Re: Triggers. Genetics. Preventatives.

pen Sun Aug 22, 2010 5:05 am

Sorry to be brief. Yes Becky thank you. I have never noticed anything that triggers mine.
Just wake up with one every 4/5 days. Seems regardless of "everything".
Thanks.

Jewishmother Sun Aug 22, 2010 8:31 am

One of the most frustrating things is not knowing why..............

alli Sun Aug 22, 2010 8:51 am

I've identified my main triggers through 37 years of migraines. They've changed through the years as my body changed through pregnancies and aging in general. I used to be able to drink alcohol but as I've aged I lost my tolerance and almost always get a migraine now if I drink. I didn't add that as a trigger on my list because I just don't drink alcohol anymore

weather fronts have always been a trigger. I missed more school as a teenager from migraine triggered by barometric changes than from hormones even as hormones where also a huge trigger back then. My Mom said she just thought I hated school. Fumes have also always been a trigger.

Since our brains and bodies are always changing, migraine disease shows different faces and has different obvious triggers as what we can tolerate on a daily basis changes.

I wish there was an easy answer as what triggers them and why but there just isn't one. I've gone through years long periods when they were very regular, 3-4 times a week and have not know what was triggering them or why I was having so many. All I could do was try to avoid he obvious triggers and pray for strength to get through.

pen Sun Aug 22, 2010 9:14 am

Triggers change...Hmm. But mine came with periods and stayed....
No sign of anything until I was abt 44. Then they came with cycle.

But no cycle now and no clues...
I wonder what my trigger changed into..

Weather, I keep watching it, but they seem to be on the same schedule regardless of the weather.
I am baffled..

Cathy Sun Aug 22, 2010 9:22 am

Triggers are so hard:
Missing a meal, I think, because I get them even when I eat but the worst are if I skip a meal.
MSG - hides in all kinds of things

Anything that messes with my neck. Holding my grandbabies was difficult because if I had them on my shoulder and looked at them it would trigger one. Those stupid head rests on cars and planes, shove your head forward and pull the back of your neck. Should be illegal.

Wine - I ate some Chicken Marsala and forgot it had wine and had a killer mig for 3 days. I forget this is a trigger because it's so easy to stay away from it's just automatic.

Artificial sweeteners - I think, but I had some the other day and my head didn't explode in an hour

Genetic? - I'm adopted so I don't know. My daughter gets them like I did at her age (28) not as frequently as I do now. My son gets headaches but not with the other symptoms of migraines.

Preventatives - staying away from what I know will give me a bad one but no supplements or meds have worked. Just painkillers when they're starting.

And the search continues.....

TeriRobert Sun Aug 22, 2010 9:55 am

Something I forgot to mention on the subject of genetics: Something I've seen with my own family history as well as that of other people is people in previous generations that had "sick headaches" or "sinus headaches." In her journals, my great great grandmother wrote about her "sick headaches" and that all she could do was lie in the dark, unable to care for her family. I can remember my father being in bed for days with a "sinus headache." After he had passed, the research came out showing that 90% of what people think are sinus headaches are actually Migraines.

There may also be people in families that go undiagnosed because their Migraines are infrequent and mild. My brother gets a Migraine about twice a year. If he can take a nap, that's what he does, and the Migraine is gone when he wakes. If he's too busy to take a nap, he takes some Excedrin, and the Migraine is gone by the time it wears off.

Teri

AuntieBubbs Sun Aug 22, 2010 10:27 am

alli wrote:I've identified my main triggers through 37 years of migraines. They've changed through the years as my body changed through pregnancies and aging in general. I used to be able to drink alcohol but as I've aged I lost my tolerance and almost always get a migraine now if I drink. I didn't add that as a trigger on my list because I just don't drink alcohol anymore

Alli, that's me to a "T." I could drink and not have a problem when I was in my 20s, can't drink hardly at all now, and no wine at all.

Dawn Sun Aug 22, 2010 10:47 am

1. Smells such as artificial vanilla and cinnamon (but once I get away from them the migraine goes away on their own after a few hours). Oddly enough cooking with vanilla and cinnamon doesn't trigger one. It's the artificial smells of candles, sprays, and perfumes...
2. Hormones. I had a full hysterectomy in 2007, and am on Estradiol, but the migraines keep coming in a pattern of 10 days on and 5 days off. (these don't go away on their own. I need the abortive to get rid of them).
3. Alcohol (red wine seems to trigger more intense migraines over other types of alcohol...so I have a general rule to avoid alcohol use all together as a preventative).

My maternal grandmother had migraines most of her life and found out that it was caused by a heart condition (can't recall the exact diagnosis), once she got her heart problem fixed, her migraines stopped. My maternal aunt, and half sister get them as well.

I use abortive Demerol and Promethezine which work for me.

Dawn

pen Sun Aug 22, 2010 11:32 am

I am beginning to wonder if I have migraines at all.

No family links (not even sick headaches or sinus headaches).
No apparent triggers.

IBS, now that does occur in other family members on my mum's side...

So what on earth have I got then, because I do seem to be the odd one out here.

P

TeriRobert Sun Aug 22, 2010 12:14 pm

Pen,

By your symptoms and the fact that triptans work, it should be Migraines.

As for the family history, it really is possible that others in your family have had infrequent and mild Migraines that have been passed of as "just headaches."

Didn't you say that you often wake with a Migraine? Usually, that's a sign of a sleep issue. I thought I was sleeping fine, but I wasn't. Had two sleep disorders. Taking care of those helped. Disrupted sleep or just not sleeping well for a night can still trigger a Migraine for me.

Teri

pen wrote:I am beginning to wonder if I have migraines at all.

No family links (not even sick headaches or sinus headaches).
No apparent triggers.

IBS, now that does occur in other family members on my mum's side...

So what on earth have I got then, because I do seem to be the odd one out here.

P

pen Sun Aug 22, 2010 2:58 pm

Thanks Teri. Could you elucidate at all please?
I do have FMS and it is notorious for messing up sleep of course.
90% of my migraines come on some time between 3am and 7am.
Seemingly regardless of everything.

I have tried different pillows etc and all that jazz.
How do I suss it? Is it too much sleep, too little, wrong position?
I sleep about 8 hours. I dont feel refreshed when I wake, but they tell me that is the fibro..

We dont seem to go into sleep much over here.
I have never been offered anything for my head pains except drugs.
Triptans, and preventatives, some of which I should never have been prescribed...

What was it with you please? Your sleep problem?

Thanks
Pen

TeriRobert Sun Aug 22, 2010 10:07 pm

Pen,

My sleep disorders were sleep apnea and periodic limb movement disorder, which is somewhat like restless leg syndrome. Since I had a deviated septum that needed repaired, I decided to have throat surgery for the sleep apnea at the same time, even though the success rate is only 50%. I got lucky, and it worked. Periodic limb movement disorder makes my arms and legs jerk when I sleep and keep me from getting into the deeper stages of sleep. Medication takes care of that.

Before I had a sleep study, I thought I slept well and soundly through the night. But it showed I didn't. Various issues with sleep can be triggers -- too much sleep, too little sleep, an irregular sleep schedule, waking during the night, poor quality sleep. It's recommended that Migraineurs go to bed and get up at the same time every day, including weekends and holidays.

Sleep issues are the most common triggers for waking with a Migraine, and I'd certainly look into it as fully as possible, but it's also possible that something else is the problem.

Teri

pen wrote:Thanks Teri. Could you elucidate at all please?
I do have FMS and it is notorious for messing up sleep of course.
90% of my migraines come on some time between 3am and 7am.
Seemingly regardless of everything.

I have tried different pillows etc and all that jazz.
How do I suss it? Is it too much sleep, too little, wrong position?
I sleep about 8 hours. I dont feel refreshed when I wake, but they tell me that is the fibro..

We dont seem to go into sleep much over here.
I have never been offered anything for my head pains except drugs.
Triptans, and preventatives, some of which I should never have been prescribed...

What was it with you please? Your sleep problem?

Thanks
Pen

pen Mon Aug 23, 2010 5:43 am

Thanks Teri. have no other clues except the hormones.
Not sure if our NHS does this sort of thing, will see what I can find out...

Glad it worked for you.

P

30yrsofheadache Mon Aug 23, 2010 7:25 am

Hi, Pen. I have had almost all of the triggers others site. My head is just so sensitive, any increased sensory input can throw me over at certain times. The threshold is lowest during my periods, before, and after. That is a total of about 10-15 days. During that time I cant smell a whiff of bleach, drive in a flicker of sunshine, etc.

Other times, it takes several triggers at once. I would say my top 3 are:
Hormones, neck problems, weather. Undersleeping is no problem, oversleeping is a sure fire trigger! I dont drink and am very strict with my diet. As far as heredity, I come from a long line of migraine sufferers.My mother's father had bad migraines, both parents had "sinus headaches", both sisters have migraine(one infrequent, one monthly), one daughter has severe migraine, one none.

The only preventaive that has helped is Inderal and maybe Welbutrin.

Hope you have a good day,
Cindy

crt Mon Aug 23, 2010 1:21 pm

pen wrote:Thanks Teri. have no other clues except the hormones.
Not sure if our NHS does this sort of thing, will see what I can find out...

Glad it worked for you.

P

Pen,

You had a thread about sleep back in June. At that time I looked up sleep studies in Britain and they definitely have them. Apparently sleep apnea is spelled sleep apnoea in your country. Now I realize that there might not be a facility close enough to you to go to, but it's worth looking into.

I think the reason some folks get a migraine while sleeping or while flying is the same - too low a level of oxygen. True, commercial passenger flights in the US must pressurize the cabins to no higher than 8000 feet altitude but that may be too high an altitude for some folks to stay migraine free with.

I once was taking a flight in a small plane with friends. Of course, the plane wasn't pressurized and we were not very high, 6500 feet, I think. One of my friends has a Fingertip Pulse Oximeter and Oxygen Meter. It was interesting to see what our oxygen saturation was. I was shocked to see mine was down to 86%. I was able to bring it back up to 98% by taking several very deep breaths.

Oh, I didn't get a migraine. I have yet to get a migraine while flying. Up in the air is one of the places I feel most comfortable so my stress is low. However, if my oxygen got too low, I probably would get one.

Chris

Brenda Tue Aug 24, 2010 12:46 am

Pen, I used to wake up with terrible migraines very often. I went and had a sleep study done and found out that I had severe sleep apnea. My oxygen level was dropping to 59% when I was in REM sleep. I wear a C-PAP now and I don't wake up with bad ones nearly as much as I used to. I can't say it's helped the ones that develop through the day, but now i wake up with a bad one maybe 2-3 times a month instead of daily. Could be worth looking in to

dlbritton Tue Aug 24, 2010 8:34 am

I have between 3-5 migraines a week, no rhyme or reason even when avoiding triggers.

Main treatment is 50 mg Imitrex (US). Generic Ranbaxy (sp?) ok, generic Dr. Redy is better.
Zomig, Maxalt Relpax effective but leave me nauseous.

Top 3 triggers:
1) Alcohol (especially red wine, dark beer, whiskey: one swallow is enough). 1 oz. of vodka is safe, 2 oz. is migraine trigger.
2). Chocolate
3). Cream cheese (go figure). No problem with aged cheese such as cheddar, blue cheese, etc.

No preventative has ever worked for long. Have tried atenolol, inderal, propranolol, Norvasc (required prednisone to alleviate migraine), Topomax, Zonegram, various tricyclic anti-depressants, muscadine grape seed extract (this showed promise-kept migraine away for 3 weeks, than I got 3 weeks worth all at once).

Chinookgrl Tue Aug 24, 2010 9:58 am

I have had migraine since 15 so over 20 years. I believe I have always had the same triggers, I have just become more sensitive over time to each of them.

1. Hormones - m comes with cycle and last the duration.
2. Fluorescent lights - school was a nightmare, funny I ended up being a teacher Wink

3. nitrates, aged cheese, sadly wine

There are more triggers that I know for sure, emotional stress, throat lozenges, second hand smoke...

Definitely have a genetic component, my Mom, sister, I think granny but as Teri said, she called them bad days, but my Mom remembers her in her room, lights out , vomiting etc.

Preventatives - what has worked best for me was Epival (anti-convulsant) The Tri-cyclic anti-depressants (currently on this one) . Accupuncture, vitamin regimen, butterbur, change in diet and exercise.

pen Tue Aug 24, 2010 6:00 pm

Brenda wrote:Pen, I used to wake up with terrible migraines very often. I went and had a sleep study done and found out that I had severe sleep apnea. My oxygen level was dropping to 59% when I was in REM sleep. I wear a C-PAP now and I don't wake up with bad ones nearly as much as I used to. I can't say it's helped the ones that develop through the day, but now i wake up with a bad one maybe 2-3 times a month instead of daily. Could be worth looking in to

This is from Migraine Action. Interesting, but no real advice as to how we sort it in the UK....

New research helps explain why sleep deprivation triggers migraines

Posted on 25/06/10

Not getting enough sleep or having poor sleep habits can trigger migraines or cause occasional migraines to become frequent. Now new research may help explain the biological links between sleep and headache pain.

Pain researchers from Missouri State University report that rats deprived of REM sleep showed changes in the expression of key proteins that suppress and trigger chronic pain.

The sleep-deprived rats secreted high levels of proteins that arouse the nervous system and low levels of proteins that shut it down, lead researcher Paul L. Durham says. Durham is scheduled to report the findings this weekend at the 52nd annual meeting of the American Headache Society in Los Angeles. "In stressful situations such as sleep deprivation, these arousal proteins occur at levels that are high enough to trigger pain," he says.

In the study, Durham and colleagues deprived one group of rats of REM sleep for three consecutive nights while allowing another group to sleep normally. They found that the sleep deprivation caused increased expression of proteins p38 and PKA, which help regulate sensory response in facial nerves thought to play a key role in migraines, known as the trigeminal nerves. Lack of REM sleep also triggered increased expression of the P2X3 protein, which is linked to the initiation of chronic pain. "People with headaches often have a hard time sleeping," he says. "It is easy to see how several nights of interrupted sleep can make people more susceptible to developing a chronic pain state."

American Headache Society (AHS) President David Dodick, MD, says sleep disruption is one of the most important migraine triggers, yet very little is known about the molecular pathways that link sleep to headache pain. "The trigeminal nerve is thought to be the conduit through which migraine attacks are generated," he says. "If you think of it as a highway, this study helps us begin to understand at a very basic level the molecular changes that are occurring that cause the traffic that causes pain."

Too much sleep also triggers migraines
Although most people with migraines have one or two attacks a month or less, about 3% of the population has chronic migraines, which occur at least 15 days each month. Dodick says understanding the molecular pathways that trigger migraines or cause occasional migraines to become chronic could lead to better drugs to treat or prevent them. Although getting enough sleep is important for people with migraines, having a sleep routine is even more critical.

"Just as too little sleep can trigger migraine headaches, so can too much sleep at one time. That's why 'Saturday morning' migraines are so common," he says. "If someone with migraines who gets up during the week at 6 a.m. sleeps in on Saturday, this can cause a migraine. The same is true for irregular afternoon naps or any disruption in the regular sleep pattern. Sleep routine is very important," Dodick says.

Dr Andy Dowson from Migraine Action's Medical Advisory Board comments: "Dr Dodick highlights that change in sleep pattern often triggers migraine headaches. He acknowledges that both too little and too much sleep can also be important. This is completely in line with what we hear in clinic and on the helpline.

The researchers at Missouri State University have found that if rats are sleep deprived for three nights they have increased proteins that might change the way the trigeminal nerve works. This is the feeling nerve for the face, including the forehead and it is this nerve that is most important in the pain of migraine. This is possibly a clue in identifying how missing sleep can be a trigger."

Manx10 Tue Aug 24, 2010 6:17 pm

Hi Pen.

Those of you that know what causes you to have migraines.
Could you tell me please?

For me it's stress, neck pain (which I think is caused by stress then leads to a migraine), weather, especially extreme changes in the barometric pressure, and for the first time in 15 years, hormones.

So the argument is, how do we know, even in a family with migraines running through it that it is genetic and not "something else". Why with such an apparent strong genetic connection have they still not found this gene? Or are there more than one.??
And why does someone like me have them then. No family history at all. How recessive can this gene be??

My thoughts exactly--nobody else in my family has them or has ever had them.

Preventatives: If these borrowed drugs help some of us. Why have they not been able to determine how?
We use different families of drugs, why do they appear to work, albeit not that well for many? Surely, if they help us, knowing how they work on the conditions they are made for should help determine why they work on us?

I don't know. I know Topamax did nothing for me, but Nadolol has worked incredibly well for me. My blood pressure is already extremely low on its own, so I don't get that, but it works so I don't question it too much. As for diet & exercise, I haven't found one specific food or drink that causes them, I just try to eat "clean" and limit my sweets as I think that might contribute to it. If I do a high-intensity workout, I usually end up with a migraine later that night or the next day. My doctor thinks it might have to do with changes with my blood pressure. I stick with lower-intensity walks. Yoga has also been a trigger for me, so I avoid it.

pen Mon Aug 30, 2010 8:45 am

It seems this thread has run it's course.
Thanks everyone for posting. Very interesting.

I did a tally and it seems the top triggers of us that posted are:
With side by side for the same amount of votes.

Hunger ......Hormones.
Weather......Smells.
Sleep..........Stress.........Alcohol
Neck...........Lighting.

The top two were quite out front from the second two.
I also looked at gender. But to be honest I am not sure of the gender of a few of our newer members.
So I can only confirm one which goes Food, Alcohol, Smells...thanks John.

Anyway, hardly scientific, but interesting, well to me anyway...

WitsEnd Mon Aug 30, 2010 1:45 pm

Sorry Pen, delayed reaction. Not had much time to post lately!

Top 3 Triggers:

Weather changes
Change to sleep patterns
Emotional upset

Preventatives:

Atenolol - works wonders for me
Amitriptyline (sp) - Works to break them up when my head's in big trouble but turns me into a walking zombie
Pizotifen - Less effective than amitriptyline but less zombie-like

Genetics:

Migraines and all my other head issues (vertigo, sinus probs etc) very much a family trait on my dads side, migraines only in the women though, but the sinus probs get both genders.

Their migraines all stopped around 50, never mind then, half way there!!!

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