Can you clear something up for me? I have read before (from another source) that triggers are cumulative/stackable and that only one trigger can never cause a migraine. A recent HealthCentral article doesn’t seem to state this as irrevocable, or that is how I understood it.
I do know some fellow migraineurs who can be triggered by the whiff of fragrance. Personally, I have food triggers which I always avoid, and I try to remain hydrated—which is very important due to being on Topamax. Sleep is sometimes difficult during a bad migraine cycle. Of course I have stress to deal with from time to time, who doesn’t, and certain smells and lighting become triggers. My biggest trigger is weather changes, barometric pressure rising or falling, to be exact. This not only effects my migraines, but also my fibromyalgia which is due to over-active/sensitive nerves similar to migraines in a way. So my question is, can the trigger of weather changes alone cause my migraine, when I’m avoiding my other triggers? Or am I missing something? Thank you! Roni.
The short, simple answer to your question is - Yes, it is entirely possible for a single trigger to bring on a migraine attack.
That said, migraine triggers can be very complex. Not only do they vary from one person to the next, but how our bodies respond to our migraine triggers can be wildly unpredictable. Why this occurs isn’t fully understood. There are quite a number of things to consider about triggers:
- Some of us have some triggers that can bring on a migraine by themselves.
- Most of us have a group of triggers that one by itself isn’t enough to bring on a migraine.
- These less powerful triggers are often called cumulative or stackable because two of more of them put together will bring on a migraine.
- When our bodies are stressed from our being ill or injured or from being in a stressful situation, we’re more susceptible to our triggers. At such times, one of the less powerful triggers may be enough to tip the scales and bring on a migraine. It’s a bit like catching a cold—when our bodies are stressed, we’re more susceptible to the cold virus.
Each of us has a personal trigger threshold - what it takes to bring on a migraine. We can be pushed over that threshold by a single trigger, two or more stackable triggers, or a single trigger at a time when our bodies are stressed. The best way to determine what single or stackable triggers we have is by keeping a good migraine diary.
Here’s more information about migraine triggers that should be helpful:
- Do We Need to Avoid Our Migraine Triggers
- 10 Common Triggers of Migraine (infographic)
- Common Migraine Triggers (article)
- Managing Migraine - Migraine Food Triggers
Thank you for your question,
Dave Watson and Teri Robert
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© David Watson and Teri Robert, 2016.
Dr. David Watson is a UCNS certified migraine and headache specialist and the director of the West Virginia University Headache Center. Dr. Watson takes a special interest in migraines, cluster headaches, and tension-type headaches. He strives to stay up-to-date on current research and treatments and regularly attends continuing medical education conferences. “Dr. Dave” is also very active in the migraine community, taking part in and leading advocacy efforts to benefit the entire community. He is the founder and chairman of the board of Runnin’ for Research, a nonprofit organization that helps interested patients and doctors set up races in their areas to raise research funding for headache disorders. He’s also a regular participant in the Alliance for Headache Disorders Advocacy’s “Headache on the Hill” event and is co-secretary of the American Headache and Migraine Association. You can follow Dr. Watson on Twitter.
Teri Robert is a leading patient educator and advocate in the area of migraine and other headache disorders, and has been writing for the HealthCentral migraine site since 2007. She is 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 for “ongoing patient education, support, and advocacy,” in 2004 and a Distinguished Service Award from the American Headache Society in 2013. You can find links to Teri’s work on her web site and blog and follow her on Facebook, Twitter, StumbleUpon, Pinterest, LinkedIn, and Google+.
Do you have questions about Migraine? Reader questions are answered by UCNS certified Migraine and headache specialist Dr. David Watson, and award-winning patient educator and advocate Teri Robert. Questions may be submitted via our submission form. Accepted questions will be answered by publishing the answers in our Ask the Clinician column. For an overview of how we can help and questions we can and can’t answer, please see Seeking Migraine and Headache Diagnoses and Medical Advice.