Migraine triggers

There are lots of potential triggers and they can vary from one person to another. We investigate the most common triggers.

Environmental triggers

Various environmental factors are thought to precipitate or trigger migraines. Some migraines are totally unpredictable, occurring for no apparent reason.

Common examples of triggers include:

• Undue stress or relaxation after a stressful period of time

• Anxiety

• Exposure to chemicals such as paints, varnishes and strong cleaning solutions

• Hormone levels during the menstrual cycle

• Bright or glaring lights

• Alcohol

• Unusual weather conditions

• Over-exercising

• Too little sleep or too much sleep/lack of oxygen

Migraine sufferers find it helps to keep a personal diary of when headaches occur and suspected triggers to learn the best way to avoid them in the future. It’s all about knowing your own body.

Nutrition triggers

The most commonly identified culprits are:

• Dehydration

• Alcohol

• Caffeine withdrawal

• Missing a regular meal, causing excessive hunger

Suspect foods

A craving for certain foods is likely to be a symptom of an imminent migraine approaching rather than a cause of the migraine. A recent review of research evidence concluded these suspect foods could not be shown to trigger attacks or that a diet avoiding these foods will not stop people having migraines.

Nevertheless some migraine sufferers do individually report good results when they avoid some foods. As a result some specialists will recommend people cut these out of their diets.

The foods long suspected of being trigger foods are those that contain histamine, tyramine, nitrates, nitrites and sodium glutamate.

Tyramine and histamine occur in foods naturally, particularly those that are aged or preserved. Histamine is also released in the body in response to eating certain foods (an allergic response) whereas nitrates and nitrites are added to foods to preserve them.

Glutamates (or flavour enhancers numbered 620-625 on food labels) are a traditional form of flavouring additive. The chemical family of glutamate compounds is also found naturally in some foods such as hard cheese, soy sauce and fish sauce, and small amounts are found in many other foods.

Foods containing these substances

• Aged cheddar, blue and white rind cheeses

• Chocolate

• Smoked and cured foods, eg salami, pepperoni

• Fermented foods, eg soy sauce, miso, sauerkraut, beer, sherry, ginger beer, vinegar, yoghurt, soured milk products

• Salted and dried foods e.g. bacon, anchovies

• Pickled foods, eg olives, gherkins

• Broad or fava beans

• Yeast extract, eg Marmite, Vegemite, soup mixes

• Meat tenderiser

• Monosodium glutamate (MSG or flavour enhancer 621 or INS 621)

If you’re trying to avoid these foods when eating out, ask for details from the kitchen if you’re unsure of the ingredients in a dish.

Thanks to Annette Hallam, National Director of New Zealand Migraine Sufferers Support Group for her advice and assistance in reviewing the contents of this article.