Effective Migraine Prevention

Migraines are more than an inconvenience. These intense, unilateral headaches can result in prolonged and debilitating symptoms. Noticing my first migraine while in my 30’s and properly diagnosed by a neurologist in my 40’s, I experienced mild to severe side effects that previously interfered with day-to-day functioning.

After struggling to care for my newborn while having postpartum migraines over a decade ago, I began to track migraine severity and frequency. Through personalized tracking, academic research, and clinical work with other migraineurs, I gained insight into various contributors and integrative prevention strategies.

Migraine Tracking

If you search online for migraine causes, you will likely find a long list. Migraine triggers can vary among individuals, so it’s critical to track your own dietary and lifestyle habits, sleep patterns, and migraine frequency into a paper tracker or online application (app).

With an app like Migraine Buddy, you can customize tracking by adding your own potential triggers to observe and monitor. After personally tracking migraines for one year, I learned much more about my own migraine causes than any article or practitioner could have offered.

Helpful Tip: When using an online app, ensure that you keep electronic use to a minimum, maintain an upright neck position, and reduce blue light effects, which can contribute to migraine onset.

Migraine Types

I have helped clients who experience traditional, hormonal, abdominal, and vestibular migraines. Symptoms can vary among these and other classifications of migraine, so it’s important to have your unique situation evaluated and diagnosed by a specialist. Sinus headaches and migraines can manifest with similar symptoms, so self-diagnosis is not recommended.

Common Migraine Causes & Triggers

Dietary and Gut Contributors:

• Gut flora imbalances

• Poor elimination or detoxification (constipation, alterations in MTHFR C677t, etc.)

• Low fiber, high processed foods diet

• Low water intake

• Food additives (monosodium glutamate, aspartame, etc.)

• High tyramine foods (pickled, brined, or fermented foods)

• Elevated histamine - gut flora imbalances contribute to high histamine

• Inadequate nutrients (low magnesium, riboflavin, B12, etc.)

Lifestyle Contributors:

• Inadequate sleep or poor sleep quality

• Infrequent exercise

• Elevated stress

• Eye strain - bright or flashing lights, electronics use, contact lens wear, etc.

• Environmental triggers – odors, chemicals, smoke, pollutants, too much time spent indoors, etc.

Other Physiological Contributors:

• Fluctuating hormone levels - dips in estrogen before menstruation or during perimenopause, pregnancy, postpartum

• Glucose and insulin dysregulation (insulin resistance)

• Neck or shoulder issues, poor posture - cervical misalignment, TMJ disorder, etc.

• Sinus issues, which may be confused with a migraine or coincide with symptoms of a migraine

• Medications – overuse of headache relief medications or other medications may contribute to migraine symptoms (check with your doctor and review side effects)

Top Integrative Interventions

1. Track migraines with a paper tracker or online app like Migraine Buddy

2. Eat real, whole foods - focus on foods rich in fiber, omega-3 fatty acids, and protein while avoiding ultra-processed items (food manufacturers don’t have to list all their ingredients, so avoidance of ultra-processed foods is advised)

3. Improve sleep quality and duration - make sleep a priority and discuss any sleep issues with your doctor

4. Incorporate regular exercise (walking, weight training, etc.)

5. Enjoy outdoor activities to improve fresh air intake & vitamin D levels

6. Integrate mindfulness exercises (belly breathing, yoga, tai chi, etc.)

7. Balance hormones – lower stress, manage insulin through diet quality and meal frequency, encourage optimal sex hormone balance through diet and lifestyle interventions

8. Use low brightness features on electronics and turn off blue light generating devices at least 2 hours before bedtime

9. Practice good posture and utilize an ergonomically beneficial work area - limit looking down at your smartphone or other electronic device

Possible Integrative Interventions

• Avoid high tyramine & histamine-producing foods for 3 weeks – if gut dysbiosis is already present or if you’re unable to determine dietary triggers

• Add nutraceuticals, when appropriate - magnesium, calcium, riboflavin, ubiquinol (CoQ10), B6, B12, feverfew, butterbur (free of pyrrolizidine alkaloids, PA), probiotic strains that don’t elevate histamine, etc., may be helpful in the right dosage

• Consider acupuncture

• Evaluate contact lens use – if contact lens wear coincides with migraine onset, discuss contact lens fitting with your optometrist or ophthalmologist

Personalized Approaches

Navigating migraine causes and effective complementary treatments can be overwhelming when experiencing severe migraine symptoms. Partnering with an integrative nutritionist who specializes in evidence-based migraine prevention and personalized nutrition can greatly improve outcomes and empower migraineurs to regain their health.

References:

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Bunner, A. E., Agarwal, U., Gonzales, J. F., Valente, F., & Barnard, N. D. (2014). Nutrition intervention for migraine: A randomized crossover trial. The Journal of Headache and Pain, 15(1), 69. https://doi.org/10.1186/1129-2377-15-69

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Linde, K., Allais, G., Brinkhaus, B., Fei, Y., Mehring, M., Vertosick, E. A., Vickers, A., & White, A. R. (2016). Acupuncture for the prevention of episodic migraine. The Cochrane Database of Systematic Reviews, 2016(6), CD001218. https://doi.org/10.1002/14651858.CD001218.pub3

Moffett, A., Swash, M., & Scott, D. F. (1972). Effect of tyramine in migraine: A double-blind study. Journal of Neurology, Neurosurgery, and Psychiatry, 35(4), 496–499. https://doi.org/10.1136/jnnp.35.4.496

Ornello, R., De Matteis, E., Di Felice, C., Caponnetto, V., Pistoia, F., & Sacco, S. (2021). Acute and preventive management of migraine during menstruation and menopause. Journal of Clinical Medicine, 10(11), 2263. https://doi.org/10.3390/jcm10112263

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