Understanding Migraines
A Modern Naturopathic Perspective
If you live with migraines, you know how frustrating they can be. They often feel unpredictable, and if you've ever found yourself wondering, "Why did I get one today?" you're certainly not alone.
The good news is that our understanding of migraines has changed dramatically over the last decade. Gone are the days of handing patients a long list of foods to avoid and hoping for the best. Today, we understand migraines as a complex neurological condition, and our approach is much more individualized, evidence-based, and, in my opinion, much more helpful.
Let's talk about what we know now and how that might change the way you think about your migraines.
Migraine Triggers vs. Prodrome: One of the Most Important Things to Understand
One of the biggest shifts in migraine medicine is understanding the difference between a trigger and a prodrome symptom.
Most patients I see have a list of things they think trigger their migraines. Maybe it's chocolate, red wine, bright sunlight, or even something as random as wearing a particular shirt. And honestly, that makes complete sense. When you're dealing with recurring pain, it's only natural to look for patterns and try to figure out what caused it.
But here's where things get interesting.
Research has shown that many of the things people believe are migraine triggers aren't actually supported by the evidence. That doesn't mean your experiences aren't real, it means we may have been interpreting them differently than we should.
Migraines don't usually begin with the headache itself. They often start hours, or even a day or two beforehand, during what's called the prodrome phase. During this time your brain is already undergoing changes that can cause symptoms such as:
Neck stiffness
Fatigue
Mood changes
Food cravings
Difficulty concentrating
Yawning
Increased sensitivity to light or sound
These symptoms are easy to mistake for triggers.
For example, many people notice neck pain before a migraine and assume the neck pain caused the headache. More often, the neck pain is actually one of the earliest symptoms of the migraine itself. In other words, the migraine had already started before the pain in your head appeared.
I find that understanding this distinction can completely change how we approach migraine management.
Tracking Your Migraines Can Reveal Patterns
Because every person's migraines are a little different, tracking them is one of the most valuable things we can do.
Rather than trying to remember what happened weeks ago, keeping a record helps us identify meaningful patterns and measure whether treatment is actually helping.
Things I often recommend tracking include:
How many migraine days you have each month
How severe they are
How long they last
Any medications you used
Menstrual cycles, if hormones may be playing a role
Possible prodrome symptoms and triggers
I have a trigger tracker available for download here.
We can also use tools such as the MIDAS and HIT-6 questionnaires to better understand how migraines are affecting your daily life. These questionnaires help guide treatment decisions and give us an objective way to measure progress over time.
Looking at the Bigger Picture
Modern migraine treatment isn't about finding one magic trigger to avoid.
Instead, I like to step back and look at the bigger picture.
Some of the areas we commonly explore include:
Sleep quality and consistency
Hormonal changes
Stress and nervous system load
Hydration
Meal timing
Blood sugar stability
Caffeine habits
Alcohol use
Rather than focusing on one specific food, we often think about the overall "load" on your nervous system. Sometimes it's the combination of several small stressors that lowers your migraine threshold rather than one single event.
Nutrition, Supplements and Medication
Nutrition plays an important role in migraine prevention.
Simple strategies such as eating regular meals, staying hydrated, and avoiding long periods without food can make a noticeable difference for many people. Fasting is typically not appropriate for people who experience migraines. Rather than eliminating caffeine completely, maintaining a consistent intake is often more helpful. Alcohol is another common contributor for some people.
When it comes to supplements, there is good evidence supporting a small group of affordable options that can help reduce migraine frequency and severity. I often recommend trying these consistently for about three months before deciding whether they're helping. I've seen this combination work remarkably well for many patients.
If supplements aren't enough, or if you'd prefer medication, there are many effective prescription options available. Together we can discuss the benefits, potential side effects, and what makes the most sense for your individual situation. My goal is always to make sure you feel informed and comfortable with your treatment plan.
What About Acupuncture?
One question I get asked frequently is whether acupuncture actually works for migraines.
Overall, the research is encouraging.
Studies have found that acupuncture can reduce migraine frequency, with results comparable to some preventive medications over a three-month period. It also tends to have fewer side effects, which makes it an attractive option for people who would prefer to avoid medication or who haven't tolerated medications well.
Interestingly, research suggests that the exact acupuncture points may not be as important as we once thought. Personally, I tend to focus on the muscles of the neck, shoulders, and upper back because these areas often become tight or sore during the prodrome phase, and treating them makes sense clinically.
To see the best results, acupuncture usually needs to be done as a series rather than as a one-time treatment. Most studies involve about 12 treatments over three months.
Cost is, of course, an important consideration. Twelve treatments can add up quickly, and I never want finances to prevent someone from receiving care that could improve their quality of life. If you think acupuncture might be a good option but cost is a concern, please let me know. I'd much rather find a solution that works than have someone miss out on treatment because of finances.
You Don't Have to Figure This Out Alone
Migraines are complicated, and there isn't a one-size-fits-all solution.
The good news is that we now understand migraines far better than we did even ten years ago. With careful history-taking, thoughtful pattern recognition, evidence-based nutrition and supplementation, appropriate medications when needed, and treatments like acupuncture, there are more options than ever before.
If migraines are affecting your quality of life, I'd love to help you better understand what's driving them and work with you to build a treatment plan that fits your life.
You don't have to keep guessing. Relief starts with understanding your migraines, and finding the right approach for you.
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