Figuring out migraine triggers is tricky

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It is nearly impossible for migraine sufferers to pinpoint the causes of their attacks on their own, researchers say.

Many people with migraines try to figure out for themselves the things that trigger their migraines. For example, they may conclude that it is stress, hormones, alcohol or even the weather.

"But our research shows this is a flawed approach for several reasons," Timothy Houle, an associate professor of anaesthesia and neurology at Wake Forest Baptist Medical Centre in Winston-Salem, North Carolina, said.

"Correctly identifying triggers allows patients to avoid or manage them in an attempt to prevent future headaches," Houle said.

"However, daily fluctuations of variables – such as weather, diet, hormone levels, sleep, physical activity and stress – appear to be enough to prevent the perfect conditions necessary for determining triggers."

Not enough information

Houle and a colleague conducted a study that included nine women who suffered migraines and kept a daily diary and tracked their stress for three months.

Daily morning urine samples were collected from the women and tested for hormone levels. In addition, the researchers analysed local weather data during the study.

It was extremely difficult for the women to identify the causes of their migraines, according to the findings, which were published recently in the online version of the journal Headache.

"People who try to figure out their own triggers probably don't have enough information to truly know what causes their headaches," study co-author Dana Turner, also of the Wake Forest Baptist Medical Centre anesthesiology department, said.

Medication-use strategies

"They need more formal experiments and should work with their doctors to devise a formal experiment for testing triggers. Many patients live in fear of the unpredictability of headache pain," Houle said. "As a result, they often restrict their daily lives to prepare for the eventuality of the next attack that may leave them bedridden and temporarily disabled."

"They may even engage in medication-use strategies that inadvertently worsen their headaches," he said.

"The goal of this research is to better understand what conditions must be true for an individual headache sufferer to conclude that something causes their headaches."

The US National Institute of Neurological Disorders and Stroke has more about migraines.

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