Knowing your triggers and avoiding them key for migraine sufferers

Knowing your triggers and avoiding them key for migraine sufferers. Migraines cause more time off work than any other illness. Stock Photo

Michael Zitney is a family physician at the Headache and Pain Clinic in Toronto and has been treating headaches and chronic pain since 1986. He said one of the biggest misconceptions is that headaches are the same as migraine headaches.

A migraine sufferer for more than 20 years, Stuart Green said people don't understand that having migraine is not the same as having a bad headache and can't be cured by popping a few Advil.

"As someone who suffers from them legitimately, it really bothers me when someone with just a bad headache thinks that they're having a migraine because it really diminishes how debilitating migraines can be for a lot of people," Green said.

Zitney said a headache is any pain in your head so the differentiating factors between the two are the specific symptoms that accompany a migraine.

This includes nausea, sometimes vomiting and environmental sensitivity to smells, lights and loud noises.

"You need to have at least two of those symptoms in order to be able to call it a migraine because it's not always on one side of the head or throbbing like people think," Zitney said.

Generally, it's a more significant headache that usually lasts longer, but Zitney said it's hard to categorize a migraine because its length, symptoms and triggers vary for each person.

For every ailment there is a cause and in the case of migraines, Zitney said, while there is still a lot of work that needs to be done, they are slowly getting a better understanding of how they start. This means, they can try and prevent them.

What doctors know for sure is there is a genetic component when you are born that says that you can "make" and therefore have a migraine. But doctors still can't pinpoint whether someone has the gene or not.

"Everyone can have a headache, but only a certain amount of people actually have the genetic program that can make this migraine type of headache," he said. "Probably about 25 per cent, maybe 30 per cent of the population all over the world can have migraines, doesn't mean they're going to have that many, but it means they can."

Green, who said migraines do run in his family, said he will never forget the time he had his first one.

He was 23, a reporter at the time and on an assignment. The building he was in was freshly painted and the smell was quite strong.

"An hour after I got there, my vision started to go all weird and I almost had this sort of tunnel vision. To put it mildly, I was freaking out. I didn't know what was going on," he said.

Thirty minutes later those symptoms began to clear, but then came a blinding head pain and some nausea, so he took a few Advil and went home. Once there, he told his mother who said it was possible he had a migraine attack because it runs in the family.

However, Zitney said there are those who can't trace it back to their family tree and still suffer from migraines. It's also been said that it's difficult to prove whether a person has a migraine or not as there isn't a diagnostic test to prove it.

"I can't prove by doing a test on you that you have it, of course examining you and seeing what's going on I can say this is a migraine or it isn't, but I can't do a blood test or an X-ray or anything like that," he said.

However, Zitney said doctors can help to identify what triggers your migraines. He said it's usually a combination of several triggers that affect the area of the brain called the headache centre. This centre is constantly receiving and processing signals from all over the head, neck and body.

"You have a natural migraine defence system working to protect you all the time, but when the signals overwhelm your defences, you'll end up with the migraine," he said.

Zitney said sometimes people feel run down and their defence system weakens so they don't even realize they've been fighting off a migraine days before it occurs. A lack of sleep is also a common trigger as is stress and exposure to things in your surroundings.

"Like perfume or fluorescent lights, weather changes all kinds of things, and if they all come at the same time it can be overwhelming," he said.

Certain foods can also be triggers, but Zitney said there isn't a list of foods to avoid because it's different for everyone. This means people should try and figure out what their own trigger foods are.

"Most of the time people will have an idea after a while that, for example, if they eat pickles or drink orange juice, they'll get a migraine," he said.

However, Zitney said it's not only what you eat, but the pattern of how you eat. For example, if you go too long without eating your blood sugar drops and that can trigger a migraine. Similarly, this can also happen if you eat too much sugar.

"So it's the pattern of how you eat and when you eat throughout the day as well as what you're eating," he said.

Green said after being told by his doctor about triggers, he eventually figured out what caused his migraines and today avoids them. These includes bananas, MSG and caffeine.

"The big one that I can't control is weather," Green said. "The only time I get them is radical changes in weather and generally changes in season, so between spring and summer and then fall and winter, that's when I tend to get them."

Zitney said while it's important to try and avoid your obvious triggers, just as important are the hidden triggers that people often don't consider. This includes having stress that causes muscle tension in the areas around their neck, shoulders, upper back and jaw muscles. If not looked after, that tension will build up and eventually trigger a migraine.

Green said he is lucky because before he gets a migraine, his vision goes spotty, so he immediately takes his medication, Zomig, and a few Advil. This way, he catches it in time and he can work right through it, despite some residual throbbing.

Green said he also considers himself lucky because before he knew about triggers, he used to get a migraine once a month. Today, he has four or five a year due to weather changes

Zitney said knowing your triggers are important because if you can predict them ahead of time, you can try to avoid them. And rest assured, if you are healthy Zitney said you should be able to fight off a single trigger, but this means migraine sufferers need to eat healthy, get a good night sleep and have good stress relievers.

Also, avoiding triggers and maintaining a healthy lifestyle means if you do get a migraine, you'll be able to reduce the severity of your migraines, reduce how long they last or how bad they are.

The most important thing to know is you don't have to suffer.

Zitney suggested people go to their doctor and ask about migraine medication. It can be expensive, but it may be a better alternative to missing a few days of your life and work.

Unfortunately, Zitney said people are sceptical and generally, what people can't see they find hard to believe. This makes the severity of a migraine a tough sell to a boss or family member who doesn't suffer from them.

"Especially people who don't get migraines, they can't understand how bad it can feel, they just think it's like a regular headache," he said. "Not to mention how bad it makes your whole body feel, a migraine is almost like a whole body condition."