Migraine Triggers

Some who live with migraines don't know what sets them off, whereas others can list specific triggers. Unfortunately, the list of migraine triggers make it seem that anything can be at fault. But for an individual, triggers tend to be limited. What's important is figuring out what triggers your migraines.

Everyone has a different threshold for the onset of a migraine. For some people, a single trigger can unleash an episode. Others face problems only if several factors gang up. Imagine a see-saw at the playground; when the sea-saw is level, you're fine, but when it becomes imbalanced, your head starts to pound. The more triggers that pile up on the teeter-totter, the more likely it will tip.

If you're wondering what triggers kick off your episodes, consider the following questions and answers:

Some people are sensitive to alterations in daily routines. Skipping meals or inadequate sleep can set off a chain of chemical events that results in a painful migraine.

Business and vacation travel can be particularly disruptive. However, trying to keep to your usual schedule may help you avoid problems.

Many -- but by no means all -- of the major culprits contain the flavor enhancer monosodium glutamate (MSG), sulfite or nitrite preservatives, or the amino acid tyramine.

You may want to avoid some of the most likely offenders contained in the following foods:

• Chinese food and other restaurant food
• Processed foods, such as boxed dinners
• Foods containing soy
• Salami, pepperoni and other cured meats
• Chocolate
• Caffeine -- (If you really need that daily morning Java, the lack of caffeine or caffeine withdrawal could be a trigger.)
• Grape products, including raisins, wine, vinegars
• Beer, red wine or other alcoholic beverages -- (Too much alcohol may trigger headaches, but alcohol in moderation may reduce their frequency.)
• Aged cheeses
• Nuts
• Beans
• Citrus fruits
• Yeast-containing baked goods
• Aspartame (NutraSweet)

Many other foods have been tagged as migraine inducers, so consider asking your doctor for a more comprehensive list.

Dehydration is another potential migraine trigger, so drink plenty of water, especially when exercising or when staying outdoors in warm weather.

A variety of medications -- prescription, over-the-counter (OTC), dietary supplements and herbal remedies -- have been linked to migraines, including birth control pills, nonsteroidal anti-inflammatory drugs (such as ibuprofen), stomach-acid blockers and nitroglycerin (the angina-treating medication).

Stress is a frequently cited migraine trigger. The triggering stress may be emotional, physical or both. The reason for the stress-migraine link is within our brain chemistry. Anxiety, sadness or fear causes the release of adrenaline into your bloodstream, which can prompt changes in the brain that leave you vulnerable to a migraine.

Physical exertion (including sexual activity) can also trigger migraines in some people. The good news is that moderate, regular physical activity seems to play a positive role in reducing stress. Other stress-reduction techniques may also help keep the stress gremlins at bay.

Various environmental factors can contribute to a migraine, including:

• chemicals (such as some insecticides) and pollutants (for example, tobacco smoke)
• atmospheric changes (weather, barometric pressure or altitude -- one reason air travel is problematic)
• sensory stimuli (such as sun glare, fluorescent lighting or other bright or flashing lights)

Travelers face a variety of challenges that can increase the likelihood of migraine. Unaccustomed motion, lack of sleep, changes in altitude, unfamiliar foods, stress, dehydration and sudden changes in weather, season or time zone -- are all a veritable recipe for a migraine.

Is It Your Time of the Month?

Thanks to hormone shifts, women are particularly vulnerable to migraine headaches around the time of their menstrual period.

Discovering your personal migraine triggers can take some detective work. Many have found that keeping a migraine diary is helpful. You can journal the following:

• Your daily medications (prescription, OTC, dietary supplements and alternative remedies)
• Information about your daily routine:
  • What did you eat and drink?
  • How much did you sleep?
  • Any new or unusual stressors?
  • Any new activities?
• Information on weather changes or other environmental factors
• Information about each headache:
  • When did it start?
  • How long did it last?
  • Where was the pain in your head located, and how did it feel?
  • What other symptoms did you notice?
  • How did you treat it?
  • What medicine(s) did you use to treat it?
  • Did the medicine(s) help?

Your diary can help you track the conditions that occur just before each headache, letting you zero in on likely troublemakers. Of course, some factors are just out of your control, such as the weather. However, changes you can make may give you more control over your migraines.