Each year I have a physical involving a blood test to screen for diabetes. Diabetes runs in my family, so this is not a test I want to skip. Unfortunately, it requires an eight hour fast. Because fasting is a big migraine trigger, every year I dreaded this test.
Migraine triggers are stackable. More than one trigger is often required to set off an attack. By learning to reduce my trigger load, I have prevented most fasting-induced migraine attacks. With a little trial and error, I learned which precautions were most likely to offset my risk.
Medical testing and procedures are not the only reasons for fasting. Many faith traditions also encourage fasting as a spiritual discipline. Whatever the reason, these tips can help reduce the risk of getting a migraine attack during a fast.
- Schedule an early appointment.
If fasting is required for medical testing, insist on the earliest possible appointment. Our bodies are accustomed to fasting overnight for at least 8 hours. This leaves fewer risky hours for migraine to develop. By scheduling appointments early, we minimize the disruption to our routine.
- Get a good night’s sleep.
If you have migraine, good quality sleep is your best friend. Create a relaxing bedtime ritual so that your body and mind are well prepared for sleep. Make sure your bedroom is free from lights or sounds that might keep you awake and that the room is not too hot. Then go to bed early enough that you can get at least seven hours of uninterrupted sleep. If you anticipate any trouble sleeping, talk to your doctor about using a short-term sleep aid.
- Stay hydrated.
Some medical tests and procedures require us to avoid drinking anything for several hours, too. If that is not the case, then make sure you are getting enough fluids. Even when fluids are restricted, I have discovered that drinking plenty of water right up to the cutoff time helps reduce the risk of a migraine attack.
- Protect your senses.
Take precautions to avoid exposure to strong smells, loud noises, and bright or flashing lights. Wearing ear plugs or noise-cancelling headphones can provide a nice buffer from noise. A little peppermint oil or Vicks can be dabbed under the nose to block offensive odors, too. Avoiding light triggers takes a little more advanced planning. In a pinch, dark sunglasses can help. Although, I’ve found that a good quality pair of glasses with an FL-41 tint is a better approach.
- Manage stress.
Try to avoid undue stress leading up to and during the fast. While stress, itself, may not be a trigger, there are stress behaviors that can trigger a migraine attack. Clenching your jaw, squinting, crying, and muscle tension in the face, neck, and shoulders can all be problematic. Relaxing both body and mind is important.
- Avoid other triggers.
Hopefully you’ve been keeping a detailed migraine diary long enough to have identified your triggers. Foods high in tyramine, nitrates, artificial sweeteners, or citrus foods can be culprits for some. Weather triggers are more difficult to avoid, but you can minimize their impact by staying indoors as much as possible.
- Take precautions.
Despite our best efforts to reduce our trigger load, sometimes fasting alone is enough to trigger a migraine attack. If this is your experience, talk to your doctor about the use of your abortive medication while fasting or preventive strategies. Have plenty of comfort measures available, especially ice packs.
More helpful information:
Reviewed by David Watson, MD.
© Tammy Rome, 2017.
Headache disorders advocate, blogger, and mental health therapist, Tammy maintains a private practice specializing in behavioral pain management, as well as writing for her own blog, Brain Storm. She also volunteers as Vice Chair of the American Headache and Migraine Association and as President of The Cluster Headache Support Group. You can read more of Tammy’s work on her blog and follow her on Facebook, Twitter, StumbleUpon, Pinterest, LinkedIn, and Google+.