Lifestyle Effects on Migraines
The daily choices you make can affect how many migraine headaches you experience. Many behaviors you might not think twice about can induce migraines-- activities as basic as eating, sleeping, and getting a little exercise.
Much has been written about food substances that trigger migraines: these include chocolate, monosodium glutamate (MSG), and tyramine, a naturally-occurring substance found in fermented, aged, smoked, or pickled foods. Many meats and most cheeses contain enough tyramine to trigger migraines in susceptible people. Even foods as seemingly healthy as yogurt contain tyramine. Knowing which, if any, foods trigger your migraines and avoiding them is one of the basic building blocks of a lifestyle strategy to limit the impact that migraines have on your daily existence.
Alcoholic beverages are fermented. The biochemical effects of alcohol that cause migraine headaches are not clear, but about one third of migraine patients report that drinking alcoholic beverages will trigger a headache. Some studies show that red wine is primarily responsible, but other studies show that white wine or other alcoholic beverages also act as triggers. For that reason, many people with migraines avoid alcohol altogether.
Cigarette smoke can also trigger migraines. Smokers have more migraine attacks, and smoking more than five cigarettes a day can bring on a headache. In the past, some researchers believed that smoking helped prevent migraines through stress reduction; however, recent studies make it clear that the effect of smoking-- and of secondhand cigarette smoke-- is more migraines.
Less than 1% of people with migraines report that smoking marijuana helps; the effect is more likely due to relaxation than to any medicinal action of cannabis. In addition, smoking marijuana can cause "thunderclap" headaches. These headaches, which become severely intense within seconds to a minute of onset, require emergency evaluation and treatment.
Emotional stress is listed most frequently by migraine sufferers as a trigger for their attacks. During the body's response to stress, chemicals are released to create the “flight or fight” response; these substances also cause blood vessel changes that result in migraines. A vicious cycle can result, since migraines themselves cause stress from discomfort and missed activities, school, or work.
Since stress can't be eliminated from anyone's life, developing an effective repertoire of stress management techniques is essential to limiting the effects of stress on migraines. Stress management strategies can include biofeedback, deep breathing and relaxation, mindfulness and meditation practices, yoga, and regular exercise.
However, many patients with migraines are reluctant to exercise for fear that exertion will bring on a headache. In a recent study, patients with migraines used an exercise bike at a moderate level of exertion three times a week for three months under the supervision of a trainer. No patients experienced a worsening of their headaches. After two months, all patients reported fewer migraines, lower intensity headaches, and less use of migraine medication. Testing also revealed that the effects of exercise included a significant increase in their capacity to take in and use oxygen effectively.
The effect of medications to treat migraines can be counterproductive. Using over-the-counter pain medications for headaches more than twice a week increases the odds of experiencing more headaches when you're not taking pain relievers. Over-the-counter pain relievers containing caffeine are particularly problematic. Even though caffeine can help relieve headache pain, overuse of caffeine-containing drugs, foods, or beverages can stimulate more migraines because caffeine withdrawal increases blood flow in the brain.
Even prescription medications supervised by a physician can make migraines worse. A type of drug called triptans has become a primary weapon in the fight against migraines. Drugs such as Imitrex®, Zomig®, and Maxalt® have provided immediate relief to millions of migraine sufferers. However, daily use of these agents can result in chronic migraine headaches.
There is no one-step solution to living with migraines. Through a combination of lifestyle changes that avoid causes, enhance your ability to handle stress, and improve overall fitness, as well as the careful use of non-prescription and prescription medication, you can limit the effect that migraines have on your life.