Regulate Your Caffeine Intake
Caffeine is a component in some over-the-counter migraine medications such as Excedrin . That’s because caffeine can help control and prevent migraines. But for some people, ingesting caffeine actually induces migraines.
Caffeine is a vasoconstrictor , and migraine is associated with vasodilation. If your body becomes accustomed to caffeine-induced vasoconstriction, your natural vascular controls will adjust to that. It can take time to adapt again when there’s a change in your routine.
Typically, it’s a change in your caffeine intake that affects migraines. For example, caffeine withdrawal can prompt an episode.
As is the case with most things, listen to your body. If you can tolerate some caffeine, it is best to keep your caffeine intake predictable and regularboth in amount and in timing.
If you notice, however, that caffeine consumption tends to trigger migraines, you might consider simply avoiding it altogether. Be aware that coffee, chocolate, cocoa, and tea all contain caffeine.
Oral Contraceptives May Reduce Menstrual Migraine Frequency
There is some evidence to suggest that certain types of oral contraceptive pills can actually reduce the frequency of menstrual migraine and menstrually related migraine, Hindiyeh says.
This doesnt apply to all kinds of oral contraception, so you should talk with your gynecologist, primary care doctor, or neurologist about which ones youd want to consider, says Hindiyeh. There are specific ones that will keep your estrogen level from fluctuating so much, she adds.
If youre considering taking oral contraceptives as a means of birth control or to try to improve your migraine symptoms, tell your healthcare provider about your migraine history, says Hindiyeh.
Identifying And Avoiding Triggers
One of the best ways of preventing migraines is recognising the things that trigger an attack and trying to avoid them.
You may find you tend to have a migraine after eating certain foods or when you’re stressed, and by avoiding this trigger you can prevent a migraine.
Keeping a migraine diary can help you identify possible triggers and monitor how well any medicine you’re taking is working.
In your migraine diary, try to record:
- the date of the attack
- the time of day the attack began
- any warning signs
- your symptoms
- what medicine you took
- when the attack ended
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How To Get Started
Before starting an exercise program, its important to check with your doctor. To prevent stress and overexertion, we recommend slowly introducing exercise into your routine. By pacing yourself, preparing for your routine with the right gear and carefully considering your diet, you can help reduce the risk of exercise-induced migraine attacks and get the most out of a workout.
First, make a plan to help you stick to staying active. Set reminders to get moving by adding time to your calendar, putting up sticky notes or setting an alarm. It helps if you aim to make your exercise more convenient by fitting it into your schedule where it works best. Some people prefer morning activities while others prefer after-work exercises. Either way, try to remove barriers to getting active by choosing a convenient location and time to workout.
Before any physical activity, warm up your muscles by stretching or taking a slow-paced walk. Over time, you can build up your tolerance and tackle longer or tougher exercises. But be sure to listen to your body and avoid pushing yourself too hard, as that can trigger a migraine attack.
Have Consistent Lifestyle Habits
Migraine is a problem between you and your environment, says Cowan. And my migraine patients who do the best take their lifestyle habits seriously.
This means eating meals the same time every day and going to bed and waking up at the same time, Cowan adds. Be regular and consistent with your exercise. These are the things that set the patterns for the brain to know whats coming: sleep, wake up, eat, exercise.
Migraines hate change. Being consistent reassures your brain that everything is okay.
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Stick To A Sleep Schedule
I think one of the most effective tools for my migraine patients has been focusing on healthy habits, and sleep is a big part of that that can be especially challenging right now with all the changes that the pandemic has brought into our lives, says Strauss.
Consistency is key, says Strauss. I recommend going to bed and getting up at around the same time every day, even on weekends, and avoiding naps if possible, she says.
This can be difficult, because sometimes sleep is the only thing that can help people during a headache, says Strauss. The issue is if youre taking excessive naps during the day, that makes it harder to go to sleep at night. Try to limit daytime sleeping, and move all your sleep to the night, and keep the same bedtime, she says.
What Are Rebound Migraines
Women who use acute pain-relief medicine more than two or three times a week or more than 10 days out of the month can set off a cycle called rebound. As each dose of medicine wears off, the pain comes back, leading the patient to take even more. This overuse causes your medicine to stop helping your pain and actually start causing headaches. Rebound headaches can occur with both over-the-counter and prescription pain-relief medicines. They can also occur whether you take them for headache or for another type of pain. Talk to your doctor if you’re caught in a rebound cycle.
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Are Migraine Headaches More Common In Women Than Men
Yes. About three out of four people who have migraines are women. Migraines are most common in women between the ages of 20 and 45. At this time of life women often have more job, family, and social duties. Women tend to report more painful and longer lasting headaches and more symptoms, such as nausea and vomiting. All these factors make it hard for a woman to fulfill her roles at work and at home when migraine strikes.
What Are Common Migraine Symptoms
Migraine progresses in four distinct phases, although not every person who gets migraine will go through all of them. That said, you might experience, according to the Cleveland Clinic:
Prodrome: This is the preheadache phase when you may start to see some warning signs like neck stiffness, mood changes, and frequent yawning. The prodrome phase can happen about 24 to 48 hours before the headache starts. Approximately 30% of people who get migraine experience these preheadache symptoms.
Aura: Up to 20% of people with migraine will experience sensory changes known as an aura. Most commonly, an aura changes how you see things, so you might notice sparkles, dots, flashing lights, wavy lines, or blind spots in your vision. Aside from affecting your eyes, an aura can make you feel numb, tingly, and cause ringing in your ears. These symptoms usually disappear just before the pain in the head begins. Headaches that occur with auras are known as migraine with aura, and headaches that dont are known as migraine without aura.
Attack: This is when the actual migraine head pain hitsand you may also have nausea, vomiting, and sensitivity to light or sound, as we mentioned above.
Postdrome: After an attack ends, some people get a migraine hangover, meaning they feel depleted, fatigued, and just out of it for a day or so. Postdrome is more common than prodrome, with roughly 80% of people who deal with migraine getting to this stage.
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Citrus Fruits And Bananas
Citrus fruits were reported to be a trigger for migraines in about 11% of people in one study.9 The same study found that there wasnt much crossover between citrus fruits and chocolate in migraineurs, though, unlike with chocolate, cheese, and alcohol. This suggests a different mechanism by which citrus triggers migraines. Unfortunately, researchers havent figured out this mechanism as yet.
One theory is that while citrus fruits dont contain much histamine themselves, they may be histamine liberators. This means that they can prompt your bodys cells to release histamine. This remains a theory, though, with no clear supporting evidence.
Just as with citrus, bananas may be so-called histamine liberators. Again, theres no good evidence to back this up.
What does that mean for you? Well, you may want to start keeping a food and symptom diary. This can help you figure out if your migraines are linked to citrus fruits or bananas. If thats the case, consider following a three week elimination diet where you dont eat bananas or citrus . Then, reintroduce the foods one at a time and see what happens.
Preparations Before You Start
As you add more physical activity into your life, you should pay attention to your diet and water levels. You need to fuel your body on a regular schedule and prevent yourself from feeling thirsty. Thirst is a sign that your body is low on fluids, which is a migraine trigger for many. It is important to stay hydrated, which means drinking water before and after your workout and throughout the rest of the day.
Many people living with migraine already monitor their diets closely to reduce their exposure to food triggers. If youre increasing your physical activity, consider that you may have to alter your diet to meet your changing caloric needs.
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Daily Use Side Effects May Limit Use
Since its impossible to predict when a migraine will happen, these medications must be taken daily. But the more often you have to take a medicine, the less likely you are to take it faithfully. If you dont have the symptom right away when you skip a dose, then you are even more likely to skip doses, says Dr. Schramm.
All medications, and herbal remedies, have the potential to cause side effects, cautions Dr. Schwamm. Antiseizure medicines can reduce concentration and may cause drowsiness. Beta blockers can slow the heart rate and sometime cause depression or sexual dysfunction. Topiramate can cause weight loss, so some patients are more compliant with this drug, says Dr. Schramm.
What Is An Aura
An aura is a group of sensory, motor and speech symptoms that usually act like warning signals that a migraine headache is about to begin. Commonly misinterpreted as a seizure or stroke, it typically happens before the headache pain, but can sometimes appear during or even after. An aura can last from 10 to 60 minutes. About 15% to 20% of people who experience migraines have auras.
Aura symptoms are reversible, meaning that they can be stopped/healed. An aura produces symptoms that may include:
- Seeing bright flashing dots, sparkles, or lights.
- Blind spots in your vision.
- Numb or tingling skin.
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Who Gets Migraines What Are The Risk Factors
Its difficult to predict who may get a migraine and who may not, but there are risk factors that may make you more vulnerable. These risk factors include:
- Genetics: Up to 80% of people who get migraine headaches have a first-degree relative with the disease.
- Gender. Migraine headaches happen to women more than men, especially women between the ages of 15 and 55. Its likely more common in women because of the influence of hormones.
- Stress level. You may get migraines more often if youre high-stress. Stress can trigger a migraine.
Do Any Home Remedies To Treat Migraine Work
You cant relieve a migraine attack instantlyif only! But many people use home remedies in addition to their OTC or prescription medications to help make the pain more manageable.
Its important to have a plan in place, even when you dont have a migraine headache. This can just outline what youll do whenever you feel one coming on because early management can help squash your symptoms before they become debilitating. Keeping your medication handy in multiple places can be invaluable. Then consider trying these pain relief strategies:
- Rest in a dark, quiet room. This can be beneficial because movement, light, and sound can be particularly unpleasant when youre in the throes of a migraine attack.
- Treat it like an injury. Applying a cool compress can help numb the pain in your head, Dr. Csere says: But some people prefer warmth, so if youve tried cool compresses and it doesnt help, warm ones may. Thats because warm temperatures may help relax tense muscles in the head, neck, or shoulders, easing any pain that may be associated with that tension.
- Hydrate, hydrate, hydrate. Becoming dehydrated can make you feel much worse.
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Calcium Channel Antagonists For The Prevention Of Migraine
lists selected calcium channel blockers used for the preventive treatment of migraine. Data from older studies regarding verapamil, nimodipine, nicardipine, diltiazem, cyclandelate, and other nonselective calcium channel antagonists have not shown superiority over placebo in well-designed clinical trials, and these medications cannot be recommended for migraine prophylaxis.
Cheese Milk And Other Dairy Products
Remember what we said about histamine and allergies being linked to migraines? Well, guess which foods are a common trigger for an immune system reaction. Yep, dairy.
If youve had your genome run, you probably already know if youre lactose intolerant. If you are, eating dairy products could well play a role in triggering migraines .
Even if youre not lactose intolerant, though, cheese, milk, and other dairy products could still be a cause of your migraines. This might be because some cheese is incredibly high in tyramine . Indeed, some 9-18% of migraineurs report sensitivity to aged cheese in particular.9
Many types of cheese also contain histamine, which has been linked to migraines.11 Frustratingly, what doesnt trigger a migraine one day may quickly trigger a migraine on any other given day. This is thought to be due, in part, to something called histamine load. Put simply, if your histamine levels are already high because of your environment, eating a food high in histamine may trigger symptoms. If your histamine load is low, you might not notice any effect from eating that food.
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Use Natural Dietary Supplements To Prevent Migraines
Natural dietary supplements, such as those indicated for migraine by the University of Michigan, are available over the counter at most pharmacies. It is best to discuss with your primary care doctor or neurologist before starting supplements for long-term use.
Healthy Eating For A Healthy Head
The Dietary Guidelines for Americans make food recommendations to help you live a healthier life. Some recommendations are:
- Aim for half of your grains to be whole grains. Whole grains have more fiber and vitamins. Try to change things like white bread, white rice, and pasta in your diet to whole grains.
- Aim for increasing fruit and vegetable intake. Half your plate should be fruits and vegetables, every time! Eat a variety of vegetables.
- Aim to eat healthy fats, not low fat. Limit saturated and trans fats when possible. Try to increase seafood consumption to two to three times per week to get your omega-3 fats.
- Limit sodium to less than 2300 mg/day. Most salt in our diets comes from processed foods . Cook from scratch whenever possible, or choose foods labeled as low sodium whenever possible.
In addition to the basics of a healthy diet, there are a few things to think about if you have migraines:
- Dont skip meals, especially if this triggers migraines.
- Consider eating 5 small meals per day. Eat a carbohydrate with a protein or a good fat to stay full longer.
- Dont eat or drink anything that you KNOW triggers your migraine. Some common food triggers are alcohol, aged cheeses, caffeine, and chocolate.
- Drink water throughout the day instead of sugary drinks like soda or juice.
Rockett, F. C. et al. Dietary aspects of migraine trigger factors. Nutr. Rev. 70, 337356 .
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Antiepileptic Drugs For The Prevention Of Migraine
Antiepileptic drugs are increasingly recommended for migraine prevention because of well-conducted placebo-controlled trials . It is important for the clinician to recognize that most antiepileptic drugs may substantially interfere with the efficacy of oral contraceptives, with the exception of valproic acid, topiramate , zonisamide, gabapentin, pregabalin, and levetiracetam, among others.
Gabapentin. Gabapentin showed efficacy in a placebo-controlled double-blind trial only when a modified intent-to-treat analysis was used. Another double-blind placebo-controlled trial showed positive results however, the ability to draw conclusions from the placebo-controlled studies is limited because of their methodologic and analytical limitations. Recent reviews, including a Cochrane review, conclude that further evaluation of gabapentin in migraine prophylaxis is warranted in order to inform clinical practice.
Silberstein and colleagues conducted a randomized double-blind placebo-controlled trial of gabapentin enacarbil, a transported prodrug of gabapentin that provides sustained dose-proportional exposure to gabapentin. No statistically significant difference between active treatment and placebo was found.
When Should I Seek Help For My Headaches
Sometimes, headache can signal a more serious problem. You should talk to your doctor about your headaches if:
- You have several headaches per month and each lasts for several hours or days
- Your headaches disrupt your home, work, or school life
- You have nausea, vomiting, vision, or other sensory problems
- You have pain around the eye or ear
- You have a severe headache with a stiff neck
- You have a headache with confusion or loss of alertness
- You have a headache with convulsions
- You have a headache after a blow to the head
- You used to be headache-free, but now have headaches a lot
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Fruits Vegetables And Legumes
We all know it. To be healthy, we must adopt a diet rich in fruits and vegetables. This also goes for migraines. In addition to providing a lot of vitamins and nutrients that are essential for the well-functioning of the body, fruits and vegetables also contain plant estrogen that can make up for a deficiency in women during menstruations.
Indeed, a lot of women experience menstrual migraines due to a sudden drop in estrogen production just before their period.