If you suffer from frequent headaches, or worse, yet, migraines, you know how miserable they can be. Many of my patients tell me that with a bad flare, they might have to crawl into bed for as long as three days and lay there in a dark, quiet room just to cope. Migraines lead sufferers to miss school, work, and social engagements. Women experience them way more often than men, and some women are plagued with them close to their periods. Migraines are just awful!
The good news is that you can prevent chronic headaches and migraines… naturally.
Here are the key recommendations I give to all of my patients. I recommend incorporating all of these tips into an overall headache prevention plan.
Tip #1. Identify and eliminate your headache/migraine triggers
The most common triggers are:
- Caffeine
- Red wine
- Aged cheese
- Sugar
- Nitrites (found in hot dogs and deli meats)
- Food additives (for example, MSG)
- Low blood sugar
- Stress
- Neck and shoulder tension
- Allergies leading to sinus congestion
- Hormonal changes
- Medications
Here is a super helpful headache diary from the University of Wisconsin Integrative Medicine Center. I give this to all of my patients. You can download it and start to track your migraine patterns. Use it to monitor your progress once you get started on your headache prevention plan.
Most people don’t know this, but there is a phenomenon called medication overuse headache (MOH). When you take pain medications for headaches, including narcotics, Tylenol, aspirin, caffeine, and ibuprofen, on a regular basis, these medications actually start to cause headaches. So as crazy and scary as this might seem to you to try, stop all of your pain medications for a few months. You might be surprised to find that you are actually having fewer headaches! The triptan drugs and propranolol do not fall into this category, however they have their own side effects.
Tip #2 Manage your stress!
Adequate sleep, visualization, meditation, yoga, breathing exercises – all of these can help you manage stress and prevent headaches and migraines. Biofeedback has been show to reduce migraine as well as propranolol does, and unlike propranolol, which can cause depression, fatigue, and sexual dysfunction, these other practices can make you feel GREAT! Remember that driving yourself with caffeine when you are tired is a vicious cycle. Both the fatigue and the caffeine cause migraines, and the fatigue and migraines make you want more caffeine! So break the habit and get the rest you need.
On an even deeper level, it’s important to ask yourself how the migraine impacts your life – what do you “get” to skip or miss when you have a migraine, for example, work or stressful events? Sometimes our bodies, in their infinite wisdom, create symptoms for us when we don’t know how to speak up for ourselves. This might not be the only thing going on, but often, with chronic problems that have a stress component, there is a tiny golden nugget of truth in there. If this rings true for you as part of the picture, is there a different, healthier way you can meet your needs other than through painful symptoms?
Tip #3: Get rid of gnarly neck tension.
Wow! You wouldn’t believe how much neck tension contributes to headaches, and how easy this is to treat. Massage therapy, physical therapy, and osteopathic manipulation can all relieve neck tightness and spasms – and with it your headaches! And your doctor can recommend these and your insurance should cover them!
Tip #4 Take your vitamins!
Riboflavin, or Vitamin B2, has been shown to safely prevent recurrent migraines by 50% compared to 15% for placebo – that’s a lot! Dose: 400 mg daily. It may take about a month to notice results, but hang in there. It’s often very effective. And if you are on a beta-blocker for migraine prevention, riboflavin has been shown to enhance the benefits so it may allow you to lower your dose or get better results from the dose you are taking.
Magnesium calms the nervous systems and helps improve blood vessel tone, preventing migraines. It can also help migraines associated with your period (hallelujah sister!) Dose 600 mg daily. It may take as long as 3 months to see results, but hang in there wit this one, too.
Tip #5 Herbs can help, too!
Feverfew is an herb that acts as a natural anti-inflammatory. It reduces migraine frequency and severity, as well as lessening migraine-associated symptoms. Dose: 25 mg daily. If you are on blood thinners, feverfew is not for you – it can interfere with your medication and increase bleeding.
Butterbur (also called Petasites) is also anti-inflammatory and has been shown to lead to a significant reduction in headache frequency. The dose is 75 mg twice daily. It may take several months before you notice major improvement, but give it a whirl. Because it also helps with symptoms of allergic rhinitis, this is an especially useful herb if you have allergy-associated headaches.
Note that neither feverfew nor butterbur (petasites) are safe for use in pregnancy!
Tip #6: Eat an anti-inflammatory diet and keep your blood sugar balanced.
Reducing the pro-inflammatory foods in your diet, particularly sugar, red meat and poultry, and processed foods, while adding antioxidant rich fruits and vegetables and good quality oils can reduce your headache frequency. Oils I recommend include olive oil, walnut oil, and coconut oil, all of which can be eaten raw or cooked. Also, avoid low blood sugar by eating healthy meals at regular times, and eating healthful snacks such as vegetables with hummus, a small handful of nuts or seeds, or an apple with almond butter. Future blogs will talk more about the anti-inflammatory diet and healthful eating. If you struggle with inflammation or blood sugar problems read The Blood Sugar Solution by Dr. Mark Hyman.
Supplementing with fish oil (750 mg/day eicosapentaenoic acid and 500 mg/day docosahexaenoic acid), which is anti-inflammatory, has been shown to reduce headache frequency, length, and severity.
I have seen these migraine prevention tips work for so many patients! If you have suggestions for things you have found helpful in migraine prevention, please let me know – I’d love to know what methods work for you! And if you have success with any of these suggestions, please be sure to drop me a comment!
Thanks for the tips! Unfortunately, I inherited all these issues and at
Times get debilitating migraines. Fortunately, I’ve become pretty
In tune with my body & have made huge healthy attitude strides
In my life.
The only tip that I had a question about is eating good quality oils.
I completely agree but I was under the belief that coconut oil was
The only one safe to eat after cooking. EVOO is great raw in salads,
Etc but shouldn’t be used for cooking. Thoughts?
Thanks again! I’m sure you hear this a lot, but you are l are living my
I’m on the road… As doula, cbe, & midwifery student among other things.
Dream.
-Janine H.
I am having trouble with my hormones. I have a regular yearly exam and I am down to one period per year. I am not on hormone replacement supplements yet. I have alot of concerns about what the doctors prescribe to women. I eat healthy but I have gotten really thick around the middle and I have gained weight about 15 pounds since last year. : – (. I don’t get a good nights sleep (thats bad in itself) and I don’t have a sex drive anymore, I feel really depressed about myself. I don’t really have time to exercise any more because I recently moved and now I have an hour and a half drive to my job of 14yrs every morning and evening. I used to be able to go home and work in my garden before going to bed. Help
Lydia, you might try reading Body Ecology or The Yeast Connection. Feel better!
I get migraines a day or 2 before my period. My mother also had them & says they go away with menopause. Yes! Something to look forward to. LOL I have found that using herbs to level out my hormones works not only to prevent the migraines from coming but also greatly reduces or even eliminates cramping. I like chaste berries in a cup of tea 1 wk before & then the wk. of my period. Another way is to get them in powder form & add 1/4 tsp to smoothies.
When I get migraines at other times of the month I can usually trace it to not drinking enough water, not eating all morning or having eaten something with MSG in it. Plenty of times when I feel that migraine start I’ve been able to stop it with a BIG glass of water or else eating something with protein like an egg. But once the migraine is full blown it’s too late. Nothing will work then, so it’s important for me to listen to my body at all times.
I have discovered that I need to get enough water. If I go a day or two without making sure to get plenty of water, that is when I often get migraines. I have tried to discover my other triggers, but it seems like it’s hormonal (ie, worse in pregnancy and breastfeeding) and dehydration that just kick me over the edge.
I am assuming these doses are for adults. My 9 year old daughter(she weighs about 60 pounds) gets occasional migraines, how do I adjust the dosages for her?
Hi Jackie,
The dosing should be the same for your daughter, though I’d keep to 1000 mg of fish oil and not combine both fish oil and feverfew. At her age, though, I’d really suss out migraine triggers ’cause that might be enough to sort it out for her. Low blood sugar, not drinking enough fluids, stress (school, home, neighborhood), environmental, diet…. Wishing you the best!
These are some great tips! I have a few different meds that can cause headaches as a side-effect but it’s so vague – I like the idea of tracking your headaches in a journal! I think I get migraines from overstimulation and PMS, and headaches sometimes when the weather and air pressure changes. Can you go more in-depth on how medication overuse can cause their own headaches, especially over the counter medications? or link to the clinical study showing that? I’m not sure I understand the biology behind that, and as someone who is prescribed NSAIDS often I think it would be really interesting. Thanks for the post!
Thanks for the suggestions! I had been considering adding on butterbur for my migraines, but didn’t know what specific dosage would be helpful. The book that has really helped me to gain a deeper understanding of migraines is Migraine by Oliver Sachs. In particular it has helped me to identify my earliest signs that tell me a migraine is brewing which has helped me to nip several attacks in the bud. I hadn’t realized the systemic inflammatory reactions and had just paid attention to the aspects that are more frustrating like the aura, pain, and clouded thinking that I experience.
Ah! I am a HUGE Oliver Sachs fan!
I’ve never had a migraine until this year – and after a few days I realized the issue! Weaning. Happened too quickly and man those hormones are fierce.
Hi,
Just wanted to chime in because curing the migraines was a major issue for me. I got them every month beginning around 40 years old and they caused intense vomiting. I began taking a magnesium supplement which is a powder that you dissolve in water. The brand is “Natural Calm” and it stopped my migraines. I only need to take it a few times a week now to stay migraine free. I tried all the other tips and tricks mentioned, but nothing worked except for this magnesium. The pill form of magnesium did not work for me either! I have been completely migraine free for over a year now, and it’s been nothing short of a miracle in my life. I know everyone is different, but if you get migraines I think magnesium is worth a try. There is also magesium that you can apply to your skin and absorb, if magnesium upsets your digestion. (Too much oral magnesium at once will cause diarreah, btw, so you have to learn how your body responds)
Hi Aviva,
Do you have any recommendations for remedies to take once a headache starts? I’m in the process of the making lifestyle changes (including many of the suggestions you listed on your post) to prevent headaches, but in the meantime when I get a headache I usually end up taking advil or tylenol. I’m uncomfortable taking a lot of meds, especially becuase I’m nursing, but my headaches are debilitating and if I don’t take something as soon as I feel a headache coming on I end up getting really sick. Do you have any suggestions for herbal or other natural remedies that a) can be taken once a headache sets in, b) don’t have the same side-effects as taking OTC drugs, and c) are safe during lactation?
Hi Belinda,
My household rememdy for family or visitors who develop a headache is a combination of equal parts of herbs called Cramp Bark and Jamaican dogwood, in tincture form, 40 drops ,repeated in 15 minutes, then 15 minutes again, then ever 2-4 hours as needed. These should be ok during breastfeeding, though the data is limited. BUT preventing the headaches is the most important thing!!! Be well. Aviva
My migraines started after having a pacemaker put in. Doctors assured me that pacemakers don’t cause migraines. I didn’t say they did. I just started getting them after surgery. I have found many of the triggers and avoid them like the plague but I sometime still get them. Here is the kicker; as the years went by the migraines came less often lasted a shorter period of time, and were not as severe. then my pacemaker was replaced. The pain from the migraines was excruciating! I have found a pattern. I am working on my 4th pacemaker. Each time it is replaced the migraines begin again. Doctors believe it is all in my head. No pun intended. The last replacement gave me a migraine for 5 weeks before I tried acupuncture. That helped for a couple of weeks. I fear the next replacement in 4 years time. Any ideas what is going on?
Hi Lee,
Are you getting general anesthesia for the placement? That could be a trigger for you…
Warmly, Aviva.
Hi Aviva, Thanks for the tips! I have noticed some of my headache triggers to be around my period and stress, and every time I cry, would that be included in stress? Even I get a little sad and just shed one tear I get this horrible headache! Another trigger for me is rainy weather. I looked it up and found that I’m not alone it has something to do with the pressure in the air. So would you reccomend I take feverfew regularly, like around my menstrul cycle and when I know its going to be a rainy day?
Thanks, Alisha
Hi Alisha,
Yes, absolutely. And hormonal imbalances perhaps driving some of it, since it happens around your cycle. You might actually want to work with a local integrative MD, an herbalist, or a naturopath to sort out some of the hormonal issues that are probably underlying this, and perhaps work with some herbs that support your mood since you get weepy. Warm wishes! Aviva
I have been using the “vitamin protocol”. In fact I found a product called Migravent from the States. I have had great success with this! It has everything all in one tablet so instead of taking a handful of vitamins three times a day, I take one! The downside…it is only available from ONE pharmacy in Bloor West Village.
Hi Aviva,
I often get headaches immediately after sex. Will the herbs/supplements help prevent these? Or do you have any suggestions of things to do to help or reduce these headaches? Thanks
Hi Meg,
Likely, something else is going on that these herbs may- or may not- help. Most likely you have some changes in brain flow to the brain either from relaxation during sex, reclining, or diversion of blood flow to other parts of your body. I’d work with hydration before and immediately after, and see if being more upright during helps. Other herbs that are specifically more for acute headaches might be more helpful, but you can certainly try the B2, etc.