Migraine: Causes, Symptoms, and Management

Migraine is a complex and often debilitating neurological condition that affects millions of people worldwide. Unlike a typical headache, migraines are characterized by intense throbbing or pulsating pain, usually on one side of the head, and are often accompanied by other symptoms such as nausea, vomiting, and extreme sensitivity to light and sound. According to the World Health Organization, migraines are among the top 10 most disabling medical conditions globally. Despite its prevalence, migraine is often misunderstood, misdiagnosed, or inadequately treated. This article aims to provide a comprehensive understanding of migraine, including its causes, symptoms, types, diagnostic approaches, treatment options, and preventive strategies.

What Is a Migraine?

Migraine is more than just a severe headache; it is a complex neurological disorder that affects various systems in the body and significantly impacts daily functioning and quality of life. A migraine attack is a result of abnormal brain activity, which can influence nerve signaling, chemical balances, and blood flow in the brain. It typically presents as a recurring, often one-sided, throbbing headache accompanied by a range of other symptoms, which vary widely among individuals.

Migraine is categorized as a primary headache disorder, meaning it is not caused by another medical condition. It is a chronic condition that can persist throughout a person’s life, with episodes ranging from occasional to frequent and severe.

The Neurological Basis of Migraine

Research suggests that migraines originate from the activation of the trigeminovascular system, a network of nerves involved in facial sensation and pain perception. This activation leads to the release of neuropeptides and inflammatory substances that cause blood vessels in the brain to swell, contributing to the pain and other symptoms experienced during an attack.

Additionally, a phenomenon known as cortical spreading depression—a wave of electrical activity that moves across the brain’s cortex—has been linked to the aura phase of migraines and may play a role in triggering attacks. This process leads to a temporary disruption in normal brain function, affecting visual, sensory, and motor skills.

How Migraine Differs from Other Headaches

Unlike tension-type headaches or sinus headaches, migraines are usually more intense, disabling, and long-lasting. The pain is often described as throbbing or pulsating and tends to worsen with physical activity. Migraines are commonly associated with nausea, vomiting, and heightened sensitivity to external stimuli, such as light, sound, or smell.

Migraines also have distinct phases, which can help differentiate them from other headache types. The predictability and recurring nature of these phases—especially the presence of aura in some cases—can aid in accurate diagnosis and management.

Migraine as a Systemic Disorder

Although migraine is classified as a neurological condition, its effects are systemic. It can disrupt gastrointestinal function, influence cardiovascular health, and is linked to hormonal fluctuations, especially in women. People with migraines are also more likely to experience mood disorders such as depression and anxiety, suggesting a broader impact on overall health.

Migraine Prevalence and Burden

Migraine affects approximately 1 in 7 people globally and is more common in women than men, particularly during the reproductive years. The condition is a leading cause of disability among young adults, often affecting individuals in their most productive years of life. The economic burden is substantial, with costs related to medical care, lost productivity, and reduced quality of life.

Understanding migraine as a multifaceted neurological disorder rather than just a severe headache is crucial for effective management and treatment. Early recognition of symptoms and comprehensive care strategies can dramatically reduce the frequency and severity of attacks, improving overall well-being.

Phases of a Migraine

A migraine attack typically progresses through four phases:

1. Prodrome: This phase can occur hours or even days before the actual headache begins. Symptoms may include mood changes, food cravings, neck stiffness, increased thirst, frequent urination, and yawning.
2. Aura: Experienced by about 25% of migraine sufferers, aura involves visual or sensory disturbances such as flashing lights, zigzag lines, blind spots, or tingling in the arms or face. Auras usually last from 20 to 60 minutes.
3. Attack: The headache phase, which may last from 4 to 72 hours. The pain is often localized to one side of the head and is typically described as throbbing or pulsating. Additional symptoms may include nausea, vomiting, and sensitivity to light, sound, or smell.
4. Postdrome: After the headache subsides, individuals may feel drained, confused, or euphoric. This phase can last for a day or more.

Causes and Triggers

The exact cause of migraines is not fully understood, but they are believed to result from abnormal brain activity that temporarily affects nerve signals, chemicals, and blood vessels in the brain. Several contributing factors may play a role in both the development and triggering of migraines, and these can vary significantly between individuals.

Genetic Factors

Studies have shown that migraines often run in families, suggesting a strong genetic component. If one or both parents have a history of migraines, there is a higher likelihood that their children will also experience them. Specific gene mutations, especially those associated with familial hemiplegic migraine, and other genes involved in regulating ion channels and neurotransmitter function, are known to increase susceptibility.

Hormonal Influences

Hormonal changes are a significant factor, especially in women. Fluctuations in estrogen levels—such as those that occur during menstruation, pregnancy, and menopause—can influence the frequency and severity of migraines. Some women experience migraines exclusively during their menstrual cycles (menstrual migraines), while others may find relief during pregnancy or after menopause.

Neurological Factors

Migraine sufferers often have a hypersensitive nervous system, which can overreact to certain stimuli. This heightened sensitivity may lead to the activation of the trigeminal nerve and subsequent release of inflammatory neuropeptides, resulting in the pain and associated symptoms of migraine.

Environmental and Lifestyle Triggers

Migraines can be triggered by a wide range of environmental and behavioral factors. Common triggers include:

• Stress: Psychological stress, anxiety, or emotional upheaval can provoke or exacerbate migraine attacks. Stress management techniques are often essential in treatment plans.
• Sleep Disruption: Both insufficient sleep and oversleeping can trigger migraines. Maintaining a regular sleep schedule is critical.
• Dietary Factors: Skipping meals or fasting can trigger migraines, as can certain foods and beverages. Common dietary triggers include aged cheeses, processed meats, chocolate, alcohol (especially red wine), caffeine, and food additives like monosodium glutamate (MSG) and nitrates.
• Dehydration: Inadequate fluid intake can lead to migraines. Staying well-hydrated is a simple yet effective preventive measure.
• Sensory Stimuli: Bright or flickering lights, loud noises, and strong smells (like perfumes or smoke) can provoke migraines in susceptible individuals.
• Weather and Environmental Changes: Sudden changes in weather, humidity, or barometric pressure can be a major trigger for some people.
• Physical Factors: Overexertion, intense physical activity, or even poor posture can contribute to migraine onset.
• Medications: Certain medications, including vasodilators and oral contraceptives, may influence migraine frequency.

Comorbid Conditions

People with migraines often have other health conditions that can interact with or exacerbate migraine symptoms. These include:

• Depression and anxiety disorders
• Epilepsy
• Irritable bowel syndrome (IBS)
• Fibromyalgia
• Sleep disorders

Understanding and identifying personal migraine triggers is a key step in developing an effective management plan. Keeping a headache diary to track patterns, triggers, and symptoms can help both patients and healthcare providers tailor strategies to minimize attacks and improve quality of life.

Types of Migraine

There are several types of migraine, each with unique characteristics and varying degrees of severity. Identifying the specific type is crucial for determining the most appropriate treatment and management strategies.

1. Migraine Without Aura (Common Migraine)
2. Migraine With Aura (Classic Migraine)
3. Chronic Migraine
4. Hemiplegic Migraine
5. Vestibular Migraine
6. Retinal Migraine
7. Menstrual Migraine
8. Abdominal Migraine
9. Ophthalmoplegic Migraine

Migraine Without Aura (Common Migraine)

This is the most prevalent form of migraine. It is characterized by moderate to severe head pain, usually on one side, accompanied by symptoms such as nausea, vomiting, and sensitivity to light and sound. There are no preceding neurological disturbances (aura).

Migraine With Aura (Classic Migraine)

This type includes neurological symptoms that typically occur before the onset of headache pain. Auras can be visual (e.g., flashing lights, zigzag lines, blind spots), sensory (e.g., numbness or tingling), or speech disturbances. The aura phase usually lasts less than an hour and is followed by the headache phase.

Chronic Migraine

Defined as experiencing migraine headaches on 15 or more days per month for more than three months, with at least eight days meeting the criteria for migraine. Chronic migraines can severely impact quality of life and may require both acute and preventive treatment strategies.

Hemiplegic Migraine

A rare and severe type of migraine that involves temporary paralysis or weakness on one side of the body, often accompanied by visual disturbances, speech difficulties, and sensory changes. It can be familial (inherited) or sporadic (without family history).

Vestibular Migraine

This form is characterized primarily by vertigo, dizziness, and balance disturbances, which may or may not be accompanied by headache. Vestibular migraines often affect coordination and can be confused with other inner ear disorders.

Retinal Migraine

A rare type marked by temporary vision loss or visual disturbances (such as flashes or blindness) in one eye. These symptoms are usually short-lived and reversible but should be evaluated by a healthcare professional to rule out other serious conditions.

Menstrual Migraine

These occur in close relation to the menstrual cycle and are triggered by hormonal fluctuations. They often appear without aura and can be more resistant to standard treatments.

Abdominal Migraine

More common in children, this type presents as recurrent episodes of abdominal pain, nausea, and vomiting with little to no head pain. It can sometimes evolve into typical migraine later in life.

Ophthalmoplegic Migraine

Extremely rare, this type involves headache accompanied by weakness of the eye muscles, leading to drooping eyelids or double vision. It is now often categorized under cranial neuralgia.

Each type of migraine presents differently, and patients may experience more than one type over the course of their lives. Accurate diagnosis by a healthcare provider is essential to managing the condition effectively.

Diagnosis

Diagnosing migraine involves a comprehensive evaluation that includes a detailed medical history, a physical and neurological examination, and sometimes additional tests to rule out other conditions. Since migraines can mimic other neurological disorders, a precise and thorough diagnostic process is essential.

Clinical History

The first step in diagnosing migraine is obtaining a complete and accurate medical history. This involves asking the patient detailed questions about their headaches, including:

• Frequency, duration, and intensity of the headaches
• Description and location of pain
• Presence of nausea, vomiting, visual disturbances, or other neurological symptoms
• Possible triggers and family history of migraines
• Any medications or lifestyle factors that may contribute

A headache diary can be particularly useful in documenting patterns and identifying potential triggers or associated symptoms.

Physical and Neurological Examination

A physical examination, including a neurological assessment, helps rule out secondary causes of headaches, such as brain tumors, infections, or other structural abnormalities. A normal neurological exam is typical in individuals with migraine.

During this examination, a healthcare provider may evaluate:

• Reflexes and motor strength
• Coordination and balance
• Sensory response
• Eye movements and visual fields
• Cognitive function

Diagnostic Criteria

The International Classification of Headache Disorders (ICHD-3), established by the International Headache Society, provides standardized diagnostic criteria for migraines. According to the ICHD-3, a diagnosis of migraine without aura requires at least five attacks fulfilling the following:

• Headache lasting 4 to 72 hours (untreated or unsuccessfully treated)
• Headache has at least two of the following characteristics: Unilateral location – Pulsating quality – Moderate or severe intensity – Aggravation by or causing avoidance of routine physical activity
• During the headache, at least one of the following: Nausea and/or vomiting – Photophobia and phonophobia

For migraine with aura, at least two attacks meeting criteria for aura symptoms (such as visual, sensory, or speech disturbances) are necessary.

Imaging and Laboratory Tests

While imaging tests are not typically required for diagnosing migraine, they may be recommended in certain cases to exclude other causes of headache, especially if there are red flag symptoms such as:

• New-onset headaches after age 50
• Sudden, severe (thunderclap) headache
• Neurological deficits or seizures
• Headache with fever, stiff neck, or weight loss

Tests may include:

• Magnetic Resonance Imaging (MRI): To detect brain lesions, tumors, or stroke
• Computed Tomography (CT) Scan: Often used in emergency settings to identify bleeding or structural abnormalities

Laboratory tests are not usually needed unless there are signs of systemic illness.

Differential Diagnosis

Because migraine symptoms can resemble those of other conditions, it is important to differentiate migraines from:

• Tension-type headaches
• Cluster headaches
• Sinus headaches
• Cervicogenic headaches
• Secondary causes such as stroke, tumor, or infection

Accurate diagnosis enables the selection of appropriate treatments and prevents unnecessary tests or ineffective therapies.

Treatment Options

Treating migraines effectively requires a personalized and multi-pronged approach. The primary goals are to relieve symptoms during an attack (acute treatment), prevent future attacks (preventive treatment), and improve overall quality of life. Treatment strategies can be broadly categorized into pharmacological therapies and lifestyle or non-drug interventions.

Acute Treatments

These treatments aim to stop or reduce the severity of symptoms once a migraine attack has begun. The earlier they are taken during an attack, the more effective they tend to be.

• Over-the-Counter (OTC) Pain Relievers: Medications such as ibuprofen, aspirin, naproxen, or acetaminophen are often used to relieve mild to moderate migraine symptoms.
• Triptans: These are specific migraine drugs that work by stimulating serotonin receptors to reduce inflammation and constrict blood vessels. Examples include sumatriptan, rizatriptan, and zolmitriptan. Triptans are most effective when taken early in the migraine attack.
• Ergot Alkaloids: Medications like dihydroergotamine (DHE) are sometimes used when triptans are ineffective. They are more commonly used in hospital settings for severe or prolonged attacks.
• Anti-nausea Medications: For migraines with significant gastrointestinal symptoms, drugs like metoclopramide or prochlorperazine can be helpful.
• CGRP Receptor Antagonists (Gepants): These newer medications block the calcitonin gene-related peptide pathway, which plays a key role in migraine pathophysiology. Examples include ubrogepant and rimegepant.
• Lasmiditan: A newer class of acute treatment, lasmiditan targets serotonin receptors and is suitable for individuals who cannot take triptans due to cardiovascular risk.

Preventive Treatments

Preventive or prophylactic treatments aim to reduce the frequency, duration, and severity of migraine attacks. They are typically recommended for individuals who:

• Experience frequent migraines (more than four per month)
• Have migraines that are prolonged or debilitating
• Do not respond well to acute treatments

Preventive treatments can take several weeks to months to show full effectiveness. They include:

• Beta-blockers: Medications such as propranolol and metoprolol, originally used for high blood pressure, can help prevent migraines.
• Antidepressants: Tricyclic antidepressants like amitriptyline are effective in some individuals, even those without depression.
• Anticonvulsants: Anti-seizure medications such as topiramate and valproate are often used for prevention.
• CGRP Monoclonal Antibodies: These are injectable medications that prevent migraines by targeting CGRP or its receptor. Examples include erenumab, fremanezumab, and galcanezumab.
• Botulinum Toxin (Botox): Approved for chronic migraine, Botox injections are administered every 12 weeks at specific sites around the head and neck.
• Hormonal Therapy: For women with menstrual migraines, hormonal treatments such as contraceptives or estrogen patches may be beneficial.

Combination Therapy

In some cases, a combination of acute and preventive treatments may be necessary to manage the condition effectively. Coordination with a healthcare provider is essential to avoid medication overuse and potential interactions.

Personalized Treatment Plans

Each person’s experience with migraine is unique, so treatment must be tailored to individual needs. Factors that influence treatment choices include:

• Frequency and severity of migraines
• Presence of aura
• Co-existing health conditions
• Lifestyle factors and personal preferences
• Response to previous treatments

A collaborative approach between patient and provider can optimize outcomes and empower individuals to take control of their migraine management.

Non-Pharmacological Treatments

Non-pharmacological treatments for migraine are integral to a comprehensive management plan, especially for individuals who prefer to minimize medication use or who have not responded adequately to drugs alone. These approaches aim to reduce the frequency, intensity, and duration of migraine attacks, and improve overall well-being through lifestyle adjustments and complementary therapies.

Lifestyle Modifications

• Sleep Hygiene: Maintaining a regular sleep schedule—going to bed and waking up at the same time each day—can help prevent migraines. Avoiding both sleep deprivation and oversleeping is key.
• Regular Exercise: Engaging in consistent, moderate-intensity aerobic exercise (like walking, cycling, or swimming) has been shown to reduce migraine frequency. Exercise helps manage stress, improve sleep, and regulate hormones.
• Balanced Diet: Eating regular, well-balanced meals and avoiding known dietary triggers (e.g., caffeine, alcohol, aged cheeses, and processed meats) can be beneficial. Skipping meals can also trigger migraines.
• Hydration: Drinking sufficient water throughout the day is essential, as dehydration is a common trigger for migraine.

Stress Management

Stress is a major trigger for many migraine sufferers. Incorporating stress-reduction techniques into daily life can be highly effective:

• Mindfulness Meditation: Practicing mindfulness helps regulate the body’s response to stress and may reduce migraine frequency.
• Deep Breathing and Progressive Muscle Relaxation: These techniques help calm the nervous system and alleviate physical tension that may contribute to migraine onset.
• Cognitive Behavioral Therapy (CBT): CBT helps individuals identify and change negative thought patterns and behaviors that contribute to stress and anxiety, which are known migraine triggers.

Biofeedback

Biofeedback is a technique that teaches individuals to control physiological functions, such as muscle tension, heart rate, and skin temperature, often with the use of electronic sensors. It has been shown to be particularly effective in managing migraines, helping individuals recognize early signs of an attack and apply relaxation techniques to prevent escalation.

Acupuncture

Acupuncture, a traditional Chinese medicine practice, involves inserting fine needles into specific points on the body to balance energy flow. Several studies suggest that acupuncture can help reduce the frequency and severity of migraines, possibly by stimulating nerves and altering pain processing in the brain.

Supplements and Natural Remedies

Some supplements have shown potential in preventing migraines, especially when used under medical supervision:

• Magnesium: Deficiency in magnesium has been linked to migraines. Supplements can help, especially in individuals with low levels.
• Riboflavin (Vitamin B2): High doses of riboflavin may reduce migraine frequency by supporting mitochondrial energy production.
• Coenzyme Q10: This antioxidant may help improve cellular energy metabolism, which is often disrupted in migraine sufferers.
• Feverfew and Butterbur: These herbal supplements have shown mixed results but may help some individuals. However, quality control and safety are important concerns.

Physical Therapy and Chiropractic Care

For some people, physical therapy targeting the neck, shoulders, and upper back can alleviate tension that contributes to migraines. Chiropractic spinal manipulation may also offer relief, though evidence is mixed and should be approached with caution.

Aromatherapy and Essential Oils

Aromatherapy using essential oils such as lavender and peppermint may provide temporary relief from migraine symptoms. Inhalation or topical application (with a carrier oil) can promote relaxation and ease pain.

Digital Health Tools

Mobile apps and wearable devices that track migraine symptoms, triggers, and treatment responses can empower patients to take control of their condition. Some apps also provide guided meditation, CBT exercises, and lifestyle coaching.

Living With Migraine

Living with migraine is a continuous journey that requires understanding, adaptation, and resilience. Since migraine is a chronic condition with episodic flare-ups, managing it effectively involves not only medical treatment but also daily strategies to minimize triggers, cope with symptoms, and maintain a high quality of life.

Developing a Migraine Management Plan

An effective migraine management plan includes both preventive measures and acute response strategies. Patients benefit from working closely with healthcare providers to create a personalized plan that may involve medications, lifestyle changes, stress management, and regular follow-ups.

A management plan often includes:

• Identifying and Avoiding Triggers: Keeping a migraine diary helps track patterns, identify triggers (such as specific foods, sleep disturbances, hormonal changes, or stress), and assess treatment effectiveness.
• Scheduling Regular Medical Reviews: Ongoing communication with a neurologist or headache specialist ensures that treatments remain effective and are adjusted as needed.
• Emergency Protocols: Knowing when to seek immediate care (e.g., for severe, sudden headaches or new neurological symptoms) is essential.

Emotional and Social Impact

Migraines can affect emotional well-being, relationships, work performance, and social life. Many people with chronic migraine experience frustration, anxiety, or depression. It is important to address these issues openly and seek mental health support if needed.

Ways to support emotional health include:

• Joining Support Groups: Both online and in-person communities offer a safe space to share experiences, coping strategies, and emotional support.
• Counseling and Therapy: Working with a therapist can help manage the psychological burden of living with a chronic condition.
• Education and Advocacy: Learning about migraine and advocating for awareness can be empowering and reduce the stigma often associated with invisible illnesses.

Work and Productivity

Migraines can interfere with job responsibilities and professional growth. Employers may not always understand the impact of migraines, which can lead to workplace stress and misunderstanding.

To manage migraines in the workplace:

• Open Communication: Discussing accommodations with employers, such as flexible hours, access to a quiet space, or work-from-home options, can help reduce stress and improve productivity.
• Documenting Episodes: Keeping records of attacks may be helpful when requesting workplace adjustments or medical leave.
• Utilizing Disability Benefits: In some cases, short-term or long-term disability coverage can provide financial support.

Family and Relationships

Migraine doesn’t just affect the individual—it can impact family dynamics and relationships. Loved ones may feel helpless or confused about how to support someone with frequent, unpredictable pain.

Strategies for strengthening relationships include:

• Education: Helping family members understand the nature of migraines can build empathy and patience.
• Setting Boundaries: Being honest about limitations can prevent misunderstandings and reduce stress.
• Including Family in Care Plans: Inviting loved ones to medical appointments or migraine education sessions can foster involvement and support.

Living a Full Life

While migraines can be life-altering, they do not have to be life-defining. Many people with migraines lead full, active, and successful lives by embracing a proactive approach to health and well-being.

Key principles for thriving with migraine:

• Self-Care: Prioritize rest, nutrition, hydration, and gentle physical activity.
• Mindset: Cultivate a positive outlook and practice self-compassion.
• Flexibility: Adjust plans as needed without guilt or self-judgment.
• Empowerment: Stay informed, be your own advocate, and celebrate progress, no matter how small.

By integrating medical treatment with holistic self-care and social support, individuals living with migraine can regain a sense of control and pursue a meaningful, balanced life.

Frequently Asked Questions

How to stop a migraine from coming on?

The key to stopping a migraine is early intervention. At the first sign—like visual disturbances, neck stiffness, or light sensitivity—take your prescribed migraine medication. Many people find that NSAIDs like ibuprofen help if taken early. Avoid known personal triggers (like bright lights, strong smells, or stress), stay well-hydrated, and try resting in a cool, dark, quiet room. Some find relief through cold compresses on the head or neck, practicing deep breathing or meditation, or drinking a small amount of caffeine (as it can constrict blood vessels and reduce pain early on).

What is the main cause of migraine?

The exact cause of migraines isn’t fully understood, but they’re believed to result from a combination of genetic, neurological, and environmental factors. Abnormal brain activity affects nerve signaling, neurotransmitters (especially serotonin), and blood flow in the brain. Triggers like stress, hormonal changes, certain foods, sensory stimuli, and sleep disruption can initiate this cascade. If migraines run in your family, you may be genetically predisposed.

What is a stage 3 migraine?

Migraines typically unfold in four stages: prodrome, aura, headache (stage 3), and postdrome. Stage 3—the headache phase—is when the migraine pain actually hits. It’s often described as intense, throbbing or pulsing, usually on one side of the head. It can last from several hours to three days. During this phase, people may also experience nausea, vomiting, and extreme sensitivity to light, sound, and smells. Physical activity can worsen symptoms, so rest is usually necessary.

What happens if you don’t treat migraines?

Leaving migraines untreated can lead to several complications. They may increase in frequency and severity over time, potentially developing into chronic migraine (defined as 15 or more headache days per month). Untreated migraines can also result in “status migrainosus,” a debilitating migraine that lasts more than 72 hours. Additionally, persistent pain can impact daily functioning, mental health, and overall quality of life. Medication overuse or avoidance can also create rebound headaches, making things worse.

What helps calm down a migraine?

There are several methods to calm a migraine, depending on the severity and your personal triggers. Medications like triptans, NSAIDs, or anti-nausea drugs are common. Resting in a cool, dark, quiet room helps many people. Applying a cold pack to the forehead or back of the neck can reduce pain. Hydration is essential, especially if dehydration is a trigger. Gentle massage, aromatherapy (lavender or peppermint), and relaxation techniques like progressive muscle relaxation or deep breathing may also help ease symptoms.

What triggers a migraine?

Migraine triggers vary from person to person, but common ones include:

• Stress or anxiety
• Hormonal changes (e.g., during menstruation)
• Sleep disturbances (too much or too little)
• Dietary factors like aged cheese, chocolate, alcohol, or caffeine
• Dehydration
• Sensory stimuli like bright lights, loud sounds, or strong smells
• Weather changes (especially shifts in barometric pressure)
• Skipping meals or fasting
  Identifying your personal triggers with a headache diary can help with prevention.

How long does a migraine last?

Migraine attacks can last anywhere from 4 to 72 hours without treatment. Some people experience shorter migraines that last only a few hours, while others may suffer for days. The total duration may include different phases: the prodrome (subtle warning signs), the aura (if present), the headache, and the postdrome (a “migraine hangover” with fatigue or brain fog). Duration can also depend on how quickly treatment is taken and whether the migraine responds to it.

What are the 5 C’s of migraines?

The “5 C’s” are a mnemonic used by some to remember common migraine triggers:

1. Chocolate – contains both caffeine and tyramine
2. Cheese – especially aged cheeses that are high in tyramine
3. Caffeine – in excess or withdrawal can both be problematic
4. Citrus fruits – like oranges and lemons, which may affect some people
5. Change – in sleep, schedule, weather, or hormones
   While not everyone is sensitive to these, they’re commonly reported triggers in migraine sufferers.

Can dehydration cause migraines?

Yes, dehydration is a well-known and common migraine trigger. When your body lacks fluids, it can cause the brain to temporarily contract from fluid loss, which may trigger pain receptors. Even mild dehydration can set off a migraine, especially if you’re already prone to them. Staying consistently hydrated—especially during hot weather, exercise, or illness—is a simple but effective way to reduce risk.

How to know if it’s migraine?

Migraine pain is usually moderate to severe, often on one side of the head, and pulsating or throbbing in nature. Other key features include:

• Nausea or vomiting
• Sensitivity to light, sound, or smell
• Visual disturbances (called aura)—like flashing lights or zigzag patterns
• Worsening pain with physical activity
  If you experience recurring headaches with these characteristics, you may have migraines. A neurologist or healthcare provider can make a proper diagnosis.