Causes of Migraines

Below is a comprehensive list of possible causes and triggers based on medical research and clinical observations. Some are well-established, while others are less common or still being studied. Note that migraines often result from a combination of factors rather than a single cause.

Possible Causes and Triggers of Migraines

1. Neurological and Genetic Factors

• Brain Chemistry Imbalance: Overactivity of certain brain cells and changes in neurotransmitters like serotonin can trigger migraines.

• Genetics: A family history of migraines increases likelihood—specific gene mutations (e.g., CACNA1A in familial hemiplegic migraine) are linked to susceptibility.

• Cortical Spreading Depression: A wave of electrical activity across the brain, thought to cause aura and pain in some migraines.

2. Hormonal Changes

• Menstruation: Drops in estrogen before or during periods (menstrual migraines).

• Pregnancy: Hormonal shifts can trigger or relieve migraines.

• Menopause: Fluctuating or declining estrogen levels.

• Hormonal Medications: Birth control pills or hormone replacement therapy can provoke migraines in some.

3. Dietary Triggers

• Caffeine: Excess intake or withdrawal (e.g., coffee, tea, energy drinks).

• Alcohol: Especially red wine, beer, or spirits high in histamines or tyramine.

• Tyramine-Rich Foods: Aged cheeses, cured meats, soy products, fermented foods (e.g., sauerkraut).

• MSG (Monosodium Glutamate): Found in processed foods or restaurant meals.

• Artificial Sweeteners: Aspartame or sucralose in some people.

• Nitrates/Nitrites: In processed meats like bacon or hot dogs.

• Skipped Meals: Low blood sugar from fasting or irregular eating.

• Dehydration: Inadequate water intake.

4. Environmental Factors

• Weather Changes: Barometric pressure drops, storms, or extreme heat/cold.

• Bright Lights: Flickering lights, sunlight, or screens (e.g., computers, TVs).

• Loud Noises: Sudden or prolonged exposure to sound.

• Strong Smells: Perfumes, cigarette smoke, chemicals, or gasoline.

• Air Pollution: High levels of smog or allergens.

5. Stress and Emotional Factors

• Stress: Acute stress or the "let-down" period after stress resolves.

• Anxiety: Chronic worry or panic attacks.

• Emotional Shock: Grief, anger, or excitement.

6. Sleep Issues

• Sleep Deprivation: Too little sleep or poor-quality rest.

• Oversleeping: Sleeping longer than usual (e.g., weekend "catch-up" sleep).

• Shift Work: Disrupted circadian rhythms.

7. Physical Causes

• Muscle Tension: Neck or shoulder stiffness, often from poor posture or stress. One cause that is often overlooked may be a sports bra that is too tight on the top of the shoulders where the nerves exit cervical spine.

• Exercise: Overexertion or sudden intense activity (especially without warm-up).

• Head Trauma: Concussions or injuries can trigger migraines.

• Fatigue: Physical or mental exhaustion.

8. Medications and Substances

• Vasodilators: Drugs like nitroglycerin or some blood pressure meds.

• Oral Contraceptives: Estrogen-containing pills.

• Overuse of Painkillers: Rebound headaches from frequent use of triptans, NSAIDs, or opioids (medication-overuse headache).

• Drug Withdrawal: Stopping certain meds or substances abruptly.

9. Sensory Overload

• Screen Time: Prolonged exposure to digital devices (e.g., "tech neck" or eye strain).

• Motion Sensitivity: Travel, car rides, or virtual reality experiences.

10. Health Conditions

• High Blood Pressure: Uncontrolled hypertension.

• Infections: Sinus infections or viral illnesses.

• TMJ Disorders: Jaw clenching or teeth grinding.

• Allergies: Inflammation from seasonal or food allergies.

• Brain Issues: Rarely, tumors, strokes, or vascular abnormalities (e.g., AVMs).

11. Nutrient Imbalances

• Magnesium Deficiency: Linked to increased migraine frequency.

• Vitamin B2 (Riboflavin) Deficiency: May play a role in some cases.

• Electrolyte Imbalance: Low potassium or sodium from dehydration or diuretics.

12. Other Triggers

• Altitude Changes: High elevations or air travel.

• Smoking: Nicotine or secondhand smoke exposure.

• Temperature Extremes: Hot showers, saunas, or cold exposure.

How It Works

Migraines often involve a "perfect storm" of triggers. For example, someone might be genetically prone, then encounter a hormonal shift, skip breakfast, and face a stressful day—boom, migraine. The trigeminal nerve and blood vessel dilation also play roles in the pain phase, but the exact "why" can differ person to person.

Tracking Your Triggers

Since causes are so personal, keeping a migraine diary (noting food, sleep, stress, weather, etc.) can help pinpoint what sets yours off. Common culprits like stress, dehydration, and hormonal shifts top the list for many.