Migraine triggers or trigger factors do not cause migraine but they can help to bring about an attack.
It is thought that trigger factors are implicated in about 40% of attacks, so a good trigger-management strategy can be a very powerful tool in helping you manage your migraine.
Although there is no specific ‘cure’ for migraine, you may be able to reduce the number of attacks you experience by identifying and avoiding your triggers.
Certain foods, drinks, situations or environmental conditions may precipitate or bring on a migraine. It is important to recognise that everyone’s trigger factors are highly individual and that even the most common ones may not be detrimental to you at all.
Common Trigger Factors
- Travel (motion sickness)
- Sleep related triggers – sleep deprivation or disturbance, irregular sleeping patterns, too much sleep
- Changes in routine e.g changing to shiftwork
- Increases in stress or anxiety levels
- Excitement or other positive stressors
- Foods and Beverages – Cheese, chocolate, products containing MSG (e.g. hot dogs, Chinese food), citrus fruits, dairy products, nuts, wheat, fatty foods, nitrates and marinated or pickled foods
Keeping a Migraine Diary accurately may point out a pattern over time. Trace your diet back 48 hours before the onset of migraine to see what you have eaten. Don’t unnecessarily eliminate the entire list above from your diet. They may not be responsible at all for your attacks and a mass elimination policy can also be dangerous to your health.
Trigger Factors Continued
- Lack of food, delayed meals, irregular eating patterns, fasting and dieting (all lead to lowered blood sugar levels)
- Alcohol, especially red wine
- Caffeine products or withdrawal from caffeine,
- Hormonal changes in women. Puberty, menstruation, pregnancy, HRT and menopause are all potential triggers.
- Meteorological Triggers – change of seasons, high atmospheric pressure, heat or cold
- Environmental Triggers – smoke, strong smells, high altitude, loud noise, bright, irregular or flickering lights, glare (e.g. from sunlight, from wet surface while driving)
- Exercise – too much exercise may act as a trigger, although lack of exercise can also be a trigger
- Smoking or passive smoking
Over-exertion / dehydration
- Long periods in front of a computer screen
- Head, neck or back injury, High Blood Pressure and other physiological irregularities.
The Migraine Threshold
While some people may be very sensitive to specific triggers, others may be vulnerable only when several triggers combine at once. For example, a deadline at work together with long hours and a missed meal may bring on an attack in someone who can usually tolerate any one of those triggers individually.
If you find that this happens to you, then you may be able to limit your exposure to migraine by avoiding the ‘avoidable’ factors (such as alcohol, food, late nights etc) at times when the ‘unavoidable’ ones are present (hormonal changes, weather changes etc).
- Trigger factors are highly individual
- Some people appear not to have any triggers at all
- Do not always blame food
- Keep a Migraine Diary to identify possible triggers
- Look out for combinations of triggers