The story behind your migraine: Common triggers to look for

Migraine days steal more than hours. They steal plans, focus, and peace. Let’s look at what might be triggering yours and find support that fits you.

Estrogen fluctuation

Estrogen changes are one of the best-documented migraine triggers. When estrogen drops, serotonin tends to drop with it. Lower serotonin leads to the nervous system becoming more reactive to stimuli. Heightened reactivity extends to the trigeminal nerve that supplies the face and the brain's lining. This nerve triggers the release of inflammatory neuropeptides, resulting in dilated, inflamed blood vessels around the brain which produces the pain felt with a migraine.

The liver

The liver helps clear excess hormones, including estrogen, and metabolic by products from the bloodstream. When your lifestyle includes a poor diet, alcohol, medication load or toxin exposure, the liver can slow down clearance. The toxins that are not detoxed by the liver can build up and fluctuate more erratically. Liver function also plays a role in blood sugar regulation and histamine clearance, both known migraine triggers.

Sugar balance

The brain makes up about 2% of your body weight but uses roughly 20% of your energy. It holds almost no fuel reserves and depends on a steady glucose/sugar supply from your blood.

When your sugar levels drop from skipped meals or fasting the body treats it as an emergency. The liver releases its stored glycogen first. When that runs low, adrenaline, cortisol and glucagon surge to push glucose back up. These stress hormones constrict blood vessels which then rebound and dilate, making the nervous system, including the trigeminal pathway, more excitable.

Research suggests the migraine brain handles energy demands less efficiently. When glucose dips, neurons struggle to keep their electrical balance, making the brain more prone to an aura and to firing the trigeminal nerve.

Chronic stress

Stress triggers a surge of cortisol, adrenaline and noradrenaline, which constrict blood vessels, making the nervous system particularly the trigeminal pathway more excitable. When stress tighten the neck, shoulders and jaw, it feeds pain signals into the same nerve pathway. Disrupting sleep and draining magnesium, which normally keeps nerve cells from over-firing.

The drop in stress can be just as risky. High cortisol acts as an anti-inflammatory, switching on the body’s own pain-dampening systems. When stress then suddenly lifts, like over the weekends, that protection falls away and blood vessels rebound and dilate. The migraine brain is sensitive to change, which is why both the spike and the sudden drop in stress can set one off.

Other common triggers

Dehydration; poor or irregular sleep; certain foods like aged cheese, red wine, processed meats (nitrates), MSG, excess caffeine or caffeine withdrawal.

Keep a migraine diary

Migraines rarely have a single cause, which is why tracking is so powerful. Each time you get one, record the date and time, where you are in your menstrual cycle, what you ate and drank, how well you slept, and your stress levels. Within a month or two, patterns often emerge, giving you a clearer picture of your personal triggers and making it far easier to plan effective treatment with your practitioner.

Need some support?

I'm a registered homeopath and acupuncturist (MHSc, UJ). I consult in Lyttelton Manor, Centurion (Mon–Wed 08:00–17:00, Sat 08:00–13:00) and at Hope Studio, 107 Pritchard St, Randburg (Fridays 08:00–17:00). Book online at drsimune.com or WhatsApp: 083 704 5287.

This article is general information and not a substitute for medical advice. If symptoms are severe, sudden or worsening, please see your doctor.