Migraines – not just a headache!

If you have ever experienced a migraine you will know that it is a disabling condition.  Your head feels like it wants to explode.  You are overcome with nausea.  Light, sound, the slightest change in position all make you feel like someone is stabbing you behind your eye with a screwdriver.  You can’t see.  You can’t think.  You can’t move.  For most of us who have experienced this type of headache, there is only one solution… find a dark, quiet place to lie in silence until the pain escalates to the point of vomiting, or until the medicines we use to treat migraine knock you unconscious.

What causes a migraine?  

We don’t understand migraines fully, but we believe that migraine headaches are triggered by changes in blood flow in the vessels in and around your brain.  For whatever reason, those blood vessels change their calibre or pressure and that sets off a migraine headache which explains the pulsatile, pounding nature of the pain.  

For most people, there are specific triggers or factors that will get your migraine going:  

• Certain foods:  Chocolate, cheese, alcohol and caffeine are the usual suspects.  For me, food additives like MSG and tartrazine are deadly!
• Ultra-processed foods + high-sugar foods
• Sleep deprivation
• Dehydration
• Exposure to screens or eye strain
• Exposure to bright light / glare
• Changes in environmental temperature (like going from air-conditioning to a hot outdoor environment)
• Intense exercise / sudden change in heart rate and blood pressure
• Stress or emotional distress

It is often extremely useful to keep a “MIGRAINE DIARY” where you record the frequency and intensity of your migraines along with your routine leading up to the migraine attack:  Your activities, exposures, food and drink intake, sleep status, stress levels etc so you can identify your specific triggers and try to eliminate or reduce them.  

Case study:  

Tamara is 34 years old.  She works in finance as a compliance officer.  Long hours in front of the computer.  Her employer asked her to see me because she was suffering from frequent debilitating migraines.  She’d noticed that Tamara was ‘zoned out’ in meetings and she was taking too long to complete her work.  Tamara was apparently relying on painkillers every single day because of her constant headaches.  

When I consulted Tamara, I could see she was in pain.  Her eyes were narrowed against the light in my office and she spoke quietly because even her own voice was hurting her.  

She’d apparently been in this state for months… living with a severe headache every day.  

Once I ruled out any sinister cause (I asked her to do an MRI scan of her brain) and optimised her medical treatment to reduce the frequency and severity of the attacks… we discussed her lifestyle.  

She was extremely stressed.  Work pressure was high, and not being able to do her work effectively was making it worse.  There were challenges at home.  She was still living with her parents who were constantly pressuring her to find a partner, settle down and have children.  She had no time for exercise.  

Her nutrition was a major issue.

Breakfast:  2 cups of coffee with sugar and milk.  Effervescent vitamin booster with caffeine.

An energy drink (Monster / Red Bull) in the car on the way to the office

More coffee

For lunch:  She would get a delivery of panini with cheese and pesto or Chinese fried rice or noodles. Eat at her desk.  

Another energy drink.

Sweet pastries in the afternoon with coffee

Sandwich with jam when she reached home in the evening

Tea with milk and sugar

Dinner with the family:  Rice and chicken with vegetables.  Chocolate or sweetened yoghurt for dessert.  

On weekends… she would secretly drink vodka at night before bed ‘to help her relax’.

She did not drink any water at all. 

Her sleep was awful.  She struggled to fall asleep in the first place and would wake up regularly in the night with racing thoughts and anxiety about the following day.   

Tamara acknowledged that there were multiple factors contributing to her headaches.  We agreed on the following strategy:  

Cut down on caffeine.  

Initially eliminate the energy drinks, effervescent caffeinated vitamin booster, then reduce the coffee and replace it with decaf.  

Get more nutrition.  

Include a protein-based breakfast in the morning.  Boiled eggs or leftovers from the night before.  Vegetables and protein during the day.  Avoid take-out and store-bought pastries / snacks that often contain flavour enhancers and preservatives that might trigger migraine.  Focus on whole real foods.  No sugary snacks.  Include fruit, nuts, seeds, coconut instead.  

Hydration.  

I asked her to check her eyes and get an anti-glare filter for her computer screen and blue-light blocking glasses.  I advised that she invest in a good pair of sunglasses to wear while outdoors.  

And, I asked her to do some deep breathing exercises at night before bed and to stop drinking alcohol unless it was an occasional celebratory drink in a social setting.  

I prescribed a magnesium supplement to take at night-time and asked her to practice good sleep hygiene.

Within 3 weeks, we were able to stop all medication.  She did not even need to take a paracetamol during the day.  Her headaches completely resolved.  She was sleeping better.  Her energy levels were better.  She was more focussed and productive at work, and so her stress was significantly less.   

I saw her more than a year later for an insurance medical and she said she never suffered another migraine after eliminating all her lifestyle triggers.         

This case illustrates that migraine can be triggered by lifestyle-related factors, and eliminating exposure to those triggers can reduce the frequency and severity of migraine headaches or even prevent them from happening in the first place.  

Here are my Top 3 lifestyle interventions for reducing migraine frequency and severity:     

• Balanced Blood Sugar with Whole Foods – Avoiding blood sugar spikes and exposure to food-based triggers (especially highly processed foods and common trigger foods like chocolate and cheese) helps prevent migraine onset.
• Consistent Sleep Schedule – Sleep deprivation and irregular sleep patterns are major migraine triggers.  Practicing good sleep hygiene so you get regular good quality sleep makes a huge difference. 
• Magnesium & Hydration – Magnesium-rich foods (spinach, almonds, avocados) and staying hydrated help prevent migraines by supporting optimal circulation and stabilising nerves.

Please comment below with any questions.  And, share this article with anyone you think may find it useful.