Migraine Triggers: Internal and External?

Sometimes when we talk about migraine triggers we refer to them as “internal” or “external”.  Why?

A lot of people think of migraine triggers in very black and white terms.  “I eat a banana, I get a migraine”.  But in most cases, things are a little more complicated.

For most of us, triggers don’t tend to be one thing, but a number of things working together.  You can think of it like a bathtub.  More and more “triggers” get added, filling up the tub.  Finally, there’s that last drop – that cup of coffee, onion, the smell of perfume – and it overflows.  Hello migraine attack.

Sometimes triggers can be quite obvious, and almost any time you’re exposed you have an attack.

But other times it’s hard to tell, because there are a number of things that are combining to get the migraine chain-reaction started.  It’s like a safe with 50 combinations that work.

Sometimes we divide triggers into those things that we put into our bodies, or things we’re exposed to, and things that are in our bodies that we have less control over.  The first things would be “external”, the second “internal”.

An external trigger could be red wine, strong cologne, cigarette smoke, a lightning storm, a flickering bulb, or fresh yeast bread.

Internal triggers might include hormonal changes (for example your monthly cycle), sleep apnea, a cold, or a back problem.

Sometimes another disease can trigger migraine symptoms.  In that case you may not actually be diagnosed with migraine – you may be able to treat the disease and the symptoms will go away.

But in other cases, both internal and external triggers work together and bring on attacks.  Sometimes dealing with just one trigger (for example solving your sleep problem or not eating chocolate) may not stop the attacks – you may need to avoid a number of triggers in order to actually get rid of your symptoms.

And as you’ve guessed, that’s not so easy.  It’s not easy to find triggers when any number of 6 combinations may be triggering your attacks.  It’s not easy when one trigger may be a “hidden” internal trigger that you don’t even know about.

But this is just another reason to keep careful records in the form of a headache diary.

“Internal” and “external” triggers aren’t always clear categories.  The main purpose of these categories is to remind us that triggers are much more than three kinds of food.  It can be hard to find which trigger combinations are causing problems, but many people fought back against migraine, found their triggers, and found relief.

Read more here:  Migraine Triggers: Track them Down