Migraines & Headaches Health Center

The best way to manage migraine headaches is to avoid them. And to avoid them, you need to know what things (or triggers) bring them on. By finding and avoiding your triggers, you can limit how often you get migraines and how bad they are.

Try to avoid as many triggers as you can. Triggers add up, so the fewer you have at one time, the better your chance of preventing a migraine.

To manage your migraines:

• Use a headache diary(What is a PDF document?) to find your migraine triggers.
• Make sure you sleep, exercise, and eat on a regular schedule.
• Don't eat foods that are likely to trigger a migraine.
• Manage stress.
• Avoid smoking and secondhand smoke.

Migraines may be triggered by food, stress, and changes in your daily routine.

The most common migraine triggers are:

• Stress (either during a stressful time or right after stress subsides).
• Menstrual cycle in women.
• Changes in your routine, such as how much you exercise or how much you sleep.
• Fasting or skipping meals.
• Changes in the weather, heat, or high humidity.
• Bright lights, glare, or reflected sunlight.
• Foods, such as chocolate.
• Alcohol-all alcohol, or one type of alcohol in particular, like beer or wine.
• Odors such as perfume, paint, dust, and certain flowers.

Other migraine triggers include:

• Strong emotions, such as depression or anxiety.
• Pushing yourself too hard when you exercise.
• Aspartame.
• Monosodium glutamate (MSG).
• Nitrates, which are found in cured meats such as hot dogs, bacon, and cold cuts.
• Tyramines, which are found in pickled or marinated foods, aged cheeses, and yeast.
• Smoking or being around someone who smokes.
• Excessive caffeine or caffeine withdrawal.
• Birth control pills and hormone therapy.
• Medicines that expand (dilate) the blood vessels (vasodilators), such as nifedipine, and nitrates.
• Overuse of headache pain medicines, leading to rebound headaches.

Finding out your triggers and avoiding them can help you have fewer migraines and can improve the quality of your life.

Keeping a headache diary might seem boring and pointless at first. But by listing things such as what you eat and drink and when you exercise, you may see a pattern to your headaches. This will help you know what to avoid so that you can have fewer migraines.

You can find out what your triggers are by keeping a headache diary and trying to follow a routine every day.

Use a headache diary

In a headache diary(What is a PDF document?), you write down:

• What you eat and drink.
• What type of exercise you do and when you do it.
• The overall state of your health.
• What the weather is like (hot or cold, rainy).
• Other things that might affect your headaches, such as strong feelings or stressful events.
• When you get a headache and how bad it is.
• What medicine you take when you get a headache, and how well it works.

Over time, you may see a pattern to your headaches. For example, maybe you get a headache after you drink wine or eat a certain food.

It may take only a few months before you can find your headache triggers. When you find your triggers, you can take steps to avoid them.

Keep to a daily routine

Doing the same things every day and at the same times can help you find triggers. If you change your routine and get a migraine, then you may have found a trigger. To keep a routine, try to:

• Get regular exercise. If you do have a migraine while you exercise, write down the activity you were doing, the weather, and what you ate that day.
• Keep regular sleep patterns. Sleeping too much or too little can trigger migraines. If you do get a headache when your sleep pattern has changed, this may be a trigger that you can control.
• Watch what you eat. Many foods-such as cheese, red wine, chocolate, and foods or drinks with caffeine-are migraine triggers.
• Eat regularly. Skipping meals leads to migraines in many people. Try to eat on a regular schedule, and have healthy snacks if you get hungry.
• Drink plenty of fluids, enough so that your urine is light yellow or clear like water. This is especially important when you exercise. Not getting enough water can trigger a headache.
• Manage your stress as best you can. Many people get a migraine after a stressful event is over. You may not be able to control stressful events, but you may be able to control how you react to them. Relaxation exercises or biofeedback may help reduce your stress level.

You can't control some triggers, such as changes in the weather and in your hormones (during pregnancy or menstrual cycles). But knowing that these things trigger your migraines may help you have a plan in place when you are around your triggers.

Triggers add up, so if you can limit your triggers, you may be able to prevent a headache or reduce the pain when you get one. For example, if it's hot outside (and hot weather is a trigger for you), make sure to drink enough water so that you don't get dehydrated. While you're in the heat, you also may want to avoid any foods that you know are triggers for you.

Now that you have read this information, you are ready to start finding and avoiding migraine triggers.

Talk with your doctor

If you have questions about this information, print it out and take it with you when you visit your doctor. You may want to use a highlighter to mark areas or make notes in the margins of pages where you have questions.

Take your headache diary with you when you visit your doctor. Be sure to let your doctor know if you are seeing changes in your symptoms.

Talk with your doctor about what might be triggers for you. Discuss ways you can avoid those triggers.

Organization