Sodium Chloride, Migraine and Salt Withdrawal: Controversy and Insights.

Ronald B Brown

doi:10.3390/medsci9040067

Abstract

This paper examines evidence implicating migraine headache as a withdrawal symptom of excessive sodium chloride intake. Emerging research in food addiction posits that food and drug addictions share common features, such as withdrawal symptoms. Salt (sodium chloride) meets the criteria for the diagnosis of substance dependence, including withdrawal in which the substance is used to relieve withdrawal symptoms. The premonitory symptoms of migraine include food cravings for salty foods, which can alleviate migraine pain. Edema, possibly related to large amounts of salt consumed in binge eating, can cause approximately four pounds of retained fluid. This amount of fluid is similar to the fluid retained before the onset of migraine headache, which may be accompanied by polyuria. This paper proposes that inhibited withdrawal from highly processed food intake, rich in salt, mediates an association between increased sodium chloride intake and relief from migraine headache pain. The relief from withdrawal symptoms could also be a mediating factor that explains the controversial findings inversely associating dietary sodium intake with migraine history. Moreover, the withdrawal of retained sodium and edema related to the use of nonsteroidal anti-inflammatory drugs may elucidate a potential mechanism in medication overuse headache. Further research is needed to investigate the pain experienced from sodium chloride withdrawal in migraine headache.

Highlights

Like many drugs, salt has therapeutic, toxic, and addictive effects [1].Sodium chloride meets criteria for the diagnosis of substance dependence, first listed in 1994 in Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV), and combined with substance abuse in DSM-V in 2013 under substance use disorders [2]
This paper examines evidence implicating migraine headache as a withdrawal symptom of excessive sodium chloride intake
This paper examines the evidence implicating migraine headache as a withdrawal symptom of excessive sodium chloride intake, with the aim of contributing potential preventative strategies for migraine headache by reducing dietary salt intake

Summary

Introduction

Salt (sodium chloride) has therapeutic, toxic, and addictive effects [1]. The results from a randomized clinical trial comparing a Western dietary pattern and the Dietary Approaches to Stop Hypertension (DASH) diet found that lower sodium intake was associated with 31% lower odds of headache compared to higher sodium intake, regardless of dietary pattern [23]. Another sodium-reduction intervention was associated with a 41% reduced risk of headache compared to a control group in a 36-month follow-up of the Trial of Nonpharmacologic Interventions in the Elderly (TONE) [24]. The highest rate of adherence to a DASH diet (consisting of lower sodium intake levels in 266 women referred to a headache clinic) was associated with 46% reduced odds of severe migraine headache compared to the lowest rate of adherence to the diet [25]

Sodium Chloride and Controversial Migraine Relief

Findings

Highly Processed Food Withdrawal