Migraine is a well-known cause of headaches. It is also a common cause of vertigo and dizziness. Vertigo due to migraine can occur without headaches. Migraine headache is often treated with over-the-counter and prescription-only medications.
Identifying, avoiding and/or controlling the common triggers can be used along with medications to control or reduce the frequency of the condition.
The triggers are not the same for everyone, but keeping a migraine diary (www.migraine.org.uk/information/factsheets/migraine-diary) may help sufferers to identify the factors that specifically trigger an attack. This could be several hours beforehand. If vertigo is the predominant symptom, substitute ‘headache’ with ‘vertigo’ in the diary.
This information sheet provides a summary of migraine triggers and lifestyle modifications but does not offer any advice on drug treatment. The list is not necessarily complete: you may discover triggers specific to your individual situation that are not on the list below.
FOOD and DRINKS
Chocolate: All forms including flavourings and drinking chocolate
Advice: Avoid
Dairy products: ripened, strong cheeses (cheddar, stilton, blue, brie)
Advice: Cottage and cream cheeses are allowed
Alcohol: (especially oaked/aged), red wine, port, whisky, brandy
Advice: Limit alcohol to beer or unoaked white wine or, preferably, avoid altogether
Meat/fish: canned, aged or processed meat or fish: ham and bacon, game, fermented sausage, salami, pepperoni, Frankfurter and hot dog sausages, smoked meat, pickled herring and dried fish. Also, occasionally chicken liver and shellfish
Advice: Use fresh or frozen meat and fish without preservatives or additives
Yeast extract: Marmite, stock cubes, gravy mixes etc
Advice: Make gravy from pan juices
Caffeine: coffee and tea, cola
Advice: Avoid cola. Take decaffeinated tea/coffee
Fruits: red plums, avocado, passion fruit, citrus (orange, lemon, lime, grapefruit) fruits, strawberries, ripe bananas
Vegetables: beans, peas, tomatoes
Others: foods containing MSG (monosodium glutamate), canned soups, non-white vinegars, fermented, pickled or marinated products and aspartame (artificial sweeteners)
Advice: Avoid diet drinks and sweeteners as may contain aspartame
STRESSES
Emotional stress: strong emotions (anger, worry, tension), depression and anxiety
Advice: Relaxation and stress management, Anticipate and manage lifestyle changes properly
Physical stress: exertion, tiredness, poor sleep pattern including jet lag, dehydration, disruption of lifestyle, travelling
Advice: Take moderate routine exercise (eg 3 to 5 times a week
Irregular eating: skipping meals or bingeing
Advice: Eat regular meals and drink enough water
HORMONES
Hormonal changes: puberty, menstrual cycle (especially the pre-menstrual period), oral contraceptive pill, pregnancy (migraines may cease during pregnancy and may return after), menopause and HRT
Advice: Advice from GP may be required to avoid oestrogen-only oral contraceptive pills
ENVIRONMENT
Bright lights eg supermarket, car headlamps, Flickering or flashing lights (from televisions and, computers), fluorescent lights, Loud sounds
Advice: Wear dark glasses to reduce glare from bright light, Dim the background light on the computer
Strong odours eg: perfume, petrol, paint, cigarette smoke, some food
Advice: Avoid exposure to strong smells
Weather changes: rapid changes in atmospheric pressure, rising temperature and humidity, Stuffy environments, Smoking
Advice: Stop smoking
Reference
- http://www.migraine.org.uk/information/triggers
- Diamond S: Dietary factors in vascular headache. Neurology Forum 1991; 2:2
- Tusa R. Migraine, Meniere's disease and Motion Sensitivity. In Vestibular Rehabilitation, 3rd edition pp195-6 Editor, Herdman SJ.
The following links provide further patient-focussed information:
- http://www.migraine.org.uk
- https://www.migrainetrust.org/living-with-migraine
- https://www.migrainetrust.org/living-with-migraine/coping-managing/exercise
- https://www.migrainetrust.org/living-with-migraine/coping-managing/sleep
Compiled by Dr Victor Osei-Lah on behalf of BAAP/2017
Acknowledgements:
- Dr Veronica Kennedy, Dr Chung Chan,
- Dr Louisa Murdin, Dr Peter West and Dr Dolores Umapathy
