Popular Sweetener Sucralose as a Migraine Trigger

Rajendrakumar M. Patel, MD; Rakesh Sarma, MD; Edwin Grimsley, MD

Disclosures

Headache. 2006;46(8):1303-1304. 

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Sucralose was the first noncalorie sweetener made from sugar (or natural sucrose).

Discovered by Tate & Lyle, a British sugar company, investigating ways to use sucrose as a chemical intermediate, sucralose has a key molecular difference that makes it similar in structure, yet different in metabolism and function. Chemically, 3 chlorine atoms in the form of chloride ions replace 3 hydroxyl groups in native sucrose.

Sucralose has a sweetness intensity roughly 600 times that of sucrose and is nonnutritive and noncaloric.[2] The majority of sucralose is unabsorbed in the gastrointestinal tract with the remainder excreted renally. Toxicology data on mice have demonstrated little overall harm, with perhaps the most significant finding being shrunken thymus glands (by as much as 40%) with large ingestions of sucralose.[3] Toxicology overview studies concerning sucralose's carcinogenic potential, teratogenicity, neurotoxicology, or genetic toxicology have showed no detrimental effects as a result of sucralose administration.[2] One animal study reviewed demonstrated cecal enlargement in rats (but not in mice, dogs, or nonhuman primates) when fed with 3% to 8% sucralose in their diet. Conversely, humans fed up to 500 to 1000 mg/day of sucralose in their diet did not reveal similar findings of cecal enlargement. On average, humans consume 1.1 mg/kg/day of sucralose.[4]

Despite a few studies demonstrating the relative safety of sucralose in animals and humans, anecdotal reports abound about sucralose's adverse effects. For example, websites devoted to revealing the harmful effects of sucralose explain that it may contribute in triggering migraine headaches, manifest unusual rashes, and even have transient ischemic attack (TIA)-like symptoms/drop attacks. Unusual crampy abdominal pain including bloating, gas, and nausea has even been reported to have subsided after discontinuation of sucralose. These websites are easily found by looking up sucralose on internet search engines. However, scientific evidence-based research is still lacking concerning this topic.

The growing popularity of artificial sweeteners and their abundance convey a societal implication of their relative safety. Despite research indicating little or no long-term negative sequelae to sucralose use, enough anecdotal reports exist that bring this popular product into question. Finally, population-based studies have showed that approximately 23% of households contained at least 1 member suffering from migraine. Identifying potential triggers for migraine headaches, in this case sucralose, may help alleviate some of the cost burden (through expensive medical therapy or missed work opportunity) as well as provide relief to migraineurs.[5] Physicians treating patients with headache or migraine should inquire about dietary use of sucralose. As the actual incidence of sucralose triggering migraines is unknown, data reported by physicians will be helpful in determining prevalence. Certainly more research will be necessary before making any final conclusions.


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