The goal is simple: figure out what triggers your migraines and then steer clear of the offenders. Easy, right? Not so much.

The problem is that there are so many possible triggers you have to become a bit of a detective in order to identify what’s actually causing your migraines.

A good place to start is your diet, which can contain some of the most common migraine triggers. For example, alcohol will start a migraine in one-third of sufferers, while chocolate affects nearly one in four migraineurs, according to The American Headache Society.

Other common culprits include:

• Aspartame, a sweetener added to thousands of products, from cereals to sugar-free cookies
• Caffeine
• Cheeses and yogurt
• Foods containing monosodium glutamate (MSG), a flavor enhancer often found in prepared foods
• Processed meats like salami and bacon
• Foods with tyramine, a chemical produced as food ages (this happens in soy sauce, dried fruits, nuts, pickled foods and leftovers kept in your fridge more than two days)
• Alcohol

“You need to watch out for those things that might be provocative, such as chocolate and cheese,” says neurologist Steven Herzog, M.D., of Baylor University Medical Center at Dallas. “The list goes on and on, but just because something is on the list doesn’t mean it’s a particular patient’s triggering factor.” Some people can drink red wine without getting a migraine while others can’t. Some women can eat chocolate as long as they are not menstruating, which is another migraine trigger all on its own.

Start the Elimination Process
By removing the foods suspected of causing migraines from your diet, you can collect clues as to what causes your migraines. Those clues can help bring you closer to discovering how to control the pain.

Holistic health counselor Karim Fugel, who regularly works with migraine patients at her New York City practice Lettuce and Freedom, says an elimination diet is the best way to identify food sensitivities. “Thirty days is ideal,” she says. “If they can devote this period of time and be really focused, by the end of the 30 days they can be feeling great.”

Fugel starts by advising patients to remove common culprits from their diets. That means no wine, no coffee and no take-out Chinese food. To be successful, she recommends cooking at home, reading food labels, and asking pointed questions of restaurant staff when you go out to eat. Once the month is up, you can slowly add foods back into your diet.

How to Reintroduce Foods
Pick one food on the list, such as chocolate, and eat one serving. Then wait four to five days, which is the amount of time Fugel says it takes your body to fully process and eliminate the food. Continue that process until you’ve reintroduced all the foods you removed from your diet. The entire process should take about 90 days, Fugel says.

“If a food is a trigger, it doesn’t mean that you can never eat it again,” Fugel says. “There are often foods that we can eat every five days, for instance, but there’s not enough in our system to create a reaction.”

As you are returning foods to your diet, keep a food diary to help you figure out which foods you can eat in large quantities and which you need to eat sparingly. Record not just the foods you ate but any other issues such as stress, lack of sleep, skipped meals or menstruation that could be affecting your headache status. Also record when you had a headache and which medications you took, if any, to relieve the pain.

If headaches continue despite having removed the most common culprits from your diet, the food diary can help your nutritional counselor or neurologist work with you to further investigate what particular foods, if any, you are sensitive to.

If you get a headache while introducing a new food, consider that the food alone might not be the culprit. You might learn, for example, that you can eat chocolate as long as you’re not premenstrual, or that alcohol only affects you if you did not drink enough water that day.

Your neurologist can help you decode the information in your food diary. “We look at the frequency and severity of the headache and what might have triggered it,” Dr. Herzog says. “We look at whether you’re getting proper rest, proper hydration and whether you’re taking medication.”

Using the clues you’ve collected in your food diary, your doctor can then help you craft a custom treatment plan that will work best at reducing the number of headaches you suffer.