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Self-Diagnosis: Recent Headaches

May 18, 2011

On Saturday, my workout started very successfully, with a Deadlift personal best of 400lbs. Then I got a brain-crushing headache that cut my workout short. The headache set in during my first heavy set of bench-press, with such force that I had to sit motionless for over a minute before I felt it was safe to walk. It lasted for the next 10 hrs and felt a lot like my only ever clinically diagnosed migraine (back in 2003).

I assumed the headache was due to my pre-workout stimulant, likely because I feel subconscious guilt about my choice to use this particular stimulant (it’s not paleo). For my next workout (yesterday), I skipped the pre-workout stimulant, ingesting only my BCAAs. This time, the headache hit much harder, and during my warmup set of chin-ups. I had to sit down for five minutes. It didn’t make sense to me – I skipped the stim, but my symptoms were worse.

My next thought was what I should have asked myself from the beginning – what have I been doing differently? I’ve been taking the same stim since early March with no previous problems. Still, I thought “2 months isn’t so long.”

I’ve been taking ZMA before bed since August, and BCAAs with a stim before workouts since early March. What do the three have in common? Vitamin B6. 10.5mg in the daily dose of ZMA, 10mg in thrice-weekly BCAAs, and an undisclosed amount (let’s assume 20mg) in the thrice-weekly stim. That’s 163.5mg of B6 per week, which seems like a lot. I thought that the B6 must have been building up in my system over time, and only now exhibiting negative effects. But B6 is water-soluble (as opposed to fat-soluble), and therefore much less likely to build up in my system. This should have been the first clue that I was barking up the wrong tree.

I stuck with it, investigating B6 toxicity. From Wikipedia (the most reliable of all sources):

The primary symptoms are pain and numbness of the extremities, and in severe cases difficulty walking. Sensory neuropathy typically develops at doses of pyridoxine in excess of 1,000 mg per day. However, there have been a few case reports of individuals who developed sensory neuropathies at doses of less than 500 mg daily over a period of months. None of the studies, in which an objective neurological examination was performed, found evidence of sensory nerve damage at intakes of pyridoxine below 200 mg/day.

Clues 2 and 3 that B6 is not the culprit: none of the studies found adverse effects at more than 7 times my average daily dose, and the symptoms don’t match my headaches. Ever diligent, I convinced myself that if B6 can cause sensory neuropathy in large doses, it can surely cause headaches in low-doses.

Further seeking to confirm my condemnation of B6, I googled “headache B6” and found that many have had success eliminating headaches and migraines with B6 supplementation in doses much higher than mine. Finally, reason took hold, and I decided to do for myself what I would do if someone else presented with newly-occurring headaches: I pulled out the food log.

Here’s what I found: the most noticeable change in my diet in recent days was bacon. Lots of bacon. I’ve been eating the stuff like candy (well, like someone else might eat candy), and I’ve been frying lots of sweet potato fries and hash browns in bacon grease. Not only had my intake of bacon fat increased substantially, the bacon source has changed as well (though not as recently). You see, I’m a student without a whole heckuva lot of money, and between the grass-fed beef and raw pastured butter, something had to give. That something was preservative-free bacon. Not only have I been eating lots of bacon fat lately, it’s been laced with undisclosed amounts of the preservative sodium nitrate.

Sure enough, a googling of “sodium nitrate headache” returns a myriad of hits – mostly focused on nitrate-induced migraines, fondly referred to as “hot dog headaches.” Now we’re onto something.

Basically, my recently elevated intake of sodium nitrate could be impairing my blood’s ability to carry oxygen. When I work out, my muscles are taking more oxygen out of the bloodstream, and the underperforming blood doesn’t have enough oxygen to maintain a supply to my brain, causing a headache.

No conclusion yet on whether the nitrates are causing my headaches, but it certainly seems more likely than B6. My plan is to completely eliminate any nitrites or nitrates (except those naturally occurring in vegetables) and see what happens. I will, of course, keep you updated.

The larger lesson here is to exercise the same due diligence in self-diagnosis that we do tearing apart flawed research and faulty conventional wisdom. In other words, use science.

Also, I’m glad that I keep a food log, because having data makes real science a lot easier. Lately, I haven’t been counting calories diligently, but it helps to at least take note of what you’re eating.

Here’s to hoping for a headache-free workout tomorrow.

*UPDATE Here.*

Entry filed under: Food Choices, Headaches, Nitrate, Science. Tags: .