The Basics of Migraine Triggers
Many people are aware that particular events, situations, foods, and beverages make them much more likely to experience a migraine headache. Triggers are highly individual, so while someone else with migraines might be able to eat whatever they like, you may be highly intolerant of, for instance, cheese and chocolate.
The list of potential migraine triggers is extensive. However, a handful of well-known categories of migraine triggers—along with a few specific examples within them—are listed below.
Hormonal shifts. Among women (who are twice as likely as men to suffer from migraines) changing estrogen levels are a common trigger. Many women have their first migraine around the time of their first menstrual period and continue to have headaches at predictable times during their cycles for as long as they continue to have periods. Commonly, this is around the time of ovulation, just before, or during the menstrual period. Pregnancy, peri-menopause, and menopause are other times when shifting hormones can make migraines more likely, as can birth control pills and hormone replacement therapy.
Stress. When evaluating the role of stress in triggering your headaches, keep in mind that stress can come from both negative and positive experiences. To your migraine-prone brain, getting married may be just as stressful as losing your job. If you handle stress poorly or repress your emotions—rarely admitting or talking about feelings of anxiety, sadness, anger, or loss—you're more likely to experience stress-related migraines.
Stress relief. A classic migraine pattern is someone who works or studies hard all week, only to collapse with an intense migraine on the weekend.
Sleep disturbances. Missing sleep, getting too much sleep, napping, or even going to bed and getting up on an irregular schedule can trigger migraines for some people.
Sensory stimulation. Bright lights, especially glare from the sun, can produce a migraine, as can other visual stimuli, like flashing lights or eyestrain. Smells—both pleasant and noxious—are another common trigger. Everything from perfume to paint thinner can lower your migraine threshold. Secondhand cigarette smoke is a well-known migraine trigger.
Environment. Factors you have no way of controlling can trigger migraines. These include changes in the barometric pressure as weather shifts, changes in altitude (which can mean in-flight headaches), and changes in temperature or humidity.
Exertion. Particularly if you're not used to vigorous exercise, over-exertion can make it more likely that you'll get a migraine. The exertion of sexual activity can also be a headache trigger for some people.
Medications. Overuse of some over-the-counter pain relievers can actually cause headaches. A good rule of thumb is that if you're using a non-prescription pain medication more than twice a week, you're actually likely to trigger a rebound headache each time it clears from your system. Pay close attention to your use of caffeine-containing pain relievers, since caffeine is also known to trigger migraines
Dietary triggers. In addition to skipping meals or fasting, specific foods and beverages trigger migraine headaches in many people. There are many different foods that individuals have identified as triggering their migraines. Some of the better-known dietary triggers include:
Caffeine in coffee, tea, or colas
Alcohol (particularly red wine, sherry, and beer)
Chocolate, including hot chocolate and cocoa
Tyramine-containing foods. Tyramine is a chemical by-product created by protein breaking down in aged foods, like certain cheeses. In general, the longer a food ages, the more tyramine it contains. Processed meats can contain tyramine, as well as nitrates and nitrites, which are also triggers for some people.
Food additives. Monosodium glutamate (MSG) is a key offender against people with migraines. So are artificial sweeteners, particularly aspartame (NutraSweet®). Meat tenderizers, fermented products like soy sauce and tamari, and nutritional yeast supplements can also lower your migraine threshold.