Caffeine & Diet: Heal Thyself!

I quit drinking coffee (both caffeinated and decaffeinated) at the end of 2004. Before that, I was only a cup-a-day coffee drinker, but I did drink an occasional Diet Coke, maybe 2-3 per month.

I had just read David Buchholz's book "Heal Your Headache: The 1-2-3 Program for Taking Charge of Your Pain", which recommends a 60-90 day elimination diet to remove all possible food triggers. Buchholz is a neurologist at Johns Hopkins in Maryland, a rather esteemed medical establishment. I figured if he doesn't know headaches, no one does.

I learned a lot from this book, a lot of interesting theories anyway. Things like (i) tension-type (and sinus) headache has the same mechanism as migraine, (ii) my back/neck muscles aren't really tight; my aching brain is just telling me they are, and (iii) i can heal my headaches (supposedly).

His basic premise is in the 1-2-3 thing. Step 1 is to get off any OTC medications that might cause rebounding, things like Excedrin (with caffeine) and others. I didn't take many of these things anyway, but if you do, you wean yourself off the bad ones. Then Step 2 is to clean up your diet. He recommends a strict trigger-free elimination diet that removes all the usual bad-actors and a long list of others. The list includes foods containing: caffeine (coffee, tea, colas, possibly decaf coffee), chocolate, MSG, processed meats (aged, canned, cured, smoked, or preserved with nitrites/nitrates), most cheeses (unless fresh like ricotta or cottage or cream cheese) and some dairy products (yogourt, sour cream), nuts of all kinds, alcohol and vinegars (the ones that are fermented) especially red wine, beer, and condiments containing vinegar (mustard, mayonaise). Certain fruits and fruit juices like citrus fruits, bananas, raspberries, avocados, and so on aren't allowed either. Certain vegetables are also no-no's, including onions and certain beans (lentils, lima, etc.) as well as fresh-baked breads, aspartame, and possibly soy products. He gives an exhaustive list of chemicals which may be hidden sources of MSG (very helpful). Once the 60-90 day stint is over, you slowly re-introduce individual foods. And if that doesn't work, there is Step 3: Preventatives and Abortives: drugs like Elavil and the triptans.

I followed the diet religiously, saintly even, for 90 days. I ate a very pure diet and any processed foods were usually organic (the organic varieties had much shorter lists of chemicals and fewer of the bad actors). Many mainstream processed foods contained chemicals from his MSG list.

The diet was hard. I had to cook all the time, prepare snacks and lunches in advance, and never eat out (where I didn't know the ingredients). I discovered that every canned soup (except some varieties of tomato) has onion in it (onion is a no-no). I didn't eat vinegar (nor mayonaise nor mustard). No wasabi! I stopped drinking coffee, decaf coffee, and caffeinated soft drinks cold turkey. I didn't eat chocolate. I didn't eat soy products (no tofu dogs, no soy sauce!). No fresh bread. Nothing flavored with lemon/orange. No processed meats. Which was okay because sandwiches became virtually impossible without mayo or mustard. No nuts. No trail mix. No peanut butter! I cooked almost every night to supply lunches for the following days, and didn't have a social life. I reverted back to an almost-vegetarian diet. I was once a vegetarian (ovo-lacto for 12 years), so many clever meals came back to me. I ate a lot of permitted-fruits and veggies, rice and other grains, re-constituted dry beans (canning could mean preservatives) and rarely... minimally processed organic meat. I switched to teas (rooibos, herbals). I lost a few pounds and became painstakingly careful about labels. I slowly went mad.

Did a miracle happen? No. The diet didn't work. After 90 days, I saw no change in headache intensity nor duration nor frequency. Except for the first two weeks, when headaches worsened (likely due to the elimination of caffeine).

There were, however, some benefits: I kicked an arbitrary coffee habit, and completely lost my sweet tooth (my passion for chocolate has since returned, with a fury). I also learned that addiction to any foods (like chocolate and bread, in my case) is pure habit. Once certain foods were off my radar for a couple of months, I stopped wanting them.

Since then, I haven't drunk caffeinated coffee. Once in a blue moon, probably every 4-6 months, I have a decaf for nostaligia's sake. But it tastes awful to me now.

But on the diet-journey, I have made a fascinating new discovery, in the last year or so: Caffeine makes my headaches worse, always. It doesn't temporarily make them better, like all the evidence suggests. How do I know this? Every time I drink a decaf, my headache worsens almost immediately upon drinking it. In fact, my headaches take on a sickly, nauseating full-on migraine-like quality. How can this be? Decaf still contains caffeine (about 5mg compared to 150mg for a regular coffee) and my body seems highly tuned to it. But caffeine is a vaso-constrictor and is supposed to help your headache temporarily and only worsen it during rebound, when the caffeine wears off and your vessels re-dilate. But for me...having a decaf kills me. I feel like total crap and my head ache gets severe after having even a cup.

So what I want to say is...caffeine isn't always the god-turned-devil that causes retribution headaches after making you feel better briefly. For me, it isn't a god at all; it is pure demon from the get-go. So everyone's body must be different. You need to find your own fixes and failures.

And as for the "elimination diet" I hope it works for some people. All the rave reviews I read on Amazon say so. But my triggers are clearly non-food related, so while this is a great idea, it doesn't fix everyone. David Buccholz doesn't address non-food triggers very well, except for saying that they exist and if so, keep reading. So his book is great for food-issue folks, but it ain't magic and it didn't "heal my headaches" even though I was a perfect patient.

It did teach me a thing or two: like I need to pay attention, careful attention, to myself. It cued me to become aware of my other triggers, to keep a careful eye on things, to keep trigger diaries, to take as much responsibility as I can for reducing the triggers within my control. It helped fine-tune the way I look at my body. It helped me kick caffeine.

But it also insulted me. Healing thyself isn't as easy as following a diet and stopping eating meds like candy. The preponderance of books like these make us feel like lazy head-aching whiners who are clearly causing our own problems. They make it look like we can all "fix" ourselves. We can't. Which is why he covered his butt with Step 3: Drugs! Heal thyself (with the help of your pharmacist).