Avoid Your Migraine Triggers

The best place to begin the process of managing your migraine headache symptoms is to reduce the frequency of attacks by avoiding triggers. Common migraine triggers range from physical activity and environmental stimuli to certain foods, food additives and stress. The key always is to know your own personal triggers. Here are some common triggers to watch for:

• Food Additives—MSG, nitrates, artificial sweeteners.
• Caffeine and Alcohol—Beverages such as coffee and red wine.
• Environmental Stimuli—Loud noises, bright lights and glare as well as certain odors (e.g., perfume); also, changes in weather and altitude.
• Poor Sleep and Eating Patterns—Poor diet and irregular eating habits; too little or too much sleep or interrupted rapid eye movement (REM) sleep.

Pay attention to all your activities prior to the onset of an attack, record this information in a journal and share that record with your physician. Working together you may be able to identify a pattern of behavior, foods or stimuli that trigger your migraine attacks.

Explore Preventive Treatments

Be proactive in fighting your migraines. Discuss with your physician and/or naturopath a course of medications and natural remedies that may reduce the intensity of your migraines, their duration and frequency. Some options include:

• Physical Exercise—Try a mild-to-moderate cardio workout, such as swimming, cycling, jogging, dancing or fast walking. Your goal is to reduce stress and release endorphins while keeping your heart rate below 150 BPM. A Swedish study suggests cardio holds promise for migraine patients.¹
• Stress Reduction—In addition to physical exercise, you can try a series of mind-body programs, including yoga, meditation and massage.
• Supplements—The right combination of vitamins (especially B vitamins), herbs (Butterbur and Feverfew) and minerals (magnesium) may help reduce both the severity and frequency of migraines. Although available without prescription, consult your physician and/or naturopath before starting any regimen. Let your healthcare provider know if you are pregnant, have other medical conditions or are taking any prescription medications.
• Medications—While most medications relieve headache pain and accompanying symptoms during attack, your physician may want to try a few preventive medicines: anti-seizure (e.g., topiramate), tricyclic anti-depressant (e.g., amitriptyline), and Beta Blockers (high blood pressure medications).
• BOTOX®—Botulinum toxin, the popular cosmetic treatment, is FDA-approved as an effective treatment for preventing chronic migraines.

Take Action during the Prodrome Phase

This first phase of a migraine is like an early warning system to what is coming. It’s also an opportunity to focus on medications and treatments that may reduce the severity and longevity of your migraine headache symptoms:

• Triptans (serotonin receptor agonists) are vasoconstrictors that help narrow blood vessels to reduce pressure and shorten severity of a migraine attack.
• Transcranial magnetic stimulation (either as an external device or implanted) may be used at the first sign of a migraine to modulate nerve function through the application of electric and magnetic energy.
• Biofeedback, chiropractic adjustment and acupuncture are natural therapies that may help relieve prodrome symptoms as well as symptoms throughout the duration of a migraine.

Go to Your Dark and Quiet Space in the Aura Phase

During the aura phase, symptoms can range from flashes of light and dizziness to tingling or numbness in arm or leg and speech disturbances (aphasia). There are not a lot of specific treatments for managing your migraine headache symptoms during aura, except to keep yourself as comfortable as possible. In particular, a dark and quiet room may help reduce trigger stimuli.

One medication, however, may be useful is Domperidone (a dopamine receptor antagonist). It may help to reduce the hypersensitivity of the neurotransmitters that control muscle contraction, cognition and energy. Domperidone also includes an anti-emetic to relieve nausea and vomiting.

Attack

During the third phase of a migraine, you need to focus on managing your migraine headache symptoms:

• Pulsating, throbbing headache pain
• Nausea and vomiting
• Dizziness, vertigo and fainting
• Temporary vision problems, including blurred vision
• Sensitivity to bright lights and loud sounds

Natural treatments include aromatherapy, massage, chiropractic adjustment, sleep and cold compresses on the forehead and the back of the neck. Medications may also help to relieve the pain and some of the associated symptoms. First, your doctor may recommend you try non-prescription analgesic or nonsteroidal anti-inflammatory drugs (NSAIDS) such as aspirin, ibuprofen and acetaminophen with an anti-emetic (for vomiting).

If you don’t get relief, your doctor may prescribe drugs based on your symptoms, any pre-existing conditions, such as high blood pressure and pregnancy. With any medication, whether it’s over the counter or prescribed by a doctor, follow directions. Overuse may irritate your stomach or kidneys, damage your liver or even induce a medication overuse headache (sometimes called rebound headaches).

Postdrome

During the fourth phase of a migraine, as your symptoms subside, you’ll feel relief. A few people even feel euphoric. But most report feeling drained of energy and wiped out. Therefore, it’s best to give your body the TLC it craves. Think of this as nursing a migraine hangover. Even if you have some minor head and neck pain, you can probably reduce your dose and cut back to over-the-counter medications.

Other treatments include:

• Supplements—B vitamins (e.g., riboflavin), magnesium, CoQ10
• Hydration—Drink plenty of water; dehydration causes many headaches
• Sleep—Let your body recuperate

Finally, remember to report all your symptoms and any possible triggers in your journal. And don’t be discouraged. It may take time to find the best preventive and remedial course of action. But with your healthcare provider’s help, you may find a way to manage migraine headache symptoms better.