Head Banger

Hormones, food additives, and weather changes can trigger a migraine, but there are options for relief.

Brian Nutt

Neck stiffness, food cravings, flashes of light, and tingling in the arms and legs aren’t just annoying; for millions of people, they’re telltale signs of an oncoming migraine.

In the United States, about 18 percent of women and 6 percent of men suffer from migraines, according to the Migraine Research Foundation. A migraine is essentially a cascade of inflammatory neurotransmitters initiated from the brain’s trigeminal nerve. The neurotransmitters release pain-producing neuropeptides. Imbalances in brain chemicals, such as serotonin, also seem to be involved.  

Many people are thought to be genetically susceptible to the cascade, says neurologist Dr. Ronald Davis, director of the Epilepsy Surgery Department at Arnold Palmer Hospital for Children in Orlando. In fact, the Mayo Clinic reports that up to 90 percent of migraine sufferers have a family history of migraine attacks. 

Hormonal changes often produce migraines in teenage girls and adult women, while common environmental triggers for both genders are food additives, the tannins in red wine, and even changes in the weather.

“In our carotid arteries that supply blood to the brain, there’s a receptor called a barometric receptor,” says Dr. Marc Sharfman of The Headache and Neurological Treatment Institute in Longwood. A change in barometric pressure triggers the trigeminal nerve, a major pain pathway, which then causes headaches, he says.

About 40 percent of his migraine patients are affected by Central Florida’s changeable weather. “They can smell the pressure,” Sharfman says. “They know when a front is coming through.”

Some patients even consider moving out of state. “But each part of the country will have different weather patterns that can trigger headaches,” he says, “so we don’t recommend geographic moves because you still bring your genetics with you.”

Migraine treatment varies, says Davis, depending on whether migraines are infrequent or chronic—15 or more times a month. That’s why migraine patients are asked to complete a headache diary.

“A diary gives you the opportunity to decide how episodic or chronic your headache is,” Davis says. “The diary might help you pick up on some triggers or patterns, so it’s a big deal.”

Drugs called triptans target serotonin, Davis says, and can work well for patients who experience acute, infrequent headaches preceded by any of the telltale signs. “If you can identify your phases, use them as an opportunity to head it off at the pass,” he says. 

For patients who suffer chronic headaches, the treatment is often a combination of triptans and medications that were originally designed to treat other conditions. Among these drugs are beta-blockers, anti-epilepsy medications and certain anti-depressants. Working through a variety of mechanisms, each type of medication has been shown to help individual migraine patients, depending on their biochemistry.

“The goal is to make you pain free,” Davis says, “keep you that way for some period of time, then wean you away and see if the headaches stay gone.”

Although there’s no migraine cure, Davis says, “There is a slew of medications in development that identify some component of the cascade. We’re closer to really tailored medication options.” 

Alternative Options 

  • Lifestyle changes, including exercise, adequate sleep and unprocessed foods
  • Craniosacral massage
  • Biofeedback
  • Vitamin cocktail: magnesium, calcium, B-2 and Coenzyme Q10, taken daily
  • Acupressure
  • Acupuncture
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