Migraines can be debilitating, annoying, and impact your quality of life-but there is much you can do to avoid them. From identifying what triggers your headaches to making proactive lifestyle changes, it's possible to get better control and manage your migraine symptoms.
1. Be aware of your triggers.
Migraines do not impact everyone the same and the events that trigger a migraine can vary significantly from person to person. While you will never be able to avoid all triggers, you will be in a better position if you know which triggers impact you. Common triggers include emotional stress, menstruation and other hormonal changes in women, skipping meals, weather changes, irregular sleep, strong odors, lights and other visual stimuli, sudden noises, smoke, exercise or overexertion, or sex.
2. Watch your diet.
Many patients are not aware that what you eat can significantly impact your migraine symptoms. Studies show as many as 50% of migraine sufferers have headaches triggered by a food item. While I find some patients know that migraines can be related to aspartame or monosodium glutamate, they are often surprised to learn that alcohol, caffeine, cheese, chocolate, and processed meats may also impact migraines.
3. Keep a headache journal.
Keeping a headache journal can be a great tool to help you not only identify triggers, but also figure out what treatments might work best for preventing and relieving your headaches. Make sure to record the date, time, intensity, preceding symptoms, triggers, medication, and response to medication. You may also want to record how frequently headaches are occurring, other associated symptoms, where the pain is located, and a description of the pain (e.g. throbbing or piercing). Consider also tracking food intake, any over-the-counter vitamins or supplements you are using, what your sleep is like, and how much exercise you have been doing.
4. Consider a medicinal preventive treatment.
I find many migraine patients suffer in silence. While there are no hard and fast rules or guidelines, I generally offer preventive therapy to patients if they have more than four migraines in a month, if they have significant headaches that last 12 or more hours or if the migraines are debilitating. There are a number of different medication options that will depend on your particular medical situation.
5. Look into alternative preventive treatments.
Feverfew, coenzyme Q10 and butterbur root are the most widely-studied alternative treatments for the prevention of migraines. Butterbur root is an herbal medicine that is marketed in the United States as a food supplement. Several studies have shown that taking 150mg daily can prevent headaches. In a small study using an antioxidant called coenzyme Q10, a significant number of patients reduced migraines by more than half at a dose of 100 mg three times daily. Feverfew, an herbal plant-based remedy, has also had a number of trials but results on its efficacy are conflicting. If you decide to implement an alternative treatment, talk with your doctor to make sure these products will not interfere with any other medical treatments. These products are not as widely studied and not as tightly regulated by the FDA.
6. Try over-the-counter medicines.
Mild headaches are often relieved with over-the-counter (OTC) medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, or acetaminophen. All medications can have side effects, so be sure to ask your doctor what OTC medicine is best for you. If a medication works for you, consider asking your doctor about a prescription product that combines it with caffeine, as the combination sometimes works better than the OTC medicine alone. While migraines can be hard to get rid of, treating at the first sign of headache symptoms will increase your likelihood of relief.