11 Surprising Migraine Triggers
Skull-busting pain, nausea, an acute sensitivity to light—the misery of a migraine can be totally debilitating. What's worse, it can last for as long as two days. "That no one dies of migraine seems, to someone deep into an attack, an ambiguous blessing," wrote Joan Didion in an essay titled "In Bed." But here is a glimmer of hope: "Roughly 76% of people who are predisposed to migraines can identify the triggers that result in an attack," says Lee Peterlin, DO, a director of research at the Johns Hopkins Headache Center. While stress is the most common culprit, there are a host of other possibilities—from the weather to processed meats. Read on to learn about these unexpected triggers, so you can stay one step ahead of the wretched ache.
Start a headache diary
Triggers are different for everyone, and they're not always consistent. A rainstorm may set off a migraine one day and not another, for example. That's because there's typically more than one factor to blame: "Triggers may build up to bring on an attack," explains Dr. Peterlin.
Pinpointing the unique combinations that trouble you (say, impending rain, a side of bacon, and looming deadlines at work) can be tricky. But
tracking patterns over time might help: Jot down notes about your activities and the circumstances during the 24 hours before your migraines strike, especially if you suspect any of the triggers described in the slides ahead.
RELATED: 18 Signs You're Having a Migraine
Working through lunch
Skipping a meal is a risky move for migraine sufferers. Experts aren't sure exactly why, but it could affect the hypothalamus, the part of the brain that governs your body clock; and fMRI research has shown that the hypothalamus lights up when a person is having a migraine attack. It's also possible that a drop in blood sugar could set off an attack, says Dr. Peterlin, who points to a 2014 study that found that migraine-prone adults were 40% less likely to get a headache if they had a bedtime snack the night before. Either way, try to eat regularly to keep migraines at bay.
You expect that skimping on shut-eye might lead to a migraine attack—but so can logging too much sleep. Staying in bed longer than you normally do disrupts your circadian rhythm, and migraine-sensitive brains don't relish changes in routine. They do best with a consistent schedule, says Dr. Peterlin, which is why she advises her patients to turn in and wake up at the same time every day, even on weekends.
Stress is a well-established migraine trigger. But relaxing after a stressful period is an even more significant trigger, according to a 2014 study published in Neurology. A drop in the hormone cortisol could explain this "let-down headache," which may occur at the beginning or your weekend, for example, or the day you leave on a trip. One way to avoid it is to work in small doses of relaxation (like yoga stretches or short walks) during an especially tough week or month, to prevent a build-up of stress.
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A large study done at the Headache Center in Atlanta found that, among 1,200 migraine patients, about 22% identified exercise as a trigger. But the problem appears to be sudden bouts of physical activity, because regular aerobic exercise actually reduces the frequency and severity of migraines, according to Dr. Peterlin. "Overall I look at exercise as a good thing," she says. "I have people build up to a routine, so they can get used to it." Staying fit is part of what she calls the "migraine lifestyle," along with regular sleep habits and eating healthy.
Hot dogs and cold cuts
Many suspected food triggers are highly individual, and haven't been proven, says Dr. Peterlin, but there's data that indicates processed meats are true triggers. Hot dogs, bacon, salami, and other deli meats contain nitrites or nitrates, preservatives that causes blood vessels to dilate, and may set you up for a head-pounder. If you think there might be a link between nitrites and your migraines, try sticking with fresh meats instead.
RELATED: 10 Foods That May Trigger a Migraine
Research has found that nearly 38% of migraine-prone adults are sensitive to alcohol. Red wine seems to be particularly problematic. But researchers have yet to determine the precise reason for booze-induced attacks. An immediate throb could possibly be triggered by alcohol's vasodilation effect. Another theory is that alcohol causes fluctuations in serotonin, a pain-regulating neurotransmitter, that trigger headaches.
RELATED: How Alcohol Affects Your Body
Not drinking enough water
You know dehydration is no good for your body. But the results of a small study published in the European Journal of Neurology suggest the powerful prophylactic effects of water for migraine patients. Those who started drinking an extra six cups a day experienced less pain than a group that took placebo drugs: In two weeks, the well-hydrated folks endured 21 fewer hours of headaches.
Watch the video: Health Benefits of Drinking Water
Obesity raises your risk of episodic (or occasional) migraines by 81%, according to Dr. Peterlin's research. "Obesity is a chronic state of inflammation, and that can contribute to pain," she says. There are also many similarities in the pathways involved in migraines and obesity. "But the truth, we don't fully understand the link," she explains.
The wind, fluctuations in barometric pressure, warmer days—these environmental conditions have all been associated with migraines. In 2009, Harvard researchers actually found that the risk of migraines increased by 7.5% with every 9-degree hike in air temperature above the usual temperature. There's not much you can do to avoid a weather trigger, Dr. Peterlin points out. But some people will pre-treat based on the forecast. "If they know it's going to rain the next day, for example, they take Aleve the day before. But you should only do this under a doctor's guidance."
Hormones are the second-most common trigger for migraines in women (and also the reason these headaches affect three times more women then men). Every month the menstrual cycle involves a drop in estrogen, which causes other chemical fluctuations that can make a woman more vulnerable to pain, explains Dr. Peterlin, "especially two days before the menses to three days after." If you're getting migraines during this window, ask your doctor about a continuous oral contraceptive (the kind that makes you skip you period). "If you don't have that menstrual cycle, that can stop headache frequency," says Dr. Peterlin.
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There's no doubt that bright light can make a migraine feel worse—which is why it helps to retreat to a dark room. "During an attack, things that normally don't bother you can become painful," explains Dr. Peterlin, like a computer glare, or even a ponytail holder or tight t-shirt. But many people believe bright light is actually what sets off their attacks, Dr. Peterlin adds. (Participants in a 2011 study reported that light was the cause of their migraines about half the time.) "I believe my patients," says Dr. Peterlin. "If they say light is a trigger, it is."