Seven ways ... to manage migraines

Monitor triggers

Migraines can be triggered by a variety of environmental factors, ranging from certain foods to perfumes. Keep a headache diary over the course of several months and record what you did or ate before the migraine. Sufferers often then start to notice patterns they can avoid in future. Common food triggers include products that contain monosodium glutamate, meats containing sodium nitrates such as bacon and salami, red wine, aged cheese, smoked fish and baked goods. Alcohol, sudden stress, loud noises, bright lights and smoking can also be migraine risk factors.

Take medicine, but not too much

For mild migraines, over-the-counter pain medications such as ibuprofen or aspirin can help. For more severe migraines, the main prescription drugs available are triptans. Even if they don’t help, it is worth trying alternatives as studies show that while 30-40% of migraine sufferers do not respond to the first triptan, they may respond to another. However, all pain medication has to be taken with caution. If taken on more than three days a week on a regular basis, you are at risk of rebound headaches due to overuse.

Try to stick to routines

If you suffer from migraines, your brain is sensitive to environmental changes, ranging from the external (loud noises) to internal (hormonal changes), that it perceives as threatening, resulting in pain. If you are as consistent as possible in your daily routine, from your sleep schedule to mealtimes to when you exercise, it can help prevent the number of attacks.

Try supplements

It is best to consult your doctor before trying anything new, but various studies have shown that different nutritional supplements such as magnesium, vitamin B2 and coenzyme Q10 have the potential to prevent migraines in some patients. One study of 31 migraine patients who took coenzyme Q10, which reduces damage to cells caused by the environment and other factors, reported that 19 found their migraine days were reduced by half.

Mild exercise

Research suggests that mild regular aerobic exercise, such as jogging, swimming, dancing or cycling for 30 minutes, three times a week, can reduce the frequency and severity of migraines in some patients. Exercise induces your body to produce natural painkilling chemicals known as endorphins. However, make sure to eat and drink before exercise, to avoid potential migraine triggers such as low blood sugar levels or dehydration, and try to stretch for 10 minutes before and afterwards to prevent muscle tension, which can also be a trigger.

Cut out caffeine

Caffeine is one of the most common migraine triggers, particularly if you regularly consume large amounts on a daily basis. This can then stimulate withdrawal headaches, which in turn trigger the brain’s migraine centre. Experts advise limiting your caffeine intake to just 200mg a day, which is one medium-sized cup of coffee.

Look out for new medications

Over the next couple of years, a new category of drugs called anti-CGRP antibodies, administered via a monthly injection, are expected to reach the market. They work by reducing the levels of a protein found to be raised in migraine sufferers that causes your blood vessels to dilate, and have been found to be effective in clinical trials with minimal side-effects. However, only half of migraine sufferers appear to respond to anti-CGRP antibodies, so they aren’t the complete answer.