migraine doctors

Migraine Doctors

One of the most frustrating aspects of getting your headaches treated is finding a doctor who is knowledgeable and up-to-date regarding current treatment and theories. Many doctors are simply not knowledgable about what really causes migraines as well as how to effectively treat migraine attacks using preventative and abortive medications. Nothing is worse than visiting your doctor looking for help and answers only to be told that you “need to relax more,” “its all in your head,” or “maybe you just have a low tolerance for pain!”

Finding a Migraine Doctor

The first step to finding a good migraine doctor is locating one in your area if at all possible. This will save you a lot of time and hassle if you need to visit your doctor regularly. While you do have the option of immediately searching out a specialist (headache specialist, not just a neurologist) – do not rule out how helpful any doctor with a strong interest in treating headaches can be.

Where do you go to find a good local doctor? Try starting with the National Headache Foundation’s Physician locator. This tool will allow you to search for doctors who have completed the Certificate of Added Qualification in Headache Management (CAQ.) At first glance this designation may sound trivial but in actuality this certificate is only granted to physicians who devote the majority of their practice to headache management.

The American Headache Society also maintains and extensive list of physicians.

Another great physician locator tool is maintained by Teri Robert (of the bestselling book “Living Well With Headache and Migraine Disease.) All of the physician indexed in this listing have been personally recommended by patients. The directory is not “pay to be listed” or anything like that.

Finally if none of the resources above work, do not hesitate to do an internet search for “city + headache + specialist.” Searches like this will frequently bring up past forum postings and reader replies that you may find useful.

Selecting Your Doctor

Once you have a short list of doctors, begin making initial appointments. During this time make note of whose office is the most pleasant to work with. If you have trouble getting prompt professional responses now, likely this problem will only be more obnoxious if you are in the middle of an emergency or need help with medication.

When you arrive check your first impressions of the doctor’s office and make note. Is everyone friendly and professional? Is the lighting and office environment migraine-friendly?

Once in the examination room, pay attention to who you end up seeing. Is it the doctor himself or an assistant? Are you asked detailed questions about your headache and migraine history? While you are speaking is the doctor actively listening and paying attention?

If your prospective doctor suggests further testing, does he or she explain why and detail any potential risks involved for you?

If you ask questions or for clarification of terms, how does your doctor react?

Does your doctor have a plan for what to do if the first course of treatment fails? What about the third?

Find out how open your doctor is to exploring alternative therapies if this is something you are interested in.

Be sure to learn who to contact for follow up questions and after hours emergencies.

sinus migraines

Sinus Headache or Migraines?

Many people do not know that chronic sinus headaches are largely believed to actually be migraine attacks and NOT related to one’s sinuses. Migraine pain can actually felt around the eyes and nose – areas frequently associated with one’s sinuses – in many cases. Furthermore, during a migraine attack one will feel not just pain but also feelings of inflammation and stuffiness due to the inflammation of blood vessels around the head and neck. This inflammation can lead to feelings of congestion or cause other symptoms such as runny nose or watering eyes.

How can you tell the difference between a sinus infection (rhinosinusitis) and a migraine?

Sinus infections are rare, not chronic. There will be a clear beginning and end. Migraines, however, can occur with great regularity and last for a period of days.

Sinus infections will be accompanied by other symptoms of infection such as fever, discolored, and/or foul smelling discharge. If these symptoms are absent, your pain is likely being caused by migraine.

The symptoms of sinus infection should be resolved by a course of antibiotics. If the pain continues despite treatment by antibiotics, consider that migraine may be the true cause of your pain.

Are your sinus headaches brought on by changes in the weather? Believe it or not this is a frequent trigger for most migraine sufferers.

Do you experience symptoms of nausea, light or noise sensitivity, throbbing sensations of pain, and the inability to go about your daily activities until the pain has passed? If so, you are likely experiencing a migraine.

Do over-the-counter decongestants and other sinus medications seem ineffective and lead to rebound headaches? If so, consider migraines.

The Next Steps

If you suspect that you may be dealing with the symptoms of migraine rather than sinus headaches or infection there are two things you need to do. First, make an appointment with your doctor to discuss your symptoms and see if you can get medication specifically for the treatment of migraines. If this medication is effective at easing your pain, then this is the most effective feedback you can get regarding the cause of your discomfort. Secondly, consider keeping a headache diary – note all of your symptoms day by day as well as other factors including the weather, what you ate, how you slept, stress levels, exposure to chemicals, strong fragrances or bright lights.

migraine and pregnancy

Migraine and Pregnancy

Will My Migraines Get Worse During Pregnancy?

As many as 15% of all women see an increase in the number of migraines during the first trimester of pregnancy. Why is this? During this time hormone levels in your body, specifically estrogen, will rise rapidly. Many migraine sufferers are sensitive to fluctuations of any kind in hormone levels – this is not a sign of hormonal abnormality. The good news is that for most women, headaches and migraines decrease significantly during the second and third trimesters as hormone levels stabilize.

What Can I Do to Treat My Migraines During Pregnancy?

If you are planning on getting pregnant and currently take medication of any kind – over-the-counter or prescription, your best course of action is to speak with your doctor. Many medications carry risks for pregnant or breastfeeding women, especially commonly prescribed medicines for migraines such as triptans and pain relievers. Even Aspirin and Advil have been known to cause problems with pregnancies. Only Tylenol is considered safe for periodic use. Just keep in mind that in high doses Tylenol is toxic and kills thousands of unknowing people every year. Be sure to always follow the instructions on the label of any medication.

The best course of prevention, although not always the easiest, is to avoid your personal migraine triggers. This is your best alternative as your options for aborting a migraine once it begins are more limited. If you do not already know your personal migraine triggers, then it is recommended that you start keeping a “migraine diary” so that you can spot important trends in your attacks. Common triggers include (but are not limited to) certain foods and food additives, strong smells, chemical exposure, dehydration, poor sleep, stress, bright lights, and loud repetitive noises.

Make sure that you avoid any “natural treatment” that has not been approved by your doctor. Just because a substance is natural doesn’t make it safe. Even common vitamins such as Vitamin A can be damaging to a developing fetus.

Be sure to avoid the following migraine herbal supplements while trying to conceive, pregnant, or nursing:

• Melatonin (can prevent conception)
• Butterbur root (not safe in many cases as it requires special processing to remove cancer causing agents)
• Feverfew (not safe for pregnant or nursing women, or children under two years of age)

What is Safe for Migraines During Pregnancy?

Only your doctor can tell you for sure but many women have luck using magnesium supplements for migraine prevention, as well as biofeedback, and ice massage. Make sure you also stick to a regular sleep schedule, eat plenty of healthy fresh foods, and exercise regularly.

Keep in mind that safety data is being updated all the time. Here are three websites that I rely on for current information:

http://www.womenshealth.gov/faq/pregnancy-medicines.cfm

http://www.fda.gov/ScienceResearch/SpecialTopics/WomensHealthResearch/ucm134848.htm

http://www.nlm.nih.gov/medlineplus/pregnancy.html

Safety data on medication usage during pregnancy is divided into pregnancy risk categories ranging from A, B, C, D, and X by the Federal Food and Drug Administration (here in the United States.) Only drugs in category A have been proven to be safe. Drugs in categories B and C show uncertainty either towards the positive or negative, and categories D an X show positive evidence of fetal risk.

Some abortive medications such as Fioricet and Lortab can still be used on a limited basis during pregnancy.

For more information on headaches, migraine and pregnancy, as well as treating migraines, be sure to sign up for our newsletter!

headaches back of head

Do Headaches or Pain in the Back of the Head Make it Hard for You to Sleep, Work, or Relax?

Do Your Headaches and Pain Refuse to Go Away No Matter What You Do?

If so, what you are doing to treat your headaches and pain isn’t working. At best – you are suffering needlessly, worst – what you are doing to try to treat your pain could actually be making your problem worse. You need REAL help for your headaches and pain in the back of the head. Read on to discover how to identify and Treat the Real Cause – Not Just the Symptoms and End the Pain.

Introduction

Having a constant or reoccurring pain in the back of the head, neck, or shoulders is incredibly annoying AND frustrating. Despite the fact that headache or pain in the back of the head or neck is incredibly common, it seems no one knows what to do to treat the problem. I know that for me, the first time I visited a doctor it was recommended that I spend thirty minutes per day practicing “conscious relaxation” lying on the floor with a towel rolled under my neck. I simply could not believe this was the best advice the doctor could give me! Future visits to physical therapists had me spending hours per day doing neck stretches that did not seem to relieve my constant pain and tightness in my neck and back of the head. Frustration with finding a workable solution is what led me to research the problem on my own.

Fact #1: Doctors Want to Find Physical Evidence of Your Pain in the Back of the Head

This is not inherently a bad thing. Anytime you experience unusual or ongoing pain you should visit the doctor to rule out other serious problems – especially if you have recently (within the last year and a half) been injured or in an accident of any kind. When you experience pain in the back of the head or neck it is always possible the source of your pain is a structural problem or misalignment which can be diagnosed by xrays and other types of medical imaging.

There are many physical causes of pain or headaches in the back of the head or neck including:

Cervicogenic Headaches, which are caused by problems with the top two or three levels of the cervical spine.

Cranial or Occipital neuralgia, a source of nerve pain which can cause ongoing pain (of an “electroshock-type” sensation) in the back of the head, neck or shoulders.

The problem?

When xrayed, lots and lots of people will show signs of spinal misalignment, structural deviations, arthritis, etc – and yet, the vast majority will be completely unaware as they will not be experiencing any pain. As much as we would like to logically pair physical conditions with pain, these two do not necessarily go together for many people. If you have been diagnosed with a physical cause of your pain but you are not feeling relief – keep reading as there is help out there.

Fact #2: People Think Headaches and Pain in the Back of the Head Is Caused by Poor Posture and Can be Fixed Through Stretching, Relaxation, Massage, and Ergonomic Adjustments

Okay, I am not going to say this is not possible. It totally is! If fixing your poor posture and spending thousands of dollars on treatments and special equipment works for you – that is fantastic. I know I have gone down this path and easily spent thousands chasing “cure” after “cure” only to be left with exactly the same pain.

If you haven’t ever examined your posture, read on as I will explain what to look for and some easy and FREE exercises you can do at home! (And if you know this doesn’t apply to you feel free to skip this section.)

Is it Poor Posture?

Sometimes poor posture or a poorly designed work space can cause pain in the back of your head, neck, and shoulders. This type of posture is known as “head forward posture.” Head forward posture can be identified by looking at one’s posture from a profile angle (from the side.) If at all possible, have someone take a picture of you from the side. This would work much better than trying to analyze one’s own posture in the mirror.

Look at how you stand. Is your head a straight line up from your neck or does it appear to angle forward? Ears should be directly in line with one’s shoulder. If instead your head appears to jut forward when viewed from the side, poor posture could be causing some of the pain in the back of your head and neck.

Why is this? Forward head posture places too much stress on one’s muscles at the base of the skull (the suboccipitals) and the muscles in the back of one’s neck (cervical extensors.) This kind of pain can manifest as stiffness from the back of your shoulders to the top of your head and can lead to a headache located in the back of your head.

Here is another test – do you have full range of motion in your neck? Can you look all the way to each side? Can you allow your head to fall forward until your chin hits your chest? Without pain?

So what can you do if you suspect this is your problem? Essentially you will need to stretch the tight muscles and strengthen the weak ones. The most effective exercises are the following:

Chin retractions

45 degree Neck Stretch

Fact #3: Everyone says, “You Look Really Tense, Are You Sure its Not Just a Tension Headache?”

Little do they know, you are actually tense because you haven’t been pain free or had full neck mobility in months or years! Anyways…so how do you know if you are experiencing tension headaches?

Tension headaches are the most common type of headaches affecting anywhere from 30-78% of all people. Originally tension headaches were believed to be caused by tension, hence their name, but more modern research is uncovering evidence that the source of pain is actually neurological in nature.

In fact, the very latest research shows that tension headaches, especially chronic daily pain, could actually be caused by low-level migraines – which is causing inflammation to the tissue around your head, neck, and even shoulders. Inflammation will actually cause the stiffness and “pops and snaps” that you may be dealing with. Unfortunately, this is a suggestion that your general practitioner is unlikely to suggest. Most family practice doctors are not as familiar with headaches and migraines (let alone the latest research!) as they would like you to believe.

In fact, as many as 50% of all patients are misdiagnosed with the wrong condition!

Most migraine sufferers are never even told there are treatment options available including new cutting-edge drugs and effective alternative therapies.

And this is a shame because migraine, while not a “curable” disease is chronic condition (much like arthritis – a condition you will have all your life) that can be managed.

The truth is, with proper treatment you can reduce the frequency and severity of your headaches and migraines! That’s right, you don’t have to keep suffering, missing work, canceling appointments, and missing out on the the things you really want to do in life!
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Together We Can Help Your Pain

Let me help you as I helped myself. While working to cure my own headaches and migraines I studied only the best and most current information. Each new source and theory brought a key to the puzzle but not the complete solution. Combining each approach took years of trial and error. Learn from my mistakes, gain from my experience.

What would you do if you didn’t have pain to hold you back?

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Discover how to treat headache conditions that men are uniquely predisposed to such as:

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migraine prescription medication

Migraine Prescription Medication

Despite the fact that today there are more migraine prescription medications than ever before, most headache and migraine suffers do not know that there are treatment options available.  Why is this? In general migraines are still not treated as a high priority medical condition and as such there not a lot of widespread public knowledge, nor are primary care providers necessarily aware of the latest treatment.

If you are  currently suffering from migraines and you have not felt any relief using over the counter pain medication, make an appointment to speak with your doctor about your migraine prescription medication options.

The Most Common Types of Migraine Prescription Medication

Migraine Prescription Medication: Pain Relief

Non-steroidal Anti-inflammatory Drugs

When you think of NSAIDs, most likely you think of over the counter pain relievers like Advil. Your doctor is actually able to prescribe NSAIDS of two kinds COX-1 and COX2 inhibitors. What do these medications do? NSAIDs block the chemicals that cause inflammation. Common prescription NSAIDs include diclofenac, meloxicam, nabumetone, and celecoxib. The most common side effects of NSAIDs are usually gastrointestinal in nature and can range from mild to extreme.

Narcotics

Narcotics are essentially very powerful pain medications that reduce your perception of pain. The main danger with narcotics (other than impaired function due to feelings of dizziness or drowsiness) is the risk of addiction. For this reason many doctors are reluctant to prescribe these types of pain medications for anything other than emergency use. The most common narcotics include oxycodone (similar to morphine), hydrocodone, and propoxyphene. The most common prescriptions combine narcotics and other pain killers such as acetaminophen examples include Darvocet, Vicodin, and Percocet (acetaminophen plus oxycodone).

Problems with narcotic drugs include addiction, powerful withdrawal symptoms, and dangerous side effects when combined with alcohol. Pregnant women, or women who may become pregnant should not use narcotics as they have not been proven to be safe for unborn babies. Narcotics may also become dangerous when combined with other prescription medications such as sedatives, tranquilizers, and antidepressants. Always make sure you are fully informed regarding drug interactions if you already take prescription drugs for other conditions.

Barbiturates

Barbiturates are central nervous system depressants and like narcotics, these are serious drugs that can act as powerful sedatives and also run the risk of physical addiction. The most commonly prescribed barbiturates for headaches and migraines are typically a combination of  acetaminophen, caffeine, and barbiturates (example – Fioricet.)

Migraine Prescription Medication: Abortives (Stop Migraine Attacks)

Ergot Alkaloids

Ergot Alkaloids are derived from a fungus called Ergot which grows on rye and other grains. Ergotamine and other derivatives are frequently prescribed to treat migraines as they are able to mimic the behavior of several neuropeptides and works a a vasoconstrictor (causes blood vessels to constrict.) Ergots are meant to relieve migraine attacks that are still in the early stages, this medication is not taken daily in order to prevent migraines. Ergots have now largely fallen out of favor due to their likelihood of causing rebound headaches with repeated use.

Triptans

Triptans work to relive migraine attacks by blocking serotonin receptors and reducing blood vessel inflammation. Like Ergots, Triptans are meant to stop a migraine attack, not prevent one. Triptans are generally considered safe except for pregnant or nursing women, those with vascular or cardiovascular conditions. If used excessively, Triptans will also trigger rebound headaches so be sure to use sparingly.

headaches depression

Headaches Depression

Its has been long noticed that people who suffer from headaches and migraines may also suffer from depression. It is largely unknown if depression causes migraines, if migraines cause depression, or if there is a common physical factor that will cause the two to co-exist. Regardless of what causes what, having migraines simply increases the chance that at some point you may need to deal with the symptoms of depression.

How do you know if you are depressed?

You may experience negative feelings (see below) for longer than two weeks (unless suffering from bereavement, in which case two months is the standard.)

You feel this way nearly every day and cannot take pleasure from things that normally would make you happy.

Significant weight gain or loss.

Trouble sleeping or sleeping too much.

Feeling like you are sluggish or moving in slow motion.

Fatigue

Feeling worthless or guilty

Have trouble concentrating or making decisions

What causes depression?

Like migraines, depression is a condition that begins in the brain. If for whatever reason your brain is not able to make enough or receive enough mood balancing neurotransmitters (serotonin, dopamine, and norepinephrine), you may begin to feel symptoms of depression. (Interestingly enough, these are also the same neurotransmitters that many believe may also be responsible for migraine attacks.)

How can migraines and depression be treated?

There are daily prescription medications (anti-depressants) that can be prescribed by your doctor for treatment of depression. As a migraine sufferer you should also know that certain anti-depressants have long been prescribed for the treatment of migraines as well, so for you this treatment could bring double benefits.

There are two categories of antidepressants that are commonly prescribed as migraine medications:

Tricyclics – These medications work by preventing nerve cells in the brain from taking up serotonin and norepinephrine thus leaving greater amounts in circulation.

Selective Serotonin Reuptake Inhibitors (SSRI’s) – These medications work similarly to the above but differ in that they only block the reuptake of serotonin.

What do I need to know about taking these medications?

Know that any medication which treats depression and migraines is going to take four to six weeks before you see a noticeable effect. Do not try to take more in order to receive a greater or more immediate effect. This will not work and you will likely only risk serotonin overdose.

While these medications may help your depression and your migraines know that there are significant side effects ranging from fatigue, weight gain, sexual dysfunction, among others that you may have to deal with. It is also important to note that if you do become dissatisfied taking antidepressants that you cannot simply stop taking the medication  but rather have to taper down gradually to reduce withdrawal symptoms.

Finally, if you are taking other prescription medications which affect serotonin levels, such as Triptans (common migraine abortive medication) or herbal supplements like St John’s Wort, then know that you could be risking serotonin sydrome – essentially an overdose of medication. For more information on migraines and serotonin click here.

migraine serotonin

Migraine Serotonin

Many of the prescription drugs used to treat migraines affect serotonin, a neurotransmitter responsible for  regulating a variety of bodily functions including sleep, depression, pain, anxiety, and….migraines. It has long been noticed by doctors that antidepressants seem to also reduce migraine attacks among migraine sufferers. For this reason antidepressants are now commonly prescribed for “off label use” (meaning used for a purpose other than originally intended) as migraine preventatives.

When used as intended, serotonin affecting migraine medications can be helpful. However when consumed in excess (in a single dosage or in combination with other medications), it is entirely possible to have a life threatening reaction known as “serotonin syndrome.”

How does this happen?

It is not that uncommon for the average migraine sufferer to take a combination of serotonin affecting prescription medicines to treat their migraines. Some medications may be taken daily to prevent migraine attacks – this may include anti-depressant selective serotonin re-uptake inhibitors like Prozac. These medication increase serotonin levels in the brain. Other medications like Triptans, also affect serotonin levels, and are intended to be taken at the onset of a migraine attack in order to stop an attack from developing.

When medications are combined, taken in multiple doses, combined with herbal supplements such as St. John’s Wort, or used in any way other than intended, its entirely possible to consume a toxic amount – even if you are not experiencing any relief from your symptoms. This is important to note as many people will take a second dose of medication because they do not feel any effects from the first. This is actually quite dangerous as even if you do not feel migraine relief, your serotonin levels will increase regardless.

Serotonin Syndrome also known as Serotonin Toxicity

Since serotonin regulates a variety of necessary bodily functions such as blood flow and breathing, an excess of this vital neurotransmitter can have a dangerous effect.

When serotonin levels in the body become too high symptoms are usually noticeable immediately.

These symptoms include:

Agitation

Confusion

Dilated pupils

Diarrhea

Elevated heart rate

Loss of muscle coordination

Shivering, sweating, and goosebumps

Twitching

Signs that your serotonin toxicity may be life threatening include:

Heart beat irregularity

High temperature

Loss of consciousness

Seizures

Any of these symptoms should prompt you to immediately seek medical attention.

cluster headache

Cluster Headache

Cluster headaches are named for the pattern in which they appear – frequently over the course of hours/days/weeks and then not again for an extended period of time (from weeks, to months to years) – although some people can have daily cluster headaches. Usually the headache strikes at the same time(s) ever day when one is experiencing a period of attacks. The average cluster headache attack can last from a few minutes to a few hours. The pain of the cluster headache is known to be the worst of all headaches – more severe than even migraines.

The pain of a cluster headache is usually single sided and frequently located around the eye area. Unlike a migraine, there are seldom any warning symptoms and usually the pain comes on suddenly all at once. The pain is usually described as having a spike driven into ones head (sharp, burning, and very severe), as opposed to the throbbing pain of a migraine. Cluster headaches are also known for driving the sufferer to move around restlessly or even bang one’s head against the wall. While experiencing an attack you may notice other symptoms on the same side as your pain such as a runny nose, tearing or blood-shot eye, dropping eyelid, or sweating. A cluster headache usually ends as instantly as it begins and seldom do any symptoms linger – other than exhaustion.

The cause of cluster headaches is still unknown but current research indicates that the hypothalamus may be responsible.Why? Interestingly enough the hypothalamus regulates the body’s biological clock. As cluster headaches reoccur with such startling regularity, abnormalities in the hypothalamus are suspected. Other factors that may contribute to developing cluster headaches include hormones (primarily melatonin and cortisol) and neurotransmitters (serotonin, etc.)

Cluster headaches are experienced by men ten times as frequently as women. People who suffer from cluster headaches may also have a tendency to drink or smoke or use nitroglycerin.

If you do not have a past history of cluster headaches,make sure that you visit your doctor to rule other other more serious problems.

Cluster headaches can be especially difficult to treat as the pain is known to come on suddenly without warning. This type of behavior makes relying on over the counter medications impossible as the effects of such medications can take 40 minutes to develop.

The most effective treatment for cluster headaches is believed to be breathing pure oxygen. People who choose to try this treatment would need to keep an oxygen cylinder and regulator with them. Some people are able to get this same effect from very vigorous exercise. Unlike migraines, cluster headaches are not thought to be caused by exposure to environmental triggers like certain foods, etc – however once a period of attacks begin, many people notice that drinking alcohol can act as a trigger.  Some people have found relief by treating their cluster headaches with an injectable form of sumatriptan (the same family of triptans used to treat migraines) or a nasal spray form of zolmitriptam – Imitrex and Zomig.

Newer treatments in development call for the surgical insertion of devices that will stimulate the occipital nerve or the hypothalamus itself.

migraine foods

Migraine Foods

Migraine Foods: Caffeine

Commonly found in: Certain prescription and over the counter drugs, coffee, tea (black and green), and sodas. Even “decaffeinated” beverages will contain trace amounts of caffeine.

Why: Since caffeine is a common additive in many foods, its easy to assume that most people do not react negatively to this additive. This is not true. Many people feel immediate side effects, including headaches, after consuming caffeinated beverages. Other people develop a dependency on caffeine (do you get a headache if you skip your morning coffee?) and develop headaches when their body does not get the usual expected amount. For many people this is primarily a problem with withdrawal headaches.

Safe alternatives: Herbal tea, carbonated water, coffee “alternatives” like Teeccino, and juices (although some fruits may also aggravate migraines.)

Migraine Foods: Cheese

What kinds: Aged cheese (examples: blue cheese, Cheddar, Swiss, Parmesan, Feta, Mozzarella (shredded), and Provolone) Other aged dairy products could also be problematic including yogurt, sour cream and buttermilk.

Why: Tyramine is found in many aged cheeses. Tyramine is an amino acid frequently found in aged or fermented foods. Tyramine is thought to cause migraines in some people due to an effect on neurotransmitters like serotonin and norepinephrine.

Safe alternatives: Young cheeses like cream cheese, ricotta, and cottage cheese. Fresh goat cheese and mozzarella can be fine for some people too.

Migraine Foods: Chocolate

What kinds: All but white. Darker chocolate will contain more compounds than chocolates with lower concentrations of cocoa.

Why: Chocolate contains caffeine, theobromine and phenylethylamine.

Theobromine is a primary alkaloid found in cocoa and chocolate that was used in the past as a treatment for circulatory problems and is still used today as a vasodilator. Theobromine also stimulates circulation, although its effects on the heart are reported to be less than that of caffeine.

Phenylethylamine functions within the human body as a neurotransmitter, although the exact concentrations reaching the brain are believed to be low after being processed through the digestive system. Regardless phenylethylamine is commonly sold as an over the counter nutritional supplement to treat depression and aid in weight loss.

Safe alternatives: White chocolate and other sweets.

Migraine Foods: Processed/Preserved Meats

What kinds: Canned, smoked, fermented, cured, etc

Why: Contains nitrites/nitrates, MSG, and tyramine.

Sodium nitrite is used to cure meat because it will inhibit the growth of bacteria and preserve the fresh red color of meat. When used in excess nitrates /nitrites are toxic, and for some people will cause headaches due to causing increase blood flow to the brain.

MSG is added to processed foods in order to increase flavor and provide a fleeting sense of satisfaction. MSG is thought to convert to Glutamate and act as a neuron exciter, which in turn can cause migraine attacks.

Safe alternatives: Check packaging for additives. Health food and organic grocery stores are more likely to sell additive free food. Also, consider sticking to fresh meats.

Migraine Foods: Red Wine, Alcohol, Vinegar, and Soy Sauce

Why: Many types of alcoholic drinks (beer, wine, and distilled alcohol) contain ethanol. This type of alcohol causes blood vessel dilation. In fact it is the dilation of blood vessels which causes one’s face to flush. Why is this important? Once a migraine attack begins (usually caused by nerve over-excitability in the brain) the blood vessels in the brain begin to dilate (constrict.) It is this constriction which causes headaches and other symptoms such as dizziness, visual disturbances, etc.

Alcoholic drinks such as red wine contain additional chemicals such as tyramine, which are thought to trigger migraine attacks. It is important to note that trigger does not mean “cause.” Instead a trigger simply ignites a process which is already primed to go. This is likely why some people are bothered by headaches and migraines after drinking alcohol and others are not.

Lastly, alcohol – namely ethanol – causes dehydration by causing your body to produce more urine than normal. Dehydration is well known for causing headaches in everyone, not just in migraine sufferers. The best way to prevent these types of headaches is by drinking water while you consume alcohol as well as afterwards. Be sure to drink more water than you normally would to offset the effects of dehydration.

Other contributing chemicals include: acetaldehydes (by product of alcohol as it is broken down by your body), congeners – by-products of fermentation, sulfites and phenols, tyramine.

Safe alternatives: Some people have no problems with vodka or white wine. Other people also report success with organic wines.

Lighter colored vinegars contain fewer aggravating chemicals. Clear distilled vinegar is best. Don’t overdo condiments with vinegar (mustard, ketchup) or pickled vegetables.

Click here to get your copy of the complete list of migraine causing foods!

migraines trigger

Migraines Trigger

Migraines Trigger: Stress

While beyond one’s control in most cases, reducing stress works to your advantage as a migraine sufferer as stress will reduce your overall migraine threshold. Techniques for stress reduction will vary from person to person. Some people will gain benefit from exercise, dance or yoga classes. Other people may prefer to try meditation or listening to relaxing music.

Migraines Trigger: Dehydration

Drink plenty of water. What is enough water for one person may not be enough for you.  Also, don’t forget that many medications can have a diuretic effect – particularly high blood pressure medications.

Migraines Trigger: Sleep

Too little sleep, poor quality sleep, interrupted sleep, and too much sleep. If you believe sleep is one of your triggers, try to avoid changing up your sleep schedule by sleeping in on the weekends or having late nights during the work week. If this does not help, consider visiting a sleep clinic where they will monitor your sleep patterns and vital signs throughout the night. Many people actually have undiagnosed sleep patterns which they are unaware of. Such problems can include sleep apnea (more common than you might think) and other disorders which prevent reaching REM.

Many people can improve the quality of their sleep by making simple changes such as wearing ear plugs, using a white noise machine, installing blackout curtains, or wearing a sleep mask. Also, consider covering any light emitting sources in your room such as a clock radio.

Migraines Trigger: Skipping Meals

Missing meals can lead to fluctuations in blood sugar. You may need to try eating differently to avoid low blood sugar crashes at certain times per day. Blood sugar crashes are more common among people who eat a diet high in refined carbohydrates (think sugar and flour.) Low blood sugar occurs when insulin is released to remove excess glucose (sugar) from the blood. If your blood sugar drops too rapidly, adrenaline is released from your adrenal glands – forcing your liver to release sugar stores in order to return balance. A side effect of this response can be feelings of anxiety or even panic.

If you think you cannot get away for lunch during the work day, it would be a good idea to have an assortment of ready to eat food with you. Try to focus on snacks that contain protein, not just sugar. Also avoid eating foods high in sugar or artificial sweeteners once you notice your blood sugar is low. Low blood sugar also puts you in a position to react more strongly to sugar and artificial sweeteners, and some people will experience migraines. Foods high in fiber can be especially helpful in balancing blood sugar – try oat bran, flax seed, and apples.

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