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Migraine Prevention Plan

Body+Soul, April/May 2006

1. Track the Triggers
"A critical process in any migraine-prevention plan is to identify what triggers your headaches," says Dr. Andrew Weil, who advises keeping a diary, noting the circumstances surrounding each migraine. What did you eat that day? Did you exercise? Migraine triggers typically include stress, fatigue, weather changes, bright lights, and strong odors, as well as certain foods. By keeping a diary, you can identify your triggers and then try to avoid them.

2. Consider Your Diet
Many foods and beverages contain chemicals that can trigger migraines in susceptible people. Common culprits include aged cheese, avocados, chocolate, fermented or pickled foods, monosodium glutamate (MSG), nuts, onions, processed meat, and red wine. If you notice that particular foods are a problem, limit your consumption of them. But whatever you eat, don't skip meals; low blood sugar can set off a migraine. A few food compounds may actually help ease migraines. Preliminary research suggests that omega-3 fatty acids, found in foods such as ground flaxseed, salmon, sardines, and walnuts, may reduce the frequency, duration, and severity of migraines.

3. Stay Active
Although sudden, vigorous activity can trigger migraines in some people, there's good evidence that regular, moderate movement can reduce their frequency and severity. According to Bushnell, exercise is also a great outlet for the stress and tension associated with migraines. For the most benefit with the least potential for pain, slowly work your way up to at least 30 minutes of a moderate activity (like walking) on most days of the week, and don't work out if you have a migraine or feel one starting.

4. Relieve Stress
Stress doesn't cause migraines, but it can trigger and aggravate them in many people. Exercising regularly, getting enough sleep, and practicing a relaxation technique such as deep breathing or meditation can help you keep a handle on stress. Click here to learn some deep breathing techniques.

5. Try Biofeedback or Acupuncture
Research shows that biofeedback -- a relaxation technique that trains patients to control a bodily function, such as heart rate or blood pressure -- can change blood flow in the brain during migraine attacks, reducing their frequency and duration. Another option is acupuncture: Scientific evidence is scarce, but Bushnell says some of her patients find it helpful. Both therapies are best used as prevention, rather than treatment.

6. Take Key Supplements
Surprisingly, the herb feverfew, which has a reputation as a migraine treatment, may not help. "Some studies suggest that feverfew may help prevent menstrual migraines," says Bushnell, "but my patients haven't had great results." Weil says the type of feverfew used successfully in several European studies may not be available in the United States, and he recommends the herb infrequently. Instead, he says, consider trying one or all three of the following supplements, giving each several weeks of daily use before you expect to see results.

Butterbur
This herb has been shown to reduce migraine frequency, perhaps by affecting blood vessels. Take 100 mg to 150 mg daily of a standardized extract (such as Petadolex).

Magnesium
Migraine sufferers are more likely to be deficient in this mineral, and supplemental magnesium may reduce the frequency of attacks. Take 500 mg daily, along with calcium to prevent diarrhea.

Vitamin B2
Studies show that high doses of this vitamin can significantly decrease the frequency and duration of migraines. Take 400 mg daily.

When a Migraine Strikes