Tracking down your triggers will help you find relief.

Tracking down your triggers will help you find relief.(ISTOCKPHOTO)No one who gets severe headaches such as migraines needs a lecture on the virtues of prevention, but it's hard to remember everything that you did the night before you had to spend that day in bed. Headache triggers vary, and your memory can be surprisingly unreliable. So specialists recommend narrowing down the suspects in a headache diary.

"I give my patients a list of triggers, I give them a diary, and I say, 'See if there's any correlation,'" explains Larry Newman, MD, director of the Headache Institute at St. Luke's-Roosevelt Hospital Center in New York City.

What to note in your diary

  • When you had the headache
  • How severe it was
  • How long it lasted
  • Things associated with it
  • Whether there was nausea and/or vomiting
  • Medications that you took
  • Detailed descriptions of your diet, activities and, for women, menstrual cycle

Sounds easy if a bit tedious. The problem is that triggers don't always have obvious or immediate effects. Eating bacon today may trigger a migraine tonight—or in 48 hours. It may take a month, even two or three, to eke out conclusive connections. And that is something many patients don't want to hear.

The Migraine Trigger Checklist


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"The first thing people want to do is find blame," says Dr. Newman. "'Why did I have this headache? It had to be the spaghetti sauce I had yesterday. I knew I shouldn't have had it.' It may have had nothing to do with the spaghetti sauce. It may be the fact that you're about to get your period in two days. So it's very confusing."

Besides helping identify triggers, for some patients a diary can make their suffering all the more real. "Knowing how many days of the month I was suffering with migraines probably made me more depressed," says 36-year-old Jenny DeFino, with a laugh. But after a lot of work, the Yonkers, N.Y., resident brought her migraines under control. She says her diary was particularly valuable for testing the medications that, along with trigger avoidance, finally reduced her migraines from 14 days a month to just two or three times monthly.

There are a number of printable headache diaries available online. Check out the daily, weekly, and monthly diaries from the American Headache Society.

To narrow down your particular triggers, see our headache Print and Carry list.