10 Ways to Avoid Migraine Triggers

Want to Control Migraines? Learn to Manage Key Triggers

By Erin O'Donnell

A migraine can be set in motion by many different factors, from your hormone levels to last night's dinner. In her book The Migraine Brain, Carolyn Bernstein, M.D., explains that people with migraines have hypersensitive brains that overreact to certain stimuli or triggers. These triggers set off a chain of events that over-excite nerve cells in the head and face, causing migraine symptoms.

Although some triggers—such as stress—are pretty universal, Dr. Bernstein says each person has their own personal pattern of sensitivities. Say, for example, that you can usually drink a glass of wine without suffering, but if you sip it on an empty stomach, you're a goner. That makes a headache diary a powerful tool. After a headache, record the severity of the pain on a scale of 1 to 10. Write down what you ate or drank two hours before the headache began, and any other circumstances that you think contributed. These notes can help you spot your personal patterns, allowing you to avoid risky situations.

To get you started tracking your patterns, here's a closer look at ten common migraine triggers, and what you can do to dodge them.

Erin O'Donnell is a former editor of Natural Health magazine. She writes about health and wellbeing, and lives in Wisconsin.

Stay Ahead of Stress

It's no surprise to anyone who's held her head in agony after a fight with the boss, or the week of a big move: stress is a major migraine trigger. Researchers think that a migraine sufferer's nervous system may be especially reactive to stress hormones.

Interestingly, some people experience "let-down" migraines a day or two after a stressful event, possibly caused by the abrupt decrease in stress hormones.

If you suffer from migraines, it's essential to build stress-busting activities—such as deep breathing, listening to music, or swimming laps—into your daily routine. Practicing guided imagery with a CD may also help. Consider A Meditation to Help Relieve Headaches by Belleruth Naparstek.

Research shows that biofeedback can also help reduce the frequency and severity of migraines by teaching you to limit the physical symptoms of stress. For example, you might wear a finger thermometer and practice raising the temperature in your hands. (Warm hands = a calm mind.) To find a biofeedback practitioner near you, visit http://www.bcia.org/.

Dial Back the Alcohol

Alcoholic beverages are a common culprit for migraine sufferers; sometimes a few sips are all it takes to set one off.

And it's no wonder. Alcohol not only dehydrates your brain, but it also contains multiple migraine-triggering chemicals. Red wine, for example, is loaded with tyramine and sulfite, two chemicals implicated in migraine attacks.

If you want to continue to drink, you may need to experiment to determine which alcoholic beverages cause you to react, and choose alternatives. For example, some migraine sufferers can drink white wine without a problem. You might also tolerate organic wines, which contain lower sulfite levels.

In her book The Migraine Brain, Carolyn Bernstein, M.D., also recommends that people with migraines chase each alcoholic drink with at least eight ounces of water to prevent dehydration.

Find Your Red-Flag Foods

Some researchers estimate that 30 percent of migraines are brought on by food. Common migraine culprits include foods that contain tyramine, an amino acid found in aged cheeses and pepperoni.

But headache docs warn that the food-migraine connection is very individual. One woman might suffer after just few bites of dark chocolate, while another can eat an entire chocolate bar and never get sick. Other circumstances can interact with food. You might eat blue cheese dressing regularly without a headache--until the day you eat it while you're dehydrated and tired. Again, a detailed headache diary can help. After each migraine, record what you ate two hours before the headache started, and watch for problem foods. Once you've learned your triggers, read labels carefully. And don't feel shy about speaking up and asking about ingredients in restaurants. After all, it might mean the difference between a miserable night and a pain-free one.

Be Smart About Sleep

A lack of sleep —think red-eye flight, insomnia, or a new baby in the house—is a notorious migraine trigger. But so is too much sleep; staying in bed past your regular waking time can also bring on a headache. Headache doctors recommend that migraine sufferers do what they can to go to bed and wake up around the same times each day. If you know that your sleep will be disrupted, it's wise to avoid other triggers as much as you can: eat regularly, drink plenty of water, and remember your stress-easing practices.

It's also important to make sure you're getting good quality sleep. Make an effort to wind down at least a half hour before you hit the hay: Turn off the computer, television, and your cell phone to help quiet your mind. Keep your room cool and quiet, and block out light with room-darkening shades and a sleep mask.

Reconsider Caffeine

Caffeine is tricky. For some people, it can actually halt an approaching migraine by causing blood vessels in the brain to constrict. For those folks, a cup of coffee or a caffeinated, nondiet soda is a time-honored migraine stopper. In fact, some over-the-counter migraine remedies contain caffeine to increase their effectiveness.

But for other people, caffeine is a migraine trigger. If caffeine bothers you, the National Headache Foundation recommends limiting your daily dose, and reducing your intake very gradually. (Going cold turkey can cause a wicked withdrawal headache.) To calculate how much you're consuming each day, visit www.caffeineawareness.org/calcu.php. As you work on quitting coffee and sodas, try less-caffeinated options, such as green or white tea. See more on caffeine content at http://www.stashtea.com/caffeine.htm.

Get a Handle on Hormones

An estimated 60 percent of women with migraines link the headaches to their menstrual cycles. Common danger points include a day or two before your period starts, the first three days of your period, and at mid-cycle, during ovulation. Researchers blame fluctuating hormone levels. So it's no surprise that some women get more headaches at other times of change, like perimenopause or the first trimester of pregnancy.

It's important to track your cycle so you know when you're likely to get a migraine and can plan for it, by minimizing other triggers and taking preventive medication. For some women, birth control pills help reduce migraine frequency, but that varies; some women suffer more on medicines that contain hormones.