Medical Moment: Migraine triggers to avoid

Dr. Olga Brusil

If you’re prone to develop migraine headaches, you know how debilitating they can be. Even mild migraine symptoms can disrupt your entire day.

“About 52 percent of visits to primary-care doctors are for headaches, the majority of which are likely migraine headaches,” says Dr. Olga Brusil, a neurologist at Houston Methodist Baytown Hospital.

Migraine symptoms and severity can vary from person to person, but Dr. Brusil has some universal migraine-prevention advice for anyone who experiences this type of headache: Know the common triggers and identify which most affects you.

Though genetics are thought to play a significant role, the underlying cause of migraines isn’t fully understood. Nor is the reason some people are more prone to developing them than others.

But Dr. Brusil notes that we do know some brains are hardwired to tip into a headache.

“People prone to migraines have stronger functional connections between the autonomic nervous system and pain centers in the brain,” explains Brusil. “A migraine headache likely happens as the result of a threshold effect, depending on the activity or excitability of a person’s brain.”

Dr. Brusil adds that it doesn’t take a lot to send “a migraine brain” over the edge.

6 migraine triggers

Knowing the common triggers of a migraine doesn’t guarantee you’ll never get one again. But for many people, it can help reduce the frequency of these headaches.

Here are six triggers of migraine headaches you may want to take steps to avoid:


Whether it’s due to issues in a relationship, work, your finances or something else, stress is a huge trigger for migraine headaches.

“They can also be triggered by stress letdown, meaning when you’re finally relieved of a specific stressor in your life,” says Brusil. “For instance, some people get a migraine headache every Saturday once the stress of the work week is over or on the first day of vacation.”

Hormone fluctuations

“For women, the estrogen withdrawal that occurs after your monthly period and after ovulation can trigger a migraine,” says Brusil.

In some cases, oral contraceptives can, too.

Changes to your routine

Even slight deviations in your day-to-day schedule, insignificant as they may seem, can have a big impact on a migraine brain.

“Mundane changes like being late for a meal or skipping one altogether can tip a person over the edge,” says Brusil. “A variable sleep pattern can, too, which is most problematic for shift workers, such as nurses, bus drivers, police officers and more.”

Of note, Dr. Brusil adds that more significant changes to your routine, like traveling to a different time zone, also can trigger a migraine.

Foods and drinks

“About a quarter of migraine patients will have a food or drink trigger,” says Brusil. “We know that nitrites and tyramine-containing foods, specifically, can lead to these headaches.”

Foods and drinks known to trigger migraines include:

  • Red wine
  • Chocolate
  • Cheeses
  • Nuts
  • Processed meats
  • Smoked meats
  • Dried fruits
  • Artificial seasonings and sweeteners (and any marinades they may be used in)

    Migraine sufferers who think they may have a food trigger should consider keeping a food-symptom journal or using a migraine tracking app.

“These foods don’t always cause a migraine right away,” says Brusil. “It can take up to three days for a food-triggered migraine to really take hold and present with that debilitating pain.”

For instance, Dr. Brusil often tells patients that the Friday glass of wine could be the cause of a Monday migraine headache.

Odors and bright lights

Some migraine brains are more sensitive to strong sensory stimuli, including:

  • Scented candles
  • Incense
  • Perfume
  • Smoke
  • Bright lights
  • Flashing lights
  • Fluorescent lighting

    “Remember, there is a threshold effect that we think is responsible for tipping a migraine brain over into a headache,” adds Dr. Brusil. “Maybe you’re on your period, your routine is off, and you didn’t sleep well. So, now all of the sudden a candle or scent that’s never bothered you before is leading to a migraine.”

In other words, keep in mind that these triggers can be cumulative.

Weather changes

Maybe you’ve heard that weather changes can lead to arthritis flare-ups, but they also seem to correlate with migraine frequency.

“Many of my patients will say that they know a cold front is coming before the weatherman,” adds Brusil.

What to do when knowing your triggers isn’t enough

Certain migraine triggers are avoidable. Others aren’t.

Regardless, Dr. Brusil says some migraine sufferers need medications to effectively manage their headaches.

“Some people are able to keep a routine ideal for preventing migraines and that’s enough to significantly decrease the frequency of them,” says Brusil.

“But this doesn’t work for everyone. About one-third of my patients are getting six to eight migraine headaches in a month no matter how perfect their day-to-day routine is,” explains Dr. Brusil. “These are the people who need to be on preventive medications.”

If your migraines still occur often or continue to be severe, your primary-care doctor may refer you to a neurologist for a more thorough evaluation. A neurologist may also recommend additional migraine treatment options, like Botox and monoclonal antibodies.

To schedule an appointment with a neurologist at Houston Methodist Baytown, call 832.556.6535.

About Houston Methodist Baytown Hospital

Houston Methodist Baytown Hospital has provided Baytown and east Harris, Liberty and Chambers counties with excellent medical care since its opening in 1948. The hospital continues to grow to meet the health care needs of its growing community through an ongoing construction and renovation program that has seen the opening of a new five-story patient tower, emergency center, outpatient center and medical-surgical units. As a health care leader, the hospital is proud to have a fully integrated residency program focused on educating and inspiring future practitioners. Today, Houston Methodist Baytown provides the most advanced and innovative procedures while never wavering from its focus on compassionate care and providing a safe, patient-centered healing environment.

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