You’ve been drinking orange juice, you’ve been eating the most delicious orange juice you’ve ever had, you have a tropical fruit allergy, and your citrus headache is worse than a bad case of chickenpox.
But what if you have none of those?
According to a new study, it may be time to seek professional advice about whether you are likely to develop a citrus headache.
A study of nearly 1,000 participants in India showed that almost a third of people with a citrus-induced headache experienced the condition at some point in their life.
According to the authors, this figure is much higher than previously thought, which suggests that many people may be suffering from a common, mild form of citrus headache with milder symptoms.
“In the current study, we found that approximately 40% of participants with citrus headache did not receive any treatment for it, and that 30% of those with severe headache were referred to the medical department for treatment,” said Dr. M. V. Bhattacharya, an assistant professor at the Department of Neurology and Neurosurgery at Jawaharlal Nehru University.
“So this could be a common feature among patients with mild headache, where they do not receive proper medical care,” said the study’s senior author Dr. Vikram Kumar.
The authors believe that a common mechanism of the citrus headache might be the loss of acetylcholine (a neurotransmitter in the brain that is vital for memory and cognition) during the headache, which may trigger the production of acetaminophen (a pain reliever).
This is a common and serious side effect of the common cold and seasonal flu, and may be exacerbated by citrus exposure, the authors wrote.
However, it’s not just about the acetylthiouracil (AuOH) in the fruit.
The study also found that a majority of participants had a history of citrus exposure.
“A significant number of participants also had a severe headache that caused difficulty breathing, difficulty swallowing, dizziness, or severe fatigue,” the authors said.
“These participants also tended to have chronic and persistent pain.
This may have contributed to their poor clinical response.”
The authors speculate that this could account for the higher incidence of severe headache among those with a history and/or symptoms of citrus headaches.
“It may be that this chronic pain and poor clinical outcome of citrus patients with severe headaches is due to the chronic stress of citrus consumption,” the study concluded.
“This could be the underlying cause of the poor clinical responses seen among citrus headache patients.”
In the United States, the National Institutes of Health recently established a Cocoa and Orange Committee to evaluate and advise on ways to improve the health of the public.
However, the committee is not yet considering the citrus migraine as a condition worthy of study.