One of the most important concepts of migraine treatment, the threshold theory (sometimes called the Bucket Theory) explains how triggers build on one another and contribute to migraine symptoms collectively.
If you have migraine, you have a migraine threshold – the point at which you experience a full blown episode. Some people have a low threshold, meaning they will experience a migraine episode when exposed to only a few triggers. If your threshold is high, you may be able to have a day full of triggers before experiencing an episode.
Each trigger you encounter throughout the day – such as waking up earlier than usual, a stressful commute, or eating a trigger food – gets you closer to your threshold. The picture to the left shows a person who is very close to a migraine episode and is likely experiencing prodrome symptoms. The idea behind migraine treatment is to reduce the amount of triggers you are exposed to, raise your threshold, or ideally, both.
Things that can contribute to your personal migraine threshold include:
- Family history
- Hormonal imbalances
- Vitamin / mineral deficiencies
- Food sensitivities
- Underlying gut health issues
- History of a head injury
- Use (or not) of preventative medications
- Decreased mitochondrial functioning
- Certain medications
Many of these factors – like family history – are very hard or impossible to control, which is why migraine treatment often focuses on reducing triggers. However, it is possible to raise your threshold by addressing certain factors.
Raising Your Threshold
To raise your threshold and increase the amount of triggers you can be exposed to before an episode occurs, you can:
- Address hormonal imbalances
- Correct deficiencies
- Identify food sensitivities
- Improve gut health
- Use a preventative medication
- Improving mitochondrial functioning
Working to raise your threshold, rather than just controlling triggers, is a more sustainable and impactful way to manage migraine.