Types of triggers

'Triggers' are specific factors that may increase your risk of having a migraine attack. The migraine sufferer has inherited a sensitive nervous system that under certain circumstances can lead to migraine.

Triggers do not ‘cause’ migraine. Instead, they are thought to activate processes that cause migraine in people who are prone to the condition. A certain trigger will not induce a migraine in every person; and, in a single migraine sufferer, a trigger may not cause a migraine every time. By keeping a headache diary, you will be able to identify some triggers for your particular headaches.

Once you have identified triggers, it will be easier for you to avoid them and reduce your chances of having a migraine attack.” —American Council for Headache Education

Examples of triggers

Medications
Overuse of over-the-counter medications can cause rebound headaches.
Missed medication doses and certain medications may cause headaches.

Sleep
Changes in sleep patterns eg napping, oversleeping, too little sleep

Hormonal
Estrogen level changes and fluctuations eg Menstrual cycles, birth control pills, hormone replacement therapies, peri-menopause, menopause, ovulation

Environmental
Weather eg Weather and temperature changes, extreme heat or cold, humidity, barometric pressure changes Bright lights eg Bright or glaring lights, fluorescent lighting, flashing lights or screens
Odors/pollution eg Smog, smoke, perfumes, chemical odors
Other eg High altitude, airplane travel

Stress
Periods of high stress,including life changes
Accumulated stress
Reacting quickly and easily to stress
Repressed emotions

Factors related to stress include anxiety, worry, shock,depression, excitement, mental fatigue, loss and grief.
Both “bad stress” and “good stress” can be triggers. Howwe perceive and react to situations can trigger (or prevent) migraines. Other triggers can include unrealistic timelines or expectations of oneself.

Stress letdown
Weekends, vacations, ending a project or stressful task (including presentations, papers, or exams)

Physical
Overexertion / Injuries eg Over-exercising when out of shape, exercising in heat, marathon running
Visual triggers eg eyestrain (if you wear glasses, make sure your prescription is current), bright or glaring lights, fluorescent lighting, flashing lights or computer screens
Becoming tired or fatigued

Dietary Triggers
Food triggers do not necessarily contribute to migraines in all individuals, and particular foods may trigger attacks in certain people only on occasion. Be your own expert by keeping a journal of foods you have eaten before a migraine attack and see whether the removal or reduction of certain foods from your diet improves your headaches.

Skipping meals, fasting, and low blood sugar can also trigger migraines. If you’re unable to follow a normal eating schedule, pack snacks.


Beverages
Chocolate and cocoa. Alcoholic beverages (especially red wine, beer, and sherry). Caffeine (even in small amounts) may be a trigger for some people.

Fruits
Figs, raisins, papayas, avocados (especially if overripe), red plums, overripe bananas.

Vegetables
Beans such as broad, fava, garbanzo, Italian, lima, navy, pinto, pole. Sauerkraut, string beans, raw garlic, snow peas, olives, pickles, onions (except for flavouring)

Bread & Grains
Freshly baked yeast bread. Fresh yeast coffee cake, doughnuts, sourdough bread. Breads and crackers containing cheese, including pizza. Any product containing chocolate or nuts.

Dairy Products
Cultured dairy products (buttermilk, sour cream). Chocolate milk. Cheese: blue, brick (natural), Gouda, Gruyere, mozzarella, Parmesan, provolone, romano, Roquefort, cheddar, Swiss (emmentaler), Stilton, Brie types and Camembert types.

Meat, fish, poultry
Aged, canned, cured or processed meat, including ham or game, pickled herring, salted dried fish, sardines, anchovies, chicken livers, sausage, bologna, pepperoni, salami, summer sausage, hot dogs, pâté, caviar. Any food prepared with meat tenderizer, soy sauce or brewer’s yeast. Any food containing nitrates, nitrites, or tyramine.

Soups
Canned soup, soup or bouillon cubes, soup base with autolytic yeast or MSG. Read labels.

Desserts
Chocolate ice cream, pudding, cookies, cakes, or pies. Mincemeat pie. Nuts. Any yeast-containing doughs and pastries.

Miscellaneous
Nutrasweet, monosodium glutamate (MSG), yeast/yeast extract, meat tenderizer (Accent), seasoned salt, mixed dishes, pizza, cheese sauce, macaroni and cheese, beef stroganoff, cheese blintzes, lasagna, frozen TV dinners, chocolate. Nuts and nut butters. Pumpkin, sesame and sunflower seeds. Anything fermented, pickled or marinated. Some aspirin medications that contain caffeine. Excessive amounts of Niacin (Niacinamide is fine). Excessive Vitamin A (over 25,000 I.U. daily).


Reference University Health Services University of California, Berkeley www.uhs.berkeley.edu