Many migraine sufferers are sensitive to things in their environment and things they ingest. Some of these things cannot be controlled. However, they can be managed to some degree. Fortunately, many sensitivities can be identified and controlled.
Manage the uncontrollable: weather, pollution, allergens
Barometric pressure change
The atmospheric barometric pressure rising or lowering is a migraine trigger, probably because of the shift of pressure in your sinus cavities. When your sinuses are congested this is stronger.
What to do?
→ Keep your sinuses clear! Use Xlear nasal spray and Quercinase or HistEze for allergies or histamine reactions. Bi Yan Pian is for congestion, allergies, and postnasal drainage. With infection, use Nasal Tabs 2. Also with infection, add 2-3 drops of a high-quality tea tree oil per 1 cup of neti pot solution, with an Xlear neti pot.
→ Get acupuncture for your sinuses and headaches.
→ Fix leaky gut and improve your microbiome (as explained in the last post).
→ Keep your indoor and outdoor climate as consistent as possible. If it’s hot and/or humid outside, don’t make your inside environment extremely cold and dry. If it’s cold and damp outdoors, don’t make your indoor climate hot and dry. Your brain and nasal/sinus cavities may adjust to barometric pressure changes more easily this way.
This is a Traditional Chinese Medicine cause of headaches. Many of my migraine sufferers report getting headaches after exposure to strong outdoor wind – which could be hot or cold in temperature. The related Chinese medical diagnosis is an invasion of “wind heat” or “wind cold.”
May patients also report headache, migraine, and Bell’s palsy attacks after exposure to cold wind from air-conditioners, often after sleeping in a hotel room. In Chinese medicine this is also considered a wind invasion, and treated as such.
What to do?
→ When the wind is strong outdoors, avoid outdoor activities altogether. If you need or want to go outdoors, protect your head and neck from the wind with an appropriate hat and scarf for the weather. Avoid being directly in front of fans or air-conditioners, especially while sleeping.
→ Acupuncture and Chinese herbs are highly effective for “wind” headaches!
Even people who don’t suffer from migraines can feel sick after too much sun, especially with less protection from the ozone layer these days.
What to do?
→ Although this is rather a no-brainer, it is still something to remind ourselves about. Sunscreen is not going to prevent sun overexposure. Besides shade; sun hats, umbrellas, and sunglasses are the best protection. Sun protective clothing is great when you are in the water. If you are like me, and forget to bring these things, or dislike packing a lot of things for the day, you can keep a set of protective gear in the trunk of your car. If you do get sun overexposure, drink plenty of water, and cool your skin with aloe vera gel.
Inhaled chemicals from perfumes, crop dusting, pesticide sprays, and exhaust fumes can trigger migraines.
What to do?
→ If you are easily triggered by environmental pollution, keep your home chemical and scent free. Use a HEPA filter air purifier. Avoid outdoor air pollution as much as you can. Wear a mask when needed.
→ Work with a Functional Medicine practitioner to test your chemical load and detox capacity, and have her or him design a gentle program for you. Chemical sensitivity is an indication that your detoxification pathways may be impaired, so help from a practitioner can lighten this load!
Mold, dust mite, pet dander, tree, grass, and pollen allergies can all trigger migraines. If you have allergy symptoms in addition to migraines, it’s likely that mopping up your allergy symptoms will help your migraines. Allergy symptoms include hayfever, wheezing, hives, puffiness/darkness under eyes (“allergic shiners”), nasal/sinus congestion, and rashes, among others.
What to do?
→ Skin prick tests from an allergist is well worth it. Then, once you’ve identified your allergens, manage your indoor environment for the indoor ones. Your allergist can give you information about this, there is also great information on this site.
→ For outdoor allergies, during allergy season or exposure, use an XLear nasal pump. It’s a saline solution with xylitol, which prevents allergens from adhering to your nasal and sinus passageways. In addition, I love the formula Quercinase®, a combination of quercetin and bromelain, both natural antihistamines. Some of my patients do these two things before bed to get a better night’s sleep, and some do them in the morning if they wake up congested or puffy. The Chinese herbal formula Bi Yan Pian is effective for allergies with nasal congestion and/or postnasal drainage.
→ Avoidance of milk products helps lessen inhaled allergies because milk can create mucus in your respiratory system. Anecdotally, all of my patients who kick milk products out of their diet get better with their inhaled allergies.
→ Avoid going outside on windy days when allergens are blowing. Or use a scarf or a mask over your nose and mouth.
→ Improve your gut microbiome and fix intestinal permeability. There’s only so much your immune system can handle! Read the last post for more information about how to do this. There are many specific probiotic strains researched to reduce allergies.
→ Some people benefit from conventional allergy shots, while others don’t. They are quite a commitment, often lasting for months or years! Newer treatments, such as Low Dose Allergen Therapy (LDA) and Enzyme Potentiated Desensitization (EPD) show promise. In my opinion, these therapies are best used if all other approaches don’t work well enough (severe, recalcitrant allergies), or if you have a compromised immune system.
→ Chinese medicine is the best form of medicine I know to treat allergies.
Both my son and I had allergies, although our allergens and symptoms were different. The one common allergen that showed up when we did pinprick testing was dust mites. I did deep research on how to manage it, and we completely revamped our house. This included getting rid of a lot of clutter (which made all of us happier, because clutter in your space can clutter your mind). It also included different bedding, closed storage of books and other dust collectors, carpet removal, and switching to blinds (or washing curtains regularly). It made an enormous difference in our health, and that was before using air filters.
More about mold
Unfortunately, this is a trigger that you can’t take lightly. This can cause serious health problems, such as chronic inflammatory response syndrome (CIRS). Find out more about CIRS here.
If you have migraine or allergy symptoms, or other health problems, plus visible indoor mold, or a musty smell anywhere in your house, it’s important to test your house and yourself. There can be significant mold growth within and behind walls that you can’t see.
You can suspect a mold sensitivity if you react to foods with mold or yeast (both fungi). These include all cheese, sour milk products, beer, wine, cider, whiskey, brandy, gin, rum, vinegar, mushrooms, truffles, processed meats (sausage, hot dogs, corned beef, pastrami, smoked fish, ham, bacon), and dried fruit.
What to do?
→ This is a sensitivity best dealt with by working with a Functional Medicine practitioner trained in yeast infections, mold toxins, and CIRS. You need to get a qualified toxic building inspector to test your home, a kit from the store is not going to do it.
Controllable sensitivities: things you put in your mouth
The leaky gut and microbiome work described in the last post are essential to lessen or extinguish reactions from all of these ingested triggers.
Common food triggers: nitrates, sulfites, tyramine, MSG, alcohol, caffeine, chocolate
This list can be daunting! However, if these are triggers, you just need to identify which ones. The American Migraine Foundation has a useful page on these migraine food triggers. As far as alcohol goes, wine is the most common trigger, followed by beer, and then followed by all spirits except vodka. Lastly, if you have several triggers from this category, you are much more likely to get a migraine if you mix several together. An example is red wine with dinner followed by chocolate cake for dessert.
What to do?
→ Look at the list. You may recognize foods that are a trigger. If not, keep a food-headache log and observe if any of these foods precede a migraine. Your best bet is to avoid them, especially in combination. However, if you improve your gut, as explained in the last post, you will probably be able to tolerate more of these.
Foods high in histamine
Here is an extensive list. If histamine foods are a trigger, you may have an underlying yeast or mold sensitivity. See above for more about mold.
What to do?
→ Avoid your trigger foods temporarily while fixing your gut. When exposed, use a safe and effective antihistamine such as Quercinase or HistaEze, and a histamine degrading probiotic such as Floramend Prime Probiotic. Work with a Functional Medicine practitioner for yeast and mold testing. Some people have a genetic variant that means they don’t make an enzyme that breaks down histamine and need to supplement with that enzyme.
These sensitivities are the most common migraine triggers, but this is not an all-inclusive list. In addition, the approaches are examples, there are many more approaches within Functional Medicine.
Read the next post on mitochondria, nutrients, and methylation related to migraines.