The Role of Diet in Vestibular Migraine

Vestibular migraine is a type of migraine characterized primarily by dizziness. Individuals with this condition may feel as though they or their surroundings are in motion. Episodes can last from a few seconds to several hours and may include symptoms such as loss of balance, motion sickness, lightheadedness, confusion, nausea, vomiting, and severe headache. Unlike typical migraines, vestibular migraine attacks do not always involve headaches, complicating diagnosis. Some studies indicate that lifestyle and dietary changes may help reduce the frequency and severity of these attacks.

How Diet Affects Vestibular Migraine Attacks

The exact cause of vestibular migraine remains unclear, though it appears more prevalent in women. Factors such as genetics, diet, lifestyle, and environment may contribute. Research suggests that avoiding certain food triggers can mitigate the occurrence and intensity of migraine attacks. Common triggers include chocolate, alcohol, coffee, aged cheeses, and processed meats, which contain compounds like tyramine, nitrates, histamine, and phenylethylamine. Additionally, hunger and mild dehydration can exacerbate symptoms. However, food triggers vary among individuals, and diet may not influence migraine episodes for everyone.

What Does a Vestibular Migraine Diet Include?

Currently, there are no official dietary guidelines for vestibular migraine. Identifying and eliminating known food triggers is a good starting point. If specific triggers are unclear, an elimination diet can be employed, where suspected foods are removed from the diet. This personalized approach allows individuals to gradually reintroduce foods to determine if they provoke symptoms. An elimination diet typically lasts 5 to 6 weeks and should be supervised by a dietitian or physician to avoid nutrient deficiencies. The process consists of two phases: elimination and reintroduction.

In the elimination phase, foods that may trigger vestibular migraine symptoms are avoided for 2 to 3 weeks, helping to establish whether diet contributes to symptoms. During the reintroduction phase, eliminated foods are gradually added back into the diet over 2 to 3 days each, monitoring for any symptom exacerbation. Foods that do not trigger symptoms can likely be safely consumed, while those that do may need to be permanently excluded. This phase lasts an additional 2 to 3 weeks, depending on the number of food groups initially eliminated.

Helpful foods for vestibular migraine include:

• Fruits: Most, except citrus and tomatoes
• Vegetables: Most, except onions, beans, and lentils
• Grains: All, such as rice, quinoa, and oats
• Meat, eggs, and fish: All fresh meats, including chicken, beef, turkey, and lamb
• Dairy alternatives: Non-dairy milks, like coconut and oat milk
• Fats: Healthy fats, such as olive oil, flaxseed, and coconut
• Beverages: Water and decaffeinated herbal teas
• Spices and seasonings: All fresh herbs and spices, plus most homemade seasonings