migraine trigger

1 August 2022

Smells and Migraine: Getting Worse?

James Discoveries & Stats, Uncategorized 0

Sensitivity to odours is osmophobia. Yes, this can refer to a fear of smells, but the hypersensitivity to smells related to migraine applies as well.

migraine stinks — *I was going to include a picture of perfumes here, but just the picture made me feel like I was getting a headache. Try it for yourself! If you dare…*

A study published in the Journal of Headache and Pain last month provides some interesting insights into common sensitivities and also a possible progression of the symptom.

The researchers, in this case, recognized that many “migraine symptoms” are not only present during an attack, but also before, after, or between attacks – or all the time. This is important to understand for people who still think that migraine only affects you when you have a “migraine headache”.

The biggest offenders probably won’t surprise you. The easy winner was “sweet perfumes”. But next to that, the odours of various foods, cigarette smoke, and exhaust fumes were common offenders. All of these sometimes covered all categories above in the sense of when they were a problem, some being bothersome all the time, and all for some people were considered triggers.

Also not surprising was that if a smell bothered you before an attack, it was likely to bother you during an attack. If it bothered you during an attack, chances were better that it would bother you all the time.

Perhaps most interesting in this study were the age differences. Patients who tended to be sensitive to certain smells between attacks tended to be about 10 years older, and/or they had had migraine for 8 years longer. This may indicate that migraine sensitivity does progress. Would the osmophobia be less if migraine had been treated properly in the early years? This study didn’t address the question, but it seems possible.

Some good news is that people with a high sensitivity to odours did not necessarily seem to be more disabled in general. In other words, although obviously this is a part of the migraine disability, it doesn’t seem like it is necessarily a sign that your migraine is getting more severe. A possible exception were those who became especially sensitive just before a migraine attack.

It may also be encouraging to know that the researchers found that patients were not nearly as likely to have an attack triggered by a certain odour as was believed from an earlier study. It could be that certain smells become more intense and annoying at certain times, such as right before an attack. But that does not necessarily mean that the perfume or whatever is actually triggering an attack.

For more on the study, check out Interictal osmophobia is associated with longer migraine disease duration.

9 November 2015

Does Vegetarian Cheese cause Migraine?

James Information 0

Vegetarian and vegan cheese in particular can be a little different from traditional cheeses. We know that cheese is often on the list of foods to avoid for migraine patients. But does vegetarian cheese cause migraine?

Let’s be careful about our terms – the cause of migraine is a complex mystery. That is, why one person has a migraine attack and another person doesn’t. What we’re actually talking about are things that trigger an attack, such as certain foods, hormonal changes and weather patterns.

Vegetarian Cheese Sandwich We’re not sure exactly why certain cheeses trigger attacks, but a likely culprit is tyramine, which is a compound found in many foods. Migraine patients may also be sensitive to other chemicals that are added to highly processed foods.

Vegetarian cheeses may still contain high amounts of tyramine, especially aged cheeses. From what I understand about the process of making vegetarian cheese, the levels will probably be similar to normal cheese. Your best bet is to go with cheeses that are fresher. For more information, check out Can I be Migraine-Free and still eat Cheese?

Now vegan cheese is a little different than vegetarian cheese. Although (aged) vegan cheese is . . . well, still aged, it is entirely plant-based. That probably means that some high tyramine products were taken out – but others may have been put in. Unfortunately, I have yet to see a good study on vegan cheeses and tyramine, and I may not see one because it’s all very different depending on the manufacturer.

One downside of vegan cheese is that it tends to be highly processed, which may cause problems for someone with migraine – again, depending on the brand.

Some common ingredients in vegan cheese can trigger migraine attacks in some people – soy, aged soy, yeast, and nuts, for example (more about vegan cheese here).

In the end, until someone starts specifically manufacturing “low tyramine” vegan or vegetarian cheese, you’re probable best to stick with regular, fresh cheeses such as ricotta and cottage cheese. If you’re on a special diet and can’t eat regular cheese for another reason, be cautious and stick to small quantities if you really want to go for a cheese fix.

Again, for basic tips on cheese and migraine, check this article.

7 February 2013

Migraine Triggers: Don’t Believe the Headlines (and the myths)

James Discoveries & Stats, Information 3

Every once in a while headlines go flashing around in the media that give a completely wrong impression. For example, I’ve recently seen these headlines:

Migraine triggers may not cause severe headaches

Report: Migraine triggers may not be so potent

Migraine “Triggers” May Not Cause Migraines After All

What impression do you get from these headlines? First, you might think,”Oh, we used to think that certain ‘triggers’ (ie chocolate, weather, MSG) caused migraines, but now with new research we know that they don’t!”

Migraine Triggers? What do the headlines say?

Worse, someone might think,”Oh yeah, I have a coworker like that. She blames everything for her headaches. Maybe now she can start taking some responsibility.”

Now if you’ve only read the headlines, you’re going to be surprised about what the articles are actually about.

The actual study

Yes, there was an interesting study done, published by the journal Neurology (ahead of print on the 23rd of January 2013 – Provocation of migraine with aura using natural trigger factors). The study was small (just 27 patients), and studied only 2 “triggers” – bright/flickering lights and exercise. Although patients said that these were triggers for them, only a few reported migraine attacks after exposure (a few from exercise, none from bright lights).

That’s it? Yup.

Of course, this raises a whole boatload of questions. How long after the exposure were patients monitored? What type of bright/flickering lights? How much exercise? Of course, the study answers these questions – but that’s not the point.

The point is – what does this really tell us about migraine triggers?

Well, there’s one thing that the study suggests. The triggers that some patients report may not always immediately trigger a migraine attack.

That’s it. And that’s not a big news story.

Migraine Trigger Myths?

Are we just believing myths about triggers? Let’s take a quick look at a few…

MYTH: A “migraine trigger” is something that causes a migraine. Actually, a trigger could “cause” an attack, in the sense that you wouldn’t have had the attack at that time if it weren’t for a certain trigger. But actually, no one knows the “cause” of migraine, and to call a trigger a cause is, in the opinion of this author, an over simplification.
MYTH: We used to think that various things “triggered” migraine attacks, but now we know better. Actually, the trigger controversy is nothing new. For many years doctors and researchers have debated about how much influence triggers, particularly common triggers (ie chocolate, bananas, flickering lights…) have on migraine. They have debated about whether it’s better to avoid them or not.
MYTH: Everyone with migraine has to fear the same triggers. Nonsense! Triggers are different in everyone. Though there are things that commonly trigger migraine attacks, those things may not be a problem at all for some people.
MYTH: If X is a trigger for you, X will always result in a migraine attack. Absolutely untrue! Let’s say raw onion is a migraine trigger for you. That does not mean that every time you eat raw onion you will get a migraine attack. That may be true for some people, but not others. It’s likely that a number of triggers are working together – once you’re exposed to too many for you, an attack begins. So on a good day with few triggers, X may not lead to any problems.
MYTH: Avoiding triggers will cure migraine. Not only will it not “cure” migraine, avoiding triggers will not always mean you won’t get any attacks. Migraine isn’t that predictable. In many cases avoiding triggers can lead to fewer attacks – in rare cases no attacks at all. But there are no guarantees.
MYTH: A migraine trigger will always immediately result in a migraine attack. Actually, there’s a lot of disagreement over this one, particularly when it comes to food. Sure, an attack will often come almost right away. But some believe that triggers could impact you a day or even several days later. That makes it very hard to study exactly how triggers work. What if exposure to trigger X on Tuesday leads to a migraine on Wednesday – but only if you’re also exposed to Y on Wednesday? See the problem?

There was a good point that some have tried to make from this study (and I’m not blaming the study itself for the headlines). That is, many migraineurs assume that certain things will always trigger an attack, and so they avoid things that could help them. This may relate to nutrition, but it’s especially true of exercise. The benefits of moderate exercise, done properly, are in most cases going to far outweigh the problems. There are ways to minimize exercise headache and migraine.

Sure, they headlines did their job – they grabbed attention. But for so many who don’t bother to read the information carefully – particularly people who “know someone with migraine” – the headlines can be very misleading.

While we’re on the topic, here are 12 ways to Evaluate Migraine News. And more information about tracking down migraine triggers.

12 September 2012

Triggers: Not Just Food! (by a long shot)

James Tips 9

It seems that, most often, when people talk about triggers they’re referring to foods that trigger a migraine attack. But our latest poll shows that food is not the only trigger – in fact, it may be a ways down the list!

Triggers: Weather? Pollution? Travel?

#1 Trigger: Weather

A full third of those who voted said that weather was the biggest trigger for them. This could include heat, changes in barometric pressure, storms – we weren’t specific in this poll. But weather is obviously a big one. Read more about headache and weather.

#2 Trigger: Hormones

Yes, hormonal changes can be a trigger (not a cause) of migraine attacks. This is what I call an “internal trigger”. 18% of our guests said that this was the big one for them. Read about some types of hormonal headache here.

#3 Trigger: Changes in Schedule

13% said that changes in schedule – including when they go to sleep, or wake up, or hours of sleep, or changes in eating times, or skipping a meal – was the big trigger for them.

#4 Trigger: Flickering Lights

11% said that this was their main trigger. It’s well established that migraine brains process flicker differently than everyone else. The biggest question is what types of flicker actually trigger attacks.

#5 Trigger: Environmental Factors

The culprits here are things like perfume, second hand smoke, pollution – and maybe even natural factors like pollen. 9% claimed this as their biggest trigger, though I’m sure a much higher percentage of people find environmental triggers to be a problem some of the time.

#6 Trigger: Food

That’s right, food was waaaay down the list! At #6, only 6% said that this was their biggest trigger.

#7 Trigger: Exercise and exertion

Only 4% put this as their biggest trigger, but we do know that exercise headache is a widespread problem.

#8 Trigger: Travel / motion

Motion sickness is a common predictor of migraine. But the motion itself can trigger attacks. Plus, travel can include changes in schedule, flickering lights, trouble controlling food, changes in weather – a nice package of triggers all together. 3% of our guests put this as their biggest trigger.

#9 Trigger: Other disease / condition

Medically, a headache brought on by another disease isn’t usually considered a trigger, but a symptom. However, as many of us know, those of us prone to migraine can end up with increased attacks from something as simple as a head cold.

Trigger #10: Medications/supplements

Actually, this one hardly shows on the graph with only 3 votes. However, migraineurs often do need to watch out for certain ingredients that are added to supplements. And we all know that the labels of many migraine medications actually list “headache” as one of the side effects!

There are a lot of fascinating things I could point out looking at this poll. But one of the most remarkable things is how low on the list food is. I can remember going to the doctor and hearing right off the top – let’s try taking bananas, chocolate and caffeine out of your diet for a while. Are doctors taking the wrong approach here? Are we as patients focusing on the wrong things?

Maybe we need to investigate a little further into what is actually triggering our attacks, and not blame everything on food. Don’t get me wrong – I believe that diet is one of the most important things that a migraineur needs to focus on. But it’s not the only thing. We could be missing some key triggers if we just talk about food triggers.

12 May 2011

1% Thursday: Caffeine Levels

James Tips 5

Many doctors will tell you to cut the caffeine when looking for migraine triggers. But did you know some doctors see things a little differently?

I’m not suggesting you ignore your doctor – cutting caffeine is a great thing to try. But there’s something else you might want to try – that is, levelling your caffeine intake. Taking about the same amount each day, around the same time.

Spikes and drops in your caffeine levels may be even more of a migraine trigger than the caffeine itself. Suddenly drinking 12 cups of coffee one night, then nothing the next day – ouch. Or even sleeping in on Saturday and missing your regular morning coffee – that can be a trigger too.

Try having about the same amount each day – but keep that amount low. Lower it gradually. Watch for caffeine in colas, and even in medication. Try to keep it level as much as possible, and see what kind of difference it makes. This alone may cut some of those attacks you’ve been getting.

What is 1% Thursday?

Every Thursday at Headache and Migraine News (weather permitting) we’ll talk about one measurable, practical thing we can do to make our lives just 1% better. Usually it will be something very easy, sometimes it will be a challenge. Let us know if you try it, or share an idea of your own – and maybe a year from now we’ll see that things have really changed for the better!