Identifying and avoiding your migraine trigger

Anyone who knows anything about migraine has heard of the migraine trigger. Articles have been written, lists compiled and theories discussed about this important aspect of migraine treatment. But what are migraine triggers, and why are they important to understand?

Valerie South RN of the World Headache Alliance, writes:

[Migraine triggers are] internal and external factors that can set a migraine in motion. Triggers are individual, and what affects one person will not necessarily affect another.

Because migraine is a disease that is not fully understood, and therefore not easy to treat or cure, much of the focus of treatment has been trying to stop the migraine chain-reaction before it starts. The migraine trigger is the thing that starts the chain reaction, in people who are already predisposed to migraine. In other words, people who already have the disease might get the symptoms when a trigger lights the fuse.

Our understanding of triggers has evolved, and there has been a lot of discussion about what should be considered a migraine trigger. For example, stress, or how you cope with it. We now know that stress doesn't cause migraine, but many people believe it could be a trigger. However, a growing consensus now believes that stress doesn't even trigger a migraine, but instead wears you down so that you may be more likely to “react” to a trigger.

What are common migraine triggers?

Migraine triggers are different for everyone, and so the list could be very long. Below are some of the more common triggers, using the categories of internal and external. This does not mean that every one of these things could trigger a migraine in your case! It's likely that you react to only a handful, or one, or none of these. Michele Sharp, author of The Migraine Cookbook, reports that very often it's a combination that gets the migraine going. The list below contains some links to other articles relating to that particular trigger.

» Hormonal changes
This includes changes during puberty, menstruation, pregnancy, menopause and changes due to birth control pills or HRT (hormone replacement therapy)

» Changes in your daily schedule
Oversleeping, not getting enough sleep, skipping a meal, a rest after a hectic schedule

» Weather
Particularly rapidly dropping barometric pressure, but also rising pressure, temperature or humidity. Walking into a headwind can trigger migraines in some.

» Foods
Foods high in tyramine are believed to be among the worst migraine triggers. This would include things such as aged cheese and deli meats. There are many foods that could trigger migraine. Caffeine, chocolate, bananas, MSG (found in things such as canned stews, soya sauce, and powdered soups), and citrus fruits. Visit our page on diet and migraine for more on dietary migraine triggers.

» Environment
This could include cigarette smoke, perfumes, or fresh paint.

Many other lists of triggers have been compiled. Check out this migraine trigger list from the American Council for Headache Education.

How can I discover my triggers?

Some people seem to “just know” that something has triggered a migraine. Other migraine triggers can be deceptive, and you may think one thing is causing the problem when it's really something you would never suspect.

The key to finding your triggers is examining the 1-2 days before several migraine attacks, to see if you can find what's in common. What did you eat? Have you had any changes in your schedule? What was the weather like? Many migraineurs keep a diary of what they've eaten and other factors, so that they can look for commonalities. When it comes to food, one plan is to try cutting out all common migraine triggers (a migraine cookbook will be helpful), and then introducing them back into your diet, one every 2-3 days or so.

The search for migraine triggers can be a long process, but for those of us who have experienced severe migraine attacks, we know that the work is worth it! Being aware of your health and diet is a good thing in

the long run anyway. It may be that you'll learn to have a healthier diet, avoid unhealthy environmental factors, and get more exercise, just because you were dealing with migraine. You've got to get something good out of all this, right? :-)

There are other great ways to avoid migraine attacks, besides just avoiding triggers. Learn more in this article on migraine prevention.