What Can I Do To Avoid Headache and Migraine Triggers?

Q: I get frequent migraines. Is there anything I can do, besides taking medicine, to try to prevent them?

A: We know there are certain lifestyle changes patients can make to reduce headache frequency. They include:

1. Diet. There are certain triggers in food, and the two big things we tell patients to stay away from are monosodium glutamate (MSG) and nitric oxide. So that’s aged cheeses, red wine, ramen noodles, chocolate and the list goes on. But you don’t have to stop everything – it’s more about moderation.
2. Caffeine. Too much caffeine is bad for people with headaches, especially people who have migraines. But a good amount, which is usually anywhere between a 100 mg to 150 mg a day, can actually be protective. We hear a lot from people that their morning cup of coffee can actually help their migraines.
3. Supplements. There are three over-the-counter products that, based on studies, we know can help. Magnesium is one of them – anywhere from 400 mg to 500 mg. Vitamin B2 can also be protective. The third one is coenzyme Q10.
4. Sleep. Sleep is an incredibly important element when it comes to headaches. And if there’s an underlying or unrecognized sleep disorder, it can have a tremendous effect on the amount of headaches or the frequency of headaches patients get.
5. Noise and light. A big trigger for some people who get migraines is noise and light. If somebody’s predisposed to migraines and they’re sitting in front of a screen with bright lights and loud sounds, it could trigger a headache.
6. OTC medicines. If somebody has a history of migraines, they may actually have more headaches if they use too much over-the-counter painkillers. I’ll hear from patients that they’ve been taking Excedrin Migraine® or another OTC pain medicine three or four times a week and say that over time they start having more headaches. Usually our rule is no more than twice a week.

Another important element that we can’t control is the barometric pressure and weather. A sudden drop or rise in temperature can really affect people.

— Headache specialist Emad Estemalik, MD