Don’t Pull That Trigger!
By Jared Paulson

 

About a year ago “Jeannie” came into my office desperately seeking help with her headaches. In the past few months she had been suffering from headaches that were so severe that all she could do was lie down and try to sleep. The headaches had recently become more frequent and she was starting to worry. Her doctor had diagnosed her with migraines and given her some medication to help. However the drug had some side effects that she was not comfortable with. She was looking for a natural way to put a stop to her headaches.

Unfortunately, Jeannie is not alone in her suffering. Migraines are a debilitating disorder that affects approximately 28 million Americans. While strides are being made in their treatment, many people still get regular migraines. However there are non-drug methods to reduce migraine symptoms. An important aspect in the treatment of migraines is the identification of the factors that are triggering them. Identifying these factors can greatly diminish the number of migraines a person experiences.

 

What causes Migraines?

Migraines are a neurological disorder characterized by abnormal nerve activity in the brain that leads to alterations in blood flow and intense pain. During this process your body’s pain suppression mechanism is inactivated leading to intense pain. Until recently the changes in blood flow were thought to be the main cause of migraine pain but now it is known that these changes are just another symptom. People with migraines have an increased susceptibility to developing these changes. Migraine experts think that almost every one has had at least one migraine in their life but that most people need extraordinary circumstances to develop one. These changes in the brain are most often triggered by an outside factor. These are called migraine triggers. There are numerous things that can serve as triggers, and most people have two to three different factors that will initiate their migraines.

 

Triggers and Food

The most common group of triggers is dietary. Common ones include alcohol, chocolate and caffeine. An interesting fact is that while caffeine is a trigger for some people it can be helpful for many others. Caffeine is the anti-migraine portion of many over-the-counter migraine pain relievers. Food additives are also a common source of triggers. These include aspartame, nitrates and monosodium glutamate (MSG). Aspartame is an artificial sweetener common in diet soft drinks. Nitrates are a preservative that is widespread in processed meats. MSG is a flavor enhancer and is common in processed and Chinese foods. Since these additives are in many different kinds of foods, it can be difficult to identify the specific trigger. Another difficulty is the fact that MSG can be listed by other names such as kombu extract, hydrolyzed wheat protein, or natural flavoring. Another example of substances that cross food groups is tyramine which is present in yogurt, sour cream, aged cheeses, and Chianti wine. Other food triggers include onions, nuts, beans, and citrus fruits. Knowing which foods trigger your migraine is a powerful tool. Some people are able to eliminate their migraines simply by avoiding these foods. The key is to find out which ones are causing problems for you.

Migraines are a complex and mysterious disorder. Triggers are an important point in the process to influence the development of your migraines. Part two of this article will explore some other sources of migraine triggers and what you can do to control them. In the meantime look at your diet and see if you can find any patterns associated with your migraines.

 

Jeannie

After my initial conversation with Jeannie, I gave her a migraine journal. After a few weeks of treatment we noticed that her migraines tended to be after meals. While looking at her journal I noticed that a couple of the meals preceding a headache had been Chinese food and a TV dinner. I suggested that she avoid foods containing MSG. While Jeannie was improving with my treatments, the elimination of MSG greatly accelerated her progress and made our work easier. I called Jeannie the other day to see how she was doing and she hasn’t had a migraine in over nine months. She had her life back just as she had hoped when she walked into my office.

 

Don’t Pull That Trigger! Part II

“Ella,” a nine year old was brought into my office a few months ago by a relative. She was experiencing very intense headaches at least once a week. Ella’s parents were in the process of a divorce and she was staying with her aunt during the transition period. Coincidentally, the headaches had started since the move. It was clear that Ella was having a very hard time adjusting to and accepting her new home life. Fortunately her family recognized the problem and was seeking help.

Migraines are an all to common occurrence in today’s society. However, no one needs to suffer with migraines; help is available. This is the second part of a two part article. In the first part, I discussed what causes migraines, the concept of triggers and how a person’s diet can be involved. This article will focus on other common sources of migraine triggers, how to identify your triggers, and what you can do to treat your migraines.

 

Your Lifestyle and Triggers

Today’s fast paced world is very hard on our bodies. Erratic sleeping patterns are often overlooked as a health problem. Chronic sleep deprivation can often lead to migraines. Even oversleeping can serve as a trigger. Stress related migraines are another product of our busy lives. These headaches can occur during a stressful situation or they can be what are called “let-down” migraines. These “let-down” headaches occur after a stressful situation is over and the person finally gets a chance to relax. Some people will develop these like clockwork every Saturday once their work week is over. Stress does not need even need to be the main trigger; people’s resistance to their primary triggers can be reduced during a stressful situation.

 

Environmental Triggers

There are many things around us that are out of our control which can cause migraines. Weather patterns are frequent triggers. Being a specialist in migraine treatment, one of the busiest times in my clinic is when a weather front is coming in. Similar to people with arthritis, these migraine sufferers can tell you without fail that a storm is coming when the sky is still clear and sunny.

Some of the strangest triggers involve smells and lights. The most commonly encountered light triggers are fluorescent or extremely bright lights. Replacing fluorescent lights with incandescent bulbs in the home and workplace can make a big difference for some people. Many people have developed chemical sensitivities which can bring on a migraine. Common smells include gas fumes, cigarette smoke, and perfumes. I have one patient who couldn’t leave her home without encountering some scent that would trigger a migraine. She became a virtual shut-in because she feared triggering a migraine. Luckily she came in for help and has been able to return to a normal life.

 

Identifying and Overcoming Trigger Factors

So how do you figure out which factors are important for you? It can be incredibly difficult to figure this all out in your head. Especially when it feels like your head is in a vice and the only thing you want to think about is getting to a dark, quiet room. In my clinic I provide my patients with a migraine trigger log. This is a set of pre-printed pages that makes it very easy to record suspect factors during a headache. You can easily create one of these for yourself. If possible try to write in your log during the early phase of the headache. If you can’t get this done until after the headache, you may find it easier to focus on one or two factors at a time. Over time triggers can change; so if you thought that you knew all of your triggers and your headaches have recently become worse, you may need to investigate possible new sources.

While discovering your triggers is important it is only one part of an effective migraine treatment strategy. Talk to your doctor and seek out the help of a migraine specialist. Migraines respond best to multiple treatment approaches at once. I work with MDs, chiropractors, massage therapists, and psychologists to treat people’s migraines. I use acupuncture and Chinese herbs to decrease people’s sensitivity to their triggers. Recent studies have demonstrated the effectiveness of acupuncture in migraine treatment. If a person’s migraines are related to stress, counseling can help as can taking up yoga or tai chi. You can even learn techniques such as biofeedback or self-hypnosis to try and decrease the intensity and the duration of your migraines. Finding your triggers is an important first step but don’t stop there, get some help.

After my initial conversation with Ella, I sent her to her MD to confirm my diagnosis of migraines and rule out any serious problems. Her migraines seemed to be stress related so in addition to my treatments, I referred her to a child psychologist that I work with. When we started treatments, she was a very gloomy and introverted girl. By the end of her fifth treatment she was a completely different child: she had no more headaches and a smile on her face.