Recently, one of my Twitter followers asked if we still need to avoid our triggers if we’re taking preventive medications that are working. My answer was, “Yes,” but it’s more complicated than that. Here are a few additional points:
- Successful prevention isn’t perfect. It doesn’t eliminate all of our migraines.
- When we’re able to identify avoidable triggers, yes, we should avoid them, especially since effective preventives can’t stop all of our migraine attacks.
- Not all triggers are avoidable.
- Avoidable triggers include some foods, dehydration, not following a regular sleep schedule, and others.
- We can’t avoid other triggers such as weather changes, hormonal shifts, and others.
- Triggers tend to be cumulative or “stackable.” We can have certain triggers that one of them alone doesn’t bring on a migraine attack, but encountering two or more of them does.
- Our trigger threshold - how much it takes to trigger a migraine - varies due to other factors. When we’re ill or stressed, it can take less to trigger a migraine. A trigger that usually doesn’t bring on a migraine unless it’s combined with a second trigger, may easily trigger a migraine during times of illness or stress.
This isn’t a contest, but many of us whose triggers are unavoidable envy migraineurs who have avoidable triggers. We wish our triggers were avoidable. Of course, this is probably a case of the grass being greener on the other side. If we had avoidable triggers, we’d have other issues.
Still, it’s only logical to avoid any triggers we can so we can reduce the number of migraines we have. There may be times when those with avoidable triggers choose to throw caution to the wind and take a risk. For example - if noise is a trigger, people may avoid parties, bars, and clubs. When a special occasion comes along, they may decide that spending time with friends and family for a celebration is worth a migraine. That’s very understandable. Migraine can be so isolating, and we all long to break out of that isolation and do “normal” things. So, overall, the best practice is to avoid any triggers we can, but there may also be times when we decide to break out of our “migraine jail” to celebrate a special occasion.
More Valuable Information About Triggers:
10 Common Triggers of Migraine (infographic)
Common Migraine Triggers (article with comprehensive list)
Managing Migraine - Migraine Trigger Foods (includes free workbook)
_Reviewed by David Watson, MD. _
Teri Robert is a leading patient educator and advocate and the author of Living Well with Migraine Disease and Headaches. A co-founder of the Alliance for Headache Disorders Advocacy and the American Headache and Migraine Association, she received the National Headache Foundation’s Patient Partners Award and a Distinguished Service Award from the American Headache Society. Teri can be found on her website, and blog, Facebook, Twitter, StumbleUpon, Pinterest, LinkedIn, and Google+.