Do I really have to eat oatmeal for a year?
October 12, 2019 1:34 PM   Subscribe

How do you figure out what is triggering your migraines? I believe I have been having migraines for a couple of years, but its only recently that I've realised the things I THOUGHT were causing my headaches (noisy children, gin and tonics, an iphone, and stress) are not the main culprits. Or not the only ones anyway.

I started having headaches when I was pregnant... I had two children who are 11 months apart and are now preschoolers. They have sensory issues and my house was super noisy and horrible to be in for a couple of years. Add on the rest of life stuff you have to deal with and it was just really stressful and HORRIBLE to the max. Throughout this time I have had headaches. And neck pain.

I noticed the neck pain about a year after I got my new iphone 8... I think looking down on it made my neck hurt and I started looking at it a lot less and have tried to remember to do strengthening exercises and have good posture etc. I'm not good at any of this but I am definitely trying!

In parallel I have had headaches... but I have often attributed those to allergies and just general noisy children... or the cocktail I had after they went to bed (while staring up at the heavens wondering where it all went wrong) just kidding, but not really.

But in the last month or so they have really grown up a lot and have been VERY chilled, my life is mostly stress free, and I haven't had my usual cocktail! And I haven't been glued to my phone.

But I have had excruciating neck pain with a headache... around my ovulation time fwiw.

I TOTALLY thought that I was going to feel amazing when my kids were more chilled out and I was having a healthier lifestyle and I am kind of horrified that I was laid up this week with a migraine. I never linked the neck pain with the headache before and they totally went together. I had a strange day on sunday, neck pain on monday and I was then out with a headache (and neck pain) until thursday night.

It really sucks because now that my children are doing really well and being sweet, I would like to be out doing things with them, not telling them to shush because I have a headache.

Or maybe that is part of being in a family? People don't feel well all the time?

But I am very curious how you figure out your migraine triggers. What are the first steps.

I will obviously go to a doctor but I am not in a country where long sessions with your doctor happen and I will have to do a lot of this legwork myself and would like to know the most efficient way to feel better again.

Thank you everyone in advance.

This really sucks, a lot.
posted by catspajammies to Health & Fitness (26 answers total) 4 users marked this as a favorite
My biggest trigger is dehydration, which can be caused by a lot of the things you mention - pregnancy, hormonal fluctuations, alcohol, and even stress (since you forget to/don't have time to drink enough fluids, or you're running around and sweating them out). Try staying ultra-hydrated for a few weeks and see if it helps. Not just water but electrolytes too, maybe even keep some Pedialyte around.
posted by showbiz_liz at 1:46 PM on October 12, 2019 [5 favorites]

One of the best ways to figure out migraine triggers is to do some sort of elimination diet. The general principle is to cut out all known difficult foods (which is a lot!) for at least two days, maybe a week, and then add food groups back in, slowly but surely. (See Whole 30 for an example.)

But menstrual migraines are also a thing, so you could also look that up and see if there are any recommended ways to deal with them.

I have dealt with migraines over many years and here's what has helped me:
(1) magnesium supplements (there are some versions that are absorbed more easily, but I can't remember which ones--definitely check that out)
(2) cutting out gluten (I did this for two years and my rate of disabling migraines decreased substantially)
(3) getting allergy shots (I've now been getting them for 2.5 years and I can eat gluten again...and while I still occasionally get a migraine, it's only once every two months instead of once a week)

Good luck figuring it all out.
posted by correcaminos at 1:46 PM on October 12, 2019 [1 favorite]

My migraine trigger just seems to be hormones. There's not much I can do about that (I'm perimenopausal, everything is fuckered up). I did start taking magnesium and there's no way to know for sure that that's what did it, but the frequency and severity of my symptoms have both gone way down since.
posted by soren_lorensen at 2:07 PM on October 12, 2019 [1 favorite]

I think you should rule out the primary trigger you described in your post: ovulation. If you're having hormonal migraines, an elimination diet is maybe going to mess up your cycle a bit and you'll think you figured it out and then your cycle corrects itself and you're back with the headaches.

The downside of going on ovulation-suppressing contraception, though, is that it can trigger more hormonal migraines. I was always fine unless I forgot a day of the pill and had to take two the next day, and then it was about 50/50 whether I'd get a migraine within 12 hours. Because of that, I was always wary of trying injected or implanted contraception that couldn't be quickly stopped, and eventually the side effects overall weren't tolerable.

I am also getting general relief from perimenopausal symptoms with routine magnesium supplements, and there are some magnesium migraine studies going on right now, so it's definitely a low-hanging fruit you can knock out for cheap.

People have other ovulation-related biological processes that might incidentally cause headache as well. Some people need to urinate more frequently or experience diarrhea around ovulation, either of which can trigger dehydration, and some people who routinely test their blood glucose notice unusual rise and fall patterns around ovulation and menstruation, so you might be getting low blood sugar headaches.

It's probably worth being sure that the type of headache you're experiencing meets the actual definition of migraine before you go down that rabbit-hole as well.

One thing you can start doing right now for a future doctor visit is start tracking your cycle, headaches, sleep, stress, and keep a pretty detailed food diary. Two or three months of that may be very informative.
posted by Lyn Never at 2:17 PM on October 12, 2019 [6 favorites]

To Lyn Never's excellent list, I would add weather. I can get knocked out by barometric changes, like when a big storm front comes through. Scientists haven't been able to find a formal link between barometric pressure and migraines, but it's pretty common among the migraine sufferers I know.
posted by Sweetie Darling at 2:26 PM on October 12, 2019 [14 favorites]

You had 2 kids in 11 months? Have you slept? Like continuously for more than 4 hours?

I have a 2.5 yr old and a 1 month old and i also have gotten musculoskeletal pain from dingling with my phone too much, because its the only little jolt of just for me satisfaction i can get. And i can get it in the 2 to 5 mins of time before im interrupted by child needs. Anyway ive been trying to ditch the phone and use some quick deep stretching to get a dopamine hit. Mybe you can try that?

Also, dont know where you are but weather, namely pressure changes, affect my headaches.
posted by WeekendJen at 2:30 PM on October 12, 2019 [1 favorite]

To not abuse the edit button, I would also say that I mostly focus on getting rid of the migraine rather than trying to anticipate or prevent them. My neurologist has shared some excellent advice: first, you can take your prescription as a preventative (I take one of my "nuclear" pills the night after the second day of my period, because I often get a migraine overnight at that point in my cycle); take something as soon as you're cognizant of the first tiny kernel of your migraine - don't drink a coke, or finish whatever you're doing, or hope it goes away; keep meds with you at all times; and don't hesitate to take a second dose if you aren't getting relief in 15-20 minutes.

(Obviously, this was her advice for me and might not be appropriate for you. But finding a headache specialist and the right triptan has changed my life!)
posted by Sweetie Darling at 2:32 PM on October 12, 2019 [4 favorites]

“You had 2 kids in 11 months? Have you slept? Like continuously for more than 4 hours? “

Yes, the only thing I managed to do very well was have the kids on a good sleep routine and that’s worked well for the last couple years...

Knock on wood.

Thank you everyone :-) all your answers give me hope.
posted by catspajammies at 2:47 PM on October 12, 2019 [2 favorites]

It can be helpful to keep a journal to start making connections to triggers. Keep track of your menstrual cycle, any nights where you get an unusual amount of sleep, any days where you drink alcohol or more/less caffeine than usual, stressful events (or the end of stressful events - my wife gets letdown migraines after significant stress ends), or any other notable things that you think might be triggers. You can also write down what you eat, but that’s a lot more work so may or may not be worth it to you. And of course, write down your non-migraine headaches and migraines to see if you can spot any patterns.

I definitely would not start with an elimination diet unless you’re pretty confident that some foods are triggers - personally, I get hormonal migraines and food, alcohol, etc doesn’t make a difference at all. Certain types of lights can trigger a migraine, but only if I’m already vulnerable due to hormone fluctuations.

I also agree that you should take whatever med is most helpful for you ASAP as soon as you get a hint of a migraine or aura; some people use ibuprofen, some people use something like Excedrin headache which has a combo of acetaminophen, aspirin and caffeine, some people use various prescription-only meds. Many people find that meds only work for migraines if they take them immediately immediately, which is different from other types of headache and pain.
posted by insectosaurus at 3:01 PM on October 12, 2019 [1 favorite]

Oh, and to answer how I personally figured out that my migraines are triggered by something hormonal - I noticed that I pretty much only got migraines right before my period, at the end of my period, and around ovulation. I don’t get a migraine at all those times every month - thankfully - but when I do get one, it’s always at a time of hormonal flux. I also get them in the first trimester of pregnancy (and apparently near the end of pregnancy too).
posted by insectosaurus at 3:05 PM on October 12, 2019

Anecdotal: my sister started getting migraines as a child, and the doctor told my parents to keep a diary. She got them every 28 days, even before hormones kicked in (she was quite little at the time, grade school, or younger even). Then she got them pre-menstruation after hormones kicked in. The doctors tried telling her she was probably reacting to triggers (like cheese, for instance), and didn't listen to her. Her only relief was to take a shower and go lie down in a dark room, with a cool cloth over her head.

She did not get them while pregnant, and then went back to having them after childbirth, every month.

I personally was getting severe costochondritis -- pain in the center of my chest, near one rib -- when I had PMS, especially when I went off the pill and got into perimenopause. I'd have to sit in a recliner all night, and take ibuprofen and then as soon as I got my period, it would subside.

I still get what my doctor calls atypical migraines, which is like nerve pain in my head, that travels down my cheekbone and ends up on my gum on one side, often causing an earache as well. That seems to be weather-related, such as before a big rainstorm (less in the winter). Stress can also bring them on, but weather is a big factor.

I also has the neck pain thing, that went up into my head, and I did find relief with a chiropractor, which I though was hogwash, but whatever he did made it go away within 2 days, and I'd been having it a lot, ongoing. Possibly made worse by stress at the time.

I drink a TON of water, and I do have a magnesium supplement (CALM powder), which I should probably take more often. Sometimes, I'll put half a packet in some tea and sip it, slowly. But yeah, I think Lyn Never and Sweetie Darling have it.
posted by Marie Mon Dieu at 3:05 PM on October 12, 2019 [1 favorite]

My mom had awful migraines until she hit menopause. There were some things that she worked out were triggers for her (red wine and bagels are the ones that spring to mind) but even eliminating them never stopped the migraines completely. Medication was the big game changer. Like, seriously, everything changed when Imitrex came out on the market. And now there's a lot more options. So don't be afraid to find one that works for you.

But I also want to add, as a kid who grew up in a house where - yeah Mom was hurting, I needed to play quietly, and we couldn't always go out and do things - I grew up fine! My mom's the best, and we're very close. The worst thing was knowing that mom was hurting. I know it's hard, especially as your kids are still little and working on their empathy still. But try not to add guilt and fear to your burdens. You will not do some kind of crazy damage to your kids or your relationship with them just because you're dealing with migraines.
posted by Caravantea at 3:06 PM on October 12, 2019 [2 favorites]

Everyone else kind of has it, but here's another vote for seeing if magnesium supplements help you -- they do me. (My migraines are VERY HORMONAL)
posted by Countess Sandwich at 3:19 PM on October 12, 2019

I don't see you mention any meds you've tried, so sorry if I just missed this, but I get hormonal migraines (halfway through pill placebo week) and although I usually am kind of lazy / reticent to take pain pills, I have learned that if I take an Advil / ibuprofen within the first couple of hours of having a headache on that day, It goes away, and if I don't take the meds until later then the headache gets worse and the meds do NOTHING.
posted by Lady Li at 3:22 PM on October 12, 2019

One other thing to track - weather / barometric pressure. There are apps that do it, but it's one more thing that you should add to your data collection process.
posted by true at 3:25 PM on October 12, 2019 [1 favorite]

On the supplement side of things, magnesium is good, but my naturopath has me take riboflavin and CoQ10 for migraine prevention. I was able to stop taking the beta blockers I was on after starting this combo. High dose magnesium as well, 500 mg per day. Good luck!
posted by bluloo at 4:19 PM on October 12, 2019

I have/ used to have frequent really bad headaches. I’ve known for a while that I grind my teeth at night, and about a year ago I decided to commit to wearing my night guard while sleeping. My headache frequency has gone down by about 80%. Apparently when I’m stressed I clench my teeth/ jaw/neck muscles, and over time this turns into a headache. I know this isn’t the definition of a migraine, but maybe it’s a factor to consider for you.
posted by jschu at 4:59 PM on October 12, 2019

A thing that can trigger migraines for me is flashing/flickering/strobe lights.
I avoid stuff like that as much as possible - the low angle light during commuting hours in winter when it flickers through the passing trees is especially difficult to avoid.

There are a lot of triggers from food to hormones to environmental causes. It can be difficult to figure out your triggers and some people never figure them out or are like me and take years to figure it out.
posted by sciencegeek at 5:39 PM on October 12, 2019 [2 favorites]

Also, there is an app for this. When I realized that the hell I've been in for several months may actually be atypical migraines (vestibular), I first tried to DIY a spreadsheet to try and identify a trigger but then I downloaded the Migraine Buddy app. It does stuff like look up your local weather when you log a migraine (to see whether that's a trigger), gives you checkboxes for everything and just in general seems like the nuclear option for identifying and tracking migraine triggers.
posted by soren_lorensen at 5:56 PM on October 12, 2019 [2 favorites]

I started getting migraines a few years ago. I used the mySymptoms app to log everything I ate and my migraine symptoms for about two months. When I went back, two ingredients became so obvious: soy and chili peppers. The soy would have been hard to catch otherwise because the migraines happened the next day.

Since then, I'm super duper careful about what I eat. I occasionally get triggered by new foods, and it's usually really obvious. Like today, unfortunately. I ate smoked salmon, and got a migraine. I looked up online (thank you Internet!) and smoked meats are high in tyramine—as are many of my other triggers.
posted by radioamy at 6:19 PM on October 12, 2019 [1 favorite]

neck pain was the primary trigger for my severe chronic intractable migraines that lasted a grand total of 6 years without more than 50 migraine-free days in the entire time. the great big HOWEVER in this case is that i had 5 disc injuries, 2 ruptured and 3 herniated, which had to be corrected with a spinal fusion. the reason they were causing the neck pain and subsequent migraines is that the muscles in my neck and shoulders were in constant spasm from being the only thing keeping the bones of my neck from grinding together at all times. no pain medication reliably made the (migraine or nerve) pain go away unless it was combined with a skeletal muscle relaxant.

if you've ever been in a car accident, even very minor, or had any kind of slip and fall where you hit your head, IME this could be a factor in neck pain and migraines. if you've had any of these things, please don't let a chiropractor "adjust" your neck for any reason, see an orthopedist and go from there.

my primary migraine trigger during those years was being alive. i know that sounds stupid and overwrought, but there was absolutely no elimination diet or attempt at controlling any aspect of my environment that ever made anything other than a statistically insignificant difference. it was all from existing in a physically injured body where nothing less than surgery - not medication, not yoga, not massage, not acupuncture, not vitamins, not drinking more water, not any of the dozens of things that people insisted would fix me instantly - could change that.

now that the neck issue has been corrected, i still get migraines just like i have since i was 5 years old, primarily from from the following:

- being air conditioning for more than 1h (cold damp air touching my head or neck triggers the muscle spasms again)
- smells like cigarette smoke or perfume or coffee
- sounds that are higher in pitch
- blue-white light
- seasonal allergies
- humidity or high pressure weather
- sleeping in a slightly off position
- any kind of wine or hard liquor, even just smelling it is enough but drinking will bring one on in under 30 min
- not getting enough sleep
- forgetting to eat
- i can't really tell if any are hormonal anymore bc now that i don't have a uterus anymore my ovaries seem to stay in their lane

and i consider all of this to be a vast impossibly amazing improvement over the previous state of migraine affairs. it's maybe 1-2 a week instead of 3-4 per day now, except in the summer when all bets are off.
posted by poffin boffin at 6:56 PM on October 12, 2019 [1 favorite]

Get a better doctor. Advocate hard (imagine you were arguing like you would for your kids!). I know health systems suck but keep pushing until you get to a migraine specialist, usually a neurologist or a pain specialist. In the mean time use an app. I mostly don't use mine anymore because my migraines are stable now but during diagnosis, it was extremely helpful. I used a bunch, the best one right now is Migraine Buddy.

You have chronic migraines or headaches at a rate that is considered severe, not mild. That they started after pregnancy which can often trigger big physical changes - joints loosen, nerves get pinched, hormone levels change drastically - there's a lot to look into.

I also suggest subscribing to the Migraine Again website. They're a little upbeat for my taste, but they do send out useful info on new treatments, short introductions to migraine symptoms, interviews with other people, all in a steady stream that is not overwhelming.

You've done amazing getting sleep handled with small children, that's like the #1 stress there. I did the elimination diet thing for 30 days to see if it was a food trigger. You then re-introduce stuff as you go and see what helps. Caffeine in moderate doses actually helped me, so as with all things migraine, YMMV!

None of the trigger avoidance would do much without the meds. Topamax basically cuts the severity down hugely and keeps me out of bed. Mild codeine taken at the start of a headache means I get the rest of the day to work. I tried the interruptors but they didn't work any different for me and cost 10x more.

And - this is a BIG DEAL: find a pain dose that works for you. Migraines and pregnancy can fuck up your pain tolerance hugely. I had a sweet well-meaning friend worriedly shame me for taking codeine meds over addiction, and I switched to Panadol for a while and suffered through a lot of miserable days before my doctor went "you've been on a stable low dose and not increasing, do not avoid your painkillers or you will wind up at the ER in agony" which I HAD. I take a dose that makes other people feel nicely buzzed and makes me feel like oh, I am not in agony and can open my eyes.
posted by dorothyisunderwood at 7:54 PM on October 12, 2019 [2 favorites]

I use Migraine Buddy to track my migraines, but I ended up realizing that my triggers were a lot of things that I couldn’t really avoid. Hormonal cycles, travel, weather changes, stress. Food wasn’t reliably associated with my headaches unless I just don’t eat at all.

What helped me was getting actual migraine meds. The OTC painkillers do not help me at all with a migraine, but with imitrex (or maxalt, there are several triptans) I can lie down for 30 mi and wait for it to kick in and then I’m back in action. This is without question the most efficient way to feel better again. And you can do this while also tracking triggers and doing a food diary, it just will keep the headaches you are having now from being so debilitating.
posted by jeoc at 6:51 AM on October 13, 2019 [1 favorite]

I just wanted to second Caravantea and tell you to please not feel any guilt over this. Not one iota. Migraines are horrible and you need to treat yourself kindly when they kick in. Attacks heal better when your body is allowed to rest properly and gets what it's asking for - which usually amounts to quiet time in a dark room, preferably asleep. Or the closest approximation of this you can manage.

It is a-ok to not be well, and to not be able to perform at the same level you can when not enduring a migraine.

Get thee to a doctor as soon as possible - partly to confirm that these are definitely migraines, and partly get the right meds for you. Regular painkillers (i.e. paracetamol/ibuprofen) do nothing to help mine, and can actually be a trigger in themselves if I'm taking them for something else. Triptans are like magic pills for a lot of people, including me, but different ones vary in effectiveness depending on the person. Zolmitriptan means my migraines, while annoyingly frequent, do not massively impact my life. It'll be a couple of hours of pain before they kick in and then mostly business as usual, albeit while trying to avoid anything that could reaggravate them (hot stuffy rooms, chemical smells, alcohol, known food triggers etc.)

For me certainly, potential triggers tend to interact with each other. Dehydrated and any alcohol whatsoever? Migraine. No fresh air all day and then eating a load of sweets/candies? Migraine. Keeping a diary - an exhaustive one - is going to be the most efficient way of getting a handle on your triggers, but try to bear in mind the potential patterns of interaction and the cumulative effect that may not immediately be obvious on the page.

In the meantime, stay hydrated, eat well and regularly, sleep the best you can, and please do not feel guilty. Parents get ill, and families adjust.

Best of luck to you.
posted by FifteenShocks at 2:14 PM on October 13, 2019 [1 favorite]

I had menstrual migraines. My preferred method for dealing with them was continuous monophasic birth control. Since I got breast cancer, I've been on Lupron that shuts down my ovaries and that takes care of that. When I go off the Lupron in another year or so, I'm planning on getting my ovaries removed since I won't be able to take the BC.

Now my migraines are more stress triggered. First sign, I take Excedrin and a bottle of the yellow/green gatorade. No idea why that helps, but it does. If I'm still feeling it after 30 minutes, I get my triptain out and take it. I have Flexeril to take with the triptan because it causes severe tension in my shoulders and neck.

Keeping the diary was really helpful when I was first looking into my migraines.

Good luck!
posted by kathrynm at 2:40 PM on October 13, 2019

Definitely go to a neurologist if there's any way at all. She may suggest Botox every 3 months as a preventative. I get that plus I take gabapentin as a preventative. I also take magnesium glycinate,
Coq10, and b complex. Finally I have triptans for once I do get a headache. My dr. is not into diets but does want me eating and sleeping at regular times. And she's a specialist--all she does is treat headaches patients. Feel better!
posted by bookworm4125 at 7:38 PM on October 13, 2019

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