The Migraine Threshold: Understand It & Take Control Of Your Life

Ruth Sutherland

Stop Living On the Edge!

"Why is it that some days, if someone looks at me the wrong way, I get a migraine; other days, it's the weather, and another day it is lack of sleep? My friend develops a headache when she misses lunch. There's no rhyme nor reason!”

Migraines are known to have multiple triggers. What makes them sneaky is that different people have different triggers. To confuse things even more, what brings on a migraine one day may not cause it the next. We can have multiple triggers, some of which we can control, while others are beyond our control. We each have a migraine threshold. This limit, when crossed, will make us likely to develop a headache. Some migraineurs have a higher threshold and can handle several slip-ups before crossing that line. Other people have a lower threshold which makes them more susceptible to migraines with fewer triggers. The secret is to raise that threshold by adopting lifestyle changes to increase the distance we live below it. The higher the threshold, the more triggers it will require to put us over the edge.

Lifestyle Changes

These are some of the lifestyle changes we can make to help decrease the number of migraines we have to suffer through.

Sleep

Get adequate, good-quality sleep. If you snore, get tested for sleep apnea. Don't vary your sleep/wake schedule by more than a few hours, days off included. Stay off screens for at least 2 hours before bedtime. Have a bedtime routine.

Nutrition

Limit caffeine consumption. Many headaches are caused by caffeine withdrawal. Did you know you can treat a headache with caffeine if you have been caffeine-free for a while?
Limit alcohol. Tannins in red wine are a common trigger for migraines.
Eat regularly. Eat healthy meals that do not cause rapid fluctuations in blood sugar levels. Try more complex carbohydrates and less processed foods.
Stay well hydrated.
Avoid food triggers such as MSG, sulfites, nitrates, high tyramine foods, and Aspartame.

Exercise

Studies show that regular moderate exercise can help control migraines.

Stress & Anxiety

We know that emotions have a strong influence on migraines. Fortunately, there are many ways to help control them through practicing self-management, relaxation, meditation, and biofeedback.

Hormones

Hormonal fluctuations can be hard to control, especially in the perimenopausal years. Regulating your hormones through birth control pills can help. If you know when your menstrual cycle occurs, your doctor may suggest that you start taking an NSAID such as naproxen for a few days before your period and continue them throughout your period. For those of you in perimenopause - there is hope! Headache frequency usually decreases after you reach post-menopause.

Medication Overuse

It seems counter-intuitive that the medication you use to treat your headache could cause one if taken too frequently. Most treatment medications, such as triptans or opioids, should be limited to 10x per month. Simple analgesics such as ASA, acetaminophen, or NSAIDs should be limited to 15x per month.

Incorporating these lifestyle changes will make you less likely to develop a migraine when one of the triggers you have no control over, such as the weather, rears its ugly head. Understanding your threshold will let you make plans that don't involve going home with a migraine. If you know you will be going to a party tomorrow night and want to be able to have a drink, take care of the rest of your triggers. Get a good night's sleep. Don't skip any meals. Hydrate. Go to your 'happy place' when your boss yells at you. Then go to the party and have fun!