Understanding Migraine Triggers

If you live with migraine then you’ve likely noticed how certain foods, environments, and daily habits can make attacks more likely. These everyday stimuli can be thought of as migraine triggers. Although they don’t cause migraine directly, they can set the process in motion at times when the brain is already sensitive to attacks. When that happens, the brain’s threshold can tip, leading to an attack.

At times when the brain’s energy is low, a single strong trigger may be enough to set off an attack. But more often, these triggers overlap and build on one another. A stressful week, a skipped meal, and a change in weather can combine to push your migraine threshold beyond its limit. Understanding how these factors affect brain sensitivity is an important step toward regaining a sense of control.

In this guide, we’ll explore the main categories of migraine triggers: dietary, hormonal, lifestyle, and environmental. These factors act in different ways, from how certain foods and compounds affect brain energy to how hormonal shifts, stress, sleep, light, and weather lower your migraine threshold by disrupting the brain’s ability to stay balanced. We’ll also look at condition-specific patterns and less common and emerging triggers that research is beginning to uncover. By understanding how different triggers influence the brain’s energy and sensitivity, you can begin to recognize your own patterns and make changes that support greater stability.

Dietary Triggers

Food is one of the most frequently reported migraine triggers, and the same foods can affect people differently. For example, you may tolerate dairy, while even a small amount of aged cheese could trigger an attack for someone else.

Certain compounds in foods influence blood vessel tone, neurotransmitter balance, and the brain’s ability to maintain steady energy, which can make some people more vulnerable to migraine attacks. This helps explain why even familiar foods can feel unpredictable and why tolerance to specific foods can vary from one day to the next.

Broadly, food-related triggers can be grouped into several main categories.

Vasoactive Compounds

Aged cheeses, red wine, and fermented foods often contain vasoactive compounds such as tyramine, histamine, sulfites, and other biogenic amines, substances that affect how blood vessels widen and narrow. In people sensitive to vascular effects, these changes may contribute to migraine pain or aura symptoms.

• Aged cheese and yogurt – contain notable levels of tyramine and histamine

• Red wine and cured meats – combine histamine with sulfites

• Fermented soy or vinegar-based foods – contain biogenic amines

See also: Can Dairy Cause Migraines, Histamine and Migraines.

Did You Know?
How your body breaks down food compounds can influence migraine sensitivity. The enzyme monoamine oxidase (MAO) helps regulate substances like tyramine and histamine, so people with lower MAO activity may react more strongly to aged or fermented foods.

Alcohol

Alcohol, particularly red wine and other fermented drinks, is a common migraine trigger. Compounds such as histamine and sulfites may influence blood vessel tone, while alcohol’s effects on hydration, blood sugar, sleep, and overall energy balance can heighten brain sensitivity.

• Red wine and fermented drinks – contain histamine and other biogenic amines that can influence vascular tone

• Sulfite-containing beverages – may increase oxidative stress and heighten vascular sensitivity

• Alcohol-related dehydration and poor sleep – reduce fluid balance and restorative rest, increasing susceptibility to triggers

See also: Alcohol and Migraines.

Did You Know?
Alcohol triggers migraine partly because its metabolism produces acetaldehyde and depletes key cofactors like NAD⁺, disrupting mitochondrial energy balance. These changes can widen blood vessels and increase oxidative stress, heightening brain sensitivity.

Energy and Metabolic Factors

The brain relies on a steady supply of glucose and electrolytes to maintain its energy balance. Skipping meals, fasting, or eating too much sugar can cause blood sugar swings, while dehydration affects blood flow and oxygen delivery. Together, these factors may lower your migraine threshold by disrupting the brain’s energy stability and increasing its sensitivity to triggers.

• Fasting or irregular meals – reduces glucose availability and raises stress hormone levels

• Sugary foods and refined carbs – cause rebound energy dips as insulin rises and blood sugar drops

• Dehydration – reduces blood flow and oxygen delivery, altering circulation and electrolyte balance

Further reading: Migraine Foods to Avoid List, Migraine Elimination Diet.

Did You Know?
The brain can’t store much energy, so even short periods of low blood sugar or dehydration can act as triggers. Keeping glucose and hydration stable helps maintain mitochondrial function, the small structures that produce energy and keep your brain cells running efficiently.

Additives and Flavor Enhancers

Some people are sensitive to certain food additives that increase excitatory signaling in the brain. These include monosodium glutamate (MSG) and artificial sweeteners such as aspartame and sucralose.

• MSG – may overstimulate glutamate receptors in the brain

• Artificial sweeteners – can affect neurotransmitter balance and vascular tone

• Processed snacks and sauces – common hidden sources of flavor enhancers such as MSG or aspartame

Related reading: Chocolate for Migraines, Cocoa Migraine.

Did You Know?
Glutamate is the brain’s primary excitatory neurotransmitter, responsible for stimulating nerve signaling. When its activity becomes excessive, such as after consuming MSG, it may increase neuronal excitability linked to migraine.

Caffeine, Salt, and Electrolyte Balance

Caffeine can sometimes help relieve migraine pain when taken early in an attack, but too much or sudden withdrawal can have the opposite effect. Likewise, both dehydration and excessive salt intake may alter circulation and fluid balance, affecting brain hydration and blood pressure.

• Caffeine changes – excess intake or withdrawal may alter blood vessel tone and adenosine activity in the brain

• Salt fluctuations – too little or too much salt can disrupt electrolyte balance and hydration, affecting blood flow regulation

• Low hydration – lowers blood volume and oxygen transport, making it harder for the brain to maintain steady circulation

See also: Best Electrolyte Drink for Migraines, Celtic Salt for Migraines, Himalayan Salt for Migraines.

Supportive Nutrients

Certain nutrients may help the brain resist dietary triggers by supporting mitochondrial energy production and reducing oxidative stress. Unlike short-term avoidance strategies, these nutrients strengthen the underlying systems that promote long-term brain stability and resilience.

• Ketones (primarily D-Beta-Hydroxybutyrate) – provide a clean, efficient fuel source that supports mitochondrial function and helps reduce oxidative stress

• Magnesium – supports nerve signaling, muscle relaxation, and vascular control

• Riboflavin (vitamin B2) – essential for mitochondrial energy metabolism

• CoQ10 – promotes cellular energy and antioxidant defense

• Vitamin D – helps regulate metabolic and immune balance

• L-Carnitine – assists in transporting fatty acids into mitochondria for energy use

• Taurine – supports antioxidant defense and cellular hydration

Together, these nutrients contribute to balanced energy availability, improved stress tolerance, and help maintain a more resilient response to everyday triggers.

Did You Know?
When glucose levels drop, the brain can use ketones such as D-Beta-Hydroxybutyrate as an alternative energy source. This flexibility helps the brain maintain energy balance and may reduce vulnerability to energy-related migraine triggers, which may help explain the growing research interest in ketogenic approaches for migraine and brain health support.

Further reading: [Magnesium and Riboflavin for Migraines], [CoQ10 Migraine], [Vitamin D Migraine].

The table below provides a list of migraine triggers commonly reported in food and diet-related patterns.

Common Migraine Food Triggers and Their Possible Mechanisms

Hormonal Triggers

Hormonal changes are amongst the most recognized migraine triggers, especially in women. Fluctuations in estrogen and progesterone affect vascular tone, neurotransmitter activity (including serotonin), mitochondrial energy production, and inflammatory signaling, all of which can affect migraine threshold and brain sensitivity. If these hormones change too rapidly, the brain can become more sensitive than usual to external triggers, so even small changes in stress, sleep, or diet may be enough to bring on an attack.

In general, hormone-related triggers can be grouped by life stage or cycle pattern.

Menstrual and Cyclic Shifts

Migraine attacks commonly occur in the days leading up to menstruation, coinciding with a naturally occurring sharp drop in estrogen levels. Some women may also notice migraine symptoms around ovulation, when hormonal peaks can alter brain excitability.

• Perimenstrual phase – a rapid estrogen decline may reduce serotonin levels and heighten pain sensitivity

• Ovulation – fluctuating estrogen and luteinizing hormone (LH) can affect vascular tone and brain excitability

• Cyclic patterns – hormonal swings may amplify the effects of other triggers like stress or sleep loss

See also: Birth Control for Migraines, Are Migraines a Menopause Symptom.

Did You Know?

Estrogen helps regulate serotonin production and signaling, a key neurotransmitter involved in mood, sleep, and pain perception. When estrogen levels fall, serotonin activity can drop too, which may help explain why migraine attacks often occur before menstruation.

Menopause and Hormone Therapy

When estrogen levels fluctuate during perimenopause or begin to decline in early menopause, migraine patterns can become less predictable. During these transitions, migraines may become more frequent or intense. Once these levels stabilize, many people notice an improvement, with fewer or milder attacks. Hormone replacement therapy (HRT) is known to influence brain energy metabolism and vascular responsiveness, which can lead to short-term changes in migraine frequency.

• Perimenopause – fluctuating estrogen levels can heighten sensitivity to common migraine triggers

• HRT changes – dosage or delivery method may influence vascular tone and alter migraine frequency

• Post-menopause – stabilized but lower estrogen levels may bring gradual improvement in migraine symptoms

See also: Best HRT for Migraine Sufferers.

Did You Know?
After menopause, the brain adjusts to lower estrogen by relying more on other hormones and neurotransmitters to regulate energy and pain signaling. This adaptation may help explain why migraine symptoms can lessen once hormone levels stabilize.

Pregnancy and Postpartum Changes

During pregnancy, migraine attacks often become less frequent or severe. This likely relates to sustained high estrogen levels and steadier hormonal patterns. After childbirth, the postpartum period (first few months following delivery) often marks a return to fluctuating hormone levels after the stability of pregnancy. As estrogen levels drop sharply in the weeks following delivery, some women experience renewed migraine activity or heightened sensitivity, especially when combined with disrupted sleep and the stresses of early parenthood.

• Pregnancy – sustained high estrogen levels and steadier hormonal patterns often reduce migraine frequency

• Postpartum – the sharp drop in estrogen, combined with disrupted sleep and stress, can increase the risk of recurrence

• Breastfeeding – ongoing hormonal adjustments and higher metabolic demands may continue to influence migraine patterns 

See also: Migraine Breastfeeding.

Did You Know?

Estrogen affects serotonin and mitochondrial energy production; two systems closely tied to migraine. When estrogen drops quickly, serotonin levels fall and brain cells become more energy-hungry, making them more sensitive to stressors that can trigger an attack.

Hormonal Changes and Migraine Patterns

Lifestyle Triggers

Both your daily habits and emotional patterns influence migraine sensitivity. Usually, it’s not a single habit but inconsistency that has the biggest impact. Sudden changes in your routine, such as poor sleep, skipped meals, a hard workout, or periods of heightened stress, can disturb the brain’s natural balance of energy and pain regulation.

Stress and Emotional Factors

Stress is one of the most widely reported migraine triggers. Stress hormones such as cortisol and adrenaline help regulate blood flow, muscle tension, and neurotransmitter balance. Interestingly, attacks can sometimes occur after a stressful period has ended, a phenomenon known as a ‘weekend migraine.’ This pattern likely reflects a sudden change in stress hormones and the relaxation of blood vessels as the body shifts out of its heightened alert state.

• Ongoing emotional stress – elevates cortisol levels and increases brain sensitivity

• Sudden relaxation after stress – may trigger vascular and neurotransmitter shifts, sometimes referred to as a weekend migraine

• Anxiety or emotional suppression – can increase neck and facial muscle tension linked to migraine pathways

See also: Migraine Stress Management, Can migraines cause neck pain.

Did You Know?
Chronic stress can deplete magnesium and increase oxidative stress, both of which may make the brain more sensitive to triggers. These changes can affect how nerve cells handle energy and signaling, contributing to a lower migraine threshold.

Sleep Irregularities

The brain depends on consistent cycles of sleep and wakefulness to regulate hormones, energy, and pain sensitivity effectively. Too little or too much sleep can disrupt these rhythms, while irregular schedules such as shift work or jet lag can confuse the body’s circadian clock. These misalignments can interfere with brain recovery and increase vulnerability to migraine triggers.

• Sleep deprivation or late nights – lower serotonin and increase stress hormones

• Oversleeping – can alter blood sugar and vascular tone

• Shift work or irregular schedules – disrupt circadian timing and melatonin balance

Further reading: Best Way to Sleep With Migraine.

Did You Know?
Melatonin, the hormone that regulates your sleep–wake cycle, is produced from serotonin, a neurotransmitter that influences mood and pain perception. It also acts as one of the body’s strongest antioxidants, helping to protect mitochondria and maintain steady energy within cells. When sleep patterns are irregular, melatonin and serotonin can fall out of sync, which may increase migraine sensitivity.

Physical Strain and Muscle Tension

Overexertion, poor posture, muscle clenching, teeth grinding, or prolonged screen use can increase tension in the neck, shoulders, and jaw, areas that share nerve connections with migraine pathways. This muscle tension can heighten migraine sensitivity and slow recovery following an attack.

• Postural strain or prolonged screen use – tightens neck and shoulder muscles, increasing tension

• Bruxism (teeth grinding) – activates jaw and head nerves connected to migraine pathways

• Intense workouts without proper hydration – combine muscular, metabolic, and oxidative stress that may raise sensitivity

See also: Physical Therapy Exercises for Migraines, Bruxism Migraine, Can wisdom teeth cause migraine headaches, Can a Pinched Nerve Cause Migraine Headaches.

Did You Know?
The trigeminal nerve, which transmits sensation from the face and jaw, also plays a central role in migraine pain pathways. When tension builds in surrounding muscles, this nerve can become overstimulated, heightening pain sensitivity and making migraines feel more intense. Muscle strain can also increase oxidative stress, which may reduce cellular energy efficiency and make the brain more vulnerable to migraine triggers.

Temperature and Emotional Intensity

Sudden changes in temperature or intense emotional release, such as crying, can alter blood flow and breathing patterns. In people with sensitive vascular responses, these shifts may trigger symptoms or intensify existing migraine pain.

• Heat exposure – expands blood vessels and can alter blood pressure

• Crying or emotional release – affects breathing and blood oxygen, briefly changing circulation

• Intense emotions or anxiety – raise stress hormones and muscle tension, which can amplify pain sensitivity

Related reading: Heat for Migraine, Heat or Ice for Migraine Headache.

Did You Know?
The trigeminovascular system connects the trigeminal nerve with the meningeal blood vessels that surround the brain. When this system becomes active, it can release pain-related neuropeptides that cause blood vessels to widen and tissues to become inflamed. Even small changes in blood pressure or oxygen levels can stimulate this response, helping explain why strong emotions or temperature shifts can act as migraine triggers.

Medication Overuse and Rebound

Regular use of pain-relief medication can lower the migraine threshold, leading to more frequent attacks, a pattern known as medication-overuse headache. This can develop with repeated use of triptans, caffeine-containing analgesics, or combination painkillers. Gradual reduction and steady preventive measures can support recovery of the brain’s normal sensitivity.

• Triptans and painkillers – frequent use can cause rebound sensitivity and lower migraine threshold

• Caffeine-based remedies – may alter vascular tone and contribute to dependency or withdrawal effects

• Mixed or combination analgesics – increase the likelihood of medication-overuse headache when used regularly

Did You Know?
Caffeine affects the brain’s adenosine system, which helps regulate blood flow and alertness. When caffeine is used frequently, the brain adapts by increasing adenosine receptor activity. These changes may contribute to both reduced effectiveness and heightened sensitivity in people who rely on caffeine-based pain relievers.

See also: Migraine vs Headache.

Sexual Activity and Exertion

A small number of people experience migraine-like headaches during or after sexual activity or intense exertion. These exertional headaches may result from rapid increases in blood pressure and vascular dilation, along with rises in oxidative stress and energy deficiency.

• Sudden exertion – causes a rapid rise in heart rate and blood pressure, which may trigger vascular sensitivity

• Orgasm-related vascular changes – brief but pronounced dilation of cranial blood vessels can contribute to headache onset

• Dehydration or fatigue – may heighten post-activity sensitivity and oxidative stress, delaying recovery

Related reading: Migraine Heart Palpitations.

Did You Know?
Rapid changes in heart rate, blood pressure, or breathing during exertion or sexual activity can activate the autonomic nervous system, which interacts with the brain’s trigeminovascular pathways. This activation may increase the release of vasoactive neuropeptides, causing vessel dilation and heightened pain sensitivity in people prone to migraine.

Common Lifestyle-Related Triggers and Mechanisms

Environmental and Sensory Triggers

The environment can play a major role in migraine sensitivity. Bright light, weather changes, strong smells, and poor air quality can all affect the brain’s ability to stay balanced. Although these factors don’t directly cause migraine, they can act as external stressors when the brain is already in a sensitive state. Paying attention to how your symptoms respond to environmental changes can help you anticipate potential triggers.

Light and Visual Sensitivity

Many people report being affected by light-related triggers such as bright sunlight, glare, flickering lights, and artificial screens. Rapid changes in light contrast, such as moving from a dim space into bright daylight, can overstimulate visual pathways that are already hyperresponsive in migraine.

• Bright sunlight or glare – can sharply increase visual stimulation and place extra strain on light-sensitive pathways

• Flickering or fluorescent lighting – may overstimulate neurons in the visual cortex, particularly in people with photosensitivity or visual aura

• Screen glare or blue light – can disrupt circadian rhythm and contribute to eye strain and fatigue, especially with prolonged device use

• LED lighting – some types flicker or emit excess blue light, which may trigger headaches in sensitive individuals

See also: Blue Light and Migraines, LED Lights and Migraines, Red Light Therapy for Migraines.

Did You Know?
The retina and visual cortex are rich in photoreceptors and neurons that connect to the trigeminal system, which helps process both light and pain signals. When these networks become hypersensitive, even normal light levels can trigger discomfort or aura-like symptoms.

Weather and Barometric Pressure

Shifts in temperature, humidity, and barometric pressure can all affect vascular tone and brain oxygenation. Some people experience migraine symptoms during cold snaps or before storms, when atmospheric pressure drops, while others are more affected by hot, humid air or dry indoor heating.

• Barometric pressure changes – can influence intracranial pressure and oxygen balance

• Cold air or wind exposure – may constrict blood vessels and increase muscle tension

• High heat and humidity – can promote dehydration and electrolyte loss

See also: Can Cold Weather Cause Migraines.

Did You Know?
Barometric pressure changes can subtly alter oxygen levels in blood and the pressure within the brain’s blood vessels. These variations may activate pain receptors connected to the trigeminovascular system, which helps explain why weather fronts or changes in altitude can precede an attack.

Smells and Odors

Strong scents are often reported as environmental triggers. Perfumes, cleaning products, cigarette smoke, and gasoline fumes can activate the trigeminal nerve endings that detect chemical irritants. Chemicals in these odors or cigarette smoke can also act as pro-oxidants, increasing oxidative stress and placing extra strain on mitochondrial energy balance. This may trigger pain directly or heighten sensitivity when combined with other factors.

• Perfumes and aerosols – stimulate trigeminal chemoreceptors in nasal passages

• Cleaning products and solvents – release volatile compounds that irritate mucous membranes

• Cigarette smoke and exhaust fumes – reduce air quality and oxygen delivery

Did You Know?
The nasal passages contain sensory nerves that respond to both smell and irritation. These pathways overlap with the same trigeminal circuits involved in migraine pain, which helps explain why strong scents can heighten discomfort or sensitivity during an attack.

Air Quality and Allergens

Poor air quality and airborne irritants such as pollution, smoke, or chemical fumes can worsen migraine sensitivity by increasing inflammation and reducing oxygen delivery to the brain. Mold spores, dust, and other particulates may also contribute to sinus pressure or immune activation, further straining an already sensitive system.

• Mold or mildew exposure – may trigger inflammatory or allergic responses

• Pollution, smoke, or chemical fumes – increase oxidative stress and reduce oxygen delivery

• Dust, indoor allergens, or insect bites – can cause sinus pressure or immune activation

See also: Can Mold Cause Migraines, Bug Bite Causing Migraine.

Did You Know?
Exposure to airborne particles can activate immune cells that release inflammatory mediators such as histamine and cytokines. In people sensitive to migraine, this immune activation can increase vascular reactivity and neural inflammation, raising the likelihood of an attack.

Screen and Technology Exposure

Extended time in front of digital screens exposes the brain to several stressors, including glare, poor posture, and mental fatigue. Prolonged near focus can strain the eyes, while blue light exposure and neck tension may further increase sensitivity.

• Long screen sessions – increase both visual and cognitive fatigue

• Poor lighting or posture – adds to muscle tension and compounds visual strain

• Evening blue light exposure – suppresses melatonin, delaying sleep onset and altering circadian rhythm

See also: Glasses for Migraine.

Did You Know?
When melatonin release is delayed, the brain’s natural nighttime repair and energy regulation processes are also disrupted. This can reduce recovery from daily stress and heighten sensitivity to light and other environmental stimuli.

Common Environmental and Sensory Triggers

Subtype-Specific or Condition-Specific Triggers

Different migraine subtypes have their own trigger profiles. While many of the same dietary, hormonal, and environmental influences still apply, some forms involve heightened sensitivity to movement, light, or sensory input. Understanding these differences can help you recognize the specific patterns that relate to your migraine experience.

Vestibular Migraine

Vestibular migraine is characterized by dizziness, vertigo, and balance disturbances. Unlike typical migraine, it may not always cause head pain but instead produces sensations of motion, disorientation, or unsteadiness that can last from minutes to hours. Vestibular migraine triggers often involve motion and sensory inputs, such as rapid head movements, scrolling on screens, navigating busy visual environments, or traveling in vehicles. Stress and hormonal changes may also increase vestibular sensitivity and slow recovery after an episode.

• Motion or visual motion – may overstimulate balance and visual pathways

• Head position changes – can disturb vestibular stability and increase dizziness

• Stress or fatigue – can heighten neural sensitivity within the balance system

See also: Basilar Migraine vs Vestibular Migraine, Migraines from Driving.

Basilar (brainstem) migraine shares some overlapping symptoms with vestibular migraine but involves deeper brainstem pathways rather than the balance system itself.

Did You Know?
The vestibular system is the part of your inner ear and brain that controls balance, spatial orientation, and motion detection. It shares close neural connections with regions involved in migraine processing, so when these pathways become hypersensitive, even small amounts of motion or visual input can trigger dizziness or vertigo.

Hemiplegic Migraine

Hemiplegic migraine is a rare form of migraine that causes temporary weakness or numbness on one side of the body, sometimes accompanied by visual or sensory aura. These symptoms usually resolve fully within hours. It can appear in inherited (familial) or spontaneous (sporadic) forms and involves heightened sensitivity in the brain’s electrical signaling.

Triggers often overlap with those of other migraine types but may produce stronger neurological reactions. Stress, bright light, or fatigue can all contribute by disrupting the brain’s energy balance and nerve communication.

• Physical or emotional stress – may heighten cortical excitability and lower tolerance to triggers

• Bright or flashing light – can overstimulate sensory pathways and prompt aura symptoms

• Fatigue or exertion – reduces neuronal stability and energy reserves

Did You Know?
Hemiplegic migraine is associated with uncommon genetic variations that affect how nerve cells regulate electrical signals. These changes can make the brain more reactive to shifts in energy or stress, leading to temporary weakness or sensory changes during an episode.

Ocular (Retinal) or Visual Migraine

This form of migraine primarily affects visual perception, causing temporary vision loss, perceived flickering or flashing lights, or shimmering patterns (often described as visual aura). Triggers often relate to light, eye strain, or vascular changes around the retina.

• Bright or flickering light – may overstimulate visual receptors in the retina or visual cortex

• Hormonal changes – may influence blood flow in the visual or optic regions

• Dehydration or low blood sugar – can impair ocular circulation and increase visual sensitivity

See also: Can Migraines Cause Blurry Vision, Migraine Pupil Dilation, 2 Migraine Auras in a Row.

Did You Know?
Ocular migraines typically affect vision in one eye. They are thought to involve transient spasms of the small arteries supplying the retina or visual cortex. These brief changes in blood flow can interrupt visual signals without always causing pain.

Silent (Acephalgic) and Abdominal Migraine

Silent migraine produces aura or neurological symptoms without the typical headache phase. These may include visual disturbances, tingling sensations, speech difficulty, or temporary confusion, often resolving within an hour.

Abdominal migraine is more common in children and causes digestive pain, nausea, and fatigue rather than head pain. Both forms are linked to nervous system hypersensitivity and metabolic shifts.

• Nervous system sensitivity – can trigger aura or sensory symptoms even without head pain

• Blood sugar fluctuations – may contribute to abdominal discomfort, nausea, or fatigue

• Sleep or hormonal disruption – can alter brain signaling patterns that activate migraine pathways

Related reading: What is an Abdominal Migraine, Aura Migraine Without Headache.

Did You Know?
The brain–gut axis links the digestive system and the nervous system through shared signaling pathways. In abdominal and silent migraine, fluctuations in serotonin and energy metabolism can alter gut motility and pain perception, producing migraine activity outside the head.

Chronic or Refractory Migraine

Chronic migraine occurs when attacks happen on 15 or more days per month for at least three months. Refractory migraine refers to migraine that remains difficult to manage despite appropriate treatment. While they can overlap, refractory migraine emphasizes resistance to therapy, whereas chronic migraine describes frequency. Both patterns often involve cumulative exposure to overlapping triggers and long-term nervous system sensitization.

• Frequent exposure to multiple triggers – can keep the nervous system in a sensitized, overreactive state

• Medication overuse or withdrawal – may perpetuate the migraine cycle and lower treatment effectiveness

• Sleep loss, stress, or hormonal instability – further strain brain energy and pain-regulation systems

See also: Refractory Migraine.

Did You Know?
Repeated activation of migraine pathways can make the brain’s pain circuits more reactive, a process known as central sensitization. As sensitivity builds, even mild triggers may be enough to provoke symptoms. Managing several small triggers together is often more effective than focusing on any single one.

Summary Table: Common Triggers by Migraine Subtype

Emerging and Secondary Triggers

Research continues to uncover additional factors that may influence migraine risk or sensitivity. Many of these emerging triggers act on the same underlying systems discussed earlier, including energy metabolism, inflammation, vascular function, and hormonal balance, though often in more indirect or newly recognized ways.

Gut–Brain Axis Disruption

The gut and brain communicate through nerve, immune, and hormonal channels. If gut bacteria or intestinal permeability become disrupted, inflammation and serotonin signaling can shift in ways that influence migraine activity.

• Microbiome imbalance – may alter neurotransmitter activity, serotonin balance, and immune signaling

• Intestinal permeability (“leaky gut”) – allows inflammatory molecules to reach the bloodstream and sensitize nerves

• Digestive discomfort – can coincide with heightened vagal activity, influencing migraine-related nerve pathways

See also: Are Migraine and IBS Linked.

Did You Know?
The gut and brain communicate through the vagus nerve, a major pathway that carries signals between the digestive system and the brain, and through chemical messengers such as serotonin. Because around 90% of the body’s serotonin is produced in the gut, changes in digestion or gut bacteria can affect the same pathways involved in migraine sensitivity.

Histamine Intolerance

The enzyme diamine oxidase (DAO) helps break down histamine from food. In some people, this enzyme functions less efficiently, leading to a build-up of histamine that may influence blood vessel tone and inflammation. This accumulation can influence blood vessel tone and contribute to inflammation in sensitive individuals.

• Aged or fermented foods – add to the body’s overall histamine load

• DAO deficiency – limits the body’s ability to break down histamine, allowing it to accumulate

• Environmental allergens or stress – can trigger histamine release and heighten vascular sensitivity

See also: Histamine and Migraines, What to Eat When you Have a Migraine.

Did You Know?
Histamine isn’t only found in food; it’s also released by immune cells in response to stress, hormones, or allergens. When DAO cannot clear histamine efficiently, the excess may influence blood vessel tone and pain pathways involved in migraine.

Endocrine Disruptors

Some everyday chemicals can mimic or interfere with the body’s hormone system, known as the endocrine system. These chemical disruptors may affect migraine activity in people who are sensitive to hormonal changes.

• Plastics (BPA, phthalates) – may weakly mimic estrogen and interfere with hormonal balance

• Personal-care or cleaning products – sometimes contain compounds that act on hormone receptors

• Everyday product contact – repeated use of plastic containers or scented products can increase exposure to hormone-disrupting chemicals

Did You Know?

Some synthetic compounds can bind to or block hormone receptors, disrupting normal endocrine signaling. These subtle shifts in estrogen or progesterone activity can influence vascular tone and neurotransmitter balance, contributing to hormone-related migraine sensitivity. Some of these compounds can also integrate into cell membranes, including those in mitochondria, where they may impair normal cellular function and energy balance.

Post-Infectious and Viral Reactivity

Migraine frequency may temporarily increase after a viral infection, likely due to short-term immune and metabolic changes. This trend has been observed following illnesses such as the flu and COVID-19.

• Post-viral inflammation – activates immune cells and raises proinflammatory molecules

• Immune fatigue – can slow neurological recovery and heighten stress or light sensitivity

• Prolonged immune activation – can sustain inflammation and oxidative stress, thereby extending migraine sensitivity

Related reading: Flu and Migraine.

Did You Know?
After a flu infection, lingering inflammation and oxidative stress can disrupt how immune and energy systems communicate. This temporary imbalance can coincide with periods of increased sensitivity during recovery.

Reducing Trigger Sensitivity

Managing migraine isn’t only about avoiding triggers but also about building resilience. Strengthening the brain’s ability to handle everyday changes can make attacks less likely and support faster recovery.

Hydration and Nutrition

Keeping on top of hydration helps to maintain steady blood flow and support healthy nerve function. When fluids or electrolytes fall out of balance or when meals are missed, the brain’s energy reserve can drop, leaving it more sensitive to triggers. Staying hydrated and eating balanced meals with protein, healthy fats, and complex carbohydrates helps sustain energy. At times when glucose levels fall, such as between meals, the body can draw on ketones for energy instead, helping to maintain steady, reliable fuel for the brain.

Consistent Sleep and Daily Routines

The brain functions best when daily rhythms stay consistent. Maintaining regular sleep schedules, steady eating habits, and manageable stress levels helps stabilize hormones such as cortisol and melatonin, both of which influence migraine sensitivity. Even small improvements in routine can support steadier energy and reduce day-to-day vulnerability.

Gentle Activity and Recovery

Moderate physical activity can help support circulation and ease stress, while overexertion or poor posture may have the opposite effect. Focus on low-impact movement such as walking, stretching, or yoga to encourage healthy blood flow without adding muscle tension. 

Resting between activities gives your system time to recover and helps prevent fatigue that can make you more prone to common migraine triggers.

Nutritional and Mitochondrial Support

Maintaining efficient mitochondrial function is key to steady brain energy production and may help reduce overall sensitivity to triggers. Nutrients such as magnesium, riboflavin, and CoQ10 are known to support these processes, alongside balanced hydration and electrolyte intake.

If you’re exploring ways to strengthen your brain’s resilience holistically, nutritional strategies may offer additional support. Brain Ritual® is a medical food developed by an Oxford-trained neuroscientist for the dietary management of migraine. It’s designed to simplify daily nutrition with science-backed ingredients that support brain energy, hydration, ketone body availability (natural fuel molecules the brain can use as an alternative to glucose metabolism), and overall metabolic balance.

You can learn more and purchase directly from the official page here.

Frequently Asked Questions

Are migraine triggers the same for everyone?
No. Each person’s migraine threshold is different, depending on genetics, hormones, and nervous system sensitivity.

Why do triggers change over time?
As hormones, stress levels, or metabolism shift, the brain’s response to triggers can change too. What affects you one year may have little impact the next.

Can you eliminate all triggers?
Not entirely. It’s more effective to focus on building resilience through steady routines, hydration, and nutritional support than to aim for complete avoidance.

Can dehydration or skipping meals cause migraine?
Yes. Both can lower brain energy and disrupt blood flow stability, making the brain more sensitive to triggers.

Final Thoughts

Migraine triggers rarely come down to a single factor, but instead interact through shared systems such as energy metabolism, hormonal regulation, inflammation, and circulation. Increasingly, research suggests that these different triggers converge on a common pathway: they raise oxidative stress, an imbalance between reactive molecules and antioxidant defences that can interfere with normal energy production. Studies also show that many people with migraine have reduced mitochondrial efficiency and energy reserves between attacks, which may help explain why even minor stressors can feel overwhelming. Recognizing this shared mechanism offers hope, since supporting mitochondrial function and reducing oxidative stress through nutrition and steady lifestyle habits may help raise your migraine threshold over time.

Strengthening those foundations is a gradual process, but small, consistent changes in your daily habits can make a real difference. Staying hydrated, eating regular meals, managing stress, and getting good sleep all help strengthen your resilience to everyday changes. Understanding how these factors interact can help you stay ahead of potential triggers and feel more in control of your migraine patterns.

If you’re looking for a simple, science-based way to support your brain and reduce migraine sensitivity, Brain Ritual® is a medical food designed for the dietary management of migraine. Its formulation supports brain energy, hydration, ketone availability, and overall balance to help you feel more in control.

_{Disclaimer: Brain Ritual® is a medical food for the dietary management of migraine and is not intended to diagnose, treat, cure, or prevent any disease. This content is for informational and educational purposes only and is not intended as medical advice.}

References

Scientific and clinical insights in this article are informed by current peer-reviewed literature, including:

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