Migraine is characterized by recurrent attacks of headache. The pain is often described as throbbing, and there may be a pulsing sensation, usually on one side of the head. Migraines are commonly accompanied by nausea, vomiting, and sensitivity to light and sound (1).
The exact cause of migraines is unknown, but they’re believed to be the result of abnormal brain activity, partly caused by imbalances in brain chemicals including serotonin. These abnormalities may temporarily affect nerve signals and blood vessels in the brain.
Prodromal symptoms often occur one or two days before the headache (2). These include constipation or diarrhea, mood changes, appetite changes including food cravings, concentration difficulties, cold extremities, increased thirst, frequent urination and constant yawning.
Warning symptoms known as aura may occur before and sometimes together with the attack. Examples are visual disturbances and sensory abnormalities such as a tingling or touching sensation on one side of the face or in an arm or a leg (3). However, 75-80% of patients don’t experience an aura.
There are known environmental factors that we can come across every day that can “trigger” migraine headaches. These include foods and food additives, medications, emotional stress, menstruation, visual stimuli such as bright lights, fasting, wine, physical exertion, sleep disturbances, intake of highly caffeinated beverages and aspartame (4).
10 Everyday Things that May Trigger Migraines
Knowledge of the most common external triggers for migraine attacks is of crucial importance for individuals who suffer from migraine.
Certain foods and food ingredients may trigger migraine attacks. For instance, a very common ingredient in diet and low-calorie foods is the sugar substitute aspartame. This artificial sweetener can affect dopamine and serotonin levels in the brain, which can be a factor in migraine headaches (5).
Another common substance in food that may hasten the onset of a migraine is monosodium glutamate, best known as MSG (6). It’s often used to flavor Chinese food, but can also be found in soups and processed meats.
Nitrites are preservatives frequently found in sausage, beef jerky, hot dogs, deli meats and other meats. Nitrate-containing compounds have been identified as common headache triggers (7).
If you suffer from migraine, the next time you get invited to a wine and cheese party, you may want to RSVP no. Wine contains preservatives called sulfites, which can potentially induce migraines (8). Sulfites can also be found in processed foods, including dried fruits.
As for the cheese plate, aged cheeses have an amino acid called tyramine, which has been associated with migraines (9).
If you think you’ll skip the cheese in favor of the fruit that’s usually paired with it, well, think again. You may be opening yourself up to a migraine attack if you eat apples or pears, which contain tannins. This natural plant substance can also be found in tea, black walnuts, red wine, tea, chocolate, vanilla, raspberries, and many herbal products
Research shows that reducing tannin in the diet may reduce the risk of migraine attacks (10).
Finally, whatever you eat, handle it carefully, especially if you tend to eat leftovers for meals. The same tyramine that can be an issue in certain cheeses can multiply in foods, especially if it’s not properly refrigerated.
In addition to wine, there are other beverages that may cause trouble for you if you are a migraine sufferer. Alcohol is known to trigger a headache if too much is consumed—ask anyone who’s ever had a hangover—and studies suggest that alcohol and migraine symptoms are linked (11).
On the other hand, caffeine has a more mixed effect on migraines—depending on the person, caffeine can lead to a migraine or guard against one. If you note that you experience symptoms after a cup of coffee, you may want to cut back on your consumption (12).
So what can you drink? Water is always a safe, and a healthy choice. In fact, if you don’t drink enough water, you may experience dehydration, and that may lead to a migraine attack.
Identifying Your Migraine Triggers
It may not always be easy to determine what environmental factors are triggering migraines. In fact, migraine attacks may be linked to a number of different things. Furthermore, a potential trigger may not precipitate an attack every time.
Sometimes, trigger factors can influence an attack up to 48 hours before a headache occurs. Such trigger factors may easily be ignored.
One study showed that most patients showed at least one dietary trigger, fasting was the most frequent one, followed by alcohol and chocolate. Hormonal factors appeared in 53% with the pre-menstrual period being the most frequent. Physical activities triggered migraine in 13%, sexual activities in 2.5%, 64% reported emotional stress as a trigger, and 81% related some sleep problem as a trigger factor. Regarding environmental factors, smells were reported by 36.5%.
One of the best ways of identifying triggers is to keep a migraine diary. Such a diary should keep a record of daily activity such as when you get up and go to sleep, what you do during the day, what you eat and drink, the surroundings, the weather, the medication you take, your mood, and the menstrual cycle if you are a woman.
Registering the timing of the attacks is essential. For example, if you suffer at weekends, your headache may be triggered by caffeine withdrawal due to drinking fewer cups at home than at work. It may also be due to more wine or alcohol consumption on the weekends. Some people with migraine find that winding down at the weekend after a stressful week or too much sleep at the weekends can trigger an attack (13).
Many thanks to Dr. Jonathan Cabin MD at the Migraine Institute for providing the infographic.