Leafy greens as a migraine trigger

Veggies and especially greens are important foods that you’ve gotta love. They’re packed full of blood-building and cleansing nutrients and exemplify all that is healthful and wholesome.  Most people with migraines and food sensitivities see vegetables as one of the safest food groups to eat from.  Spinach is occasionally recognized as a migraine trigger but usually the explanation given is that it contains high levels of oxalates or triggers histamine.  Both of these explanations may be true, but nitrates are usually not described as a migraine trigger when it comes to eating spinach.

The original SimplyWell Migraine Relief Protocol addressed the issue of nitrates – though not explicitly – by suggesting that you avoid nitrate rich foods such as lunch meats and cured meats along with most other aged and fermented foods.  What is news to us is that many fresh vegetables also contain significant amounts of nitrates – some naturally-occuring, some a result of how the plants are fertilized, and some a result of the time of year of harvest, growing conditions, and how the food is prepared.

The natural human tendency is to think that when something is good for you (ie, vegetables), more is even better for you. So our enthusiasm for taking responsibility for our health may result in us getting really amped about the practice of drinking fresh green smoothies every morning (for example)!   Unfortunately, if you get overzealous with them, raw leafy greens high in nitrates eaten in excess can be a migraine trigger, for reasons explained below.

Before moving forward, I want to point out, however, that my migraines went away before I knew about this connection and while eating nitrate-rich veggies.  I didn’t drink many green smoothies though.  My impression is that drinking green smoothies high in nitrates once in awhile should not pose too much of a problem for people who only get migraines occasionally.  But for those who have almost constant migraines, this nitrate issue may be a game-changer and reducing their consumption may improve symptoms and quality of life.  So as you read this, think of this info in light of how severe your migraines are before deciding to change how you eat greens.

The new research into nitrates and migraines

Recently there’s been some new research coming out showing that people with migraine headaches have more nitrate-reducing bacteria in their mouths and nitrate-producing bacteria in their guts.  This is important information, because:

“Nitrates, such as cardiac therapeutics and food additives, are common headache triggers, with nitric oxide playing an important role. Facultative anaerobic bacteria in the oral cavity may contribute migraine-triggering levels of nitric oxide through the salivary nitrate-nitrite-nitric oxide pathway. Using high-throughput sequencing technologies, we detected observable and significantly higher abundances of nitrate, nitrite, and nitric oxide reductase genes in migraineurs versus nonmigraineurs in samples collected from the oral cavity and a slight but significant difference in fecal samples.” (Source)

While higher levels of nitric oxide (and raw, green, leafy veggies) may be a good thing for people with hypertension and high blood pressure, it’s not sp great for those of us with hypotension and low blood pressure.  Nitrates contribute to vasodilation and low blood pressure, and when our blood pressure is low (as most of ours are who are prone to migraines), there is insufficient blood and therefore oxygen getting to the head (as well as impingement on nearby cranial nerves). If you’d like to learn more about this, read my blog post here, under the section “Why do so many people with migraine headaches have dilated blood vessels, low blood pressure, and electrolyte imbalances?”

I know this isn’t something you really wanted to hear

The last thing you need is to start being afraid of yet one more food group. In addition to alcohol, cheese, chocolate, and fermented and aged foods and supplements, you may (or may not be) already aware that you’re probably also to some degree triggered by glutamates, histamine, tyramines, benzoates, oxalates, and/or salycilates.  Now also nitrates!?!?  This news is hard to be receptive to, I realize.

The only consolation I have to offer is that by being educated about the properties of foods, we can actually be less fearful and more empowered in how we eat.  We don’t have to avoid these foods entirely (that would be impossible!), but by making discerning decisions about which foods we eat and how we prepare them, we can stop overloading our system with them.  The even better news is that once your gut flora starts to get rebalanced with help from the SimplyWell Migraine Relief Protocol, your body just won’t get overloaded quite so easily, and you’ll be more resilient.

I’d imagine that even among people who are prone to migraines, there is still a diversity in their gut (and oral cavity) microbiome and these differences among us may explain our different levels of food sensitivities and capacities to handle glutamates, histamine, tyramines, benzoates, oxalates, and/or salycilates. There may be differences in our individual capacities to handle nitrates as well, so please test these foods out on yourself to gauge your own sensitivity levels.  What does seem clear is that nitrates ultimately reduce blood pressure, and this is generally undesirable in those with migraines.

So what are the veggies highest in nitrates?

That’s not a straightforward question to answer, because of the variability in factors that contribute to nitrate content (soil, plant type, growing conditions, fertilizers, time of year harvested, how old the plant is, part of the plant consumed, etc).  I’d love to be able to provide you with a very neat list outlining fixed nitrate levels for each vegetable, but doing so would be deceptive. In addition to the factors just described, we probably each have diverse nitrate reducing gut and mouth microbe communities, meaning nitrate levels as a migraine trigger may vary in intensity for each of us as individuals.

So let’s just simplify this.

Generally it appears that there is agreement that spinach, kale, arugula, chard, cilantro, and beet greens are highest in nitrates.  These foods doin’t have to be avoided – but will be better for you to eat cooked.  Cabbage, celery, bok choy, romaine, and radishes seem to be generally in the medium range of nitrate levels.  Cabbage and bok choy are usually cooked anyway, but radishes should still be good for you in moderation because unlike the more leafy green veggies high in nitrates, radishes contain prebiotic fibers and other properties beneficial to people with migraines (which is why they remain an optional but important part of the SimplWell Protocol).  According to some lists, potatoes and carrots are on the lower end of the nitrate spectrum (and also contain prebiotics, so we want to eat them raw).  Cucumbers, iceberg lettuce, and mesclun greens are also in the low to medium range.

Fruits also contain nitrates, but nowhere near the amounts that green leafy veggies do.  It’s my personal conclusion right now that its not important to stop eating any fruits, especially since fructose breaks down into a variety of waste products, one of which is uric acid. Uric acid drives up your blood pressure by inhibiting the nitric oxide in your blood vessels.  We want to increase our blood pressure to get more blood to the head (again, since people with migraines usually have low blood pressure).  Of course, always consider this information in light of what  you already know about your own particular food sensitivities.

How to minimize nitrate load from greens in your diet:

  1. Always choose organic greens.  Organic greens generally have fewer nitrates than conventionally-raised greens (which are more likely to to be a migraine trigger).
  2. Greens harvested during the spring and summer have lower nitrate levels than those harvested in the fall and winter.  Eating locally in season is one way to reduce nitrate levels.
  3. Cooking greens significantly lowers nitrate content, so eating cooked rather than fresh veggies will be less of a trigger, especially for the greens that are still healthful, like kale and spinach, but are very high in nitrates when fresh.
  4. Vegetables lower in nitrates should be chosen when you are eating fresh vegetables in the form of salads or green smoothies.  Mesclun greens, romaine lettuce, and cucumbers are lower in nitrates, but still contain nitrates.

A reminder: this info on nitrates is preliminary

The research on higher nitrate-reducing bacteria in the mouths of those with migraines, and higher levels of nitrate-producing bacteria in their colons, just came out a few weeks ago. The implications of this research has not been tested out in large numbers of people with migraines to see how reducing nitrate-rich veggies and greens will impact their migraines.  But the mechanisms for how and why nitrates would affect those of us with migraines (and attendant low blood pressure) is pretty clear.

It just so happens that recently, when I experienced an unusual week of headaches and cloudy brain fog, I had been choosing to drink a lot of green drinks (normally I just rely on my carrot potato juice).  I had attributed my headaches to hormonal changes in my pregnancy, and low blood pressure from weather changes.  But then I found this research on nitrates. It’s almost as though the universe decided to perfectly time my green drink experiment with the releasing of this information so that I would make the connection.  So I stopped drinking the green drinks, and my headaches went away.

Important! The goal is NEVER to be more afraid of food.

The goal is to be educated enough about food and how it affects us that we can actually feel well and function while we do the important work of healing the underlying imbalances that are causing the food sensitivity in the first place.  The body knows how to heal if we support it properly, and we can do so through better understanding of the properties of foods including this new information on nitrate migraine triggers and how to eat veggies in a way that won’t overload us or lower our blood pressure to much. The only reason that nitrates may cause headaches in some people, I believe, is because they already have a high nitrate load in their bodies. Ie, similar to histamine intolerance, their nitrate bucket is already full and so “tips over” into symptoms very easily when high nitrate foods are eaten.

Check out my delicious recipe for a low-nitrate green drink made with romaine, cucumber, mint, and pear!

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