Some people with migraines can readily rattle off their triggers, from heat to stress to hormonal changes. Others might feel like migraines pop up out of nowhere, the cause a mystery. Experts have narrowed down some typical causes of migraines, and those who suffer from them can use this information, in addition to a log of their headaches, to identify potential triggers over time.
For some people, though, migraines aren’t just caused by daily events and environments. They might be a sign of something more serious going on, or an underlying condition that could be treated with medical attention.
Here’s what to know about what really might be causing your migraines.
What is a migraine, and how does it differ from a tension headache?
“The underlying cause of migraine is a genetically-influenced neurological susceptibility
involving altered sensory and pain processing,” says Dr. Nada Hindiyeh, board-certified neurologist, UCNS-certified headache specialist and chief medical officer at Haven Headache & Migraine Center in California. “A trigger does not create that disease; it may help initiate an individual attack in someone who is already susceptible.”
Migraine is a neurological disease, not just a terrible headache, which can involve head pain together with nausea, sensitivity to light or sound and difficulty carrying out normal activities, Hindiyeh says. “The validated ID Migraine screening tool focuses on three particularly useful clues: nausea, light sensitivity and headache-related disability. Having two of these three features makes migraine much more likely, although a clinician must make the final diagnosis.”
It’s easy to confuse tension headaches with migraines. Tension headaches feel more like pressure or tightness, and don’t cause nausea or get worse with routine activity, Hindiyeh says. Migraines exist on a wide spectrum. They can be mild and not too consequential to the day’s activities, if caught early enough, or ultimately rise to the level of completely incapacitating.
What are common migraine triggers?
Not all migraines are caused by a specific trigger. The most common ones Hindiyeh sees include “changes in sleep, stress or the letdown after stress; skipped meals; dehydration; hormonal fluctuations; alcohol; inconsistent caffeine intake; bright or flickering light; strong odors; and weather changes.” She adds that triggers can build off each other, such as someone being able to tolerate one night of poor sleep but not two.
Hormone fluctuations with menstrual cycles, pregnancy and menopause are common triggers for migraines, especially in the first two days leading up to a period and the first three days of bleeding, she says.
What foods cause migraines?
Migraine sufferers are commonly told to avoid certain foods, though Hindiyeh recommends instead journaling about the foods that are eaten before migraines start, rather than cutting foods more broadly. “Alcohol and caffeine are among the more consistently reported dietary triggers, although their effects vary greatly between individuals. Cured meats, aged cheeses, MSG, artificial sweeteners and chocolate are frequently blamed, but the evidence that these foods consistently trigger migraine is limited and relies heavily on self-reporting,” she says.
She notes chocolate gets a bad rap, but one reason it might be associated with migraines is that people often crave chocolate after an attack starts.
How to deal with determining the cause of your own migraines
“Patients can experience attacks even when they do everything ‘right,’” Hindiyeh says. She wants patients to identify meaningful patterns but also to avoid excessive focus on avoiding every trigger, which can cause anxiety and become restrictive. “The goal is to identify meaningful patterns while also treating the disease effectively.”
This article originally appeared on USA TODAY: What really might be causing your migraines
