Migraine

Migraine is defined as a regular throbbing or pounding sensation at the front or side of the head, often accompanied by sight problems, heightened sensitivity and limb stiffness.

The word 'migraine' is thought to be derived from the Late Latin for 'pain in one side of the head', or- 'hemicrania'. 

The World Health Organisation recently listed migraine as one of the 20 most disabling lifetime conditions and, according to the Migraine Trust, a staggering eight million people in the UK currently suffer from the condition.

Migraine is thought to be more common than epilepsy, asthma and diabetes combined, and is now the most prevalent neurological condition in the developed world. 

Migraines can be severely debilitating. The condition can render a person unable to work, unwilling to socialise or even to get out of bed. It is important to take the condition seriously, especially in light of mounting evidence showing strong connections between migraine and mental health problems.

Studies show that certain foods can affect the severity and frequency of migraine attacks. A nutritionist should be able to construct a diet plan that helps manage migraine symptoms and improve the quality of a sufferer's life.

Migraine symptoms

How can you tell if you have a migraine and not just a normal tension headache? The main differences between a migraine and a tension headache are as follows:

Factor Tension headache Migraine
Intensity Mild to moderate - distracting but not debilitating. Severe throbbing or pounding that can be debilitating.
Location Both sides of head (equal distribution of ache). One side of the head only, or the front.
Other symptoms None Numerous accompanying symptoms, including nausea and vomiting.
Sensitivity Heightened sensitivity to light and sound is rare. Heightened sensitivity to light and sound is common.
Warning signs No warning signs, just a headache. 'Aura' (warning signs) before headache.

'Aura' is the term used to describe the warning signs that one third of migraine sufferers experience before an attack. Symptoms of aura include: 

  • Problems with sight - flashing lights, blind spots, or zigzag patterns.  
  • Stiffness or tingling - a pins and needles sensation in limbs, neck, or shoulders.
  • Bad co-ordination - feeling of disorientation or loss of balance.
  • Difficulty speaking - slurred words, stammering.
  • Loss of consciousness - a very rare occurrence.

Aura symptoms usually occur around 15 minutes to one hour before the actual headache. It is possible to experience aura with only a mild migraine.  

The most common symptoms of migraine

  • Nausea - a feeling of queasiness or sickness, possibly followed by vomiting.
  • Heightened sensitivity - this could include sensitivity to light (known as photophobia), and/or sensitivity to smells (known as osmophobia). A lot of migraine sufferers feel a strong compulsion to rest in a dark room in silence until the symptoms pass.

Less common migraine symptoms 

  • lack of concentration
  • increased perspiration
  • extreme temperatures- either feeling very hot or very cold
  • abdominal pains, sometimes causing diarrhoea
  • need to urinate frequently.

Other migraine symptoms usually begin and ease off at the same time as the headache itself. Not everyone experiences the same symptoms and they can occur with different levels of severity. Symptoms can last any time between four hours and three days, although tiredness can ensue for up to seven days after the attack.

Migraine causes

Why do some people suffer from migraines and others don't? Is it inherited? Is it down to diet? Lifestyle? Age? Ethnicity?

The precise cause of migraine is unclear; however, the condition is generally associated with serotonin levels. Serotonin is a chemical compound found in blood platelets. It is a 'neurotransmitter', meaning that it helps transport signals through the nervous system. It is most commonly associated with memory, sleep and mood disorders. Drops in serotonin levels can cause the blood vessels in the brain to spasm and become narrower, which is thought to cause the aura symptoms. Soon after the spasms, the blood vessels dilate, which causes the actual headache. The exact reason for the drop in serotonin levels is, as yet, unknown.

According to Migraine Trust, 70 to 80% of migraine sufferers have family members who also suffer from the condition. Scientists have now located a number of genes connected to migraine, strongly suggesting that it is a hereditary condition.

Migraine triggers

Some sufferers notice patterns to the frequency and occurrence of their migraines. There are a number of factors though to be responsible for triggering migraine attacks. These include:

Emotional triggers

  • anxiety
  • stress
  • tension
  • excitement
  • depression
  • shock.

Physical triggers

  • lack of sleep
  • fatigue
  • bad posture
  • long-distance travelling
  • tension in neck or shoulders
  • hormonal changes- e.g. menopause.

Environmental triggers

  • smoking
  • bright lights
  • loud noises
  • flickering screens - televisions or computers
  • climate changes - humidity or temperature
  • stuffy atmosphere
  • strong smells.

Medicinal triggers

  • certain types of sleeping tablets
  • hormone replacement therapy (HRT), sometimes used to treat menopause symptoms
  • contraceptive pill.

Dietary triggers

  • dieting
  • dehydration
  • alcohol
  • irregular meals
  • tyramine - (food additive)
  • caffeine - tea, coffee or energy drinks
  • chocolate, cheese, citrus fruit.

Migraine diagnosis

If you find that your migraines cannot be managed with over-the-counter pain killers such as paracetamol, you are advised to see your GP. Although there are no specific tests to diagnose migraine itself, the GP will be able to conduct tests to identify the symptoms. This will include a physical examination to test:

  • vision
  • co-ordination
  • reflexes
  • sensations.

Your GP may also want to ask you a few questions. These are likely to include:

  • Where do you experience your headaches? On one or both sides of your head?
  • Do you experience a pulsating pain?
  • Would you describe your headaches as mild, or moderate to severe?
  • Do they prevent you from carrying out your normal daily activities?
  • Are the headaches ever accompanied by feelings of nausea and/or vomiting?
  • Are they made worse my physical activity?
  • Are they ever accompanied by heightened sensitivity to light and/or sound?

When it is important to see your GP

  • your aura symptoms always occur on the same side of your body
  • you are over 50 years old and you experience your first migraine
  • you've noticed a change in your usual migraine symptoms
  • your migraine attacks become more frequent.

Migraine treatment

There is no 'cure' for migraines, only different methods of symptom management. There are three different levels of migraine treatment. These are known as:

  • Preventative - Sometimes, migraines can be tackled before the full onset of an attack. Preventative medication is usually only taken as a temporary measure to break severe migraine cycles (between 3 and 18 months). This is because the improvement usually continues even after the patient has stopped taking the drugs. Your GP will require you to carefully monitor your symptoms. This is so he or she can identify improvements and make any adjustments to your prescription.
  • Acute - Acute treatment is designed to tackle the migraine attack while it is happening.
  • Rescue - If your acute treatment doesn't work, you may need more relief. This is known as rescue medication and could consist of anti-inflammatory, antinausia, or painkilling drugs.

Taking medication is a risk. You are advised to always consult your GP before proceeding with medication, and to pay close attention to your body whilst taking it. 

Migraine facts and statistics

Although migraine is considered to be the most prevalent neurological condition across the developed world, it is still widely misunderstood by many. Here are some facts and statistics from the Migraine Trust:

  • There are an estimated 190,000 migraine attacks experienced across the UK every day.
  • Around 25 million days are lost from work or school every year due to migraine.
  • Women are much more likely to experience a migraine attack than men. 18% of women suffer from migraine, compared to 8% of men.
  • Depression is three times more common in people with migraine than it is in healthy individuals.
  • 50% of migraine sufferers remain undiagnosed and untreated.
  • Of all the known neurological conditions, migraine gets the least public funding relative to its economic impact.

Living with migraine

Living with migraine can be difficult for both the sufferers themselves, and for the people around them. Friends and family can find it difficult to accept the habits of a migraine sufferer (such as the frequent need to lie down in a dark, quiet room), or they might often dismiss the attack as 'just a headache'. The truth is - a person's life changes when they begin to suffer from migraines. They are required to take extra care with physical activity, with what they eat, with what they drink and when they can go out in public.

If you suffer from migraine, the important thing is to try your best to keep life as normal as possible, and to keep positive.

Exercise

Many migraine sufferers avoid physical activity in case it triggers an attack. Certainly, migraines are often experienced during or directly after strenuous exercise, especially if:

  • You start exercising very suddenly without preparation (e.g. running for a bus), so your body has a sudden and unexpected demand for oxygen.
  • You did not eat properly before exercising, causing your blood sugar level to fall.
  • You don't drink enough water before or during exercise, so your body becomes dehydrated.
  • You suddenly begin a strenuous exercise regime at the same time as beginning a new diet. These drastic changes can act as an additional trigger for your migraine.
  • You exercise intensely once every so often - the extra strain you put on your muscles could act as a trigger.
  • You sustain a minor head injury during exercise (such as a ball to the head), which could provoke aura symptoms.
  • Exercise is undertaken in hot weather or high altitude.

However, new research shows that aerobic exercise can have a therapeutic effect on symptoms, and could even prevent an attack. You are therefore advised to take regular, moderate exercise to help soothe your symptoms. When you exercise, your body releases endorphins and enkephalins. Endorphins are natural pain-killers and enkephalins are anti-depressant hormones.

A well-planned exercise programme could also help you to lower your intake of migraine medication.

Excellent forms of mild exercise to try could include:

  • Brisk walk - walking has been widely overlooked as a form of exercise. Walk fast enough to work up a slight sweat, but not so fast as to become out of breath.
  • Swimming - swimming is a great form of aerobic exercise. Swim a slow breaststroke with measured breathing to avoid overexerting yourself.
  • Cycling - cycling puts minimum impact on joints, muscles and bones, thus lowering the likelihood of triggering aura symptoms.

Always warm up and stretch out properly before any form of physical activity. Practice deep breathing exercises in order to get oxygen flowing to your muscles in preparation.

Menopause and migraine 

Half of all women suffering from migraine claim that their menstrual cycle directly affects the severity or frequency of their condition. Scientists believe there are strong connections between the female sex hormones oestrogen, and the hormones involved with migraine.

The drastic hormonal changes that occur in the female body during the menopause is therefore bound to have an effect on migraine. For nearly half of all women studied, menopause caused migraine attacks to happen more often, or to become more severe. Often, migraine attacks assume a cyclical pattern after the menopause - the reason for which is unclear.

Men and migraine 

Studies show that three times as many women suffer from migraine than men. However, there is evidence to suggest that this is because men simply do not report their symptoms and therefore go undiagnosed. Experts believe this could be because the traditional idea of 'masculinity' is to be strong, in control and dominant. Some men may see admitting to migraine as a failure, or a weakness, which could explain why many fail to report it.

Migraine is not a specifically gender-related condition. It can affect anyone of any age, race or gender. It is important to seek professional advice so that it can be managed and treated appropriately.

Migraine and mental health

Migraine is associated with an increased risk of a host of mental health problems, including:

  • anxiety disorder
  • panic disorder
  • depression
  • manic depression.

Migraine is debilitating. The effect it has on some people's lives can be massive, and this can spiral into depression and anxiety. The best thing sufferers can do, is to try to manage the symptoms and triggers the best they can. With support from families, friends, charities and health professionals, living with migraine should become easier.

Diet and nutrition for migraine

Trigger foods - There are a number of foods considered to worsen or increase the frequency of migraine symptoms. According to the City of London Migraine Clinic, the most commonly cited culprits are alcohol, chocolate and cheese.

29% of those studied reported alcohol as a trigger, 19% reported chocolate and 18% reported cheese. It is thought that these products contain certain chemicals that directly affect the blood vessels connected with the onset of migraine.  This chemical occurs more commonly in wine, and less commonly in pure spirits.

'Migraine diet' - Following a strict diet can be restrictive, monotonous and just plain difficult. How do you even know if the effort is going to pay off? In clinical trials, 40% of patients dropped out of a controlled diet within the first six weeks. Of the people who completed it, only 10% reported improvement, with a similar number experiencing either no change, or a worsening of symptoms. That is not to say you shouldn't experiment with your diet. Everybody is different and you may find that cutting out certain foods seriously improves the quality of your life. 

Timing - Researchers also found that important dietary triggers for migraine were timing and hydration. Going without food or water could induce migraine, especially in young children. You may notice that missing breakfast, or going on a diet makes your symptoms worse. Sometimes all you need is a quick snack to raise your blood-sugar levels, or a glass of water to reduce fatigue.

How can a nutritionist help with migraine?

The way you manage your migraine will be unique according to your symptoms and triggers. If you believe food to be a major trigger, you could be able to control your symptoms by identifying the trigger foods, avoiding them for a few weeks, and documenting the affects. Usually, dealing with migraine is a process of trial and error. Living with a strict diet and avoiding foods can be very difficult for those of us who associate food with emotions. It can also be hard on social lives and make something as simple as going to a restaurant for a night out difficult and upsetting.

Free nutritional advice is widely available across the internet- but how do you know if any of the tips and suggestions are right for you? Speaking with a nutritionist should ensure that whatever you do is right for you, personally. A nutritionist will construct a diet plan tailored to your own needs and preferences. He or she will offer the knowledge, experience and support to help you enjoy food while avoiding the debilitating effects of migraine.

Further help

Looking for help?
Find a nutritionist
Would you like to provide feedback on our content?

Find a nutritionist dealing with migraine

All therapists are verified professionals.

Related Articles

More articles