Triggers are factors that raise the likelihood of a migraine episode occurring. Everyone has different triggers, but virtually universal ones include stress, lack of sleep, skipping meals, and dehydration.
Stress
Stress, both good and bad, causes a lot of changes in your body that can contribute to a migraine episode.
During times of increased stress, “stress hormones” like cortisol and epinephrine are released into your bloodstream that create a state of inflammation within your body. These hormones also do things like increase your blood pressure, elevate your heart rate, raise your blood sugar, and narrow your blood vessels – all in an effort to try to keep you safe from a threat! Unfortunately, all of these effects can also be potent migraine triggers.
The irony is that stress can lead to migraine episodes, but migraine episodes can also lead to stress! This is why it is particularly important to find ways to manage stress when you have migraine.
Food / Food Chemicals
Googling “foods to avoid for migraine” will come up with some crazy long lists – don’t let them fool you! While there are some common migraine food triggers, everyone is unique and has their own unique triggers.
When looking at these common triggers, it’s easier to break them into categories based on the food chemicals that actually causes the reaction. This allows you to more easily see patterns and makes these lists less intimidating.
Below is a list of the most common migraine trigger food chemicals – for more info, just click on the name!
Tyramine
Histamine
Sulfites
Phenylethylamine
Nitrates/Nitrites
MSG
Light
Bright enough lights can cause a headache in just about anyone, so it makes sense that they’d be a potent migraine trigger. However, bright lights aren’t the only issue – pulsating, flashing, and flickering lights are potential triggers as well.
One of the biggest light-related triggers for migraineurs are fluorescent lights. These lights flicker naturally, and while the flickering is typically invisible to the naked eye, it’s so well-known for causing health issues that the term “fluorescent sickness” has been termed.
Caffeine
Caffeine is a tricky one – it can be both a trigger and a treatment!
You may have noticed that many over-the-counter migraine treatments like Excedrine contain caffeine. This is likely due to its ability to take the place of adenosine, a natural chemical found in the brain. While adenosine is natural, it has been shown to be elevated during a migraine episode and can cause effects like widening of blood vessels and decreasing brain activity. Blocking these actions can stop a migraine episode in its early stages and has been shown to work as well as acetaminophen (Tylenol).
The problem with caffeine is when you drink too much, too often, then stop abruptly. This can create caffeine withdrawal, which can give just about anyone a pounding headache. Sticking to a routine when it comes to coffee (and sticking to only 1-2 cups per day) can help prevent these nasty withdrawal effects.
For more info on caffeine, click HERE!
Hormonal Fluctuations
Most commonly referred to as menstrual migraine or hormonal migraine, even natural fluctuations in hormones that occur during the menstrual cycle can be a trigger for sensitive people.
Hormonal migraine is caused by a wide variety of factors:
- falling progesterone levels
- falling estrogen levels
- decreasing magnesium levels
- release of prostaglandins
- use (or not) of hormonal birth control
Some women experience relief from hormonal migraine should they choose to get pregnant, while others notice a worsening of their symptoms.
Noise
And obvious one, right? Loud noises are a common trigger for most people, even those who do not normally experience headaches.
Noise is thought to trigger migraine by acting on the blood vessels in the head, although the exact mechanism is not yet known. One theory states that the dilation of these blood vessels in response to loud noises activates specific nerve fibers in the brain, that in turn cause the release of chemicals like CGRP (sound familiar?).
It may also just be that, due to a migraineur’s sensitive nervous system, loud noises affect us more than they would the average person.
In addition to loud noise, some people notice specific noises, like high pitched or repetitive, to be migraine triggers.
Odors
Specific odors, such as perfume, cigarette smoke, and gasoline, are well-known migraine triggers. This effect can be compounded during a migraine episode, causing nausea or even vomiting when exposed to certain odors.
While we aren’t sure why odors have such an effect on people with migraine, it does seem like everyone has their own unique tolerance for smells and fragrances.
Alcohol
Alcohol can either trigger migraine symptoms shortly after drinking, or the morning after. Those morning-after migraine episodes are due to the classic hangover we all experience from over-indulging, which migraineurs are more susceptible to.
While alcohol is thought of as a common trigger, it may not be as common as once thought. Some newer research has shown that, when compared to red wine, vodka was much less likely to trigger migraine episodes. This suggests that it may be other components, like tannins or histamines, that provoke non-hangover-related migraine symptoms.
Weather Changes
Changes in barometric pressure (aka air pressure) can be a frustrating migraine trigger for many. There is very little you can do about pressure changes!
Changes in barometric pressure, which come with storms and air travel, are thought to trigger migraine due to several factors. Even the average person can get headaches due to the pressure changes that occur within the sinus cavity and inner ear.
Other theories about barometric pressure and migraine include constriction of blood vessels, decreased availability of oxygen, and over-stimulation of the pain centers of the brain.
Sleep / Lack of Sleep
Sleep is when our body resets, heals, and processes information. Get too little, and you are very likely to suffer the consequences the next day.
But for migraineurs, it doesn’t stop there – even too much sleep can trigger a migraine episode. This may be because oversleeping disrupts serotonin, a neurotransmitter thought to play a role in migraine.
There is also evidence showing that poor quality sleep can lead to migraine symptoms due to an excess of certain proteins that can overstimulate your nervous system.
The migraine brain is truly high maintenance when it comes to sleep!
Dehydration
Dehydration is a hot topic for migraineurs. Most of us hate to be told to “try drinking some water” when we feel an episode coming on … but the reality is, dehydration is a huge trigger, and so many people don’t drink enough water!
When you’re dehydrated, your brain can actually shrink and lose water – yikes! This causes your brain to pull away from your skull (yikes again!), which understandably leads to pain, headaches, and migraine episodes.
Skipping Meals / Fasting
Skipping meals and fasting is a well-known migraine trigger. This is due to a slew of reasons, including hypoglycemia (low blood sugar). When your blood sugar drops too low, such as when you skip a meal, your brain is not receiving enough glucose, which can trigger a migraine episode.
Some people are proponents of fasting for migraine – while there are some health benefits that come with intentional fasting, it is strongly discouraged by most healthcare professionals for those with migraine.
Physical Activity
Physical activity can be a potent migraine trigger – but did you know it can also act as a preventative?
Many people experience migraine episodes in response to rigorous activity (sometimes called exertional headache). This occurs to the changes that happen within your body when you’re physically active – your heart rate goes up, blood pressure increases, temperature rises, and your blood sugar rises.
Moving in certain ways (such as inversions during a yoga practice) can also trigger migraine due to the sudden rush of blood to your head or change in position. This can be especially triggering for migraineurs with vestibular symptoms.
When used appropriately, gentle movement can also act as a migraine preventative and potentially as an abortive treatment. Studies have shown that moderate aerobic activity (“cardio”) can reduce the number of migraine episodes experienced per month, and can even get rid of an episode for some people.
Certain Medications
Certain medications can raise your risk of experiencing a migraine episode. Make sure to check with your pharmacist and/or doctor when using any new medication for how it may impact your migraine.
Resources:
The Role of Adenosine Signaling in Headache: A Review
Identification of Everyday Sounds Perceived as Noise by Migraine Patients
Why does increased exercise decrease migraine?
