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Jose G. Veliz, M.D. M.S.A.
Medical Director
Palomar Pain Management Center
Pomerado Pain Management Center

Posted February 25, 2008 10:01 PM

Any factor which can cause a headache in individuals who are prone to developing migraine headaches can be considered a migraine trigger. Triggers include fasting, bright lights, odors, hormones, sleep disturbances, stress, alcohol, caffeine, nitrites, monosodium glutamate, aspartame, chocolate, and aged cheeses. Interestingly, only a small percentage of those who suffer from migraine headaches are able to identify triggers. During the beginning of menstruation, the decline in the level of estrogen in the blood can also be a trigger for migraine headaches in some women.

Unfortunately, avoiding triggers does not always prevent headaches and exposure to a trigger does not always lead to a migraine headache. The time frame between the exposure to a trigger and the onset of a headache can vary from a few hours up to two days.

Poor quality of sleep, frequent awakening at night, sleep deprivation and excessive sleeping are associated with migraine headaches. Improving ones sleep habits reduces the frequency and duration of migraine headaches. Fasting, through the lowering of blood sugar and release of stress related hormones, can result in migraine headaches. It is prudent to avoid prolonged fasting. Bright lights can cause headaches in both patients with migraine headaches and in healthy subjects. Television, flashing lights and sunlight are examples of migraine triggers.

In high doses, caffeine can be a migraine trigger. However, when caffeine is suddenly stopped in subjects who normally consume high levels of caffeine on a regular basis, migraine headaches can result. Red wine and chocolate have been reported to be migraine triggers. Tyramine, which is a chemical found in beer, wine, cheese, sauerkraut and dry sausage, can also be a migraine trigger. Monosodium glutamate (MSG) which is common in Chinese restaurants can also be a migraine trigger. Ham, frankfurters, bacon, sausages and hot dogs which contain nitrites and nitrates are also migraine triggers. Some diet drinks and diet snacks contain aspartame, a sugar substitute sweetener, which can also be a migraine trigger.

It is not uncommon for women who suffer from migraine headaches to experience more headaches during their menstrual periods. More than likely, lower levels of estrogen at the onset of menses are the probable cause of menstrual migraines. Among users of birth control pills, migraine headaches can develop during the week in which estrogens are not taken.

In summary, one way to prevent migraine headaches is to identify and avoid triggers. Although this strategy is not 100% effective, it can reduce the frequency of the migraine headaches.

Reference: Medicinenet.com.