- Migraines commonly go undiagnosed.
- Neuro-ophthalmologist Dr Bradley Katz reveals risk factors and triggers for migraines.
- Some migraine triggers are unavoidable, but most of them are what doctors would call "modifiable."
- You can adjust your lifestyle to help reduce and prevent the occurrence of migraines.
One of the best ways to get rid of a migraine is to stop one before it even starts. Because once one hits...ooof, it does not feel good. Migraine symptoms include a pulsing, throbbing headache, nausea or vomiting, and hypersensitivity to lights and sounds. Those symptoms can last as long as three days if left untreated.
To prevent a migraine from striking, you first need to understand the causes and common triggers. That way, you can make certain lifestyle adjustments that might help you avoid getting a migraine in the first place.
The most likely cause of migraines: Your genes
It's not fully understood what precisely causes a migraine, though researchers believe that some people are likely more vulnerable to them due to genetics. That's why it's worth asking family members if they've experienced them, too. Neuro-ophthalmologist Dr Bradley Katz who specialises in treating migraine-related light sensitivity, says that a lot of people go undiagnosed or their migraines are misdiagnosed. "It's rare to find someone with migraines who doesn't have a family history. But it's a matter of asking the right questions. It's likely there is someone else in your family that has migraines but they just haven't been asked the right questions," Dr Katz says.
Researchers are in the early stages of pinpointing which genes contribute to migraine susceptibility, but there will probably be hundreds, says osteopath Wade Cooper. Someday, there may be medications that target those genes, or individualised treatments based on your own genetic makeup, he says.
Other risk factors for migraines
There are a couple of other factors that aren't causes of migraines, per se, but they do increase the likelihood that you'll experience this type of headache.
One factor is being a woman (sorry, ladies). Migraines are three times more common in women than in men. This likely has to do with fluctuating hormone levels, such as oestrogen, but it's not totally clear. We know that some women, for example, get migraines just before or during their periods - these are dubbed "menstrual migraines".
Another factor is being in your 30s or 40s. If you look at the incidence of migraines over a person's lifespan on a chart, it looks somewhat like a mountain-with risk rising until it peaks in your 30s and 40s and then starting to drop when you reach your 50s. How come? Researchers aren't sure why. It could have something to with hormones, as mentioned above. "When women go through menopause, a lot of times their migraines will go away, says Dr Katz. And menopause tends to occur at age 51, on average. It might also be linked to stress, a common migraine trigger, since a person's 30s and 40s are busy years that often include taking on larger roles professionally that have more responsibility, paying a mortgage, and raising a family.
Foods that trigger migraines
So now you know who is more susceptible to migraines. But still, something has to set one off, right? Correct. Dr Cooper refers to a migraine as a cascade of neurological events that is triggered by something specific. That "something" could be a wide variety of things, and food is a common one.
The long list includes aged cheeses, alcohol (especially red wine), smoked meats (bacon, pepperoni), caffeine, artificial sweeteners like aspartame, certain spices, chocolate, salty or processed foods, and the preservative monosodium glutamate (MSG).
10 other common migraine triggers
1. Indoor lighting
"With light, it doesn't seem to be the intensity that matters. For instance, outdoor light is not particularly bothersome-it's mainly non-incandescent, artificial, indoor light that irritates people with migraine. This could include fluorescent light bulbs, computer screens, and the type of overhead lighting you'll find in stores like Kmart and Bunnings. So it may have more to do with the wavelength of light," says Dr Katz.
2. Stress
This might come from work, home, or a relationship that's outside the home (a friend, your mother, etc). "Everyone has a different threshold for stress. It's so personal that it's hard to make any generalisations about it because what's stressful to one person is not at all stressful to another," says Dr Katz.
3. Skipping meals or becoming dehydrated
How much you need to eat/drink and how often varies from person to person, but if you find yourself skipping lunch or not drinking enough water (or drinking too much alcohol, which dehydrates you), that's a potential trigger.
4. Skimping on sleep
Not getting enough zzz's-or, less commonly, getting too much slumber-can lead to migraine. So can feeling jet lagged. How many hours of sleep you should aim to get each night is highly variable (some people function just fine on six, while others need eight), but this is where keeping a "migraine diary" or analysing your sleep info from an activity-tracking device like a Fitbit can come in handy.
5. An infection
A recent viral illness can bring on a migraine, as can something like a dental infection.
6. Certain smells
Sometimes perfumes can set off people, as well as secondhand smoke and paint thinner.
7. Loud sounds
Maybe construction or landscaping going on nearby bothers you or the sound of a subway or train car rushing by.
8. The weather
"There's a lot of data about weather sensitivity. Two things that tend to come out the most are: a change in temperature (up or down) of more than 10 degrees and low barometric pressure. About 1 in 3 people report being weather-sensitive with their migraine experience," says Dr Cooper. Barometric pressure tends to drop when there's an approaching storm, when you're in a high-altitude area, or when you're in an airplane, says Dr Katz.
9. Intense physical exertion
This could include vigorous/strenuous exercise or sexual activity.
10. Medications
Certain drugs like vasodilators (such as nitroglycerin) or oral contraceptives) may aggravate the condition.
How to stop a migraine before it starts
As you can tell, some of the triggers above are unavoidable (inhaling someone's perfume, reacting to a change in the weather), but most of them are what doctors would call "modifiable." For instance, you can adjust your diet, eat regular meals every few hours, go to bed earlier, and manage your stress better (via meditation, exercise, massage, etc).
In fact, before discussing medications, the first thing that neurologist Dr Santiago Mazuera Mejia recommends to patients is making lifestyle changes. "They are among the most important things in the treatment of migraines. If most people skip a meal, they will be hungry. But if someone who suffers from migraines skips a meal, he or she may trigger a headache with disabling symptoms. That is why taking care of yourself is so crucial, especially if you get migraines," he says.
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