Coffee and headache: what do I need to know?

Coffee and other caffeinated beverages are top favorites in Germany, but migraineurs and other headache suffers sometimes think twice before grabbing a cup. Is their caution justified?

We took a closer look at the caffeine-headache connection.

A most beloved beverage

Some of our favorite pick-me-ups and treats have a bad reputation for causing headaches. Coffee regularly features on top of the list. For many, the reason is the ingredient that gives us the buzz: caffeine. Coffee is the most popular beverage in Germany. Average consumption per head of population is two cups of coffee a day, or the equivalent of just under five kilograms a year.

The effects of caffeine

Caffeine is the main active ingredient in coffee. Tea also contains caffeine. So does cocoa, but in small amounts. Caffeine has a variety of effects in the human body. Only a few of them are mentioned here. The first is its stimulating effect on the nervous system. Caffeine increases the force of your heartbeat and your heart rate (number of beats per minute), which is expressed as an increase in your pulse. Caffeine may contribute to a slight increase in blood pressure. It also acts on respiratory organs by widening the upper airways. Caffeine narrows the blood vessels in the brain but widens the blood vessels further out.

Tea and coffee are usually harmless

The current understanding is that two to three cups of coffee a day does no harm to healthy people. However, experts disagree on whether coffee and tea are good for your health, and on the ways caffeine affects our well-being. A lot of research has been done on this, with mixed results. There does seem to be proof that caffeine can help relieve pain as well as being an effective stimulant.

Does caffeine have an effect on headache?

Yes and no, says the science. Coffee drinkers who abruptly stop drinking their favorite brew may experience headache attacks. Some scientists say this is because caffeine is a mild painkiller. Taken regularly in small quantities, caffeine makes you less sensitive to pain, including headaches. This effect has been demonstrated in volunteers in some studies, but by no means all. Some studies show the very opposite. In those studies, tea and coffee triggered headache and migraine attacks. Some researchers even conducted quite drastic self-experiments but did not find any effects.

A look at migraine

The effect of caffeine has also been studied in migraine patients. Among other things, researchers investigated whether caffeine affected response to migraine medication. Differences did indeed emerge. Patients who did not use coffee or tea responded better to the medicines usually prescribed by their physician. Patients who continued to use caffeine responded less well to their usual medicines.

Harmless pick-me-up

Coffee (and tea) may well have different effects on different people. If you follow a few basic rules – do not take too much coffee, do maintain regularity in your use, don’t stop drinking coffee all of a sudden – you can enjoy the pleasures of coffee without any significant health concerns.

  • References
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    • Dreisbach RH, Pfeiffer C. Caffeine-withdrawal headache. J Laboratory Clin Med 1943; 28:1212–9.
    • Dreisbach RH. Experimental caffeine-withdrawal headache. Proc J Pharmacol Exper Therap 1940; 69:283.
    • Fredholm BB, Bättig K, Holmén J, Nehlig A, Zvartau EE. Actions of caffeine in the brain with special reference to factors that contribute to its widespread use. Pharmacol Rev. 1999 Mar;51(1):83-133. Review.
    • Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004;24 Suppl 1:9-160.
    • Lee MJ, Choi HA, Choi H, Chung CS. Caffeine discontinuation improves acute migraine treatment: a prospective clinic-based study. J Headache Pain. 2016 Dec;17(1):71. doi: 10.1186/s10194-016-0662-5. Epub 2016 Aug 5.
    • Sawynok J. Caffeine and pain. Pain. 2011 Apr;152(4):726-9. doi: 10.1016/j.pain.2010.10.011. Epub 2010 Oct 30. Review.
    • Shapiro RE. Caffeine and headaches. Curr Pain Headache Rep. 2008 Aug;12(4):311-5. Review.
    • Shapiro RE. Caffeine and headaches. Neurol Sci. 2007 May;28 Suppl 2: S179-83. Review.
    • Silberstein SD, Olesen J, Bousser MG, Diener HC, Dodick D, First M, Goadsby PJ, Göbel H, Lainez MJ, Lance JW, Lipton RB, Nappi G, Sakai F, Schoenen J, Steiner TJ; International Headache Society. The International Classification of Headache Disorders, 2nd Edition (ICHD-II) --revision of criteria for 8.2 Medication-overuse headache. Cephalalgia. 2005 Jun;25(6):460-465.
    • Tai MS, Yap JF, Goh CB. Dietary trigger factors of migraine and tension-type headache in a South East Asian country. J Pain Res. 2018 Jun 28; 11:1255-1261. doi: 10.2147/JPR.S158151.

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