Migraine Prevention and Relief
An overview of common Migraine symptoms and triggers, preventive measures, self-administered and professional relief options, and resources for medical and holistic care.
Robert M. Wheeler, Jr.
Rapid Recovery, LLC
First, thanks for stopping in to read this white paper on migraines, their causes, and their treatment. We hope it helps you avoid migraine onset, or at the very least gives you the information you need to whip one if it’s unavoidable.
A quick note before you continue; one of the most common triggers for migraines is reading, specifically screen reading. If you’re a frequent sufferer, with multiple triggers, try to take breaks when reading this paper, and certainly do so if you’re reading on a computer screen, tablet, or smart phone. It would be a terrible irony to get a migraine from reading about migraine prevention.
You might want to go ahead and print this entire file for two reasons. As mentioned above, being able to hold a paper and read it without the glare of the computer screen may help prevent a migraine. Secondly, and probably more importantly, we’ve attached a log to the end of the paper. We’ll get into that more later on, but for now know that it’s a way to track your onset and your relief. Everyone who has migraines will tell you they know their triggers. Chemical smells, loud TV, work stress, excessive heat, or any number of other issues are often cited by sufferers. What most people don’t know is that there may be combinations of causes, times of day when you’re more or less likely to get a migraine, or any number of other factors that you may well discover by keeping a great log. Even if you can’t put the puzzle together by yourself, your doctor or migraine relief expert might be able to look at your information and discern a pattern. They can certainly make educated guesses from your discussions, but a good, solid, accurate, detailed log of your migraines can really open a migraine specialist’s eyes and help them find a way to nip those migraines in the bud.
Lastly, we’ve done a bunch of research and spoken with everyone under the sun, from physicians to sufferers, but no paper can be comprehensive without being a book, and none of it takes the place of a good old-fashioned appointment with a primary care doctor, migraine specialist, or neurologist. We hope something in this paper works for you, but if not, don’t be discouraged. There’s always plenty of help out there for sufferers.
Defining a Migraine
A common mistake among “headache” sufferers is to label every intense headache a “Migraine”. Nothing could be further from the truth, and if you’re reading this, you know it.
There are quite literally DOZENS of types of headaches, only one of which is truly a migraine. The four most common types of headaches (an all-encompassing term) are:
Keep in mind, some forms of headache which aren’t a migraine can lead to a migraine. Tension headaches and Sinus headaches frequently trigger migraines in those who commonly suffer from migraines.
So, what’s the difference, and what do I have?
You know what a Migraine is, in all likelihood. The strict definition of a migraine is a moderate to severe headache that (1) lasts for between 4 and 72 hours, (2) involves a throbbing sensation in the brain, (3) typically begins in an isolated area of the brain, or on one side, but frequently spreads across the entire brain, (4) comes with an enhanced sensitivity to, and generally worsens if exposed to, light or sound, (5) frequently involves muscle tension (particularly in the shoulders, neck, jaw, and forehead areas), and (6) can come with nausea, and vomiting.
Many people experience Cluster Headaches, and assume they’re migraines. They aren’t. The chief difference between cluster headaches and migraines is that cluster headaches are (1) almost always localized to one side of the brain whereas migraines usually spread, (2) are intensely painful for a shorter period of time, and (3) recur frequently over the course of a few weeks.
Most migraine sufferers have learned to “live with” their migraines, and unless the migraine is particularly bad try to muddle through and deal with the pain. A cluster headache is an intense, knock-you-down type pain that might only last 30 minutes, but comes back over and over again for a few weeks. There’s no “dealing with the pain” of a cluster headache. It hits like a ton of bricks and then is gone as quickly as it came. There’s no telling which is worse, but they’re both awful.
Sinus Headaches, more properly called Rhinosinusitis, are very rare, though many people who actually have a migraine believe they have a sinus headache. As a matter of fact, in a large research study 88% of the 3,000 participants who said they had a sinus headache actually had a migraine. Both consist of pain behind the eyes and sinus passages, and migraines can cause some sinus headache-like symptoms such as watery eyes and/or a feeling of sinus congestion.
A TRUE sinus headache involves an infection, either viral or bacterial, and is quite rare. Chances are that if you think you have a sinus headache, you have a migraine. If you don’t have a fever and a thick, discolored nasal discharge you almost certainly don’t have a sinus headache.
In the American Migraine Study II (of 30,000 headache sufferers) half reported sinus headaches when they actually had migraines. So, the moral of the story is, if you think you have a sinus headache, there’s a very good chance that you have a migraine.
Tension Headaches are caused by tight (or tense) muscles in the neck, forehead, shoulders, or back of the head. The pain of a tension headache is moderate, and rarely if ever becomes as intense as the pain associated with a migraine.
People who suffer from tension headaches frequently think they are experiencing a migraine. People who suffer from migraines know the intensity of a tension headache doesn’t match that of a migraine.
Part of the confusion between tension headaches and migraines comes from the fact that the early onset of a migraine often feels like a tension headache. Further, tension headaches can trigger a migraine.
The characteristics of a tension headache are (1) moderate pain, (2) muscle tension in the neck, back or head, shoulders or forehead, and (3) a lack of “throbbing” that is always associated with a migraine.
The causes, triggers, and treatments for these types of headaches are entirely different, and it’s important to know which one is affecting you. As with all medical conditions, if you don’t start with a proper diagnosis you’re wasting your time with treatments. You can’t treat an iron deficiency with Vitamin C, and scurvy isn’t cured with Advil. You have to have the proper treatment for the condition you’re suffering. If you don’t know what you have, you can’t properly avoid or treat it.
If anything in these explanations leads you to believe you suffer from migraines, read on.
Before we even begin this section, let’s clarify something. We can list fifty migraine triggers and you may experience all of them, are none of them. Yours may not even be on the list. You may not know which ones you have, thinking your migraines are occurring randomly. You may only experience a migraine when you are hit with two or more triggers.
You may not, wait for it, even HAVE a trigger. It may well be that your migraines come at random times without the presence of a trigger.
A discussion of triggers can only be couched in terms of “maybe”, so don’t be discouraged if you don’t feel like anything in this section applies to you. It just means we have to look harder, or that you may be among the 10% of people who experience migraines without experiencing a trigger. Hang in there.
Let’s first get out of the way that we aren’t going to talk about the triggers everyone knows. Loud noises, car headlights at night, strong perfumes/colognes or other smells, blinking lights, etc., are triggers that we’ve all heard of over and over and over and know to avoid.
We are going to talk about the “common” triggers that are slightly less common. These are the things which a large number of sufferers will tell you can cause their migraines, but you may not have considered. Some are unavoidable, but can be mitigated. Some are entirely avoidable. With the proper training and a little diligence on your part, you can significantly lower the odds of getting a migraine if you identify your triggers and take steps to avoid them.
We aren’t going to list these in order of the number of people who report them, or in alphabetical order, or even in order of likelihood. We’re going to list and discuss triggers in the order of likelihood that you will experience them, whether or not they trigger a migraine, because our feeling is that the easiest way to identify a trigger for YOU (not just the general population) is to identify the things that are frequently occurring in your life and eliminate them one at a time.
1. Screen time with action
Though we mentioned reading on a screen can trigger a migraine, the combination of the glare of a screen, the increased visual effort of focusing on a single object for an extended period of time, the motion of the images (forcing your eyes to follow an actor or a ball or anything else that’s moving frequently), the increased noise from the television/computer/movie screen, and the muscular stress on your neck from paying careful attention to a moving target on a screen is a very common trigger.
Think for a second of sitting on your couch, possibly slightly hunched forward or straining your neck a little even if seated comfortably, trying to catch the movement of the ball, or the facial expressions of an actor. All the while, remember you’re looking at an image that may have a rhythmic movement or sensation to it. In a conversation on the screen the image may flip back and forth between characters. During a game the camera is constantly moving between players.
To add to the dilemma, the sound level when watching a movie or TV is often louder than normal conversation or everyday life. Worse, there may be sudden “jolts” of noise when a big play occurs, or when an action scene suddenly includes an explosion or loud scream or other abnormal volume.
You’ve probably seen warnings at the beginning of some movies or TV shows that say “watching the following content may cause seizures in those who are prone to such”. It’s not much of a stretch to think that if the pulsating, noise, and glare or buzz of an electronic screen or the images on it can cause a seizure, they can trigger a migraine.
Avoidance: Let’s face it, it’s basically impossible to avoid television, smartphones, and computers entirely if you aren’t living in a commune or cave. What you can do is to be SMART about the way you take in those images and sounds in an effort to lessen your risk of a triggering event.
I. Try to avoid “big” movies in a theater.
It’s one thing to watch Iron Man on your television while sitting on your couch. It’s another thing to sit in a theater, at an odd angle, with unusual and possibly uncomfortable smells, with all of the screaming and “oohing” and “aahing” of the other moviegoers, and survive the big explosions that blast out at you, and not expect that you might end up with a migraine.
The better bet is to save that money and let it head to DVD. When you’re in your home you can take measures to make sure those triggers never get pulled.
Try these avoidance tips:
1. Watch at a reasonable volume.
2. Sit in your most comfortable and familiar position.
3. Make certain to not “crane” your neck. If you miss one tiny detail it’s not going to change the movie but it might keep you from getting a muscle stress induced migraine.
4. Take breaks. Pause the movie, get up, close your eyes for a few seconds, or simply concentrate on breathing slowly and relaxing your muscles. If you just take a break from the action every 15 minutes or so you’ll dramatically reduce your chances of getting that “all wrapped up in something loud or tense” migraine.
II. Steer clear of watching big sporting events with groups, or at the very least use “tension breaks”.
You’re probably getting stressed just thinking about all those loud, possibly drunk people who were around you the last time you watched LSU against Alabama. You love those folks, but being in that environment caused your neck to tighten, you felt like you were getting bombarded on all sides by unpredictable noise, and everyone was right on top of everyone else. The invitation might as well have said “You’re Invited to Bill and Nancy’s House for a Hell of a Migraine!”
Try these avoidance tips
1. You don’t have to stay glued to the TV, not even during the Super Bowl. It’s okay to wander off to the back of the house to a quiet area and just take a “relax break”. Everyone is going to be up and down emotionally and vocally and that sort of stress can be a real trigger. You can rest assured that if you miss the “greatest commercial ever”, or the “big play”, they’re going to be on YouTube or the news or somewhere, forever. You might think “I don’t want to be a party-pooper” by wandering in and out, but what kind of a poop on the party is it if you end up in a dark bedroom curled up in the fetal position?
2. Don’t sit near the front. You’ll not only have the problem of the screen and all its associated issues right in your face, you’ll be experiencing sound and tension from all angles. There will be crowd noise from the TV, and you’ll have party-goers shouting behind you. The tension in your neck and shoulders from that sort of enveloping sound might as well translate to “immediate migraine”. Furthermore, if you’re in or near the back or a side you’ll have much easier access to excuse yourself for a breather.
3. Get over the guilt! So many people don’t want to seem antisocial or “not fun”, and because of it they put themselves in positions to end up with a migraine. If periodically stepping out of a social function that’s loud and bright and stressful bothers someone or makes them think differently of you, that’s not your problem, it’s theirs. Remember what Dr. Seuss said? “Those who mind don’t matter, and those who matter don’t mind.”
2. All the little irritants at work
There’s a pretty good chance that if you won the megabucks lottery tomorrow you wouldn’t be doing whatever it is you do for a living right now. That’s not to say you don’t like your job, or maybe even love it, but it is saying that it isn’t what you’d choose to do every day if you were independently wealthy. The corollary to that is that there’s some stress, or performance pressure, or something that means it’s not your ideal happy place
To keep those issues from getting out of hand, there are things you can do to lessen the chances you’ll end up with a stress-triggered migraine.
1. If your chair sucks, your day will suck. It may not be top of mind, but that little constant irritant puts you one rung up the totem pole that starts at “relaxed and happy” and ends at “migraine”. Go to Office Depot or somewhere similar and sit in every single chair they have until you find one that feels like a miracle. If your boss won’t buy it for you, pay for it yourself and write it off your taxes as an unreimbursed business expense. You’ve got to be there, dealing with whatever hoohah they’re going to throw at you, so you might as well be comfortable. Whatever constant pressure on your right side, or uncomfortable angle you’re feeling, or lack of support in your back you’re experiencing is just another thing that can “set you off”. Get rid of that problem if you have it.
2. Fashionistas will tell you it’s better to look good than feel good. That might be true for people who don’t suffer from frequent migraines, but not for you. Dress in looser fitting clothes that are comfortable. An annoying collar, or thigh-rubbing pants, or awkward shoes might not be migraine triggers by themselves, but the constant irritant of being uncomfortable adds a check to the little list that says “three of these can lead to a migraine”.
3. Refresh yourself. It’ll still be there tomorrow. What? Work. It will be there from right now through the day you quit, get fired, or retire. If you take 10 minutes to get up from your desk, walk away from the counter, or put down the tools, leave your cell phone behind, and just close your eyes or breathe slowly and look at a tree, the world isn’t going to fall apart and you’re going to be much less likely to stress out to the point that you end up with a migraine that you know you’re going to suffer through until it’s time to go home.
4. Pick a pleasant ring tone, and turn down the volume. Nothing triggers that internal tiny rage that leads to a migraine like an annoying, loud ringtone on your phone that ends up making you hate it ringing. Something lower volume and pleasant is a lot less likely to make you think “I hate it when that damned thing rings”. That reaction leads right to tension in the neck and head, and that road goes straight to Migraineville.
5. You know how Bill always leaves the toilet seat up, or Annette smacks her gum, or Jill never shuts up about her kids? Let it go. There’s a good chance those people are full grown adults who aren’t about to change their habits or their opinions, no matter how irritating they are. Irritants can be triggers because they lead to muscle tension, and you’re the only one who can keep that from happening. The sooner you learn that you’re the only one it’s affecting (because they don’t care what anyone thinks or they wouldn’t keep doing that stuff), the sooner you can release that stress trigger.
Well, there’s a bummer. Alcohol is ubiquitous in society and nearly everyone is in a position to be offered a drink fairly often. The problem is that alcohol is a very common migraine trigger. Right at one third of all people who suffer actual migraines have an alcohol trigger.
The good news is that while some of us have a near immediate alcohol trigger that spans all forms of ethanol (the actual alcohol molecule in all forms of adult drinks), some are only susceptible to the by-products of alcohol creation and breakdown, impurities called congeners.
So, if you aren’t one of the 1/3 of people who are nearly immediately triggered by the consumption of any alcohol, you can still have a social drink and not end up in the bathtub with the lights off.
1. Stay away from high congener content alcohols. If you can avoid the drinks that have a high concentration of congeners (by-products) you may avoid triggering a migraine. In fairly accurate order (though brands vary, etc.), the highest congener alcohols are
Blended whiskeys (think Crown Royal)
There is a school of thought that the sugar contents in these mainly dark-colored alcohols are somehow responsible for the by-products, though not enough study has been done to make the certain link. Tequila is generally made with agave, which is a form of sweetener from cacti, and this further adds to the sugar suspicion.
2. Try to stick to low-congener alcohols. Some of the better alcohols from a congener standpoint are
Vodka (this is far and away the best)
White Wine (be careful to stay away from the Reislings and Pinot Grigios of the world, as they have a high sugar content and may well have the same effect as the bad list. Drier is better.)
3. REALLY don’t drink red wine. It makes me sad to say it, but red wine also contains histamines, and those can be a quick trigger. Histamines are naturally occurring in the body, and are part of the immune system. They are essential in the inflammatory response, and “kick in” when the body is fighting a foreign substance such as a virus or bacteria. The problem is that runny nose and watering eyes can come as a result of intake of histamines, and these can rapidly trigger a migraine. They also lead to a dehydration effect (as a diuretic) which is a major migraine trigger.
Here’s a trick: If you’re GOING to drink red wine no matter what the experts tell us about it, keep an antihistamine with you, and take it. Have a ride planned, but go ahead and at least take the antihistamine just before drinking the red wine. It may well mitigate the risk.
4. Be a Lyre. What? There’s a brand of “non-alcoholic spirits” from Australia called Lyre’s. They make everything from a bourbon substitute to a tequila, and these aren’t like the bad non-alcoholic beers we’ve been stuck with for years. If you can tell the difference between a gin and tonic, and a Lyre’s Dry London and tonic, then send me what’s left of the bottle. You’ll want to read the instructions very carefully before making a drink because you have to be careful about which mixers you use and even what type of ice you use, because the spirit can break down and lose its taste if not mixed properly, but if you do it right there’s absolutely no telling the difference between Lyre’s and alcohol. Stay social, and still manage to stay away from the migraine trigger.
4. Artificial sweeteners
Well that’s another bummer. Are we supposed to drink unsweet tea, black coffee, or just get fat?
It turns out that the biggies like Saccharin (Sweet and Low), Aspartame (Equal), and Sucralose (Splenda) don’t have any correlation to brain tumors, or cancer, or any of the other myriad of things people tried to scare us into thinking, but all of them have been identified as migraine triggers.
Until recently, that left those of us who are trying to keep off the weight in a bit of a quandary. No longer. There’s an alternative, albeit an expensive one. So there’s only one avoidance tip for this trigger: Stevia.
Stevia is still new enough that there are lots of questions about it. One concern is that are possible kidney issues associated with the use of stevia, but that only applies to whole-leaf stevia, and crude extracts. What you would buy is highly refined stevia.
You aren’t off the hook yet though. Some people (a very small number) may experience mild nausea from the use of stevia, especially if they use it in large amounts. As long as you aren’t one of those people you’re probably good to go because the only other known side effect affecting any significant number of people is a feeling of fullness, which is really a win if you ask those of us who are using it to lose weight in the first place.
Make SURE you get a refined form of stevia such as the brand name Truvia, and you should accomplish your “zero calorie sweetener” goals AND eliminate one migraine trigger.
Read carefully, because this is the stickiest of all wickets.
Caffeine is what some people refer to as an “oscillating trigger” or a “yo-yo trigger”. What this means is that too much caffeine, or too little if you’re a frequent user, can lead to a migraine.
This is where your log (again, at the end of this paper) is REALLY going to be necessary. For example, let’s say you get up every morning and have a stout cup of coffee or a latte from a coffee shop. Just about every day at lunch you drink a big Diet Coke. Around mid-afternoon you usually have another Diet Coke from the fridge or soda machine at work. With dinner you almost always have a glass of sweet tea.
If you get stuck in a meeting, and God forbid there is a presentation with a big bright video screen and someone talking on a microphone, you better have that Diet Coke with you because the vessels are accustomed to the caffeine. Turns out caffeine is not only a neurostimulant, it’s also a vasoconstrictor. What that means is that caffeine restricts the flow of blood through the blood vessels in your brain. Your body, over time, compensates for that constriction. You probably already have put together that if your body has compensated with extra cerebrovascular blood flow, and the caffeine isn’t there to counter that you’re going to have what amounts to extra blood pulsing through the vessels in your brain. That leads to throbbing, and there’s the beginning of your migraine.
Conversely, if you don’t drink much caffeine and you decide to have a triple latte, your body hasn’t already compensated for the effects of the caffeine, and you’ll have very little blood flow throughout your brain. Lack of oxygen (which is carried by the blood) will become an immediate issue, and your body will start to pump more blood, faster, to make up for the difference. Now you have an increased heart rate, a throbbing in your brain, and you can count on a migraine.
Caffeine doesn’t trigger everyone, but it’s very common, and mostly because it’s used too often in varied amounts.
If you have any sensitivity to caffeine, either the use of it or withdrawal from it, you’ll really want to count on your log.
You should log every single caffeinated drink you have, and when you had it. Log what it was, how much of it you drank, over what period of time, and when you drank it.
If you are a REAL trooper you can look up how many milligrams of caffeine were in what you drank, figure out what portion of a serving you drank, and record the exact amount of caffeine you consumed.
From here the process is easy.
Which days were you fine? What was your caffeine intake on those days? It was likely very similar each day. From the time you did it to the amount you had, it’s probably going to be very close to the same.
Which days did you end up with a migraine? Here’s the key. Was there more or less caffeine consumed that day? Did you have it at a different time than normal? Did you NOT have it (say coffee in the morning) when you usually do? The difference will let you know a lot about your trigger. It will actually DEFINE your trigger. “I missed my 3 o’clock Dr. Pepper” or “I had three glasses of tea and I normally only have one” will let you know where you stand.
From here you simply look back at the days you were fine and try to stay within your “non-trigger” pattern.
Good grief. We’re going to strangle you if you end up with a migraine from dehydration, because you got this paper from an IV treatment center. Seriously though, it’s an issue.
You don’t actually get a migraine from dehydration. What happens is that because your brain is 73% water, MUCH more than the 60% the rest of your body is, when you are dehydrated the brain obviously contracts. It can pull away from the lining that connects it to the skull, causing what is known as a dehydration headache. Don’t worry, your brain isn’t about to detach, that’s just the mechanism, and very small changes can make a big impact.
The dehydration headache, unless fixed immediately, triggers the migraine.
Not what you think. You can’t simply grab a bottle of water once the headache begins. This is one that’s going to take some preparation. First things first.
Dr. Jack Dybis of IVMe Wellness and Performance in Chicago (one of the nation’s first IV treatment centers) has a simple formula for hydration. Take your body weight in pounds, cut it in half, and that’s the number of ounces of water you need a day. If you weight 180, Dr. Dybis says you need 90 ounces of water a day.
The water requirement we just gave you assumes a few things.
1) You’re generally healthy.
2) You aren’t exerting yourself physically.
3) You aren’t outdoors or otherwise in the sun or heat.
4) You have no kidney or bladder issues.
5) You aren’t taking medications which will either dehydrate you or act as a diuretic.
Obviously if you’re in the sun, working outdoors, expending a bunch of energy, sweating, or taking part in strenuous physical activity you can add to that water requirement.
So what do you do if you’re facing the onset of a dehydration headache? You are going to need to get a glass (possibly two) of water. It needs to be warm because cold water can cause constriction. DON’T try to guzzle it. If you’re clinically dehydrated guzzling water can induce vomiting, and now you’re even farther down the dehydration hole. Drink the water at a reasonable pace, calmly, but don’t stop until you’ve got it down completely. Now start a second glass and drink it until you feel a “full” feeling in your stomach. If you don’t get that “full” feeling, finish the second glass.
Here’s another tip: head to Walgreen’s or CVS and buy something called DripDrop. It’s a powder that is packed with electrolytes. It doesn’t taste great, and it’s expensive, but it will help enough in mild dehydration cases to possibly stop the onset of a migraine.
7. Activity related triggers
Excessive exercise: There’s a fine line between staying in shape and overdoing it. The simple answer is to know your limits. The very first time you have migraine onset from running too far, working out too hard, or playing too long, whether there was dehydration or not, that’s your line. Don’t cross it or be prepared with whatever treatment works for you.
Fatigue: Everyone has a limit. The difference in your limit and everyone else’s is that yours comes with a migraine. There will be times that you are asked to work long hours, drive father than you are accustomed to, or complete tasks that are too much for you. You’re going to have to learn to say no, or at the very least learn when you’re reaching your limit and take a break. It’s as simple as the fact that you’re going to have to stand up for yourself, or suffer through the migraine. The trick with the Fatigue trigger is that it isn’t like the Exercise trigger because it doesn’t grab you immediately after you hit a brick wall. It creeps up on you. Driving 2 hours is okay for you. Driving 3 hours isn’t quite as good, but you’re surviving. By the time you’ve driven 4 hours you’re feeling a little worn down but you think you can make it a little farther. Now you’re working your way towards five hours and the throbbing starts. There’s a very fuzzy line with the Fatigue trigger so you just have to plan to stay way to the good side of it.
Exhaustion: Some of us can get by with six hours of sleep a night. Some with 5. You may need 8. Whatever amount of sleep you get, your body feels the effects of lack of sleep. Getting just a half an hour less sleep than you need each night has a cumulative effect. And guess what? There’s no such thing as “catching up on your sleep”. It takes a few days for your body to recover from a long-term loss of sleep. If you wake up and you’re still tired, and you go to work tired, and everything else during your day is the same, and nobody is banging a pot or using an awful air freshener, and you get a migraine, think about your sleep.
Exhaustion is another “oh I got away with 5 hours sleep last night and didn’t have a migraine, so I can get away with 5 hours tonight and not have one” - sneak up on you - trigger like Fatigue. You might get away with it one day, or two in a row, or three, but it’s going to bite you eventually.
A related tip is something we ALL know, but never follow. The bedroom is for sleep. Lying in bed watching TV or playing on a computer or phone pounds your retinas with the blue light that can keep you awake long after the TV is off. Working can add to your stress, get your mind racing, and keep you from sleeping deeply. Do whatever you want in the living room or den, and when you go to bed, go to bed.
Foods: Several foods can trigger a migraine, and the only way to know which foods trigger migraines for you is to have the migraine and note what you’ve just eaten. Through process of elimination you’ll learn exactly which item triggered your migraine, and you’ll have to stay clear.
Here are several food items which are widely known to trigger migraines in those with food sensitivities:
Citrus fruits and juices
Foods high in salt, nitrates, nitrites, or MSG such as:
Cured meats (think charcuterie trays)
Dry or aged cheeses
Last Comment on Triggers:
This is a limited list of triggers. It isn’t comprehensive, and it may not include yours. If you know your trigger and didn’t see it, or none of those listed trigger your migraines, never fear, we have included a list of resources at the end of this paper which may provide some help. The most important thing to remember is that as long as you are trying, there is hope.
The fact that you’ve read this far means you’re motivated to end the migraine cycle, and that’s the first step on the path to a migraine free, or migraine rare, life.
For purposes of this paper, we’re going to skip the prescription medicines. Physicians are far more trained in the pharmacology, effectiveness, side effects, and interactions of drugs than any layperson. If you are taking an anti-inflammatory (such as paracetamol), or a triptan (like Imitrex – sumatriptan - or any other brand name medicine which has the word triptan at the end of its non-brand name), and it isn’t working for you, ask your physician if you can augment your medicine regimen with any of the additional methods we list in this section.
Before we go on, add a few things to your shopping list for us. Make sure you have (one each in your desk drawer, your home, your car, and your purse if you have one) lidocaine cream and diphenhydramine.
Your remedy, assuming it isn’t just popping whatever you’re prescribed by your doctor, is going to depend greatly on your trigger, where you are, what you’re doing, and the intensity of your migraine. You aren’t going to go hide in a cool, quiet area of the house if you have the early onset of a migraine. You can’t need to pull out all the stops and work all the tricks if you’re in the middle seat, of the middle row, at a work conference. You need to have a good handle on an array of solutions, and what works best for what’s happening, when it’s happening, and where it’s happening.
First things first: Get out of there! It’s going to blow!
But seriously, what we’re saying is, “extricate yourself from the trigger”. You may think you need to sit in the conference next to the woman who bathed in perfume because you can’t be seen walking out. You might not want to get up from the lunch meeting, but the Brussels sprouts next to you aren’t going away any time soon. You’re at your nephews birthday party and they’re about to cut the cake, but the noise is driving you insane.
Ask yourself this: Are you any better at that conference, that lunch, or that party if you break into a full-blown migraine than you are if you back away from the trigger and come back when things are less likely to cause you a problem? You might not be able to stand there while they cut the cake, listening to all those screaming kids, and not get a migraine. So you suffer through that, the throbbing comes along, and you’ve got to leave immediately and head to bed. Wouldn’t you, and the party, be better off if you slipped off to a quiet part of the house while the trigger was happening, and came back to socialize with everyone when you weren’t at risk of a migraine?
Whatever your trigger is, a smell, a food, loud noise, screens, tension… the minute you realize you’re about to be triggered into a migraine, it’s time to go. There’s no “I will tough this out for 10 more minutes” because once you think it’s coming, it’s probably coming. It may come even if you walk out when you get that first inkling, but you can be sure it’s coming if you try to push your luck. When you push your luck you start stressing over it, and it’s like a snowball rolling downhill.
So, you’ve walked out and found a quiet, safer place. What’s next? This is where we dig into our bag of tricks.
(1) Focus on something incredibly mundane, and slow down. One of the best things is a glass of water. You’re probably dehydrated anyway. 80% of Americans are at least mildly dehydrated 50% of the time. No kidding. So, get yourself a glass of water and relax. Take several deep breaths, close your eyes, and count to 10. Now start working on that water. Concentrate on just the water, and the glass. Get about half of it gone.
(2) Reach for your favorite over-the-counter pain reliever and take it. But wait, you haven’t started having the migraine yet. As long as you aren’t exceeding the manufacturer’s recommendations, and as long as you don’t have some underlying health issue that would keep you from safely taking it, taking an extra ibuprofen or naproxen sodium or aspirin isn’t going to hurt you, especially because you’re taking it with water. If it turns out you never get the onset of the migraine, no harm no foul. If it keeps coming, you’ll be glad you took it when you did.
(3) Back to the breathing, and finish the water.
(4) Remember we had you buy the lidocaine cream? It’s time to take that on your ring finger, middle finger, and index finger and rub it on your temples. Do both sides, using the hand that’s on the same side so you’re using both hands.
(5) There’s going to be some lidocaine left on your fingers. Take both hands and rub that on the back of your neck. Massage it in. That’s going to help numb the area and get rid of whatever muscle tension you were building up from the stress of knowing you were about to be triggered into a migraine.
(6) If you can find a ceiling fan or another kind of fan, or even better yet if you have a small handheld fan, get to a position where you can relax and let that fan blow over your face and the back of your neck. You can even sit down, close your eyes, and just focus on your breathing.
So what all have we done here?
1. We’ve gotten ourselves away from the trigger.
2. We’ve made sure that if dehydration was a factor we’ve taken care of it.
3. We’ve taken a pain med that’s going to start working in about 20 minutes, just in case the steps we’re taking don’t work.
4. We’ve massaged our temples and the back of our neck, which serves to release stress and encourage blood flow.
5. We’ve numbed those areas with lidocaine so even if some tension starts to build, we aren’t going to feel it as much and it won’t be as likely to trigger a migraine.
6. We’ve cooled off with a fan, and being cooler is usually always better when a potential trigger is present.
And Lucky Number 7 is that what we’ve really done is take control of the situation and focused on something other than a trigger. You’ve focused on drinking water, massaging in your lidocaine, the breeze from the fan, the pain reliever, and you’ve closed your eyes and completely forgotten about whatever it was that was about to trigger a migraine.
Maybe this particular set of tricks doesn’t work for you, but it does for me. Even at this point, when I know what I’m doing and that part of it is just to trick me into releasing the trigger, it still works. If this particular bag of tricks doesn’t work for you, find a different bag, but know there’s one out there that will.
You’ve still left the trigger area by the way. So home remedy number two is going to require some preplanning. A few bucks also.
You know that caffeine is a trigger for some people, in any amount. We also discussed that it’s an oscillating or yo-yo trigger for others, meaning your body is accustomed to a certain amount at a certain time and if you don’t get it, bam, migraine.
If caffeine is a trigger for you, go ahead and skip his one. If caffeine isn’t a trigger for you, or if not enough is a trigger, here’s a handy way around that.
Cold brew instant coffee singles. I’m not a huge fan of Starbucks but I’ll admit that their Via single serving instant packets are perfect for this remedy.
Getting some caffeine in you quickly can ease symptoms, or even stop a migraine before it starts if you haven’t had your usual amount, if you don’t have a caffeine trigger. Moreover, if you’re in the middle of experiencing a migraine, caffeine can help ease the pain and get you back on the road to ending the migraine.
The reason we don’t want you to reach for a cold Coke is that even though it’s good to have a cold beverage, and it’s good to have caffeine, the carbonation can make it hard to drink the entire thing relatively quickly, it can upset your stomach, and the tension of belching can actually make the migraine worse.
You could go for an instant brew coffee like something out of a Keurig, but you aren’t always near a Keurig, and we’re pretty sure you aren’t carrying Keurig around in your purse or wallet. Also, those drinks come out HOT, and that’s the last thing you need.
Get a glass of water, put in your Via packet and stir the hell out of it, and then put cubed ice in it, along with your Truvia. Remember the Truvia we discussed? You have room everywhere (briefcase, purse, glove compartment, desk drawer) for a few packets of stevia and a Via packet. Now you’re getting your caffeine, it’s nice and cool, and you’re taking quality steps to help with your symptoms.
Remember Anacin? That’s it. It’s really that simple.
Most people have a medicine cabinet overflowing with Tylenol, Advil, Anaprox, Motrin, and everything else they can find at the Walgreen’s, but nobody still has Anacin.
Anacin not only has 400 (or 500 depending on the strength you pick), but it also has 32mg of caffeine.
There are two problems with Anacin. (1) It takes a while for anything to work its way through your G.I. tract (stomach, etc.) and into your blood stream. If you have a pill crusher you can speed up that process. (2) Anacin can cause an increase in stomach acid and heartburn. If you have to take something like a Prilosec along with the Anacin, you’re fine. It won’t be a problem for your migraine.
The American Migraine Foundation recommends four to five hundred milligrams of magnesium DAILY to help prevent migraines. They also say that you can take as much as 600mg daily for 90-120 days and then back off to 400.
During a migraine the magnesium level in your brain is significantly lower than it should be. The theory of the American Migraine Foundation is that low magnesium levels trigger migraines and taking daily magnesium can keep you from experiencing that trigger.
A warning about magnesium: Up your water intake. Large amounts can cause diarrhea.
Once you know a migraine is coming, you can still take magnesium. Probably wouldn’t hurt to keep some magnesium oxide around, and it’s quite cheap. You can get a bottle of Nature’s Bounty or Nature Made magnesium oxide from Walmart or any drugstore for less than ten bucks.
This one doesn’t work for me. As a matter of fact, it’s a trigger. Many people swear by it though, so it can’t hurt to try it.
Lavender oil can be carried in small tubes, and when a migraine is coming, or happening, you can use it to rub on your temples or just to smell. It’s said there’s something soothing about the smell of lavender. Doesn’t work for me. I can’t have air fresheners and have to use All Free because I trigger from any smells that aren’t like apple pie or brown sugar or vanilla, but several people swear by it. Can’t hurt to try.
Tips and Tricks
These are little things to remember to end a migraine, or at least mitigate the pain.
1. Don’t chew. You are creating tension in your jaw and neck. Those stresses add to your migraine.
2. Dim the lights in your office if possible, or hell, just put on sunglasses even if you’re in doors.
3. If you don’t have a frozen gel pack, try wrapping a few pieces of ice in a damp towel and putting it on the back of your neck. You can alternate heat and cold to both reduce swelling and ease muscle tension. Whichever works better for you needs to be your go-to method.
4. Stretch. It relieves tension.
5. Massage your own neck and temples. If you can get someone else to do it for you, even better.
6. Chamomile tea. It’s generally had warm, but that might not be the best idea. After you’ve sweetened it, put a little ice in it.
7. Apple cider vinegar. A lot of people will tell you not to mix it with water, but it’s absolutely unstomachable without water. Add two or three teaspoons in a glass of water, with ice, and a pack of Truvia to take the edge off the taste.
Migraine Relief Resources
Don’t laugh. These guys have a huge section on migraines, and it’s not all just doctor stuff. They have home remedies, discussion groups, food tips, and all sorts of great information.
2. Dr. Karen Pendleton in Shreveport
Pair’ODocs and BioRejuvenis are Dr. Karen’s organizations and the goal of both is to create a generally healthier you. What you’ll find is that she will treat you from the inside out and from the bottom to the top. You’ll feel better, you’ll be healthier, and that leads to fewer migraines. She does extensive labs so if you’re deficient in something and it might be casing your migraines, you’ll know. You can find her at http://www.AskIDrKaren.com
3. Migraine Professional
The amount of information in this little paper is miniscule compared to what you can get from this guy. He has a few books, a huge Facebook group with quite literally thousands of other migraine sufferers, and all sorts of tips and tricks. You can find him on the internet, in bookstores, or on Facebook at https://www.facebook.com/migraineprofessional/
4. Rapid Recovery
If worse comes to worst and nothing in this paper helps you or gets rid of the pain, we put you in a dark, cool room, in a big comfy recliner, and give you an IV with everything you’ve read about above, but we bypass your stomach and all the absorption time. You get fluids, magnesium, pain reliever, oxygen to create vasodilation, and if you’re nauseated you get a nausea med. You can find us at http://www.RapidRecoveryRoom.com
This is a great online resource consisting of some laypeople and some physicians. The site is about a lot more than just migraines, but you can find pages and pages and pages of information about migraines. The really nice thing about this site is that you might accidentally run into something that will help you in some other part of your healthcare journey.
6. The Mayo Clinic
For a big organization run by doctors, this place is willing to look into anything that will make you feel better. They have page after page after page of info, ideas, tips, and “do and don’t” advice for migraine sufferers.
The End… or is it?
You may have had migraines for long enough that you’ve done research and tried a dozen prescription meds and used every trick in the book, and didn’t find a single thing in here that will help you. That’s okay, it means you’re still reading, still learning, and you’ll get there.
If you have just started trying to help yourself, don’t be discouraged if you try everything here and can’t get rid of the migraines. There is a ton of information available and something will eventually help you. Get into a Facebook group, or join a website forum for migraine sufferers, and lean on the work and research others have done, and learn from the experiences that everyone else has had.
Stay hydrated, stay happy, and stay healthy!
Migraine Trigger Log
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