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Oranges are a startling inclusion in the list of possible migraine causes - many people disbelieve it almost instinctively, because isn't orange juice supposed to be good for you?
Not if you are sensitive to citrus. The citrus group of foods, which includes fruits such as oranges, lemons, limes and grapefruit, is a known allergen. Also, much commercial orange juice is squeezed with the rind on, bruising it and releasing synephrine, a vasoconstrictor.
There have been links between migraine headaches and synephrine as well as related vasoconstrictors, so it makes sense that this could be a trigger. Many patients found that freshly squeezed orange juice made at home caused them no problems.
A 2004 study found that: "In migraine patients, plasma levels of octopamine and synephrine were higher compared with controls, although in migraine with aura, the difference was not significant".(1)
Synephrine is a stimulant that raises blood pressure, which can also cause migraines. It is theorized that migraine sufferers with citrus allergy can gain relief from low dosage of daily blood pressure medication.
Citrus fruits also cause magnesium deficiency in some patients, and magnesium deficiency has been linked to migraine without aura. In a study where thirty migraine patients were treated with magnesium versus ten treated with placebo, the number of patients experiencing relief was so high that the possibility of the test results being coincidental was less than a 1 in 1000 chance.(2) The magnesium was administered as a magnesium citrate supplement, 600mg per day, orally. Patients were assessed by computerized tomography before and after the three month treatment period.
Citrus fruits also contain histamine, another suspect in food related allergies. A study at Texas Tech in El Paso TX found a correlation between high histamine levels and migraine attacks in susceptible persons. Antihistamines would seem to be a logical choice for treatment!(3)
An unhappy relationship between hypoglycemia and migraine can be heightened by drinking of orange juice, lemonade or other citrus juice in an attempt to raise the blood sugar - the orange juice can actually increase the migraine pain and the blood sugar level is blamed instead. This is why testing for food allergies and keeping a food diary is so very important.(4)
One woman related how she had taken migraine medication daily for years, washing it down with an 8 oz glass of orange juice each morning. It wasn't until her sons were diagnosed that she realized that she had simply been perpetuating the cycle of migraines and been triggering her sons' as well by giving them juice on a daily basis. Incidentally, orange flavored drinks such as Tang and Sunny D also contain migraine triggering substances similar to the natural fruits, so if citrus is a problem for you, avoid them as well!
Elimination of citrus is much simpler than many other migraine trigger foods, and is relatively easy to live without. For those with severe food intolerance migraines, living without orange juice, lemonade and key lime pie may be a small price to pay.
Sources:
(1) pubmed15159465.do, Cure Hunter, 05/25/2004
(2) Magnesium Research, Jun 2008;21(2):101-8. PMID: 18705538, by Koseoglu E, Talaslioglu A, Gonul AS, Kula M. Erciyes University, Medicine Faculty, Neurology Department, Kayseri, Turkey
(3) Mansfield LE , Journal of Allergy & Clinical Immunology. 86(4 Pt 2):673-6, 1990 Oct.
(4) Leira R, Rodriguez R, Revista de Neurologia 1996 May;24(129):534-8
Research by Grace-Alexander
