A lesser-known migraine trigger

The idea that oranges are considered a possible migraine trigger has surprised many of us, as orange juice is often considered beneficial in our diet.

Not if you are sensitive to citrus. The citrus food group, which includes fruits like oranges, lemons, limes, and grapefruit, is a known allergen. Also, a lot of commercial orange juice is squeezed through the peel, which subsequently bruises it and releases synephrine, a vasoconstrictor.

There have been links between migraines 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 no problems for them.

A 2004 study found that: “In patients with migraine, plasma levels of octopamine and synephrine were higher compared to 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. The theory is that migraine sufferers with a citrus allergy can get relief with a low dose 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 chance of the test results agreeing was less than 1 in 1,000. (2) Magnesium was administered as a magnesium citrate supplement, 600 mg per day, orally. The patients were evaluated by computed tomography before and after the three-month treatment period.

Citrus also contains histamine, another food allergy suspect. A study from Texas Tech in El Paso TX found a correlation between high histamine levels and migraine attacks in susceptible people. Antihistamines seem like a logical choice for treatment! (3)

An unhappy relationship between hypoglycemia and migraine can be intensified by drinking orange juice, lemonade, or other citrus juice in an attempt to raise blood sugar; orange juice can actually increase migraine pain, and blood sugar is blamed instead. This justifies the importance of keeping a food diary and testing for food allergies.(4)

One woman recounted how she had taken migraine medication every day for years, and washed it down with an 8-ounce glass of orange juice each morning. Finally, when her children were diagnosed, it became clear that by giving them juice every day, she had simply been stimulating the migraine cycle. By the way, orange-flavored drinks like Tang and Sunny D also contain migraine-triggering substances similar to natural fruits, so if citrus is a problem for you, avoid those too!

Citrus is much simpler to eliminate than many other migraine trigger foods, and relatively easy to live without. For people who suffered from severe migraines from food intolerance, living without orange juice, lemonade, and key lime pie was a minor exclusion from their diet.


(1), Cure Hunter, 05/25/2004
(2) Magnesium Research 2008 Jun;21(2):101-8. PMID: 18705538, by Koseoglu E, Talaslioglu A, Gonul AS, Kula M. Erciyes University, Faculty of Medicine, Department of Neurology, Kayseri, Turkey
(3) Mansfield LE, Journal of Allergy and Clinical Immunology. 86 (4 Pt 2): 673-6, October 1990.
(4) Leira R, Rodríguez R, Journal of Neurology 1996 May;24(129):534-8

Grace Alexander Research

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