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via How to of the Day on 11/26/10
Steps
- Keep a headache diary. The exact causes of migraines aren't clear, and migraines seem to be triggered by a wide variety of different things.[1] While this article deals with some of the more common triggers, there is no substitute for knowing what triggers your migraines. A headache diary can help you determine this, and it can also help you and your doctor monitor the effectiveness of treatments. Being able to review a record of things done, eaten, experienced, and felt during the 24 hours prior to the onset of a migraine can teach you a great deal about your personal triggers. Some of the possible triggers for migraines include:[2]
- Low blood sugar – brought on by hunger or too many refined carbohydrates.
- Foods containing tyramine and/or nitrites – eggplant, potatoes, sausage, smoked meat (bacon, ham), spinach, sugar, aged cheese, beer, and red wine.[3] Other tyramine containing foods include cheese (in general), chocolate, fried food, bananas, plums, broad beans, spinach, tomatoes, and citrus fruit. Foods with high levels of seasoning such as MSG or artificial additives might also contribute to triggering a migraine. Soy products, particularly fermented ones, can contain high tyramine levels. Tofu, soy sauce, and teriyaki sauce, and miso are examples of such soy products.[4]
- Food allergies. An allergy to a certain type of food can trigger a migraine in susceptible people.
- Dehydration – inadequate intake of fluids through the day.
- Lack of sleep – a disturbed sleep routine reduces your energy and tolerance. Insomnia increases the chances of a migraine.[1]
- Bright light, or certain colors of light.
- Shock, stress, or worry.
- Loud noise, especially continuous.
- Changes in the weather or climate (barometric pressure). A dry atmosphere or a warm, dry wind can trigger migraines.
- Close proximity to compact fluorescent lights (curly bulbs).
- Hormonal changes.
- Be aware if you're "at risk" for getting migraines. Some people appear to be more susceptible to having migraines than others. The age range for migraines is around 10 to 40, with those aged 50 and over tending to suffer much less from migraines. Women are three times more likely to have a migraine than men (with the thought that estrogen may trigger migraines), and migraines seem to run in families, with over half those suffering from migraines also having close relatives with migraines.[1] Note that oral contraceptives appear to worsen migraines for some women.[1]
- Recognize the early warning signs of a migraine. Many migraines are preceded by certain symptoms, called prodrome symptoms (early symptoms, such as the renowned "migraine aura", and changes in mood or behavior). Taking special care to relax and to avoid potential triggers when you notice these signs may prevent an impending migraine or lessen its severity. It's also important to try to keep a positive attitude if you notice these symptoms, as the additional stress and anxiety can self-fulfill or worsen the migraine. Symptoms include:[5]
- Visual disturbances: About a third of migraine sufferers experience migraine with aura, a condition in which the migraine headache is preceded by visual disturbances, including the appearance of flashing lights, blind spots, or "snowy" vision. The aura may also manifest itself as tingling or numbing sensations in the skin or in the form of auditory disturbances.
- Mood changes, including depression, euphoria, and irritability.
- Increased thirst and/or fluid retention.
- A marked increase or decrease in appetite.
- Sensitivity to light and sound. There may be jagged, shimmering, or flashing lights, or a blind spot that has flickering edges.
- Fatigue or restlessness.
- Difficulty communicating or understanding people. There may be a difficulty in talking (less common).
- Stiffness in the neck.
- Feeling dizzy, weak in an arm or leg, or lightheaded. For some, there is a sensation of losing balance.
- Diarrhea or nausea: these symptoms often accompany a migraine in addition to, or instead of, preceding it.
- Create a plan of management for migraines. While it will probably not be possible to avoid all migraines, it should be possible to learn your triggers and to react quickly to try and head them off. It is definitely possible also to do a number of things that reduce the chances of the pre-migraine symptoms from even appearing, by making changes to your lifestyle. The following steps are suggestions that will lead to lifestyle changes to improve your chances of avoiding migraines. Many of these changes will also result in other benefits to your health in general, so try to see this as a holistic exercise in ensuring your good health.
- Go through your migraine diary and try to see what patterns have developed. Which of the suggested triggers appear to match your experience of getting a migraine? What other triggers do you seem to have?
- Are there any particular times of day or the week, or even the season, that appear to create more problems for you than others?
- Map out an approach to managing the prevention of your migraines once you have ascertained the pattern. Put the plan into action, following the next suggestions. Record the outcomes and stick with anything that works for you to head off migraines.
- Avoid problem foods and eat protective foods. If you have established which foods seem to trigger your migraines, eliminate them from your diet, or at least minimize them, for a period of time to see how you feel and respond. Be aware that not everyone will have the same food triggers or responses, so this is something you need to work through yourself.
- Check out the list of foods above and be sure that they are not problematic for you. Remove those that are by trialing them on an elimination diet. Keep in mind that one challenge is the "craving" when a migraine is already triggered before the symptoms appear; this can be a difficult task to work out whether or not the food in question was a cause or a result of the onset of a migraine – it's best to speak to your doctor about the possibilities where you have concerns.
- Eat a healthy, well-balanced diet of fruit, vegetables, whole grains, and quality protein. Eat lots of dark green vegetables such as broccoli, spinach, and kale, as well as eggs, yogurt, and low-fat milk. These contain vitamin B which helps prevent migraines.[6]
- Eat foods rich in magnesium, which relaxes blood vessels and ensures proper cell function. Magnesium rich foods include nuts (almonds are especially good), cashews, whole grains, wheat germ, soybeans, and various vegetables.[6]
- Oily fish can prevent migraines. Consume oily fish three times a week to increase your omega-3 and fatty acids intake.[7]
- Don't skip meals, especially breakfast. Being hungry can bring about migraines. Eat smaller, more frequent meals to avoid blood sugar swings.[7]
- Stay well hydrated. Drink lots of water.
- Avoid caffeine. Caffeine is one of the most commonly-suspected migraine culprits.[8] Like all the other possible triggers, however, it affects some people significantly and others not at all. If you regularly use caffeine and suspect it may be causing migraines, you may want to wean yourself off it gradually, as caffeine withdrawal also seems to precipitate migraines. To further complicate the matter, some people find that if they drink a cup of coffee at the first sign of an impending migraine they can reduce the severity of the symptoms or stop the migraine altogether, and the same beneficial effect can be found for some migraine sufferers taking analgesics with caffeine content.[9]
- Include caffeine containing food and beverage in your migraine diary and elimination trials to see the effects in your own case.
- Get into a regular sleep schedule. Too little sleep and too much sleep have both been implicated as migraine triggers.[10] Beyond making sure you get adequate sleep, it's also helpful to stick to a regular schedule of when you go to sleep and when you wake up. Disturbances to a routine sleep schedule seem to trigger headaches in many migraine sufferers.
- Read How to sleep better for more ideas on improving your sleeping habits.
- Limit your alcohol intake. Alcohol can cause hangovers even for people who don't suffer from migraines. For many migraine sufferers, however, alcohol in general, and beer and red wine in particular, can trigger headaches, nausea, and other migraine symptoms that last for days, due in part to the tyramine content. Some migraine sufferers find that alcohol doesn't affect them at all, while others can't tolerate even a little bit. Make use of your headache diary to determine your threshold, and be wary of crossing it; avoid alcohol completely if need be.
- Manage or avoid stress. Stress has long been known to trigger both tension headaches and migraines. Managing stress through the use of relaxation techniques, positive thinking, and time management can help ward off migraines. Relaxation and the use of biofeedback have also been shown to help many migraine sufferers treat a migraine that has already begun.
- Use relaxation exercises, such as meditation, breathing, yoga, and prayer.
- Control your exposure to intense stimuli. Bright or flashing lights can sometimes precipitate migraines. Wear sunglasses on sunny days or even bright winter days, as the glare from snow, water, and buildings can trigger a migraine response. Sunglasses should contain good quality lenses, with side panels where possible, and some migraine sufferers find that blue or green-tinted lenses are helpful.[11]
- Rest your eyes periodically when watching TV or using your computer. Adjust the brightness and contrast levels on computer screens and TV screens. If you're using a screen that reflects, decrease the reflection with filters, or by drawing blinds and curtains when the sun is impacting.
- Non-visual stimuli, such as strong scents, can also precipitate migraines in some people. Once you've been exposed to a certain scent (whether it be paint fumes or a certain cologne) that seems to trigger a migraine, try to avoid that scent.
- Exercise. Regular exercise seems to reduce the frequency of migraines for many people, possibly because it helps reduce stress and boosts your mood.[12] Sudden or strenuous exercise, however, has also been implicated as a migraine trigger, so don't overdo it. In addition, warm up slowly, and make sure you're well hydrated before and after exercise. Avoiding exercise in particularly hot or cold conditions may also help.
- Aim to keep your posture in good shape. Poor posture can trigger headaches of all kinds, including migraines.[12]
- Change the air. Dry air can increase chances of a migraine due to the number of positively charged ions in the atmosphere, raising your serotonin levels, a neurotransmitter that increases during a migraine.[11] Open windows and doors, and use a humidifier or ionizer to decrease air dryness.
- Think twice before taking hormonal medications. Many women who suffer from migraines find that they are more likely to develop migraine headaches and nausea before or during menstruation or during pregnancy or menopause, and scientists posit that this may have something to do with fluctuations in the body's estrogen levels.[13] High-estrogen birth control products and hormone replacement therapy may exacerbate the problem for many women, so it may be best to avoid these medications or, if you're already taking them and notice an increase in the severity or frequency of migraines, to stop using them.
- Be aware though, that it's not as simple as removing these from your lifestyle. Some women find that these medications actually reduce the occurrences of migraines. Others find that migraines are triggered only when skipping a week of the pills, as is common practice with many contraceptives. Talk to your doctor about possible solutions to these problems.
- Women whose migraines tend to correspond with menstruation may find that certain over-the-counter medications prevent or reduce the severity of migraines. Ask your doctor or pharmacist for recommendations for type and dosages, such as using naproxen (Aleve), ibuprofen, etc.
- Take prophylactic medications. If you suffer from frequent or severe migraines (more than one migraine weekly), ask your doctor whether prophylactic (preventative) medications might help. These medications are available only by prescription, and many of them have possible serious side effects, so they should only be used under a doctor's supervision and only after discussing all the other preventive possibilities. The sheer number of different medications, combined with the fact that every migraine case in is many ways unique, means that finding the right combination of medicines for migraine prevention can take a while, especially since it can take several weeks to evaluate a particular drug's effectiveness. Several drug classes have been found to be effective for many migraine sufferers:
- Cardiovascular medications, including beta blockers (for example, propranolol, and atenolol), calcium channel blockers (for example, verapamil), and anti-hypertension medications (for example, lisinopril and candesartan).[14]
- Triptans, (5-hydroxytryptophan [5-ht] agonists) are another possibility, as these drugs target the receptors that stimulate the nerves supplying the cerebral blood vessels.[14] These are not suitable for anyone suffering from heart disease or angina, as they constrict the blood vessels.
- Anti-seizure medications such as valproic acid and topiramate.[14] Be fully aware that valproic acid can cause brain damage if the migraines are due to a urea cycle disorder. If you have any reaction to taking valproic acid or depakote stop the medication, immediately and seek out a metabolic specialist that treats urea cycle disorders for further tests before the disorder advances to a more serious stage.
- Antidepressants including tricyclic antidepressants (TCAs) such as amitriptyline and the newer selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) have proven effective in many cases.
- Cannabis is a traditional migraine remedy that has sparked renewed scientific interest. It's illegal in many jurisdictions, but is available by prescription in others and is legal and uncontrolled in a few places; find out the applicable laws and speak to your doctor.
- Take non-prescription supplements. Prescription drugs aren't the only prophylactic remedies that have been shown to reduce the severity and frequency of migraines in some people. Certain herbs and minerals have also shown promise in warding off migraines. Keep in mind that you should always consult with your physician before taking any herbal or nutritional supplements, especially if taken in conjunction with prescription medications, and also to be assured of the absolute safety of this course of action.
- Magnesium: Researchers have found fairly strong correlations between magnesium deficiency and the onset of migraines, and some studies have found suggest that regularly taking magnesium supplements may be beneficial for migraine sufferers.[12] Ask your doctor before taking any oral magnesium supplements, but as magnesium is cheap and relatively safe, it's often recommended.
- Several herbal supplements have been purported to reduce migraine frequency, but extracts of the feverfew and butterbur plants, as well as kudzu root seem particularly promising based on clinical studies. These supplements should not be taken by women who are pregnant.[15]
- At least one clinical study strongly suggests that daily 100 mg supplements of coenzyme Q10 may be as effective as prescription medications in reducing migraine frequency.[12] However, note that trials of its effectiveness in relation to headaches are still underway.
- Fairly high doses of riboflavin (vitamin B2) also seem to be effective for some patients.[16]
- Metabolic and hepatology studies also indicate that coenzyme or active B-6 (may be known as P5P/PAK as pyridoxal 5' phosphate,pyridoxal alpha-ketoglutarate) assists with amino acid metabolism (liver)and glucose metabolism as well as neurological transmissions. All three areas may be related to migraine sources.
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Tips
- Some migraine triggers, such as weather changes and menstruation can't be avoided. If you're affected by things beyond your control, you may find that being especially diligent in relaxation and the avoidance of other triggers will help.
- Unfortunately, there is no known "cure" for migraines. Even with the use of trigger avoidance and prophylactic medication, migraine sufferers will likely still experience some migraines.
- Migraine triggers are not well understood. While there are many recommendations for foods and activities that you should avoid, the only triggers you need to avoid are the ones that cause your migraines.
- Some headache specialists have reported success in preventing migraines using Botox injections.
- Some people report that acupressure, acupuncture, massage, and chiropractic treatments seem to help control migraines, but there is currently no scientific evidence that suggests these methods are beneficial. Still, they are generally harmless when practiced by a trained professional, so if nothing else seems to work, they might be worth a try, especially if they help you to relax.
- You could also try different herbal remedies until you fall upon the one that works best for you. Discuss herbal migraine treatments with your doctor, especially the more troublesome migraines.
Warnings
- This article is a general guide and is not intended to substitute for the advice of a medical professional. Consult your doctor before taking any medications or before making any drastic lifestyle changes.
- The symptoms of migraine may also indicate other, more serious, disorders. If you suspect you suffer from migraines, consult your physician for a diagnosis.
- If you are taking over-the-counter painkillers more than half the days of the month, you are at risk for "rebound" headaches if you quit taking these painkillers. Therefore, use aspirin, ibuprofen, etc., only when needed. If you take a daily aspirin to reduce the risk of heart attacks, make sure it is a low-dose (81-mg.) adult aspirin and not a full-strength aspirin, or you put yourself at risk of rebound headaches.
- Some supplements have the potential to harm you; always get your doctor's advice first.
Related wikiHows
- How to Avoid Headaches
- How to Use a Headache Diary
- How to Get Through a Migraine
- How to Relieve a Tension Headache
- How to Cure a Headache
- How to Tell if You Have a Migrane
Sources and Citations
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