How to Follow a Vestibular Migraine Diet

This article explains how diet may affect vestibular migraine and provides a guide for dietary changes to help reduce symptoms.

Vestibular migraine is a type of migraine condition with vertigo as a main symptom.

People who experience vertigo feel that they’re moving when they aren’t, or that their surroundings are moving around them when they aren’t. Vertigo can feel similar to motion sickness.

A vestibular migraine episode lasts anywhere from a few seconds to several hours. Its symptoms may include a loss of balance, motion sickness, dizziness, lightheadedness, disorientation or confusion, nausea and vomiting, and a severe headache (1).

While migraine attacks often involve recurrent, throbbing headaches, vestibular migraine episodes don’t always include headache symptoms — making this condition difficult to diagnose (2).

Notably, some research suggests that lifestyle and dietary changes may help reduce the frequency and severity of vestibular migraine attacks (2).

If you have migraines, then you can experience episodes due to your migraine triggers, such as certain foods, scents, or stress.

Your migraine triggers would induce your typical migraine symptoms, not a different type of migraine. So, if you tend to have vestibular migraines, your triggers would lead to a vestibular migraine episode.

How does your diet affect vestibular migraine attacks?

The exact cause of vestibular migraine remains unknown. However, this condition seems more common among women. Genetics, diet, lifestyle, and environmental factors may also play a role (2, 3).

Research suggests that avoiding dietary triggers may reduce the occurrence and intensity of migraine attacks, including vestibular migraine (3).

Common dietary triggers for migraine attacks include chocolate, alcohol, coffee, aged cheeses, and processed meats. These foods contain chemicals like tyramine, nitrates, histamine, and phenylethylamine, all of which have been linked to migraine symptoms (3, 4).

Some people report that their migraine symptoms worsen if they don’t eat, which suggests that fasting and skipping meals may trigger an attack. And even mild dehydration, which can happen if you forget to drink water, can trigger a migraine episode (5).

Keep in mind that trigger foods may vary from person to person. In fact, some people may find that their diet doesn’t affect migraine episodes.

Summary

Certain foods, such as alcohol, processed meats, and chocolate, may trigger a vestibular migraine. Fasting and skipping meals may also play a role. Remember that dietary triggers may vary from person to person.

What does a vestibular migraine diet entail?

Currently, there are no official dietary guidelines for vestibular migraines.

Consider whether certain foods, such as the foods that are known to be migraine triggers, have been associated with your migraines.

You can start by eliminating that specific food to see whether that affects your migraine frequency. If you can’t identify a dietary trigger, an elimination diet might be an approach you can take (3, 6).

With this approach, you remove foods you suspect may worsen your symptoms. Because people respond differently to foods, elimination diets are personalized for each individual (3).

You then reintroduce these foods at a later date, group by group, to determine whether any food or food group triggers your symptoms.

An elimination diet typically lasts 5–6 weeks. It should only be done under the supervision of a health professional like a dietitian or doctor, as it increases your risk of a nutritional deficiency if followed incorrectly or for too long.

Bear in mind that vestibular migraine is a complex condition, and you may find that dietary changes don’t affect your symptoms.

An elimination diet is divided into two main phases — elimination and reintroduction.

The elimination phase

During this phase, you avoid foods that may trigger vestibular migraine symptoms.

You can then tell whether diet plays a role in your symptoms because you’ve eliminated nearly all possible trigger foods.

This phase typically lasts 2–3 weeks.

The reintroduction phase

During this phase, you slowly reintroduce the eliminated foods or food groups.

Each food group should be introduced individually over 2–3 days while you record how it affects your vestibular migraine symptoms.

If you find that reintroducing a food or food group doesn’t worsen your attacks, it’s likely safe to eat. Yet, a food that triggers symptoms may need to be cut from your diet indefinitely.

The reintroduction phase takes another 2–3 weeks depending on how many food groups you eliminated initially, though it may last longer if your health care professional recommends it.

Summary

An elimination diet targeting migraine trigger foods may help reduce vestibular migraine symptoms. This diet has two main phases — elimination and reintroduction — and usually lasts 5–6 weeks.

Foods to avoid

An elimination diet for vestibular migraine should remove foods linked to migraine symptoms, such as (4):

• aged cheeses
• alcohol (particularly red wine and beer)
• aspartame, an artificial sweetener
• chocolate
• processed meats like bacon, sausages, salami, and cured meats
• monosodium glutamate (MSG)

Caffeine intake has a major impact on migraines. If you regularly drink caffeinated beverages, you might get a migraine just by reducing or increasing the amount. So you should not make changes in your caffeine intake while you are trying an elimination diet.

Other foods that may worsen symptoms but have less supporting evidence include (4):

• citrus fruits
• tomatoes
• onions
• beans and lentils
• nuts and seeds
• pickled and fermented foods
• organ meats, such as beef and chicken livers
• salted, smoked, and dried fish
• dairy products like milk, cheese, cream, ice cream, and yogurt
• canned soups, soup cubes, and bouillon cubes with MSG
• fruit juices and carbonated sodas
• bottled salad dressings and packaged dips
• vitamins and herbal supplements, especially those containing caffeine

If you suspect that other foods not listed above may trigger your vestibular migraine symptoms, you should consult a health care professional and consider removing them as well.

Discuss which foods you should eliminate with your doctor, as well as the duration of each phase, before you start any elimination diet.

Keep in mind that these food groups should only be avoided during the elimination phase, as they’re reintroduced later on.

Summary

An elimination diet for vestibular migraine can help identify what foods trigger symptoms.

Foods to eat

During the elimination phase, you’re still able to enjoy plenty of healthy, delicious foods, such as (4):

• Fruits: most fruits, excluding citrus and tomatoes
• Vegetables: most vegetables, excluding onions, beans, and lentils
• Grains: all grains, such as rice, quinoa, couscous, and oats
• Meat, eggs, and fish: all fresh meats, such as chicken, beef, turkey, lamb, eggs, and fish — though not processed or boxed meats and fish
• Dairy substitutes: nondairy milk, such as coconut and oat milk
• Fats: healthy fats like olive, flaxseed, and coconut oils
• Beverages: water and decaffeinated herbal teas
• Spices and condiments: all fresh herbs and spices, plus most homemade condiments (no store-bought dressings or dips)

If you’re struggling to stay motivated during this phase, try experimenting with a variety of herbs and spices to flavor your dishes.

Summary

An elimination diet doesn’t eliminate most of the healthy foods your body needs to maintain adequate nutrition.

Potential downsides

While an elimination diet may help reduce vestibular migraine symptoms, it has several potential downsides.

It can be tricky to adjust to an elimination diet. You shouldn’t follow it for an extended period without the supervision of a health professional, such as a doctor or dietitian.

Restricting multiple food groups for too long increases your risk of nutrient deficiencies.

Furthermore, it’s important to note that eliminating trigger foods may not work for everyone, as diet may not play a role in everyone’s vestibular migraine attacks. What triggers one person’s symptoms may not trigger another’s.

Summary

If you don’t seek professional guidance, a vestibular migraine diet may increase your risk of nutrient deficiencies. In some cases, this diet may not help treat your symptoms.

The bottom line

Vestibular migraine attacks, which are characterized by vertigo, can be extremely uncomfortable, though removing trigger foods may relieve symptoms.

The most common dietary triggers include aged cheeses, processed meats, chocolate, coffee, MSG, and alcoholic beverages like red wine and beer. Fasting or skipping meals may likewise play a role.

Some research suggests that an elimination diet may help identify specific triggers.

You should only follow an elimination diet under the supervision of a health professional. Remember that diet may not play a role in everyone’s migraine symptoms.