Author: Zawn Villines
Medical News Today
It may be possible to prevent migraine by avoiding triggers, adjusting dietary or lifestyle factors, or taking supplements. Preventive migraine medications are also available.
The methods of migraine prevention that work best can vary depending on the individual. Sometimes, a person may need to try several approaches to see an improvement.
This article will look at migraine prevention strategies and how to use them.
- sensitivity to light or sound
- aura, which refers to neurological disturbances that precede the migraine
There is currently no permanent cure for migraine. However, preventive techniques can help reduce the intensity or frequency of episodes.
Some approaches to migraine prevention include:
- keeping a migraine diary
- making dietary or lifestyle changes to avoid triggers
- trying supplements, such as magnesium
- trying medications
- trying complementary therapies
Many people find that certain smells, foods, behaviors, or habits can contribute to migraine. By identifying and avoiding these triggers, where possible, some people may notice a significant improvement in their symptoms.
Some examples of common migraine triggers include:
- sleeping too much or too little
- being hungry
- strong smells
- bright lights
- cigarette smoke
- certain foods or drinks
- stress or intense emotion
- hormonal fluctuations
Keeping a migraine diary can help with identifying triggers. In a migraine diary, people record each episode they have, along with any significant events that occurred that day.
To start a migraine diary:
- Choose a place to start recording episodes that is easily accessible, such as a journal.
- Begin noting the date and time of each episode.
- Include the symptoms, their severity, and anything that makes them better or worse.
- Record any information that could help with identifying triggers, such as food or drink intake, energy levels, or overall mood.
Females may also want to note at what time during a menstrual cycle their symptoms occur.
Over time, the diary may allow people to identify patterns between the days they experience migraine and help them determine any specific triggers they may have. They can then make dietary or lifestyle changes as needed.
In addition to being useful for trigger identification, migraine diaries can also be helpful for showing to doctors or for tracking whether or not a new treatment is working.
Once someone has an idea of what may contribute to their migraine episodes, they can begin to make changes to avoid their triggers.
Avoiding triggers is not always possible, so it can help to focus on what is within a person’s control. Some examples of changes that may help, depending on the individual, include:
- eating regular meals to avoid hunger
- staying hydrated, particularly during or after exercise
- keeping a regular sleep schedule to avoid under or oversleeping
- limiting or avoiding caffeine, cigarette smoke, and alcohol
- taking steps to reduce and manage stress, such as taking regular breaks while working
Many of these strategies are generally healthy, so trying them should involve minimal risk.
Some examples of more specific changes that may help people who can identify particular triggers include:
- avoiding specific foods or food additives
- avoiding bright or flashing lights
- avoiding strenuous exercise
Speak with a doctor or dietitian if many foods appear to cause migraine, as this may indicate a different condition, such as an intolerance.
Some research suggests that certain nutrients and herbal supplements may reduce the likelihood of migraine.
Remember that supplements can interact with other drugs and may cause side effects. Always talk with a doctor before trying supplements, especially if taking other medications at the same time.
The following sections will look at some supplements to try in more detail.
According to one 2020 review, low magnesium correlates with a higher risk of migraine. Additionally, a 2018 systematic review found that magnesium is possibly effective as a preventive remedy for migraine.
Magnesium plays an important role in electrical signals that pass between neurons, which may explain why low magnesium levels make migraine more likely.
The 2018 review suggests 600 milligrams (mg) of magnesium citrate as the dosage for acute migraine treatment. People can also take a lower daily dose to keep their magnesium at a normal level.
The amount of magnesium that people need per day varies depending on their age and sex. For most adults, the amount will be around 300–420 mg.
Some small studies suggest that vitamin B2, or riboflavin, may help reduce the frequency of migraine episodes.
An older, open-label study from 2004 found that 400 mg of vitamin B2 significantly reduced migraine episodes after 4 months. Participants relied less on migraine medications as a result.
However, the duration and intensity of the symptoms the participants still had did not change. As a result, people may wish to try vitamin B2 in combination with other treatments.
Emerging research suggests that the coenzyme Q10 (CoQ10) may reduce the frequency or duration of migraine episodes.
A 2019 meta-analysis of five studies suggests that CoQ10 offered superior results than a placebo.
A 2015 Cochrane review found some evidence to suggest that feverfew may reduce migraine frequency.
The researchers concluded that feverfew resulted in 0.6 fewer migraine episodes per month, compared with a placebo.
However, the authors note that more high quality trials are necessary.
A 2020 systematic review of herbal migraine treatments found limited evidence to suggest that butterbur may prevent migraine episodes.
A 2017 study in rats identified a specific channel through which butterbur relieves migraine, suggesting that it may work in the same way in humans.
People who experience frequent migraine episodes may require medications.
Some of the most popular migraine medications are triptans. These medications work specifically on migraine. Triptans cannot prevent migraine, but they can stop the symptoms from progressing once they begin.
Medications that may be able to prevent migraine from occurring include:
- calcitonin gene-related peptide antagonists, which include erenumab and eptinezumab
- antihypertensives, such as calcium channel blockers or beta-blockers
- anticonvulsants, such as topiramate
- antidepressants, such as amitriptyline or venlafaxine
- Botox, which doctors can inject once every 3 months for chronic migraine
People with migraine that is primarily due to hormonal changes, or menstrual migraine, may benefit from hormonal medications. These could include birth control pills or hormone replacement therapy.
Several complementary therapies could help reduce the regularity of migraine episodes.
The following sections will look at some of these therapies in more detail.
An older 2009 Cochrane review found some evidence to suggest that acupuncture may help reduce migraine pain. Previous studies have suggested that acupuncture may be just as effective as standard migraine medications but with a lower risk of side effects.
Acupuncture may be especially effective alongside other migraine treatments.
Biofeedback helps people become aware of their bodily functions so that they can learn to control or regulate them.
According to a 2017 review, one study showed that 62% of participants undergoing biofeedback experienced partial or total improvement in their migraine symptoms. Participants had 40 biofeedback sessions over 6 months, on average. Only 16% of them saw no improvements at all.
Neuromodulation is a treatment that uses weak electrical impulses or magnets to stimulate the nerves. Doctors think that it may work by preventing migraine-related brain activity or by releasing chemicals that relieve pain.
Some types of neuromodulation that may help reduce migraine include:
- external trigeminal nerve stimulation
- single transcranial magnetic stimulation
- transcutaneous vagal nerve stimulation
The Food and Drug Administration (FDA) have approved some neuromodulation devices for use in a doctor’s office.
Some people may be able to prevent or reduce the frequency of migraine episodes by identifying triggers, then adjusting their diet or daily routines accordingly.
Other migraine prevention methods include complementary therapies and certain dietary supplements.
However, people with frequent or severe migraine episodes may require medications to improve their quality of life. Speak with a doctor to get a diagnosis and learn about the treatment options.