What is a Caffeine Withdrawal Headache?

Many people wake up craving a cup of coffee or tea to help perk up their bodies and prepare their minds for the day ahead. If that sounds like your morning routine, you probably dread missing a cup (or two), which might leave you with a headache and other symptoms of caffeine withdrawal.

If you regularly consume two or more 6-ounce cups of coffee per day, then interrupt or delay (even by a few hours) your caffeine consumption, it may lead to a caffeine withdrawal headache.

This type of headache is typically moderately to severely painful, located on both sides of the head, and tends to worsen with physical activity. The pain will usually peak after one or two days without caffeine and lasts two to nine days.

Caffeine headaches aren't necessarily dose-related, and there are likely other factors that determine if you'll get one (for example, genetic influences on caffeine metabolism).

Some people get caffeine withdrawal headaches even though they only consume small amounts of caffeine, while others who regularly drink more caffeine don't get headaches—even if they drink less than usual.

Caffeine headaches typically start within 12 to 24 hours of stopping caffeine intake and may be accompanied by other symptoms.

Other possible symptoms of caffeine withdrawal include:

• Drowsiness
• Poor concentration
• Depression
• Anxiety
• Irritability
• Nausea and vomiting
• Muscle aches and stiffness

The amount of caffeine a person consumes might influence when they start to feel withdrawal symptoms, as well as how long symptoms last. However, research suggests most people start to feel better after about a week.

Caffeine is reportedly the most used drug in the world; approximately 90% of adults in the U.S. report drinking caffeinated beverages every day.

Although caffeine is considered a drug, experts don't agree on whether it qualifies as an addictive substance.

Research has demonstrated that regular use of caffeine can lead to dependence, increased tolerance, and withdrawal symptoms, but it's not clear if people become addicted to caffeine according to the technical definition of the term.

A 2006 review of the literature published in The American Journal of Drug and Alcohol Abuse concluded that caffeine use doesn't fit the criteria for pathological addiction.

However, caffeine use disorder is recognized by the medical and psychiatric community: In 2013, caffeine use disorder was added to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition under the broader category of substance use disorders.

Research indicates that about half of the people who consume more than 200 mg of caffeine a day will develop withdrawal headaches if they abruptly stop.

It's not clear why the other half do not have symptoms if they reduce their caffeine intake, but it may have to do with individual caffeine sensitivity.

Likewise, a person who is more sensitive to caffeine might experience withdrawal symptoms even if they only regularly consume 100 mg a day.

Timing and other lifestyle factors can also drive caffeine withdrawal symptoms. For example, someone who only drinks coffee during the workweek may tend to get headaches over the weekend due to pausing their caffeine intake.

If a person needs to fast (such as before a medical test or procedure) they might get a fasting headache, which is sometimes attributed to caffeine withdrawal.

While coffee is one of the most popular, there are other sources of caffeine (both natural and manufactured).

Common dietary and supplemental sources of caffeine include:

• Tea (including black, green, chai, matcha, and oolong)
• Soda
• Energy drinks or "shots"
• Coffee-flavored ice cream or yogurt
• Chocolate (especially dark and bittersweet)
• Other-the-counter/prescription medications and nutritional supplements

Researchers have theorized that over-the-counter and prescription drugs that contain caffeine, such as Excedrin and the headache medications Fioricet and Fiorinal, can lead to "rebound headaches" or "medication overuse headaches."

While research has not definitively concluded that caffeine is to blame, withdrawal might play a role in triggering a headache when someone who regularly takes the medication suddenly stops.

According to the World Health Organization (WHO), taking larger doses of these medications may contribute, but the headaches can also occur in people taking smaller doses every day.

The common ingredients in most OTC headache medications, such as aspirin and other painkillers, may also contribute to the "rebound effect."

The simplest "treatment" for caffeine withdrawal headache is to have a caffeinated beverage: most people will get relief within an hour of consuming around 100 mg of caffeine. In a 2017 study of people with migraines, adding a dose of acetaminophen to the caffeine provided even more rapid relief.

While the caffeine content of coffee varies widely based on the blend and how it's brewed, an 8-ounce cup of regular brewed coffee typically has between 80-150 mg of caffeine, though some brews have closer to 250 mg.

As with coffee, the caffeine content of tea depends on several factors, including the blend, the temperature of the water it's brewed in, and how long it steeps. According to survey data from the USDA, the average 8-ounce cup of hot, brewed, black leaf tea has about 50 mg of caffeine.

If your goal is to cut back or eliminate caffeine from your diet, there are other steps you can take to avoid the headache of caffeine withdrawal.

Research has found that the most effective way to prevent withdrawal symptoms is to slowly and gradually reduce your caffeine intake.

The amount you eliminate each day and how long it takes you to completely cut caffeine out of your diet will vary, but most recommendations advise gradually reducing over a period of two to six weeks to avoid withdrawal symptoms.

Over-the-counter pain relievers such as aspirin, ibuprofen, acetaminophen, or naproxen can help ease symptoms of caffeine withdrawal.

Excedrin, a combination of acetaminophen, aspirin, and caffeine, can be effective for headaches experienced during caffeine withdrawal. However, as noted above, this type of medication may also contribute to rebound headaches—especially if used for a long period of time.

Staying hydrated can help prevent caffeine withdrawal headaches, especially for people who get migraines (which can be triggered by dehydration).

For headaches, caffeine can be the ultimate paradox: while it has been shown to help treat migraines and tension-type headaches, regular caffeine intake has also been linked to chronic migraines and medication overuse headaches.

Even if you're not prone to headaches, decreasing or stopping your daily coffee or tea habit could cause withdrawal headaches. If the symptoms of caffeine withdrawal become difficult to manage, you might want to consider cutting caffeine out of your diet—or at least have it in moderation.