My 19 year old daughter has had a low grade daily chronic migraine every day since February, 2010. She started on Topamax in July and gradually increased up to 125 mg over 2.5 months. Over the last month her headaches increased in intensity with earlier onset, and the headaches spike 45 minutes to one hour after eating, no matter what she eats and no matter how little she eats. I have read that Topamax increases sensitivity to insulin. Her neurologist does not believe she is having blood sugar issues, but it sure looks like it. I was wondering how you are doing off of the Topamax?

For instance, don’t drink on an empty stomach or drink too much alcohol if you’re going to go for hours later without eating, which is most likely the case if you got drunk.

If you sleep a lot and the time between your first real meal and your last is more than 12 hours don’t take something sweet or high in glycemic index when you wake. Many cereals and processed foods (crackers, biscuits, white rice) contain a lot of sugar, including milk and juices. General rule : don’t take sweet things when you’re feeling VERY hungry. Try drinking a glass of warm water before.

Don’t go without food for more than 6 hours unless you have moved to all low glycemic index food for some time and done detox to restore liver and pancreas function. When you do eat stay away from highly processed, deep-fried, sweetened food even though you’re most likely tempted to eat those types of food.

Eat small regular meals. Make sure you have something healthy to standby for breakfast.

One other challenge is that cravings are sometimes mistaken for triggers when they’re not. Of course, eating a food you crave may be a trigger, but sometimes the migraine attack causes you to crave something before the attack is in full swing.

For many people, this may be the case with chocolate – not a trigger for you, but you tend to crave it early in the attack.