Because there is no definitive research on 100% effective treatments for migraines, one of the best things migraine sufferers can do is to work hard to identify and avoid potential migraine triggers. Migraine triggers are anything with the potential to cause or worsen migraines. Once a migraine hits, sufferers may struggle to accurately report what happened in their life in the days before the attack. Tracking migraine triggers can not only help to treat pain, however, but it may be able to work towards preventing migraines.
New research on tracking migraine triggers
In new research conducted by the Headache Working Group at MedUni Vienna, Christian Wöber, head of the section specializing in headaches at MedUni Vienna’s department of neurology, found that tracking migraine triggers not only helps prevent migraines but also helps individualize treatment when they do hit.
“Determining the factors that trigger migraine attacks is an important, albeit difficult, step in managing migraine. By analyzing cases on an individual basis, we are able to provide medicine that is tailored to the individual circumstances of each patient. The need for this approach, hitherto uncommon in medical studies, was recently emphasized in the leading journal Nature.”
The study looked at migraine trigger data as tracked by individuals versus reported migraine trigger data for a whole group. Researchers found that individuals tracking their migraine triggers were able to identify what caused their migraine 87% of the time. On average, migraine sufferers identified four potential triggers for each attack in combinations that were highly individualized.
Researchers analyzed the data and found that this could lead to more targeted and effective treatments, noting:
“What was unexpected was that the individual profile of possible trigger factors was extremely variable and was unique in 85% of patients. Each of the 33 migraine trigger factors investigated correlated with migraine attacks, in at least some of the patients. For the very first time, this new analysis therefore provides information about the correlation between migraine attacks and a broad spectrum of possible trigger factors for each individual patient and is therefore a step towards personalized migraine management.”
How to track migraine triggers
There are many different ways to track migraine triggers. The best system is the one that a migraine sufferer will stick with and use consistently. And, as you’ll see, the triggers that may cause migraines are varied. What may trigger migraines in one person may not trigger them in another. Foods like caffeine and chocolate are often mentioned as causing migraines, though there is little evidence that this is true. (In fact, some studies have actually shown that caffeine can help relieve caffeine withdrawal headaches.)
Therefore, if you suffer from migraine headaches it’s best to track your symptoms and your diet in order to tease out the foods that are causing issues. That sprinkle of blue cheese may not be a problem for you, but the glass of red wine might signal future pain. When tracking your potential migraine triggers, there are a few things to keep in mind.
Of all of the migraine triggers, food may be the one that is most common across all migraine patients. Keeping careful track of the foods you eat, in what amounts and when, can help identify any potential food migraine triggers. There are a number of different potential migraine triggers relating to food, including:
- Artificial flavoring, including flavor enhancers like monosodium glutamate (MSG)
- Aged or fermented cheese
- Soy products
- Citrus fruits
- Sulfites (commonly found in dried fruits)
- Nitrites (in processed or preserved meats like hot dogs and deli meat)
It does vary from person to person, but the specific foods most often associated with migraine headaches include:
- Aged cheeses: Aged cheeses, such as blue cheese and Gorgonzola, contain higher levels of a substance called tyramine. This substance is a naturally occurring by-product of the aging process of high-protein foods. Scientists are still researching this compound’s effects on migraines, but for the time being, many migraine doctors recommend a tyramine-free diet for their patients.
- Alcohol: Alcohol, especially red wine and champagne, is often indicated as a migraine trigger. Whether from the increased blood flow to the brain or the by-products the body produces as it metabolizes alcohol, many point to it as a specific trigger for their migraine symptoms. (We’ll discuss this in more detail in the next section)
- Food additives: Food additives, like MSG, and other preservatives can wreak havoc in the body. Many people with migraines find that their symptoms are triggered when they eat overly processed foods containing these additives.
- Cold food: Many migraine sufferers find that they are more sensitive to cold foods, such as ice cream, and that eating them can even trigger symptoms.
Consider limiting your alcohol
Everyone’s body is different, and gauging the impact alcohol has on migraines is a personal endeavor. Some people develop headaches several hours after consumption, others experience migraine-related hangover headaches, and others can drink alcohol without a problem.
Scientists aren’t sure why or even how closely alcohol and migraines are related. Some believe there’s a link between alcohol and stress, since many people drink while stressed. Others blame impurities found in alcohol or substances the body produces as it digests the spirits. A review of studies in the journal Headache led researchers to conclude red wine in particular interferes with the brain’s processing of serotonin, one of the major neurotransmitters involved in the development of migraines.
- Other commonly named alcoholic migraine triggers include:
The first person to blame headaches on red wine was Celsus, a second-century Greek philosopher, and the references have piled up since then. The research has been limited, however. Many abstracts published based on anecdotal evidence, according to the review of literature in Headache. Researchers concluded that red wine triggers migraines in about 30% of sufferers, but said more research is needed to explore the link.
Another study, this one completed on rats at Thomas Jefferson University, found migraine sufferers are more likely to develop headache hangovers than the general population. The rats were well hydrated and drank alcohol without impurities, leading researchers to blame either the alcohol itself or one of the byproducts of digestion.
For alcohol to be definitively named as a migraine trigger, a couple of conditions must be met, says headache expert Dr. Alessandro Panconesi. First, there would need to be a predictable period of time between drinking the alcohol and developing the headache. Second, alcohol would always trigger a migraine. Panconesi says migraine sufferers can drink small amounts of alcohol, up to five ounces, unless the drink causes a migraine.
Fatigue caused be either poor quality sleep or inadequate quantity of sleep is another common migraine trigger. Tracking your sleep using an app may be one of the easiest ways to figure out if a migraine hits because you’re tired.
Watch the weather
Migraine triggers can be hidden in the clouds. Changes in the barometer one way or the other can change the pressure in the vascular system in the head. Blood vessels in the brain expand when a migraine is present, and approaching weather can exacerbate that. Keeping track of the specific barometer reading isn’t necessary, but writing down precipitation and temperature can give you an idea of how weather might be a migraine trigger.
If you want to keep track of the specific barometer reading, an indoor/outdoor weather station connected to your home’s internet signal is an easy way to do that, too.
For some migraine sufferers, intense physical activity can be a trigger. This includes things like running, competitive swimming, and even sex. While exercise is an important part of overall health and wellness, keeping track of frequency, duration, and intensity of physical activity can help identify if excess physical exertion is one of your migraine triggers.
Tracking migraine triggers: By phone or by hand?
Getting started with tracking migraine triggers can be made very simple with the use of some popular pain diary apps. These apps download directly to your phone, laptop, tablet, or home computer and can keep track of all of the above potential migraine triggers. When choosing an app, you may want to consider the following:
- Price: Many popular apps for tracking migraine triggers are free. Some do come with either a small fee or monthly subscription. Read the fine print before you download the app, especially if the app asks for credit card data.
- Features: If you are looking for an app that tracks food and activity, make sure those features are included in the one you choose. It makes no sense to download an app that isn’t useful. Keep in mind that some apps have a “lite” and “pro” version. The “lite” version is generally free, but the “pro” version may offer more customizable features.
- Communication: Some apps offer the option to send reports directly to your pain management specialist or primary care provider. If you are juggling multiple doctors, this may be an invaluable feature.
- Ease of use: Any app that you download is only as effective as the amount of times you use it. If it’s hard to read, difficult to understand, and impossible to navigate, chances are good that it won’t get much use.
- Availability: Make sure that the app you choose is available for use on the device of your choice. If you want to use an app on your tablet, make sure that it functions well there.
If downloading an app doesn’t work for you, you aren’t alone. Many people tracking their migraine triggers use a simple diary method, writing down relevant information as it arises. This diary can then travel with you to each doctor’s appointment.
Getting started tracking migraine triggers isn’t the hard part: sticking with it is. Try to record key potential triggers at the same time every day to get yourself in the habit. If you do use an app to track migraine triggers, add it to multiple devices so that it is always available no matter what your schedule is. Make it as easy as possible for you to stick with whatever system you choose.
Knowing your migraine triggers can help prevent – and may eventually treat – migraine pain. If you need more focused help for your migraine pain, reach out to a pain specialist in your area for more help.