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A migraine headache can cause severe throbbing pain, usually on one side of the head. In contrast to other types of headaches, migraine headaches are often accompanied by nausea, vomiting, and sensitivity to light and sound. Migraine attacks can last for several hours and up to a few days. The pain is often so intense that it interferes with your daily activities.

About 39 million Americans have migraines, making it quite common. We recently did a survey from people who receive my blogs, and info on preventing migraines was at the top of the topic list, which is why I selected this subject.

Migraines occur three times more often in women than in men and can begin at any age. Most commonly the first migraine headache occurs in teenagers. Migraines often become more intense during your 30s, and gradually become less severe and less frequent after age 50.

For some people, a warning symptom known as an aura occurs before or with the headache. An aura can include visual disturbances, such as flashes of light or blind spots, or focal neurological symptoms with tingling on one side of the face, or in an arm or leg, or difficulty speaking. Shortly after the aura occurs, the headache begins.

Sensitivity to light is bothersome, but also reassuring. Most other headaches (tension and sinus headaches or more rarely a headache from a brain tumor) do not become more intense with bright light exposure. If in doubt about what type of headache you have, especially if they are worsening over time, always see your physician to discuss the diagnosis and treatment options.

Common Triggers That Cause Migraine Headache to Occur Include:

  • Specific foods (deli meats like hot dogs, sausage, and bacon, aged cheese, red wine, and chocolate)
  • Food additives (such as MSG) and artificial sweeteners
  • Lack of sleep or irregular sleep hours
  • Bright intense lights or flashing lights (such as glare from bright sunlight, driving at night with oncoming headlights, strobe lights)
  • Loud noises
  • Magnesium deficiency
  • Dramatic changes in the weather
  • For women, changes in menstrual cycle. Many women tend to experience more migraine headaches during, or just before, their menstrual period. Some women notice a significant improvement in migraine intensity and frequency when they go through menopause.
  • Inactivity (and in contrast, over-exertion from very intense activity)
  • High levels of acute stress

By identifying and avoiding specific triggers, many people can minimize their chances of having a migraine.

Tips to Decrease Migraine Frequency and Intensity:

1. Sleep well and consistently. Aim to get at least 7 hours of sleep nightly, and some people need 8-9 hours of sleep daily. Aim to go to bed and wake up within one hour every day. Irregular sleep cycles and lack of sleep have been shown to cause migraine headaches.

2. Choose moderate activity daily. Inactivity appears to increase the frequency of migraines, and daily moderate activity helps to prevent migraine headaches. Stay active, but avoid extreme activity levels.

3. Avoid food triggers and skipping meals. Specific foods impact people differently. Identify foods that appear to trigger your migraines and avoid them. Also, avoid skipping meals. For people with frequent migraines, I recommend following an elimination diet, especially avoiding gluten, and diary products, for at least 3 weeks to see how you respond. It can also be very helpful to make a food diary and write down what you have eaten 24 hours before a migraine occurs—looking for food patterns that might help you identify food triggers.

4. Take Magnesium. 70% of Americans and people from western countries are magnesium deficient, causing migraine headaches along with many other health issues. Good food sources for magnesium are nuts, seeds, green leafy vegetables, whole grains, and beans. Yet even healthy eaters often benefit from taking a magnesium supplement (such as magnesium glycinate, magnesium malate, or magnesium chelate) with 200 to 400 mg daily. Cheap sources of magnesium, such as magnesium oxide, can cause gastro-intestinal distress. Excess magnesium can cause loose stools.

5. Proactively Manage Your Stress. It is hard to avoid all stress, but you can take steps to proactively manage it with yoga, meditation, and software tools like HeartMath.

6. Consider Taking a Butterbur Supplement. Butterbur (Petasites hybridus) is an herbal remedy that comes as a purified root extract in pill form to treat headaches and migraines. A 2012 study published in Neurology concluded that it is effective for migraine prevention when taken as 50- to 75-milligram doses twice daily. Although it does help some people, not everyone will improve with this therapy. If you live in Europe, Butterbur might be hard for you to obtain — the U.K. and Germany have both banned butterbur from being sold because of safety concerns with the leading manufacturers.

What to Do When You Have a Migraine Headache

Consider the following treatment options.

  • Caffeine. Drink a caffeinated beverage. In small amounts, caffeine alone can relieve migraine pain in the early stages or enhance the pain-reducing effects of acetaminophen and aspirin. Be aware that excess caffeine intake can cause migraines to recur. Drinking too much caffeine too often can lead to withdrawal headaches later on. And having caffeine too late in the day may interfere with your sleep, which can also affect migraines.
  • Find a Dark and Quiet Room. Find a quiet, dark room, and lie down and relax.
  • Aromatherapy with Lavender. Known for its sweet smell, lavender oil (made from the flowers of the lavender plant) is highly fragrant. A 2012 study suggests that inhaling lavender oil during a migraine may help relieve symptoms quickly. To use lavender oil, best is to use an aromatherapy diffuser with a diluted solution, or apply a diluted solution to the temples. Undiluted lavender oil can irritate the skin and can be toxic if taken in excess dosages, so follow the product recommendations for dilution.
  • Over the Counter Medications (OTC). OTC medications such as Acetaminophen and NSAIDS (such as Naprosyn and Ibuprofen) can help with migraine headache pain but also have side effects. Always discuss these options with your doctor before using.

If your migraine headaches worsen in frequency or intensity over time, there are a variety of medications that can be used to help prevent your symptoms and abort headaches when they occur. Always check with your physician as to the best option for you.

I wish you the best of health!

Steven Masley, MD, FAHA, FACN, CNS



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