of stimulant without the nervous effect. If you can take chocolate use dark chocolate only.

chocolates are a trigger for me. But I can eat the ultra dark 70%+ chocolate without any problems. I try to avoid all chocolate during cycles, but mine usually last 3 months and that is tooooo long to go without chocolate. So I make do with dark....

clusterica wrote on Dec 6^th, 2012 at 11:03am:

My triggers are: cigarettes or smoke or sleeping disorder. But lately i did ate some chocolate and the i got the attacks, but i'm not sure that the choc. is the cause. As i wrote in my msg i have 3 month old baby so i don't sleep enough.

I did the cluster cycle with pregnancy/newborns not fun at all.  I found that stress and lack of sleep were big triggers for me.  In cycle I don't touch any alcohol not that I'm a big drinker and cigarette smoke.  After I go a few months without hits I will then maybe have a glass of wine.

Have your son try energy drinks too, like Red Bull or Monster. Anything with both caffeine and taurine can help cut the duration and intensity of a CH for most of us. Just drink it rapidly at the start of a CH.

Hard to say for me.  Lack of sleep for sure, stress, and oddly enough, I think peanut butter. 

Thankfully not a trigger for me. I love chocolate once in a while.

I had this crazy theory a couple of weeks back that everything that would dial down your senses can be a cluster headache trigger.

For example sharp smells or bright light are triggers for me, and I figured that when you perceive such hyper stimuli there is some system in your brain that dials down the amount you perceive so that you don't get overstimulated.

That dialling down triggers a headache :)
Alcohol impairs your senses, going to sleep too...

I know, way too general and crazy.
Just throwing it out there :)

chocolate a trigger???...and i LOVE my chocolate... if had to guess,i eat it 5-6 days of the week on average...kinda sounds like a MIGRAINE thing

Chocolate triggers my waist to grow.

Samiam wrote on Feb 6^th, 2013 at 6:32pm:

clusterica wrote on Dec 6th, 2012 at 11:03am: My triggers are: cigarettes or smoke or sleeping disorder. But lately i did ate some chocolate and the i got the attacks, but i'm not sure that the choc. is the cause. As i wrote in my msg i have 3 month old baby so i don't sleep enough.  I did the cluster cycle with pregnancy/newborns not fun at all.  I found that stress and lack of sleep were big triggers for me.  In cycle I don't touch any alcohol not that I'm a big drinker and cigarette smoke.  After I go a few months without hits I will then maybe have a glass of wine.

I got cycles with newborns as well. With both my kids, I had a cycle due during pregnancy that did not come, only to have it appear on the day I gave birth (yes, both times). Not fun. As lack of sleep seems to be one  of my worst triggers, both the "newborn cycles" were the worst I ever had.
Alcohol is another big trigger for me. I stopped drinking completely, even out of cycle, since I figured it out. The fear of what might happen is too intense to enjoy a drink anyway.
Thank heaveans I can eat chocolate though...!

Chocolate has been shown to cause vasodilation so i'd say yes.

And i'd guess it can take up to many hours for this effect to start working (depending on how fast it is digested/absorbed)

Wine is a big trigger for me.   I am not really a drinker at all. In a blue moon I have a glass of wine when out with friends.   The vit D kept my cycle away this year but I had half a glass of wine one night when out and had a headache all night.   Enough to ruin my night but thankfully not a full on cluster.  I am a chocoholic and thankfully not a trigger.   

Hi there,

Alcohol is a trigger for every Clusterhead I know. One 250ml glass of beer in Rome in 2004 was my last one, and I remember the night that followed to this day.

Don’t touch the stuff when in episode.

If chronic, don’t touch the stuff at all.

Peter.

Peter510 wrote on Dec 3^rd, 2018 at 5:32am:

Alcohol is a trigger for every Clusterhead I know

Almost all, AussieBrian and I don't have alcohol as a trigger and there will be more. However it seems that for the majority of people alcohol is a CH trigger.

Mike NZ wrote on Dec 4^th, 2018 at 4:21pm:

Almost all, AussieBrian and I don't have alcohol as a trigger...

And haven't I received some hate-mail as a result!!!   Even so, it remains a serious trigger for many, many CHeads along with chocolate and almost everything else that's enjoyable and sustains life.

This really is a lousy disease.

Effect of chocolate in migraine: a double-blind study

A. M. Moffett, M. Swash, D. F. Scott


Abstract


Quote:

The effect of chocolate on a group of volunteer migrainous subjects, who had observed that headache regularly occurred after the ingestion of small amounts of cocoa products, was investigated. Two separate studies were carried out in a double-blind placebo controlled manner. Only 13 headaches occurred to chocolate alone in 80 subject sessions, and only two subjects responded consistently to chocolate in the two studies. This suggests that chocolate on its own is rarely a precipitant of migraine. Other possible implications of the results are also discussed.

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The Lancet
Volume 343, Issue 8906, 7 May 1994, Pages 1127-1130

A population study of food intolerance

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Abstract


Quote:

We did a population study to identify the prevalence of reactions to eight foods commonly perceived to cause sensitivity in the UK. A cross-sectional survey of 7500 households in the Wycombe Health Authority area and the same number of randomly-selected households nationwide was followed up by interviews of positive respondents from the Wycombe Health Authority area. Those who agreed entered a double-blind, placebo-controlled food challenge study to confirm food intolerance. 20·4% of the nationwide sample and 19 9% of the High Wycombe sample complained of food intolerance. Of the 93 subjects who entered the double-blind, placebo-controlled food challenge, 19·4% (95% confidence interval 11·4% -27 4%) had a positive reaction. The estimated prevalence of reactions to the eight foods tested in the population varied from 1·4% to 1·8% according to the definition used. Women perceived food intolerance more frequently and showed a higher rate of positive results to food challenge. There is a discrepancy between perception of food intolerance and the results of the double-blind placebo-controlled food challenges. The consequences of mistaken perception of food intolerance may be considerable in financial, nutritional, and health terms.

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Cluster headache

Elizabeth Leroux and Anne DucrosEmail author

Orphanet Journal of Rare Diseases

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    Received: 20 February 2008Accepted: 23 July 2008Published: 23 July 2008

Abstract


Quote:

Both CH and migraine can be triggered by alcohol, and relieved by triptans, but CH necessitates parenteral routes of administration. Stress, foods (like chocolate) and menstrual cycle, are not typical triggers for CH.

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Pediatric Neurology

The diet factor in pediatric and adolescent migraine

Abstract


Quote:

Diet can play an important role in the precipitation of headaches in children and adolescents with migraine. The diet factor in pediatric migraine is frequently neglected in favor of preventive drug therapy. The list of foods, beverages, and additives that trigger migraine includes cheese, chocolate, citrus fruits, hot dogs, monosodium glutamate, aspartame, fatty foods, ice cream, caffeine withdrawal, and alcoholic drinks, especially red wine and beer. Underage drinking is a significant potential cause of recurrent headache in today’s adolescent patients. Tyramine, phenylethylamine, histamine, nitrites, and sulfites are involved in the mechanism of food intolerance headache. Immunoglobulin E-mediated food allergy is an infrequent cause. Dietary triggers affect phases of the migraine process by influencing release of serotonin and norepinephrine, causing vasoconstriction or vasodilatation, or by direct stimulation of trigeminal ganglia, brainstem, and cortical neuronal pathways. Treatment begins with a headache and diet diary and the selective avoidance of foods presumed to trigger attacks. A universal migraine diet with simultaneous elimination of all potential food triggers is generally not advised in practice. A well-balanced diet is encouraged, with avoidance of fasting or skipped meals. Long-term prophylactic drug therapy is appropriate only after exclusion of headache-precipitating trigger factors, including dietary factors.

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Relationships Between Food, Wine, and Beer‐Precipitated Migrainous Headaches

Abstract


Quote:

Five hundred seventy‐seven consecutive patients attending the Princess Margaret Migraine Clinic from 1989 to 1991 have been questioned about dietary precipitants of their headaches. Four hundred twenty‐nine patients had migraine, of which 16.5% reported that headaches could be precipitated by cheese or chocolate, and nearly always by both. Of the migraine patients, 18.4% reported sensitivity to all alcoholic drinks, while another 11.8% were sensitive to red wine but not to white wine; 28% of the migrainous patients reported that beer would precipitate headaches. There was a definite statistical association between sensitivity to cheese/chocolate and to red wine (P<0.001) and also to beer (P<0.001), but none between diet sensitivity and sensitivity to alcoholic drinks in general. None of 40 patients with tension headache (diagnosed by International Headache Society criteria) reported sensitivity to foods, and only one was sensitive to alcoholic drinks. The prevalence of sensitivity among 46 patients with some migrainous features was intermediate between the migraine and tension headache categories. It is concluded that cheese/chocolate and red wine sensitivity, in particular, have closely related mechanisms, in some way related more to migraine than to more chronic tension‐type headache, while quite separate mechanisms play a major role in sensitivity to alcoholic drinks in general.

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Trigger factors of migraine and tension-type headache: experience and knowledge of the patients


Quote:

The objective was to examine potential trigger factors of migraine and tension-type headache (TTH) in clinic patients and in subjects from the population and to compare the patients’ personal experience with their theoretical knowledge. A cross-sectional study was carried out in a headache centre. There were 120 subjects comprising 66 patients with migraine and 22 with TTH from a headache outpatient clinic and 32 persons with headache (migraine or TTH) from the population. A semistructured interview covering biographic data, lifestyle, medical history, headache characteristics and 25 potential trigger factors differentiating between the patients’ personal experience and their theoretical knowledge was used. The most common trigger factors experienced by the patients were weather (82.5%), stress (66.7%), menstruation (51.4%) and relaxation after stress (50%). The vast majority of triggers occurred occasionally and not consistently. The patients experienced 8.9±4.3 trigger factors (range 0–20) and they knew 13.2±6.0 (range 1–27). The number of experienced triggers was smallest in the population group (p=0.002), whereas the number of triggers known did not differ in the three study groups. Comparing theoretical knowledge with personal experience showed the largest differences for oral contraceptives (65.0 vs. 14.7%, p<0.001), chocolate (61.7 vs. 14.3%, p>0.001) and cheese (52.5 vs. 8.4%, p<0.001). In conclusion, almost all trigger factors are experienced occasionally and not consistently by the majority of patients. Subjects from the population experience trigger factors less often than clinic patients. The difference between theoretical knowledge and personal experience is largest for oral contraceptives, chocolate and cheese.

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Migraine Triggers May Not Be So Potent After All


Quote:

Bright lights and too much exercise are well-known migraine launchers, but the latest study hints that sufferers may not be as sensitive to these triggers as previously thought. Researchers report in the journal Neurology that commonly suspected migraine triggers might not be responsible for a hurting head after all. Unlike previous studies of migraine triggers, in which sufferers were asked about what conditions or situations preceded a headache, the scientists exposed 27 migraine patients in a lab to flashing lights, intense exercise or a combination of both to provoke a migraine with aura, a type of headache accompanied by often debilitating visual disturbances. Only a handful of subjects experienced any sort of migraine, and those who did had exercised, suggesting that bright lights may not be to blame. The participants ran or used an exercise bike at maximum effort for an hour, while researchers used a combination of lamps, flashes and other visual stimuli to mimic light disturbances for up to 40 minutes in order to study the combined effect of light and exercise. After these sessions, only 11% of the participants — three patients — experienced migraines with auras, and an additional 11% experienced migraines without auras. “What have generally been reported as sure triggers for migraines are not so sure when you actually expose people to them” says Dr. Jes Olesen, the study’s corresponding author from the University of Copenhagen in Denmark and a fellow of the American Academy of Neurology. (MORE: Can Brain Freeze Solve the Mystery of Migraines?) Dr. Stephen D. Silberstein, a professor of neurology at Thomas Jefferson University and the director of the Jefferson Headache Center who co-wrote an accompanying editorial for the study, suggests that some of what people think are triggers may actually be symptoms of migraines instead. “You eat chocolate and you get a headache. Does that mean chocolate triggers the headache?” Silberstein asks. “What probably happens is the first symptom of your migraine attack is the desire to eat chocolate. Just like when you’re pregnant, you might want pickles or ice cream. That’s one end of the spectrum, where the desire to do something is part of the migraine attack, not the trigger.” Distinguishing between triggers and symptoms is challenging, not just for those who study migraines but for patients as well. Silberstein says there are some known triggers, such as certain odors, hunger, chemicals in alcohol and hormonal changes linked to menstruation, but that other factors may fall somewhere between an actual trigger and a symptom. How can patients tell? “Everybody with a migraine should try to find out what is triggering their attacks,” Olesen says. “When they have a suspicion, it would be a good idea to try and see if it induces an attack. In most cases, it’s probably not going to be true.” Both Olesen and Silberstein say there are a number of factors that determine whether these suspected triggers will actually lead to an attack. Patients likely have individual thresholds that vary from day to day and from environment to environment: some days your brain is less vulnerable to certain triggers, while on other days the conditions might be right for a migraine. (MORE: Migraines May Raise Risk of Depression in Women, Study Says) Stress, for example, is one of the most commonly reported migraine triggers, and bright lights and exercise may simply be markers for when stress levels are high. The fact that only exercise appeared to trigger migraines came as a surprise to Olesen, considering a majority of the study’s participants believed bright lights induced migraines more than half the time upon exposure. “The patients were almost apologetic to us because they had indicated it would cause an attack, but it didn’t,” Olesen says. If these suspected triggers aren’t causing migraines, though, why have they been fingered as responsible for the headaches? Most of the evidence linking the triggers to migraines comes from studies in which patients self-reported what they thought were the factors responsible for their headaches; for the most part, these factors weren’t tested in the way that Olesen analyzed the effect of bright lights and exercise on migraines in the lab. People’s beliefs about migraines may also complicate how researchers explore migraine causes. Similar to the placebo effect, how patients think about migraines will often influence how they experience them. If you’re convinced a certain food will a trigger a migraine, your suspicion might become a reality; if you’re worried you’ll get a migraine, you might just bring about one. (MORE: Migraines Linked to Brain Lesions in Women) That’s not to say lights will never cause a migraine. Because the study was conducted in a lab setting, the exposure to triggers may not accurately replicate the conditions that launch a real-life headache. For example, if a migraine strikes after you exit a dark movie theater and walk into bright light, it could be the sudden contrast from the darkness of the theater that made the light problematic. Or, you might have been hungry or sleep-deprived before being exposed to a bright light, which would still make the light a trigger, albeit one of a combination of factors that prime your brain for the headache. Olesen says researchers have a better understanding of migraines without auras — they have identified certain chemical triggers that have led to the development of a new class of migraine drugs, for example — but migraines with auras continue to be more of a mystery. The findings hint, however, that some long-held truths about avoiding triggers that can induce migraines with aura may be outdated. “Trigger avoidance is overdone,” Silberstein says. “If you know something is going to cause your headache, whether you believe it as a result of conditioning or reality, avoid it. But people who take away everything in life that they love because it might trigger their headache, that’s useless.” He argues that it’s worth trying to find out what truly triggers your migraines, even if the process is painful. That suffering may be worth it in the long run.

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Great post John - thank you.

Now do I eat more chocolate as it maybe isn't a trigger for me? Or be healthier and skip it?

If chocolate was a trigger I would probably be able to lose those last 10 lbs.    Not a big drinker but the last 2 times I had wine while dining with friends I wasn't even in cycle but had a headache the whole night.  At least it's a conversation starter when I tell people I don't drink.   Or sometimes I just tell them 12 step program.....some people won't take no for an answer when they offer you a drink....

BC,

I don’t know where you live, but in Ireland you are practically a freak if you don’t drink alcohol and come under enormous pressure when you tell people.

Try telling them you suffer from a rare neurological condition which prevents you from drinking alcohol. If you are asked what condition, say......Trigeminal Autonomic Cephalgia.

That usually makes them back off pretty quickly.

Peter.

Even during my worst episodes chocolate had never been a trigger for me. Excess consumption of sugar in any form IS a trigger, though (like excess consumption of nearly anything, I think).