You should think twice before giving that someone special chocolates this Valentine’s day – it may just give them a migraine! And that’s not because they’re not in the mood; for the first time a scientific double-blind study shows chocolate can trigger migraines.

The London-based study, published in Cephalalgia, the official journal of the International Headache Society, was conducted on 20 migraine sufferers. Chocolate bars were given to the subjects and bars of carob were used as a placebo. The chocolate bars caused migraine in 8 of the 20 migraine subjects while the carob bars did not induce migraine in a single sufferer.

Dr. Elliot Shevel, South Africa’s migraine surgery pioneer and the medical director of The Headache Clinic, says the study clearly shows individuals who are prone to getting migraines should be careful when eating chocolates.

“The reason for this is chocolate contains a chemical called phenylethylamine which is thought to trigger migraines by affecting the arteries in the scalp which are the source of the pain. Unfortunately phenylethylamine is found in the cocoa bean which is what chocolate is made from,” he says.

Carob bars, available from your local health store may drastically improve your chances of getting lucky this Valentine’s Day! You’re welcome.

When do I consult with a medical professional about my migraines?

“People should not leave a migraine untreated,” says Dr. Shevel. “It is imperative that you undergo a multidisciplinary investigation to diagnose the specific factors behind the recurring headache.

“There are a number of healthier treatment options than medication available right here in South Africa. It is possible to get to the bottom of the problem and resolve the pain permanently without medication so that you can enjoy the quality of life you deserve.”

Dr. Shevel’s guidelines for when it might be time to consult a medical professional:

  • If you have to use pain killers regularly
  • If a headache persists or if you frequently get them.
  • If it interferes with your day-to-day activities.

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Sunrise on ETV interviews Dr Shevel, the medical director of the headache clinic on the topic of headaches and back pain.
Dr Shevel explains the relationship between back pains, headaches and muscle tensions. If you have any further queries call 011 484 0933 where a trained consultant that is passionate about trying to help people get rid of their headaches can answer your questions.


Whether you wake up with a headache or suddenly develop an excruciating pain behind the eyes, your first thought might be that it’s a brain tumour. An expert weighs in and gives us some reassuring information.

There are times when you know exactly what caused your headache – a hangover, stress or even lack of sleep. And then there are other times when you can only guess at the cause.

But no matter what type of headache you have, it’s usually not caused by any life-threatening condition.

Finding the cause

People often assume that a recurring headache is an indication of something sinister like a brain tumour or impending stroke, but Dr Elliot Shevel of The Headache Clinic has reassuring news.

He says that although a headache can be triggered by different things in different people, the pain usually originates in one (or both) of two structures – either the muscles of the jaws and neck, or from the tiny arteries outside the skull just under the skin.

“Arterial pain and muscle pain are the most common causes of headaches,” explains Dr Shevel. “But it’s important to first be sure that it’s not the brain causing the pain [even though it may feel as though it is]. For this reason, a neurological examination is done first to rule out serious conditions such as brain tumours or meningitis.”

He continues, “Once we are certain that there is no neurological condition causing the pain, we test the structures outside the skull to determine whether it’s muscular or arterial or both.”

Once the cause has been identified, Dr Shevel and his team can find the most suitable treatment.

In patients with mainly muscle pain, Dr Shevel prescribes a very comfortable appliance that is worn in the palate, and which is highly effective in relaxing the muscles of the jaws and neck. The painful arteries are treated with a minimally invasive procedure with excellent results.

Headache triggers

People often say that something has triggered their headache or migraine – a food or smell – but Dr Shevel says a trigger is not necessarily the underlying problem. Only when there is an underlying muscle or artery problem do the triggers cause a headache.

Chronic headaches

It’s normal to get the occasional headache – a stressful day at the office, your pillow is too flat, you’re dehydrated or you drank too much the night before. Regular headaches can, however, be very disruptive.

Dr Shevel says you mustn’t let recurring headaches ruin your life. “If you find you are constantly taking medication or it’s affecting your work, you probably suffer from chronic headaches. The problem we see is that doctors tend to treat the symptoms and not the underlying problem.”

The bottom line: if chronic headaches are disrupting your life, get help!

To read Mandy Freemans article on Health24, click here.


Studies have shown that environment, lifestyle, and diet can play a large role in how often you get migraines.

Migraine is a very common problem that affects about 18 percent of women and 6 percent of men.

Dr Elliot Shevel, medical director and founder of The Headache Clinic, says that the most commonly reported migraine triggers include alcohol (especially red wine and beer), chocolate, aged cheese, cured meats, food preservatives that contain nitrates and nitrites, and monosodium glutamate (MSG).

Although these are the most common, almost any food can be a trigger. Even so, only about 20 percent of migraine suffers have an identifiable food trigger.

There is no certainty why certain foods trigger headaches, but suggested mechanisms are as follows:

  • CHOCOLATE: 22 percent of headache sufferers identify chocolate as one of their headache triggers. But many people with migraines have increased appetite and food cravings just before their headaches start. Reaching for a chocolate bar may be the result of a migraine, rather than the cause.
  • ALCOHOL: Sulfites used as preservatives in red wine have been linked to migraine headaches. Alcohol in any drink causes the blood vessels in the scalp to dilate, and can also result in dehydration, both of which might be headache triggers. Alcohol is also a potent trigger for cluster headaches – otherwise known as “suicide headaches”. They are known as suicide headaches because the pain is so severe that sufferers do sometimes actually commit suicide.
  • CAFFEINE: Caffeine can actually help get rid of a migraine headache, and caffeine may be included in some migraine medications, but too much caffeine can be a headache trigger when you come down from your caffeine ‘high’.
  • AGED CHEESE: It is generally agreed that aged cheese is more likely to cause a headache, because it contains a substance called tyramine that forms as the proteins in cheese break down over time. The longer a cheese ages, the more tyramine it has.
  • MSG: Monosodium glutamate (MSG), which is found in soy sauce and as a food additive, has been implicated in causing migraine. The interesting thing though, is that in cultures where MSG is used extensively, the percentage of migraine sufferers is the same as in other countries.

To visit the South Coast Herald Site – click here.


It’s best to get the condition sorted out before falling pregnant.

Having a migraine is no fun at all, and especially not during pregnancy. (Pixabay)

Migraine may become worse during the first three months of pregnancy, but is most women, the migraines remits or ameliorates during the last six months.

According to The Headache Clinic (based in Johannesburg), studies have now found that migraine increases the risk of problems for both mother and child.

In one study of 4911 people in Taiwan, researchers demonstrated that women with migraine had an increased risk of pre-eclampsia.

This is a condition where the mother develops high blood pressure, and with increased protein in the urine, it can lead to a number of serious side-effects that can affect both mother and baby.

It can also lead to premature delivery and increased need for caesarian delivery. Babies can also have an increased risk of low birth weight.

A study from Hungary confirmed the higher incidence of pre-eclampsia, and found that women with migraine suffered more from severe nausea and vomiting.

Dr Elliot Shevel is an internationally recognised migraine expert and migraine surgery pioneer.

He’s also the medical director of The Headache Clinic.

He said the results of these studies underline the necessity for women with migraine to have the condition treated before falling pregnant.

The best way therefore to avoid the increased risk to both mother and baby is to eliminate the migraine before planning a pregnancy.

This is now possible with the highly successful treatment methods developed by Dr Shevel for the diagnosis and treatment of the underlying causes of migraine.

Pregnant women cannot use the usual migraine medications because of the risk to the baby, so the drug-free methods used at The Headache Clinic are particularly valuable during pregnancy.

To visit the South Coast Herald Site – click here.


Bonita published article in Issue 3, 2017 titled – Making sense of migraines.

Migraines are one of the most common reasons individuals visit the doctor, affecting approximately 18% of women and 6% of men. We enlisted Dr Elliot Shevel, founder and medical director of the Headache Clinic South Africa, to share his insights on headaches and migraines as well as triggers and treatments available…

View the full article, click here.
Bonitas – Making sense of migraines
Making sense of migraine cover

Bonitas magazine – making sense of migraines

*Treatment results may vary from person to person.


Copyright by The Headache Clinic 2020. All rights reserved.


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