Distinguishing what is and isn’t a migraine trigger

By: Gemma Jolly, Information and Support Services Manager

We know that many people try to identify things which may be causing or exacerbating their migraine. Often people think if they can remove these things it will help to make their migraine more manageable, and might mean they happen less often or are less severe.

Migraine can be such a debilitating condition, and people, understandably, want to try anything that may help.

The idea of certain things triggering migraine has been around for years, and people are often told to look for triggers in case it helps with managing their migraine.

Many of us have heard that certain foods or situations might make migraine worse, and it often seems that there may be a link – but is there more to it?

What is a migraine trigger?

Put simply a migraine trigger is anything that seems to cause a migraine. Many people with migraine believe their migraine are triggered by certain factors such as diet, stress, dehydration, alcohol etc.

If I can identify my triggers will it make my migraine more manageable?

This is where things get slightly more complicated. Researchers have looked into trying to trigger migraine with certain things such as chocolate and bright light. However, these attempts have been largely unsuccessful which has led many people to conclude that some things which may be considered triggers may actually be due to the migraine itself.

Factors people usually think trigger their migraine include hormones and menstrual cycle, stress, changes in sleep, changes in routines, environment (such as lights and sounds), missing meals, dehydration, the weather and certain food. These tend to vary from person to person.

Some of these things you can’t do much about, some may play a role in triggering or making migraine worse and some may be linked to the premonitory stage of migraine rather than being a trigger in themselves.

What is the premonitory stage of migraine?

The premonitory stage of migraine describes the stage of migraine before headache or aura, and may be referred to as the ‘warning’ stage. It features a range of symptoms including mood changes, sensitivity to light and sound and cravings for certain foods.

These symptoms are often linked to triggers, and may be confused for them. For example, chocolate.

Someone may have a craving for chocolate as a result of the premonitory stage (although they may not realise this is a symptom related to migraine). They eat some chocolate due to the craving and then get a headache. This, understandably, can lead to them thinking chocolate is a trigger and then avoiding it. Although the migraine process had already started and the person would likely have had the headache regardless of whether they’d eaten the chocolate or not. This example can apply to a range of factors including a bright light, certain noises or smells.

We don’t yet fully understand how migraine starts and causes symptoms. Although we do know the brain behaves abnormally during the premonitory stage in areas that may be causing the symptoms. For example, the hypothalamus which is responsible for the regulation of food intake and sleep cycles.

What can I do if I think my migraines are triggered by certain things?

We know that people with migraine have brains that like balance and are sensitive to change, generally. For example, preferring a regular sleeping pattern. So, trying to keep to a routine and keep things balanced can help.

If people think something is triggering their migraine the best thing to do is keep a headache diary. This can include details about their migraines and any potential triggers. It can then be reviewed to look for patterns or connections.

If you do identify something, you could consider avoiding it for a period of time and seeing how that impacts your migraines. Although it’s important to be aware it is unlikely that a migraine will be triggered by any one thing, and usually migraine occur because of a range of factors. It’s also possible that it will vary from migraine to migraine. You should also continue with the diary after the migraine so you have a record of any impact from avoiding or removing a potential trigger.

There are also some factors which seem to affect migraine more than others including stress, changes in routine, changes in sleep pattern, dehydration and skipping meals. It can help to look at ways to try and manage these and see how that affects your migraine.