A Neurologist Explains the McDonald’s Migraine Trend

As someone with chronic migraines, I’m always on the lookout for anything, anything at all, that might help when one strikes. And I can always count on social media to provide me with yet another dubious “hack” that might save me from an aching head—but a recent hack that came across my feed genuinely surprised me.

Jessica Lowe, M.D., who goes by Doctor Brain Barbie on TikTok, recently shared that turning to the McDonald’s drive-thru might help you stave off an oncoming migraine. Ordering a fountain Coca-Cola and some fries has become a bit of a trend on social media, and Lowe suggests it may work because of the caffeine in the soft drink and the salt in the fries, plus the carbs in both.

Some folks may have migraines that can be stopped in their tracks with caffeine or electrolytes, Lowe explains, and others may start to get a migraine if their glucose begins to drop. That combo of caffeine, sodium and carbs may be able to ward off certain migraines. Lowe, who is a neurologist and epileptologist in the Bayhealth Department of Neurology, does admit that Excedrin, gatorade and food might work better and faster—even if a cola and a large order of fries sounds like more fun.

But if you have more severe migraines, you might be baffled by the idea of heading out on an errand when one strikes. I spoke with Juliette Preston, M.D., associate professor of neurology and director of the Headache Center at Oregon Health and Science University, to get another doctor’s perspective on the hack.

“Probably a non-migraineur came up with that hack,” Preston says. She and I commiserated about how our migraines are too nauseating to allow for a quick fast-food run—we’d rather lie down in the dark until it passes. However, she did explain to me why this viral hack makes sense—and offered some alternative solutions. First things first: the caffeine.

“When you get a headache the blood vessels around your meninges around your brain vasodilate and get fatter,” Preston explains. “[Since] caffeine promotes vasoconstriction, it makes sense that drinking caffeine or taking caffeine in the form of a pill will help break a migraine.”

Chugging a coke probably isn’t the best solution, though. Preston suggests being careful with caffeine because consuming excessive amounts will only make you more vulnerable to headaches. Regularly having more than 200 milligrams of caffeine each day may even “have the opposite effect” and make your headaches “less responsive to regular medication.” A fountain coke at McDonald’s has about 32 milligrams of caffeine per 12 ounces, so you don’t have to worry too much about having just one—but try not to go overboard.

The salt in the fries serves a different purpose in headache management. When in bed with a migraine, it’s easy to become dehydrated because you may not be eating or drinking as much as you would if you were feeling well.

“Salt has the power to retain volume in the body, so it’s rehydrating you in a way,” Preston says. “Eating a little bit of extra salt can make you feel better for that moment.”

Unsurprisingly, however, fries are not the best way to rehydrate.

“In general, if you look at processed foods…they always end up causing more migraines, so you don’t want to start adding salt randomly just to prevent or treat your migraines,” Preston shares.

And we know that consuming excess sodium on a regular basis can be hard on your heart. Like caffeine, salt is a migraine solution you don’t want to overuse.

Instead of a “McMigraine” cure, Preston says the best treatment for migraines is prevention. “If possible, be aware of triggers and prevent them,” Preston says. “So being hydrated, exercising, sleeping well, keeping stress to a minimum—that will diminish your risk of migraines.”

If you’re having regular issues with migraines, speaking with a medical professional about what could be causing them may help. And they may even be able to offer you personalized suggestions about how to calm your migraines when they do show up. In general, taking an over-the-counter pain reliever may be a good solution for immediate help—just be sure you follow the package instructions.

Instead of salt or, as the TikTok neurologist suggested, Gatorade, Preston said to avoid excess sugar in Gatorade (and Coke) and opt for electrolyte packets added to water, which she said “will certainly help make you feel better right away.” And, “add water on top of it to really rehydrate,” Preston said.

And Preston shared one more point of contention with this so-called migraine “cure”—you can’t cure migraines. “A cure is for a disease,” Preston shared. “Let’s say you have pneumonia, and we give you antibiotics. We cure you of pneumonia, and it’s not coming back. But with a migraine, all we do is manage it.”

As Preston explains, there’s always the possibility a migraine will return. Since it’s a condition in need of managing, planning ahead with comfort measures and medications is a smarter idea than fast food, especially in the long run.