Updated: Mar 16
Written by health writer Gerda Venter
Medically reviewed by Dr. Daniela Steyn
When most people hear the term migraine, they often think of a severe headache. But headaches are only one symptom of migraines. There are many different types of headaches, so identifying the location and nature of your pain can help determine the cause.
The most common types of headaches are:
The pain from tension headaches tends to spread across both sides of the head, often starting at the back and creeping forward. Tension headaches are the most common form of headache. Eyestrain, stress, and hunger are frequent causes of tension headaches.
Sinus headaches often strike when you are sick or feeling congested. They are caused by swelling in the sinus passages, resulting in pain behind the cheeks, nose, and eyes. The pain is often worse when you wake up and when you bend forward.
These headaches are usually excruciating and occur in "clusters," meaning they happen daily (usually at the same time), sometimes up to several times per day for months. They result from dilation in the blood vessels of the brain due to a release of serotonin and histamines. They can be caused by physical exertion, bright lights or even altitude.
What is a migraine
A migraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually only on one side of the head. Although the formation of a migraine attack is difficult to be explained medically, what is known is that it involves the contraction and expansion of the blood vessels connected to the brain. Migraine pain happens when the blood flow at the back of the brain is reduced, causing an increase of blood flow at the front part of the brain.
The trigeminal nerve in your head runs to your eyes and mouth. It also helps you feel sensations in your face and is a major pathway for pain. Your levels of serotonin may decrease at the start of a migraine and this nerve can release chemicals called neurotransmitters that travel to your brain and cause pain.
In addition to severe head pain, migraines are often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities.
Auras are signs or symptoms before a migraine attack. Sometimes you will have a migraine without aura (without warning), and sometimes you will have a migraine with aura (with warning signs). Migraines without aura happen five times more often than those with a warning.
A migraine episode may occur in four different phases. Not everyone will experience all four of these phases. The phases include:
Sometimes also called the pre-headache phase. This stage features painless symptoms that occur hours or days before the migraine attack. Symptoms include mood swings, food cravings, constipation, frequent urination, fluid retention, frequent yawning, and neck stiffness.
Refers to sensory disturbances occurring before or during a migraine. Auras can affect a person's vision, touch, or speech.
A migraine usually lasts from 4 to 72 hours if untreated. How often migraines occur varies from person to person. Migraines might occur rarely or strike several times a month. The attack phase is when the pain usually hits, ranging from mild to debilitating. Physical activity and exposure to light, sound and smells may worsen the pain. Some people can have a migraine without developing a headache.
The final step is when the pain has subsided. People may feel exhausted, confused or generally unwell during this phase.
While headaches usually have easily traceable causes, migraines have common triggers, but no one cause. If you suffer from migraines, you may find that certain factors trigger the onset. These factors include:
Gender and Hormonal shifts
Women are three times more likely to suffer from migraines than men. Fluctuations in estrogen seem to trigger headaches in many women. Women with a history of migraines often report headaches immediately before or during their menstrual cycle, when they have a significant drop in estrogen. Other women have an increased tendency to develop migraines during pregnancy or menopause. Hormonal medications, such as oral contraceptives and hormone replacement therapy may worsen migraines. Some women, however, find their migraines occur less often when taking these medications.
Family history and genetics
People with family members suffering from migraines are more likely to develop migraines themselves.
This is one of the most common migraine triggers. When you're stressed, your brain releases chemicals that set off your "fight or flight" response. Anxiety, worry, and fear can create even more tension and worsen a migraine.
A common trigger of migraines are food sensitivities, the top one being gluten. Certain foods like salty, processed foods and aged cheeses like blue cheese are known triggers. The artificial sweetener aspartame and flavor enhancer monosodium glutamate (MSG) may cause migraines, too. Certain citrus fruits like oranges, lemons, tangerines and mandarin oranges can cause migraines and foods high in tyramine (for example, cheese, yogurt, and beans).
Imbalances in the gut
Because the connection between your gut and brain are so significant, identifying and treating bacterial imbalances or yeast in the gut can help combat migraines. Getting your gut healthy with enzymes, probiotics, and omega-3 fats is essential.
Magnesium is the relaxation mineral. If you are deficient, you are more likely to suffer from migraines.
If you miss a meal, your blood sugar could drop, triggering a headache.
Alcohol and caffeine
Alcoholic drinks and drinks high in caffeine can be migraine triggers. Alcohol contains phenol, a photochemical ingredient. The ingredients in beer or whiskey increase serotonin production, which can cause migraines. Caffeine like tea and coffee has stimulating effects. Significant caffeine intake will stimulate the blood vessels and may cause a migraine.
Bright lights and sun glare can induce migraines, as can loud sounds. Strong smells - including perfume, paint thinner, second-hand smoke, and others - can trigger migraines in some people.
Changes in your sleep pattern
If you get too much or too little sleep, you may get a migraine. Travelling between time zones (jet lag) can be a cause, too.
An intense workout, like heavy exercise or even sex, can cause a migraine. If you suspect that physical strain is causing your migraines, you should still be active, but you might do better with a more moderate pace.
Changes in the weather or barometric pressure can prompt a migraine.
Oral contraceptives and vasodilators, such as nitroglycerin, can aggravate migraines. If you have migraines and take medicines for them more than ten days a month, you may be setting yourself up for what's called a rebound headache.
Day of the week
Often, migraine attacks do not happen when you are stressed but after you are calm again. This is also known as the weekend migraine. To avoid a weekend migraine, you should try to wake up at the same time during the weekend as on weekdays. Make sure you maintain stable stress levels throughout the week. Don't create your own mental, physical, or emotional stress. Drink plenty of plain water and if you are out during the weekends, wear sunglasses with UV protection to avoid exposure to direct sunlight.
While there is no specific cure for migraines, lifestyle changes and medication can help treat your symptoms and prevent future episodes. Although you might not prevent migraine triggers entirely, healthy lifestyle habits like regular, good-quality sleep, a healthy diet, exercise, and stress management may help you stop them before they start.
Over the counter (OTC) pain medicines like acetaminophen, ibuprofen and aspirin can be helpful for mild migraines. However, if you experience moderate to severe migraines regularly, OTC treatments might not be enough to manage your symptoms. In this instance, your doctor might prescribe medication to help reduce the severity of your migraine and prevent future occurrences. Prescribed medicine may include beta-blockers, Antidepressants, Anti-seizure medication or Botox injections.
Natural remedies prescribed at Wellness MD include:
Magnesium Glycinate or Magnesium Citrate, typically 300-600mg twice daily
Vitamin B2 supplement. We advise a bio available supplement, typically Riboflavin 400mg daily
Melatonin at bedtime
We work with clients to establish the root cause of their migraines which are often food allergens. Our clients do this by following an elimination diet for 3-4 weeks.
We recommend all our migraine clients to keep a migraine journal. When we find a women's migraines are related to her menstrual cycle, we help her to balance her hormones by eating broccoli, flax seeds, tofu, black berries and minimize caffeine, alcohol and sugar. Implementing certain types of exercises certain days of your hormonal cycle may also aid in balancing your hormones.
It is estimated that less than 50% of migraine sufferers seek medical advice. Migraine attacks should not be dismissed and seen as “only another headache”, as it may worsen if left untreated.
Seek medical advice if you suffer from frequent, painful migraines. Ask yourself, "Is my migraine controlling me, or am I controlling it?". If your migraines are controlling you, or are interfering with your daily functioning and happiness, we at Wellness MD would love to help you. We have a passion for enabling clients to achieve optimal body, mind, and soul wellness. Rather than managing symptoms, we assist you in establishing the root cause of your migraines while also developing a plan for you to take your life back and thrive.
Listen to our podcast on migraines today!
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