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Migraine Information

Migraine headaches are a comon type of headache often associated with the following symptoms: 

  • nausea/vomiting

  • light sensitivity/sound

  • feel throbbing, pounding or pulsating 

  • pain can be dull or severe

  • pain can be behind the eye or in the back of the head and neck

  • pain startes on the same side each time

  • often starts as a dull ache and get worse with in minutes to hours and usually last 6-48 hours

  • chills/sweating

  • increased urination

  • fatigue/sleepiness

  • numbness, tingling or weakness

  • problems concentrating or finding words

Migraine Aura:  An Aura is a warning sign that happens before the headache begins.   Auras start 10-15 minutes before the heaches starts.  Symptoms of an aura can be:

  • vision changes: blurred or tunnel vision, blind spot or eye pain, flashing lights

  • odd smell

  • odd taste

Migraine Triggers:  Migraine Triggers are factors that increase your risk of having a migrain headache. The migraine suffere has inherited a sensitive nervous system that under certain circumstances that can lead to a migraine.

Triggers do not cause migraines. Triggers are thought to activate processes that cause migraines in people who are prone to the condition. Triggers do not cause migraines in every person or everytime. 

Common Food Triggers:

  • Beans: Broad, Fava, Garbanzo, Italian, Lima, Navy, Pinto & Pole

  •  Caffeine: even in small amounts

  • Chocolate & Cocoa

  • Fruits: Figs, Raisins, Papaya, Avacados, Red Plums, Limit Bananas and Citrus

  • Vegetables: Fermented foods like Sauerkraut,  String Beans, Raw Garlic, Snow Peas, Olives, Onions (except for flavoring)

  • Pickles or anything pickled

  • Freshly baked yeast  bread or donuts, sourdough bread

  • Cultured diary products: Buttermilk & sour cream

  • Cheese: Blue, Brick, Gouda, Gruyere, Mozzarella, Parmesan, Provolone, Romano, Roquefort, Chedder, Swiss, Stilton, Brie & Camembert

  • Aged, Canned, Cured or Processed Meats: Ham, Sausage/Summer Sausage, Pepperoni, Salami, Hot Dogs, nitrate foods, Bacon

  • Canned soups

  • Nuts and Nut Butters: peanut butter, almond butter, cashew butter

  • Seeds: Pumpkin, Sesame or sunflower seeds

  • Preservatives and aritficial sweetners: MSG, nutrasweet, aspartame, splenda, nirates, nitrites

Environmental Triggers:

  • Specific smells

  • Sunlight

  • Flickering or flashing lights

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Physical Stressors:

  • Skipping meals or fasting

  • Lack of sleep or over sleeping: Your awake time should be within the same two hour window daily and your sleep time should be within the same two hour window. You should try to keep weekends on the same time schedule.

  • Dehydration

  • Stress

  • Improper prescription eyewear

  • Neck and shoulder strain

  • Medications

  • For girls: Menstration

Daily migraine prevention: 

  • Get regular sleep with consistent sleep/wake times

  • Limit or avoid caffeine intake

  • Eat regularly without skipping meals and avoid identified trigger foods

  • Stay well hydrated and drunk plenty of water during the day; If you are urinating every 2-3 hours then you are getting enough to drink.

  • Get regular exercise daily. The goal is 30-60 minutes of exercise a day. 

What to do at the start of a migraine: 

  1. Drink 6 ounces of gatorade/water

  2. Take appropriate dose of Ibuprofen or Acetaminophen may repeat once.

  3. Rest in a cool dark place

  4. Sleep if this helps

  5. If you need to take medication more than twice a week the medication is not working and you need to return to clinic for follow-up. 

Rebound headaches:  These occur when using your medication more than twice a week. 

These headaches can last for more than 24 hours and are hard to treat. 

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Prophylaxis:  If you are experiencing frequent headaches prophylaxis supplements or medications can be helpful.

Types of Supplements:

  • Vitamin B2/Riboflavin: up to 400 mg daily

  • Magnesium: up to 400 mg twice a day (can cause diarrhea)

  • CoEnzyme Q 10: up to 100 mg three times a day

  • Butterburr Extract (Petasites hybridus): 50-75 mg  tiwce a day with food

  • Feverfew (Parthenium integrifolium): 50 mg daily

  • Melatonin: 3-6 mg taken at bedtime (can cause nightmares)

  • Migavent: combination product: www.migravent.com

  • Migrelief: combination producte: www.migrelief.com

Types of Medications:

  • Beta-Blockers (Propranolol & Others):

    • Advantage:  Once a day dosing, good safety record

    • Disadvantage: Tiredness, poor exercise tolerance, may make asthma worse

  • TriCyclic Antidepressants (Amitriptyline, Nortriptyline):

    • Advantage: May help with sleep, generic forms so they are inexpensive, well tolerated

    • Disadvantage: Tiredness, dry mouth, dizziness, increased appetite, toxic if overdosed

  • Topiramate (Topamax): 

    • Advantage: FDA approved for migraine, weight loss, mood stabilizer

    • Disadvantage: Must start slowly and increase over time, can have changes in taste especially with soda and sweet foods, blurred vision, weight loss, interferes with birth control

  • Valproate (Depakote):

    • Advantage: FDA approved for migraine prophylaxis, good mood stabilizer

    • Disadvantage: Weight gain, hair loss, tremor, rare blood, liver or pancreas problems (needs to be monitored with blood test)

Headache Tracking Apps

iHeadache (webpage/iOS/Android)

Migraine Buddy (iOS/Android)

Migraine eDiary (iOS/Android)

Migraine Resources:

American Counsel for Headache Education

American Headache Society

MAGNUM: Migraine Awareness Group: A National Understanding for Migraineurs

IHS: International Headache Society

NHF: National Headache Foundation

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