I suffer migraines often, as does over 13% of the American population. They’re classed as one of the most disabling chronic illnesses, with more than 90% of sufferers claiming that they miss school or work when experiencing one.
“Keep your friends close, and your enemies closer”
Given that these attacks have plagued me since I hit puberty, I figured I should educate myself on them–hopefully you learn a few things as well!
What Causes Them?
What’s Going On In My Head?
It’s always good to give bad news first, right? Well, the bad news is that nobody is really sure what causes them. There are two popular theories:
- Changes in the brainstem that affect how it interacts with the trigeminal nerve, which is one of the most crucial pain pathways.
- Chemical or hormonal imbalances, especially in seratonin. This theory is supported by the fact that levels of this hormone are very low during attacks–though that may be an because of the pain, not the original cause of it. (1)
- An incomplete or unusual network of arteries supplying the brain. (2)
What is known is what the mechanical affect is. During a migraine, the temporal artery (the one that runs across your temple), one of the major arteries for your head, enlarges. This causes a rush of chemicals that trigger inflammation, pain, and–in an evolutionary fluke–further enlargement of the artery.
Are My Symptoms Normal?
These hormones cause a variety of symptoms. Migraines are characterized by:
- Extreme, aching pain that seems to originate from the temples and radiate around the head.
- Decreased blood pressure, which causes cold hands and feet.
- Sensitivity to light and sounds. You probably want to be somewhere dark and quiet, even though it doesn’t make you feel better.
- Intestinal distress, such as vomiting, diarrhea, and general discomfort.
Triggers and Warnings
What’s more important for sufferers to know–more than the mechanical reason for them–is what their particular trigger or triggers are. Some of the most common ones…
Tyramine or phenylethylamine
These two amino acids are found most abundantly in chocolate, aged or fermented cheeses such as Brie, cheddar, and “moldy” varieties, citrus fruits, vinegar, nuts, and soy products. (3) Since that most likely eliminates many of your favorite foods, make sure to document what you ate right before your migraine started so you can narrow the list down.
If this is true for you, be careful of eating leftovers. Tyramine content increases over time, so try to only store foods that don’t have to be in air tight containers, and be wary of situations where food has been left out for a while, such as parties and office snacks.
Lastly, many alcoholic beverages, such as beer, red wine, sherry, and vermouth contain copious amounts of the chemical, so try to find alternate adult beverages for partying without the pain. More on boozing further down!
Coffee, tea, energy drinks, and even some dark chocolates can start the aching for some.
Alcohol and Dehydration
These two belong together, as boozing is one of the few times where the more you empty your cup, the most dehydrated you are. Alcohol itself may be your trigger, but before you convict this culprit, try alternating alcoholic beverages with tall glasses of water.
Tea, red wine, and red fruit (apples, pears, and grapes all qualify) and their juices can all cause migraines. If you frequently suffer after consuming red or purple foods or beverages, this may be your prime suspect.
Nitrites, nitrates, and sulfites have all been guilty of causing migraines. These chemicals are doing your body no favors. Be wary of hot dogs, deli meats, dried fruit, and, one more time, wine.
That cute little pink envelope by the coffee doesn’t look so friendly when you suffer from migraines. Check labels when you chose to drink diet beverages, light yogurts, or anything labelled “sugar free” that still tastes sweet.
As if you need another reason to hate these days of the month.
Strong perfumes, flickering lights, and excessive stress can all be triggers.
It’s important to keep a diary of when you get migraines, and narrow down what causes them. This will help you avoid them in the future. The triggers listed are only the most common, you may have something else to blame, such as medication or certain physical activities.
You probably started reading this article to find out how to treat the stupid things, right? Well, here it is…
The best way to treat migraines is to prevent them as often as you can. Find out what your triggers are, and avoid them! Even if it’s chocolate–it’s really just not worth the pain.
If your migraines are particularly severe, often, or both, talk to your doctor. They may prescribe preventative medicines, such as:
- Cardiovascular drugs such as beta blockers or calcium channel blockers.
- Tricyclic antidepressants or selective seratonin reuptake inhibitors, as they can help regulate your seratonin.
- Anti-seizure drugs such as Depacon and Topamax have been shown to reduce the frequency of migraines. These drugs have some serious side effects, so it’s recommended you only take them if you absolutely must.
- Botox injections in the muscles of the head and neck have been shown to help lessen the effect and frequency.
- Anti-inflammatory drugs such as naproxen may help.
Treatment During an Attack
If you can take pain medications right when you’re feeling the beginnings of a migraine, they’re more likely to work. NSAIDS (Advil, Motrin IB) are hit or miss. Acetaminophen (Tylenol) helps some but is less likely.
Drugs marketed as specifically for migraines, such as Excedrin Migraine (this one is my personal favorite), help for mild to medium severity attacks, but don’t do much if you wait to take them.
All of these medications lead to stomach complications if taken too often.
If these don’t work for you, or you have migraines more than once a month, talk to your doctor about:
- Triptans, which constrict blood vessels, have been proven to help end migraines sooner, and manage pain. There’s several side effects, however, and they are not recommended to those who are at risk for stroke or heart attack–if you have high blood pressure, don’t take these.
- Dihydroergotamine (Migranal) is an ergotamine derivative with less side affects. It’s available as either a nasal spray or injection.
- Opioids should only be taken as a last resort, as they’re fairly addictive. They can be helpful for those who cannot take triptans or ergot.(4)
If you can sleep, do. It’s one of the best ways to cure a migraine that doesn’t come in pill form.
Do you have any tips, tricks, or anecdotes you’d like to share about your migraines?