Migraine—what really triggers it, and how can you cope without pills?

Aim of the study: Recent studies seeking to develop forecasting models for the onset of new migraine attacks and reviewing triggers and protective factors are encouraging, but further improvements are needed to produce models with high predictive accuracy. This updated review of the available data has the potential to improve the accuracy of migraine attack predictions.

Results: Furthermore, these findings have valuable implications for migraine forecasting models. The most consistent results were seen for specific diets, dietary supplements, and physical activity. Although trends were noted in stress management and sleep, further research is needed to clarify their influence on migraine frequency and how they can be incorporated into a migraine forecasting model. This study is registered with PROSPERO (ID CRD42024511300).

Aim of the study: A wide variety of triggers can prompt attacks in episodic migraine. Although experimental triggers such as glyceryl trinitrate reliably produce migraine, natural triggers are much less predictable and vary in importance between individuals. This review describes the most common triggers in episodic migraine and provides strategies for managing them in clinical practice.

Results: Multiple migraine attack triggers have been established based on patient surveys, diary studies, and clinical trials. Stress, menstrual cycle changes, weather changes, sleep disturbances, alcohol, and other foods are among the most commonly reported factors. Clinical studies have confirmed that fasting, the premenstrual period in women, the letdown after stress, and most likely low barometric pressure can trigger migraine. Premonitory symptoms such as neck pain, fatigue, and sensitivity to light, sounds, or odors may be mistaken for triggers. Many studies clearly show that triggers occur in episodic migraine, often in connection with changes in the body's balance or the environment. Many common migraine triggers cannot easily be changed, and avoiding them may not be realistic. Healthy lifestyle choices such as exercise, adequate sleep, stress management, and eating regularly may help prevent triggers and the development of chronic migraine over time.

Aim of the study: Migraine is characterized by recurrent attacks of disabling headaches, often accompanied by sensory and motor disturbances. Clinical manifestations of migraine are influenced by dietary habits and dietary components.

Results: Future research may make it possible to identify migraine patient subtypes and offer personalized recommendations in line with biopsychosocial models for migraine management. Diet, an important part of lifestyle, is a modifiable factor that needs further attention. Well-designed, systematic research on diet, guided by an understanding of how it works, is needed to provide evidence-based dietary recommendations specific to migraine. This narrative review aims to present the current state of knowledge and future perspectives on diet and migraine, to encourage further research and awareness.

Aim of the study: Migraine is a highly prevalent disorder that places an enormous burden on societies. Different types of medication are used to control both acute attacks and to prevent them.

Results: In addition, weight control, management of migraine-related conditions, lifestyle changes, behavioral treatment and biofeedback, patient education, keeping headache diaries, and improving patients' understanding of the disease are recommended as parts of migraine management. Neuromodulation techniques, dietary supplements such as riboflavin, coenzyme Q10, and magnesium, and acupuncture may also be helpful. Non-pharmacological approaches should be considered in migraine management. Furthermore, combining pharmacological and non-pharmacological approaches is more effective than using either on its own.

Aim of the study: Although a wide range of acute and preventive medicines are now available to treat migraine headaches, many patients will not see a significant improvement in the frequency and severity of their headaches unless they make lifestyle changes.

Results: A detailed dietary history can help identify food triggers. Although the evidence about the role of certain foods and substances in triggering headaches is disputed, some groups of patients may be sensitive to phenylethylamine, tyramine, aspartame, monosodium glutamate, nitrates, nitrites, alcohol, and caffeine. The available evidence that certain vitamins and supplements can help prevent migraine supports their use in treatment. Identifying food triggers with the help of food diaries is an inexpensive way to reduce migraine headaches. We also recommend the following supplements for migraine prevention, in order of preference: magnesium, Petasites hybridus, feverfew, coenzyme Q10, riboflavin, and alpha lipoic acid.