Migraine; Prevention.

While appropriate medication and avoiding known or suspected migraine triggers can help extinguish migraine pain, other headache management strategies can help, including:

adopting regular sleeping habits

modifying eating habits (although most people who have food-induced headaches already know what foods trigger headaches, and avoid those foods).

taking vitamin B2 (to increase riboflavin in the diet) and supplements to increase magnesium levels

increasing exercise, which improves blood flow to the brain and increases the production of endorphins, naturally occurring painkilling substances the body produces more of during physical activity.

The key to effectively managing migraine headaches is identifying the unique triggers that provoke your headaches and then minimizing them or eliminating them altogether. Common triggers include:

Hormonal triggers. Women may have headaches around the time of their menstrual period, possibly related to the body's fluctuation of estrogen and progesterone. But there are no steadfast rules when it comes to hormonal triggers. Taking oral contraceptives and hormone replacement therapy and even pregnancy have been blamed for causing severe and frequent migraine attacks. But other women who suffer from migraine say these things improve their condition or make the attacks disappear altogether. Following menopause, when estrogen and other hormone levels decline, women who previously suffered from migraines may find their headaches subside completely. In some women, however, migraines come on or worsen during menopause as a result of fluctuating hormone levels.

Diet triggers. Some migraine sufferers have an acute sensitivity to a specific food or foods. Researchers are not certain why particular foods provoke migraine headaches, but they suspect it is because the foods' chemical properties affect the diameter of blood vessels in the brain.

Tyramine, for example, a chemical produced as a result of the natural breakdown of the amino acid tyrosine, is widely viewed as a migraine provoker. Tyramine levels increase in some foods when they are aged, fermented or stored for long periods of time. Red wine, aged cheeses and processed meats (like hot dogs and bologna) are good examples. Other common food-related triggers include: champagne, ripened cheeses (cheddar, Stilton, Brie, Camembert), nuts and nut spreads, sourdough bread, onions, lentils, snow peas, citrus fruits and bananas, sour cream, chocolate, and MSG, the flavor enhancer, found in soups, restaurant food, frozen foods and potato chips. Additionally, if you're used to caffeinated beverages, foods or painkillers, withdrawal from these substances can trigger a headache, though not necessarily a migraine.

In addition to particular foods, a change in eating patterns can trigger headache, although not necessarily a migraine. Fasting, missing meals or dieting may also cause low-blood sugar levels, another possible migraine trigger.

Environmental triggers. Altitude changes, excessive light and noise and changes in weather patterns (such as high winds and high humidity) are a few of the many environmental triggers of migraines. Airplane travel is one of the biggest triggers. When cabin pressure drops, blood vessels dilate and expand, which may lead to a migraine attack for some people. Bright light, whether from television, a movie screen or the sun at the beach, may also provoke attacks. Excessive or repetitive noises can also trigger migraine headaches, as well as strong odors (such as cigarette smoke). As with food triggers, you should carefully identify environmental triggers and avoid them, when possible.

Emotional triggers. Anticipation, excitement, stress, anxiety, anger and depression are known to trigger migraine attacks. Even "positive" excitement, such as a job promotion or a wedding, can provoke a migraine attack. An effective stress management system can help a migraine sufferer prevent or minimize headaches triggered by these factors and can contribute to a sense of overall good health.

Activity triggers. Changes in lifestyle patterns can also bring on a migraine. Women have reported migraines resulting from too little sleep, too much sleep, overworking and physical overexertion. Vacation time, with its inherent rushing, excitement and altered daily schedule, often triggers a migraine. Sometimes, sexual activity may provoke migraine attacks. Other triggers include motion (such as plane, car, bike and carnival rides), head injuries and interaction with certain drugs, including over-the-counter pain relievers. Always consult your health care professional about medications.

References

R.B. Lipton, D. Dodick, R. Sadovsky, et al. " A Self-Administered Screener for Migraine in Primary Care." Neurology 2003 Vol. 61. (pages 375-382) http://www.healthfinder.gov.

National Institute of Nuerological Disorders and Stroke, National Institutes of Health. NINDS Migraine Information Page. September 5, 2003. http://www.nih.gov.

American Council for Headache Education. http://www.achenet.org. Accessed June 4, 2004.

"Headache Consortium Guidelines" American Headache Society. http://ahsnet.org. Published April 2000. Accessed June 4, 2004.

W.F. Holmes, E.A. MacGregor, J.P.C. Sawyer, R.B. Lipton. "Information About Migraine Disability Influences Physicians' Perceptions of Illness Severity and Treatment Needs." Headache, The Journal of Head and Face Pain. Vol. 41, No. 4, April 2001. http://ahsnet.org

National Headache Foundation. Chicago, IL. http://www.headaches.org. Accessed June 4, 2004.

"Migraine Headaches." National Women's Health Information Center. Office of Women's Health. U.S. Department of Health and Human Services. 1998. http://www.4woman.gov. Accessed June 4, 2004.

"Women and Migraines: Take Charge of the Pain." National Women's Health Resource Center Health Report. Vol. 20, No. 1. February 1998.

"Migraine Medications" Jewish Hospital HealthCare Services. Updated March 2002. http://jhhs.org. Accessed June 4, 2004.

"Guidelines for Treatment of Migraine Headaches" No. A-650-600. Geisinger Health System. Revised: May 1999. http://www.geisinger.org. Accessed June 4, 2004.

American Migraine Prevalence and Prevention (AMPP) Study Fact Sheet." National Headache Foundation. http://headaches.org. Accessed July 7, 2006.

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