Migraines can be extremely debilitating and figuring out your unique triggers is an important step in managing migraine disease. While the exact causes are still being studied, we know that migraines can be triggered by a variety of factors including hormones, weather, foods, medications, and lifestyle habits. Identifying and avoiding your personal triggers can significantly decrease migraine frequency and intensity. This comprehensive guide covers the migraine triggers list so you can pinpoint what may be leading to your attacks.
Introduction
Migraines affect over 37 million people in the United States alone. The intense throbbing head pain, nausea, sensitivity to light and sound can be completely incapacitating. Migraine symptoms and their severity can vary widely from person to person. One of the frustrating things about migraines is that attacks can seem to occur randomly, making them difficult to anticipate and manage. However, there are a number of potential triggers that may increase migraine risk. The more triggers you’re exposed to, the more likely you are to experience a migraine attack. By recognizing your unique triggers, you can take steps to avoid them and reduce your migraine frequency.
This exhaustive list covers the most well-known migraine triggers and risk factors. It’s divided into categories including foods, drinks, environmental factors, hormones, medications, habits, and medical conditions. Keeping track of your own suspected triggers and symptoms in a migraine journal is very helpful for identifying and confirming patterns. Work closely with your doctor to determine your migraine triggers so you can optimize your treatment and prevention plan.
Food and Drink Triggers
Certain foods and drinks are common migraine triggers. Caffeine, alcohol, and foods high in tyramine or nitrates seem to be problematic for many migraine sufferers. Keeping a food diary can help you determine which foods may be contributing to your migraines. Some of the most common dietary migraine triggers include:
- Aged cheeses including cheddar, Swiss, parmesan, blue cheese
- Cured or processed meats like hot dogs, salami, dried beef
- Alcohol like wine, beer, mixed drinks
- Caffeine including coffee, tea, soda, energy drinks
- Artificial sweeteners such as aspartame
- Beans and lentils
- Nuts like peanuts, hazelnuts, almonds
- Onions, avocados, bananas, canned figs
- Pickled foods
- Monosodium glutamate (MSG)
- Nitrate-rich foods like processed meats, lunch meats
- Chocolate
- Vinegar-based foods like ketchup, salad dressings
- Yogurt
- Aspartame and other artificial sweeteners
It’s a good idea to limit intake of high-tyramine foods if you think they may be a migraine trigger. Completely avoiding alcohol and caffeine can also help for some migraine patients. Keeping a consistent daily routine with regular meal times can further reduce migraine attacks.
Hormonal Triggers
Hormonal fluctuations are a very common migraine trigger in women. Changes in estrogen levels seem to play a role in migraines. Hormonal triggers can include:
- Menstruation – Many women experience “menstrual migraines” starting 1-2 days before their period. Declining estrogen is the likely cause. These attacks may be more severe and last longer than other migraines.
- Oral Contraceptives – Birth control pills with declining levels of estrogen towards the end of the cycle can also trigger migraines.
- Hormone Replacement Therapy – Estrogen supplements or fluctuations may precipitate migraines.
- Menopause – Shifting hormone levels often worsen migraines during perimenopause and menopause.
- Pregnancy – Some women have fewer migraines during pregnancy, while others find the hormonal changes make them worse.
- Ovulation – The release of an egg and fluctuation of estrogen mid-cycle causes some women to have an “ovulation migraine”.
If hormonal fluctuations seem to trigger your migraines, your doctor may recommend preventive treatments to stabilize your estrogen levels. Birth control pills with extended cycles may help avoid declines in estrogen. Hormone replacement therapy adjustments, prescription progesterone, or medications to suppress ovulation may also be helpful.
Weather Triggers
Oddly enough, changes in weather or barometric pressure can trigger migraines in some people. If you notice migraines on sunny days, rainy days, high humidity, falling barometric pressure, or strong winds, a weather trigger may be to blame. Possible explanations include effects of barometric pressure on blood vessels or weather conditions impacting sleep quality. Keeping track of the forecast and your migraine patterns can help identify if weather is a likely trigger for you. Adding extra migraine prevention when high risk weather is forecasted may help offset weather-related attacks.
Sensory Triggers
Lights, sounds, smells and other sensations can trigger migraines in those prone to attacks. Any sort of sensory overload seems to lower the threshold for migraine onset. Common sensory triggers include:
- Bright or flashing lights
- Sun glare
- Loud noises
- Certain smells like perfume, cigarette smoke, cleaning products
- Stuffiness or high humidity
- Strong odors
- Low light or having to strain your eyes
- Lack of sleep or fatigue
- Dehydration
You can take steps at home and work to control exposure to sensory triggers. Wear sunglasses outside, avoid noisy crowded places when possible, and use earplugs, fans, or air filters to improve air quality and circulation. Drink plenty of water and maintain a regular sleep routine as prevention. Let friends and coworkers know ways they can help minimize sensory overload for you during a migraine attack.
Medication Triggers
Certain medications or medications combinations may trigger migraines. Medication-overuse headaches from overusing acute migraine drugs like ibuprofen or triptans are also common. Medications that may provoke migraines include:
- Birth control pills
- Hormone replacement therapy
- Antidepressants
- Beta blockers
- Nitroglycerin
- Blood pressure medications
- Opioid pain medications
- Asthma inhalers
- Sleeping aids like zolpidem
- Decongestants
- OTC pain relievers when overused – ibuprofen, aspirin, acetaminophen
- Prescription migraine medications when overused – triptans like sumatriptan, ergotamine
Talk to your doctor about potential medication interactions or adjustments if you think your prescriptions may be triggering migraines. Avoiding overuse of acute migraine drugs is also important to prevent rebound headaches. Using preventive daily medications may be recommended to reduce migraine frequency and severity.
Habits that Can Lead to Migraines
Certain daily habits and behaviors can either provoke or prevent migraine attacks. Lifestyle adjustments may significantly help lower your risk. Habits that raise migraine risk include:
- Irregular sleep schedule
- Sleeping too much or too little
- High stress and anxiety
- Fasting or skipping meals
- Dehydration
- Teeth grinding or jaw clenching
- Poor posture – neck strain
Whereas good migraine prevention habits include:
- Waking and going to bed at the same time daily
- Getting 7-8 hours of sleep per night
- Managing stress with exercise, meditation, massage
- Eating meals and snacks at regular times
- Drinking plenty of water
- Avoiding caffeine later in the day
- Relaxing bedtime routine
- Breaking teeth grinding habit with night guard
- Stretching and improving posture
Making lifestyle modifications can have a big influence on migraine frequency for some patients. Even small changes like drinking more water, reducing stress and improving sleep can be extremely helpful.
Medical Conditions that Can Cause Migraines
Some underlying medical conditions are linked to migraines and may act as triggers in some people. Treating these conditions may help reduce migraine attacks. Some medical conditions tied to migraines include:
- Traumatic brain injuries
- Stroke
- Head and neck injuries
- Temporomandibular joint (TMJ) dysfunction
- Gastrointestinal disorders like celiac disease or irritable bowel syndrome (IBS)
- Food sensitivities or food allergies
- Cervicogenic headaches due to neck issues
- Vestibular migraines related to vertigo and dizziness
If you have migraines along with other medical conditions, be sure your doctor is aware as treatment may need to be adjusted. Keeping these underlying issues well-managed can help minimize migraine attacks.
Putting it All Together: Finding Your Triggers
As you can see, migraine triggers are extremely varied and unique to each person. The best way to identify your triggers is through trial and error and keeping a migraine journal or log. Note your migraine symptoms, severity, timing, and any suspected triggers. Look for patterns over the course of at least a couple months.
Some potential ways to identify key triggers:
- Note any foods eaten in the 24 hours before a migraine
- Track your menstrual cycle and record which days you get hormonal migraines
- Make note of the weather each day – barometric pressure, temperature, precipitation
- Record your sleep duration and quality in relation to migraines
- Note any new medications you started taking before attacks become more frequent
- Look for links to major lifestyle stressors or changes
Discuss your observations with your doctor to get their input. Avoiding your personalized triggers is just as important as taking preventive medications or having an abortive treatment plan. Being aware of potential triggers allows you to proactively modify your environment, habits and behaviors to minimize migraines.
Conclusion
Migraine triggers are highly variable and personal. The Migraine Triggers List includes food, hormonal changes, weather, sensory stimuli, medications, habits and other medical conditions. Keeping a migraine journal helps identify your unique triggers so you can try to avoid them. Preventing migraines by managing triggers through lifestyle modifications is an essential piece of an effective treatment plan. Being aware of your specific triggers allows you to take back some control over migraine attacks. Consult with your doctor regularly to establish a customized prevention and treatment regimen aimed at reducing your migraines.
