Migraine Triggers: What Can Set Off an Attack, and Why a Trigger Isn’t the Cause

Migraine involves far more than head pain, and so does the question of what brings it on. A neurologist explains why a trigger and a cause are two different things.

Some people can pinpoint what sets off their migraine, while others can’t. There’s a difference between what triggers migraine and what causes it, and one neurologist explains it.

Triggers Aren't the Cause

Dr. Nada Hindiyeh, a neurologist and headache specialist, says migraine stems from a “genetically-influenced neurological susceptibility involving altered sensory and pain processing.” This means some people are more prone to migraine, partly because of their genes, and their nervous systems handle sensation and pain differently.

“A trigger does not create that disease; it may help initiate an individual attack in someone who is already susceptible,” she says. She notes that migraine is more than a bad headache and can include nausea and sensitivity to light or sound.

The common triggers she highlights include irregular sleep, stress, missed meals, dehydration, hormonal changes, alcohol, inconsistent caffeine, bright or flashing lights, strong smells and changes in the weather. These triggers can build on each other, and not every migraine has an identifiable one.

What About Food?

Alcohol and caffeine are among the common reported dietary triggers, Hindiyeh says. Cured meats, aged cheese, MSG, artificial sweeteners and chocolate are also reported, but she says the evidence is limited on self-reports only.

Meanwhile, Mayo Clinic more firmly lists aged cheese, chocolate, caffeine, alcohol and processed meats as foods that lead to migraines in some people.

What to Track

To identify what triggers your migraine, Hindiyeh suggests tracking what you ate before an attack and warns that trying to avoid every trigger can cause anxiety.

Mayo Clinic also recommends keeping a headache diary, noting every time a migraine began, what you were doing, how long it lasted, and what helped. It notes that some research suggests that completely avoiding triggers might make you more sensitive to them.

In some cases, migraines can be a symptom of another condition, so tell your doctor about frequent attacks.