The Heal Your Headache (HYH) Migraine Diet
There are several different migraine diets out there, but for the prevention of migraine I find the most effective to be the Heal Your Headache (HYH) diet and the Keto diet. There are a few in-between diets, like Charleston, which goes a step further than HYH to eliminate things like seeds or higher histamine foods. And many low tyramine diets, like the Johns Hopkins Headache Center Migraine Diet and the National Headache Foundation Low Tyramine Diet (both of which have similar standards to HYH), are endorsed by many as an effective tool for patients. Some claim that a combination of gluten-, dairy-, and sugar-free works best. Others say celery juice cured all their ailments. You could spend your whole life trying to find the perfect migraine diet, but it truly comes down to what you think will be the easiest for you to stick with.
Because I am a huge cheese lover, HYH seemed to be the least dramatic change I could try. The diet is based on eliminating foods that contain high amounts of tyramine, an amino acid you often find in cured meats, aged cheese, and fermented foods, which can be common migraine triggers. HYH also includes eliminating artificial sweeteners, caffeine, sulfites, and additives like monosodium glutamate. What I did not realize was that glutamate can hide under many different names other than “MSG.” I learned how to read labels and quickly spot additives over time. Even now that I’ve reintroduced certain foods, I still tend to follow HYH. A migraine diet at the very basic level is about eating fresh, whole foods.
I’m not going to lie to you: the HYH diet is tough in the beginning. Fair warning, you’ll probably have at least one breakdown in the grocery store when you realize everything you bought before has some type of additive or hidden MSG. I ask that you put those products down nicely, instead of chucking them at the migraine-free person happily adding them to their cart beside you. You want to give yourself a true chance at healing, and you won’t do that if you put in half the effort. You must have an “all-in” mindset. Try focusing on all the things you can have instead of the things you can’t.
Let’s get the foods you should eliminate out of the way before we look at all the glorious foods that you can eat.
FOODS TO ELIMINATE
AGED CHEESE The more aged, the greater a trigger it could be. This includes gouda, Parmesan, cheddar, Brie, manchego, Swiss, blue… basically all the good stuff. However, there are some fresh cheeses you can still have as long as they don’t have flavorings. No migraine diet is very clear on where the cut-off for length of aging should be. I find the sweet spot is around two months, which is typically how long a good-quality American cheese is aged. And the most common migraine diets generally agree that American cheese is safe for those with a migraine disorder. Fresh mozzarella (not aged or smoked), fresh goat cheese (chèvre), ricotta, cream cheese (carrageenan-free), cottage cheese (without live cultures), Boursin, and farmer’s cheese all fall into the less-than-two-month category.
ALCOHOL You should abstain from alcohol at the beginning of the diet until you find some semblance of equilibrium. Once the attacks are more controlled, you can consider organic or biodynamic dry white wines, or try a filter like PureWine, which removes the sulfites and biogenic amines without adding anything to the wine. Some mass-produced wines do contain added chemicals and flavorings that appear to bring on migraine, along with sulfites and biogenic amines. White wine is typically higher in sulfites, while red wine is higher in histamine. As for spirits, vodka is best tolerated, as well as other clear distilled liquors.
ARTIFICIAL SWEETENERS Aspartame (Nutrasweet) and saccharin (Sweet’N Low) should be eliminated. Sucralose (Splenda) should be okay, but try to avoid it if you can. Naturally derived sweeteners like stevia, monk fruit, and sugar alcohols are okay in moderation.
BAKED GOODS Fresh, yeast-risen baked goods should not be consumed on this diet until after twenty-four hours have passed from baking time. Avoid all baked breads less than one day old, especially sourdough due to the fermentation. Yes, this includes yeast-risen pizza dough. You can bake or buy fresh bread and let it sit twenty-four hours, and it will be safe to eat. I prefer this, because the local baker is likely using fewer ingredients than mass-produced packaged breads. However, pre-packaged breads can be consumed immediately since they are more than twenty-four hours old. Avoid additives like “malted barley flour,” as it can act like MSG. Packaged naan or pita bread is perfect for making quick pizzas but watch for yogurt in it. Yeast by itself is okay as long as you follow the twenty-four-hour rule, but yeast extract or nutritional yeast should be avoided due to glutamate. Corn or flour tortillas are safe, but be sure to read the labels and watch for any hidden types of MSG or other additives.
BEANS & PEAS Lima beans, fava beans (broad beans), navy beans, and lentils should be eliminated due to their high natural tyramine content. The same is true of fresh pea pods.
CAFFEINE This includes coffee, tea, and sodas. Unfortunately, regular decaf coffee and (most) teas should be avoided, as many contain chemical triggers and are not fully decaffeinated. The best substitute you can find are CO2 or Swiss Water Processed decaf coffees, which are naturally processed and 99.9 percent caffeine-free. I’ll go into detail about this later. Teas that are naturally caffeine-free, like green rooibos or 100 percent ginger, are good substitutes. (For more on caffeine and migraine, turn to page 229.)
Caffeine can be controversial because some people do have success with using it to abort a migraine attack, but unless you have tested this theory it should be eliminated, especially with vestibular migraine. Using large amounts of caffeine daily can even contribute to rebound headaches.
CHOCOLATE This includes organic dark and cacao nibs. Dr. Buchholz says carob is iffy, but I find that many of my readers can tolerate it quite well. White chocolate is allowed, as long as it does not contain additives. Technically, it’s not really “chocolate” at all.
FERMENTED/CULTURED DAIRY PRODUCTS Yogurt (even dairy-free yogurt), kefir, and buttermilk should also be eliminated. Organic milk and cream, hemp milk, rice milk, and oat milk are all fine, but watch for additives that are used to thicken the product. Carrageenan is a definite no (see the MSG list, page 17), but gellan gum is allowable if there is no cleaner alternative (i.e., a product without any gums). I’ve seen people try to substitute sour cream with crème fraîche—don’t do it! Crème fraîche is part buttermilk that’s fermented with cream. A label that reads “live active cultures” indicates fermentation.
Note: Dairy is not considered a migraine trigger for everyone, but it can be a source of inflammation for those who are sensitive, as with gluten. If you do not have a sensitivity or allergy to it, there’s no reason to eliminate it unless you find it triggers you. But take care—dairy substitutes in stores are typically made from nuts and can contain more additives than organic dairy products. I feel it’s best to limit dairy, but not eliminate it unless it triggers sensitivity. If you are dairy free, Oatly oat milk is a wonderful substitute, as well as hemp and rice milk.
FERMENTED VEGETABLES Sauerkraut, kimchi, and similar foods like store-bought pickles should be eliminated since they are fermented. Quick pickles (basically cucumbers in distilled white vinegar) are easy to make and allowed on the diet.
FRUITS & JUICES Certain fruits and juices should be avoided on this diet, but there are plenty that are allowed (see page 18). Citrus fruit such as lemons, limes, grapefruit, and oranges, are considered trigger foods. Bananas, raspberries, red plums, papaya, pineapple, passion fruit, figs, dates, and avocados should all be eliminated as well. Raisins and dried fruits with sulfites must be avoided. Many people tolerate dried fruit without sulfites; you can always test them and see how you do.
LEFTOVERS Avoiding leftovers is another disappointing fact about being a migraineur. This is particularly true for meat that has been in the fridge for a few days, due to tyramine, a naturally occurring food component that builds in even “safe” foods as they age. The products of the proteins being broken down are called biogenic amines, two of which are tyramine or histamine. As foods ripen or age, these biogenic amines can increase. People with excitable nervous systems, like migraineurs, can be especially sensitive to these components. I find that this is highly specific to the individual. I can usually tolerate foods that have been left in the fridge a maximum of three days, but I have also known people who cannot even tolerate Crock-Pot meals or broth that has been simmered for several hours. If you do have leftovers, it’s a good idea to freeze them right away and then thaw as needed. Keeping leftovers in the fridge for two to three days max is a fairly safe timeline to follow. Tyramine builds up in protein-rich foods where air is involved. Canned items, like tuna, are not exposed to air until they’re opened, so there’s less worry about tyramine build-up.
MONOSODIUM GLUTAMATE (MSG) You probably think you don’t eat MSG. It’s not on any of the labels! What you may not know is that MSG is considered a natural flavoring. It can be labeled under alternate names such as hydrolyzed vegetable protein, autolyzed yeast, hydrolyzed yeast, carrageenan, yeast extract, soy extracts, and protein isolate. Glutamate can also be found in natural items like mushrooms, but it seems many people are more sensitive to glutamate when it’s been altered through processing. For instance, popular collagen protein supplements are packed with what’s known as free glutamate acid, even if it’s not on the ingredient list. See the chart on page 17 for all the MSG euphemisms and take a picture so you can reference it at the grocery store.
NUTS All kinds must go, including nut butters. Even peanuts, which are really legumes, should be eliminated. Good substitutes include sunflower seeds and sunflower seed butter, tahini, and pepitas (pumpkin seeds). All seeds are allowed. Dr. Buchholz includes coconut under nuts, but coconut can technically be classified as a drupe fruit, nut, or seed. Through all my research, I noticed coconut is allowed on a more strict migraine diet, The Charleston Diet, from the Charleston Headache and Neuroscience Center. From what I have seen, it seems many who follow the Heal Your Headache diet can tolerate coconut well. Still, it might be best to eliminate it in the beginning unless you are dairy free and very limited in options.
ONION FAMILY Onions, onion powder, and dried onions are not allowed, but garlic, green onions, shallots, and leeks are good substitutes.
PROCESSED MEATS & FISH Aged, cured, fermented, smoked, tenderized, or marinated meats and fish must be strictly avoided, as most contain nitrates or nitrites as preservatives. These include hot dogs, ham, jerky, sausage, pepperoni, most deli meats, smoked or pickled fish, bacon, and anchovies. Beef or chicken livers also contain a high amount of tyramine. Acceptable meat and fish should be as fresh and unprocessed as possible. While uncured bacon does exist, if it’s packaged it’s still not considered “fresh.”
SOY PRODUCTS Miso, tempeh, soy protein isolate, and soy sauce are no-no’s on this diet. Soy milk and flour are less risky, but it is best to avoid them in the beginning. Soybean oil and soy lecithin are safe.
VINEGAR All types of vinegar except for distilled white vinegar should be eliminated. This is due to the fermentation, as well as potential sulfites in aged vinegars like balsamic. Technically, even distilled white vinegar is fermented, but because it is the best tolerated out of all types, it is permissible for a migraine-compliant diet.
- Accent
- Ajinomoto
- Autolyzed Yeast
- Bouillon and most store-bought broths and stocks
- Calcium or Sodium Caseinate
- Carrageenan (often in heavy cream and cream cheese)
- “Fermented” or “live cultures” on an ingredient label
- Gelatin and Glutamic Acid
- Hydrolyzed Corn Gluten
- Hydrolyzed Proteins (soy, plant vegetable, etc.)
- Kombu (seaweed extract)
- Malted Barley (common in flours)
- Malt Extract
- Maltodextrin
- “Natural Flavors” or “Natural Flavoring” of any kind (chicken, beef, etc.)
- Nutritional Yeast
- “Protein Fortified”
- “Seasonings” or “spices” of any kind where they are not listed individually on the label
- Soy Protein Isolate and Concentrate
- Textured Protein
- Umami or “umami” on an ingredient label
- Yeast Extract
- Yeast Food
- Citric Acid
- Guar Gum
- Xanthan Gum
FOODS TO EMBRACE
FRUIT
Açaí
Apples–some find they tolerate green/Granny Smith best
Apricots
Blackberries
Blueberries
Boysenberries
Cantaloupe
Cherries
Cranberries
Currants
Elderberries
Goji berries
Grapes–some find they tolerate green best
Honeydew
Jackfruit
Lucuma
Mangoes
Mulberries
Nectarines
Peaches
Pears
Pomegranates
Pumpkin
Strawberries
Tamarind
Tomatillos
Tomatoes (may trigger some)
Watermelons
VEGETABLES
Artichokes
Asparagus
Beets (not marinated)
Bok Choy
Broccoli/Broccolini/ Broccoli Rabe
Brussels Sprouts
Cabbage
Carrots
Cauliflower
Celery
Chard
Chicory
Chiles
Corn
Cucumbers
Endive
Eggplants
Fennel
Green Beans
Green Onions
Jicama
Kale
Leeks
Lettuce of all kinds
Mushrooms (may trigger some)
Okra
Olives (check ingredients; may trigger some)
Parsnips
Pea Shoots and Micro Greens
Peas without the pea pod (no snow peas)
Peppers
Potatoes (all kinds)
Radishes
Rhubarb
Rutabagas
Shallots
Spinach
Sprouts
Squash of all types
Sunchokes
Turnips
Watercress
Zucchini
SEEDS
Chia
Flax
Hemp
Pepitas (pumpkin seeds) and pumpkin seed butter
Poppy
Sesame/Tahini
Sunflower and sunflower seed butter
HERBS & SPICES
Amchoor/Dried Green Mango Powder
Aniseed
Basil
Bay Leaf
Caraway
Cardamom
Cayenne
Celery Seed
Chaat Masala and Garam Masala (look for any added MSG in premixed bottles; you can also make it at home)
Chervil
Chiles, dried (all types like pasilla, guajillo)
Chili powders like regular, chipotle (watch ingredients in mixes; some contain cocoa)
Chinese Five Spice
Chives
Cilantro
Cinnamon (may trigger some sensitive to histamine)
Cloves
Coriander
Cream of Tartar
Cumin
Curry, including Thai curry pastes and powders (watch ingredients in mixes)
Dill
Fennel
Fenugreek
Garlic
Ginger
Harissa
Horseradish (fresh, not mixed with additives)
Lavender
Lemongrass
Marjoram
Mint
Mustard
Oregano of all kinds
Paprika of all kinds
Parsley
Pepper - black
Peppermint
Rosemary
Saffron
Sage
Shallots, dried
Sriracha (without sulfites, citrus, or MSG)
Sumac
Tamarind
Tarragon
Thyme
Truffle
Turmeric
Za’atar
DAIRY
American Cheese, deli-style (Andrew & Everett or Boar’s Head)
Boursin Garlic & Fine Herbs cheese
Butter and Ghee (avoid labels with “natural flavors”; Kerrygold is a HYH-friendly brand)
Cottage Cheese (avoid “live cultures”; I like Daisy brand)
Cream Cheese (carrageenan-free)
Farmer’s Cheese
Fresh Goat Cheese (chèvre)
Half & Half (watch for carrageenan)
Heavy cream (carrageenan-free)
Ice Cream (no additives; Häagen Dazs or McConnell’s vanilla are good)
Mascarpone
Milk (whole milk is best)
Mozzarella, fresh (not aged, flavored, or smoked)
Queso Fresco
Ricotta (no additives)
BEANS
Black Beans
Black Eyed Peas
Garbanzos/Chickpeas
Great Northern
Kidney
Pinto
GRAINS, ETC.
Arrowroot
Buckwheat
Cassava
Cornmeal/Polenta
Cornstarch
Couscous
Farro
Millet
Oats
Rice
Sorghum
Tapioca
Wheat
DRINKS
Coffee–Certified Swiss Water Process or CO2 processed decaf coffee (see page 230 for more information)
Fresh fruit juices (see Foods to Eliminate on page 15)
Green Rooibos Tea or 100% Ginger
Sparkling Water (unflavored) with fresh juices to replace soft drinks
CONDIMENTS & STAPLES
Agave Nectar
Dijon Mustard (wine- and sulfite-free; Annie’s Organic is a good brand)
Distilled White Vinegar
Honey
Jam (without lemon or gelatin)
Kosher salt
Maple Syrup
Mayonnaise–it’s difficult to find a brand without lemon juice or MSG. Sir Kensington’s Organic has a very small amount of lemon juice.
Molasses (unsulphured)
Oils–grapeseed, canola, olive oil, sunflower oil, sesame oil
Sriracha (without sulfites, citrus, or MSG)
Sugar (brown and granulated)
Vanilla Extract
Zhoug Sauce
About Meat, Poultry & Fish
Fresh, unflavored fish, chicken, pork, turkey, duck, beef, lamb, and shellfish are all allowed when on the HYH diet, but you still must check the labels on packaging and/or talk to your butcher and fishmonger before you buy, to ensure there are no additives. If you’ve ever looked closely at a label, particularly for chicken, sometimes it may read, “injected with up to X% solution” or “contains natural flavorings.”
An article in the Washington Post from 2007 called “Crying Foul in the Debate Over ‘Natural’ Chicken” exposed some chicken manufacturers for injecting their “all-natural” birds with a solution that added up to 15 percent of their weight. The solution was made of salt, seaweed, and chicken broth, which the US Department of Agriculture approved as being natural ingredients. Therefore, these manufacturers were able to label their chickens as “all-natural” even though they contained this injected solution. Some of these solutions included ingredients like carrageenan, which can act like MSG for those who are sensitive to glutamate.
A phrase to look for when buying poultry is “air-chilled.” My local butcher finds these words to be even more important than “organic,” although having both is ideal. The USDA requires chickens to be cooled to a certain temperature for food safety. Many large corporations use the same containers filled with chlorinated water to chill their chickens, promoting cross-contamination and the absorption of water into the meat. Air-chilled chickens are separated and passed via track through different chambers of cooled air. It takes longer than a water bath, causing it to be more expensive all around. But many believe it’s worth the extra cost because (1) you’re not getting extra water in the meat so it will brown nicely while cooking, and (2) it’s better for the flavor as you are truly getting an all-natural chicken. I encourage you to look closely at what you’re buying and try out “air-chilled” chicken. You’ll notice a big difference in the flavor and how well it cooks, and it’s less likely to be injected with MSG-filled solutions.