Painful thunderclap headaches are caused by the constriction of arteries—extreme spiciness may be to blame. 

By Ananda Eidelstein
Updated August 01, 2019
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If you’re anything like us, you look for the chili pepper illustration on menus and don’t hesitate to ask how spicy a dish might be in your quest to stick to the mild side. If you love a serious kick and you get a thrill from a lip-numbing experience, you might live by “The spicier, the better.” Well, not always. Beyond sweating, clearing up your sinus, and tearing up a bit, immense spiciness can have a real effect on your body, both at the moment of consumption and for days after.

Although we have seen that eating spicy foods on a daily basis can lower mortality rates, reaching for off-the-charts spiciness can do more harm than good. Case in point: A man developed painful episodic headaches excruciating enough to drive him to the emergency room after eating the world’s spiciest pepper, a “California Reaper.” The physical reactions began promptly after he consumed the pepper at a hot chili pepper eating contest, first with dry heaves, then neck pain followed by excruciating headaches lasting days after the chili was eaten.

Following numerous negative tests for neurological conditions, a CT scan showed some arteries in his brain had constricted. This resulted in a reversible cerebral vasoconstriction syndrome (RCVS) diagnosis. RCVS can lead to these so-called Thunderclap headaches, symptoms of which include sudden, onset headaches that are blindingly painful and come and go like, well, a thunderclap. The authors of the case study consider this to be the first case associated with chili peppers, although there has been a link between cayenne pepper and sudden constriction of the coronary artery.

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Thankfully, the symptoms cleared up on their own and five weeks later a CT scan showed all was back to normal for this individual. In our opinion, thunderclap headaches just don’t sound worth the thrill of eating the spiciest foods. And if you make it a point to avoid spicy foods in general, trying something incredibly spicy on a whim probably isn’t a good call, as you likely lack much of a tolerance for spice. Better to go for foods with just the right kick, like this Spicy Tofu With Vegetables and Coconut Rice.