The Most Important Migraine Trigger: What Your Neurologist Never Told You.

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What are the most common Migraine Trigger and what is the most important trigger your neurologist has not discussed.  The exact cause of migraines is still not fully understood, or barely understood.

Neurological Triggers from Noxious Input to the Trigeminal Nerve is by far most important for a large population of migraine sufferers.  The amazing use of Sphenopalatine Ganglion Blocks to decrease and eliminate migraines clearly show how important this input is to migraine sufferers.  Learn more later about what your neurologist didn’t tell you.

The most commonly cited triggers in the medical and popular publications are discussed below.

Stress:  It is important to understand that stress can be divided into 3 categories

1  Emotional or Life Stress, Psychological Stress

2  Physical Stress including musculoskeletal stress

3.  Biochemical Stress

 

Sleep Disorders, Circadium Rythym problems, Jet Lag

Insufficient sleep can trigger acute migraine attacks as can excessive sleep.

Sleep Apnea can also trigger migraines thru changes in cortisol the stress hormone and changes in cardiac rates and cerebral blood flow

 

Food Additives:  Actually a Biochemical Stressor as well

Includes Aspartane  (also implicated in depression)

MSG or Monosodium Glutamate

 

Hunger or Dehydration is another major cause:

Skipping meals affects blood glucose levels and results in feedback loops to hypothalamus and pituitary

Dehydration is another possible migraine trigger.  About 40% of Migraine sufferers connect decreased fluid intake with headache onset.

 

Highly Caffeinated Beverages:  A more controversial trigger

Caffeine may be a cause or withdrawal may be the trigger while another group of patients may actually prevent migraines with caffeine.  There are chemicals similar to caffeine found in chocolate, tea and other foods that can also have positive or negative effects.

 

Medication Overuse is a verycommon stressor causing migraines.

This can include opiods, nsaids, other analgesics and Statins

There are 18,000-25,000 deaths annually from opiod overuse and over 40,000from nsaids.

 

Alcohol and Alcohol withdrawal are both major triggers.

A recent study showed 33% of patients were triggered migaines from alcohol.  Red Wine is an even bigger trigger, especially for female patients where it is three time more likely to trigger migraine than in men.

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Strong Smells and other olfactory inputs can frequently trigger migraine, perfume is frequently cited.  During migraine attacks smells can often have an exacerbated noxious effect with patients showing very low tolerance.  One study showed patients affected with osmophobia (smell phobia ) during attacks were more prone toanxiety and depression.

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Bright Lights and high noise level is another frequent trigger.  The Rock Concert Migraine being not uncommon.  Bright or flickering lights as well as all types of flourescent light are another related trigger.

 Bright light may be a sort of secondary trigger. People whose migraine attacks appear to be triggered by bright light should consider whether these other factors were triggers.

Sunlight may trigger migraine in some patients relief can be obtained wearing a hat that shades the eyes, wearing sunglasses, avoiding sunny places,or insuring a good night sleep.

 

Medication overuse headache often referred to as rebound headache is another frequent problem I recently covered in another post.  It is caused by opiods, nsaids and pain medications, often over the counter medications as well as drugs with bualbital such as fiorinal.  Discontinuing medication can be a miserable ordeal but can reduce frequency and severity of future migraines after withdrawal is complete.

Weather changes including changes in temperature and barometric pressurefrequently act as triggers.  Thunnder and lightning have been associated with migraine onset.  Lack of sunlight or numerous dark cloudy days as well as shortened days in winter are implicated as triggers.  SAD or seasonal affective disorders can link migraine and depression to decrease hours of sunlight.

 

Hormonal issues are especially prominent in women.Female sexual hormone fluctuate during the month with ovulation being the peak migraine time.

Many patients experience  severe migraine headaches during menstruation. A small subset of these patients experienced migraine solely during menstruation.  Others only get migraines on the first day of menses or the last day of menses.

Oral contraceptives may make symptoms better or worse and changing the typ of birth control pills can have different effects.  The ratio of estrogen to progesterone is very important to a percentage of women.  Women on BC can skip the off time to avoid menses if that is when headaches occur but other women become anxious without periods , often concerned about possible pregnancy.In the same manner most patients improve when pregnant but some get worse.

Low Thyroid especially low free T3 seems to increase risk and frequency and severity of migraine.  T3 in the bottom of the normal range may be insufficient.  Sythroid may not be effective in decreasing or eliminating migraine while natural Armour Thyroid is effective.  Low iodine levels can also have similar effects.

Physical Activity may trigger migraine.  These migraines often begin with neck pain.  Patients who also have Fibromyalgia or Myofascial Pain actually have less frequency of migraine as long as exercise is increased very gradually.

 

Foods like food additives and hormones are a type of biochemical stress;

Fastingmay increase headaches while multiple small meals can decrease headaches and migraines.   Diet is the most frequently reported trigger but often it is misinterpreted because of other triggers   As previously discussed alcohol, especially red wine, and chocolate, and caffeine  associated with migraine.

Migraines are always involved (almost 100%) with trigeminal nerve,and especially the trigeminovascular system that controls the blood flow to the anterior two thirds of the meninges of the brain.

Mayo Clinic lists Migraine headache triggers on their website that mirror the ones I just discussed.

  • Hormonal changes in women
  • Foods. Aged cheeses, salty foods and processed foods may trigger migraines.
  • Food additives.
  • Drinks.
  • Stress. S
  • Sensory stimuli.
  • Changes in wake-sleep pattern.
  • Physical factors.
  • Changes in the environment.
  • Medications.

The Main Trigger that gets left off every migraine list is nociceptive input into the Trigeminal Nervous System and TrigeminoVascular System through the teeth, jaw muscles, jaw joints, sinus lining and other trigeminally innervated tissues.

Neurological centers  do discuss imbalances in brain chemicals, especially serotonin, which helps regulate pain in your nervous system.  All of the neurotransmitters in the brain are affected by neural input to the brain and the largest contributor of neural input is the Trigeminal Nervous System.

The best method to control noxious input from the trigeminal nervous system is to use a physiologic diagnostic orthotic for a trial period prior to utilization of drugs with inherrent dangerous side effects.  If there is substantial relief correction of underlying physiologic parameters can allow healing and elimination of migraines.  Other patients have significant reductions in pain.

Elimination of this input is done by trained dentists.

Please visit the testimonial page of this website to hear real stories from real patients about migraine relief and migraine elimination.

 

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