Migraine is thought to have a genetic cause, and there are also factors that can trigger a migraine, which vary from person to person. A jump from about two migraines a year to three in the months since summer is a reason to check what changed for you over those months against those factors, beginning with how you now eat and drink.
Can eating once a day and drinking almost nothing set off a migraine?
Skipped meals can trigger a migraine, so eating once a day can set one off, and on a second list of triggers low blood sugar or skipped meals appears as a single entry. Drinking almost nothing can lead to a headache by a different route: you can become dehydrated by not drinking enough water or fluids, even if you lose no extra fluid. Signs of mild to moderate dehydration include:
- thirst
- a dry or sticky mouth
- not urinating much
- darker yellow urine
- dry, cool skin
- headache
- muscle cramps
Severe dehydration is a life-threatening emergency, so if you are not urinating at all or your urine is very dark yellow or amber, or you feel dizzy, lightheaded or confused, go straight to an emergency room or dial 911. If you think you may become dehydrated, call your doctor's office before it happens. To prevent dehydration, drink plenty of fluids every day, even when you are well, and more when the weather is hot or you are exercising.
Factors that can trigger a migraine include:
- stress
- anxiety
- hormonal changes in women
- bright or flashing lights
- loud noises
- strong smells
- medicines
- too much or not enough sleep
- sudden changes in weather or environment
- overexertion, meaning too much physical activity
- tobacco
- caffeine or caffeine withdrawal
- skipped meals
- medication overuse, meaning taking medicine for migraines too often
Coffee drunk in place of a meal puts two of these into the same day, a skipped meal and caffeine, and caffeine withdrawal can trigger a migraine as well (see How much caffeine is in a day of coffee instead of meals?). If your sleep or your stress changed over the same months, set them beside the eating too.
Hormone changes that happen with the menstrual cycle or pregnancy seem to be one important trigger for migraine, and using birth control can change how often migraine episodes happen and how severe they are. If you started, stopped or switched birth control in these months, or could be pregnant, tell your doctor when you describe the headaches.
For some people, changes to everyday habits can reduce or prevent migraine episodes. They include eating regular meals and drinking enough water, alongside exercising, avoiding food and drink that trigger episodes, stopping certain medicines with your doctor's agreement, and going to bed and waking up at the same time every day. That holds for some people, not everyone, so try regular meals and more water without counting on a return to two a year.
Losing weight, if you have obesity, may also be helpful in preventing migraines. If eating once a day is part of a weight plan someone set for you, ask that person whether the plan can include regular meals instead.
A headache diary can help you identify your headache triggers, and one of its entries is what you ate and drank over the past 24 hours, written down when the headache starts.
Does a doctor do anything with three migraines when it used to be two a year?
People who have migraine episodes once a week or more are usually prescribed treatment to prevent them, and the same is true for people whose severe migraine episodes happen less often. Three in the months since summer is well under once a week, and far from chronic migraine, which means headaches from migraine on at least 15 days of the month for more than three months, so describe how severe each one was as carefully as how many there were.
If you have frequent or severe migraines, you may need to take medicines to prevent further attacks, so book an appointment with your doctor to talk about which drug would be right for you. To make a diagnosis, a doctor takes a medical history, asks about your symptoms and does a physical and neurological exam. A doctor may also ask about your headaches: when they start, how long they last, what they feel like, what triggers them, and whether other symptoms such as nausea or vision changes come with them.
Because ruling out other medical conditions is an important part of diagnosing migraines, you may also have blood tests, an MRI or CT scan, or other tests. A scan isn't usually used to diagnose migraine itself, and a doctor might order one if they suspect another condition that causes headaches.
Can pain medicine taken often bring more headaches?
Pain medicine taken often enough can itself keep headaches coming back. Rebound headaches are headaches that keep coming back, and they often come from overuse of pain medicines taken for other headaches, such as migraine or tension headaches, which is why they are also called medicine overuse headaches. People who take pain medicine more than 3 days a week on a regular basis can develop them, and taking medicine for migraines too often can also trigger a migraine.
Talk to your doctor once you are taking pain medicines 3 or more days a week, which is before you reach the regular use on more than 3 days a week that can bring rebound headaches. After each headache, write down any medicines you took, prescription and over-the-counter alike, so the days a week are something you can count.
During an episode, three steps involve no medicine at all: resting with your eyes closed in a quiet, darkened room, placing a cool cloth or ice pack on your forehead, and drinking fluids. Drink lots of fluid, especially if the migraine episode includes vomiting.
Which headaches should not wait for a diary and a routine appointment?
A headache that comes on suddenly and is explosive or violent needs medical attention right away: dial 911, or get to the nearest emergency room, because it may be due to a ruptured blood vessel in the brain. Some headaches may be a sign of a more serious illness, so for any sign below, seek medical help right away, and if you think it is a medical emergency, phone 911 or head to the nearest emergency room instead of waiting for your doctor's office:
- this is the first headache you have ever had in your life, and it interferes with your daily activities
- the headache comes on suddenly and is explosive or violent, the one that needs 911
- the headache is "the worst ever," even if you regularly get headaches
- you also have slurred speech, a change in vision, problems moving your arms or legs, loss of balance, confusion, or memory loss with the headache, which can be signs of a stroke, so call 911 right away
- the headache gets worse over 24 hours
- you also have a fever, a stiff neck, nausea and vomiting, all with the headache
- the headache occurs with a head injury
- the headache is severe and just in one eye, with redness in that eye
- you just started getting headaches, especially if you are older than 50
- your headaches come with vision problems, pain while chewing, or weight loss
- you have a history of cancer and develop a new headache
- your immune system is weakened by disease, such as HIV infection, or by medicines, such as chemotherapy medicines and steroids
If you have been losing weight by eating once a day, tell your doctor about the weight loss, because nothing on that list says whether weight lost on purpose counts toward the sign about vision problems, pain while chewing or weight loss.
For headaches with none of these signs, if you keep a headache diary, go over it with your doctor at an appointment, because reviewing it together can help identify triggers or a pattern and shape a treatment plan.
If NicoCares connected you with a physician for weight care, write to your care team through Spruce about the headaches and the once-a-day eating. NicoCares gives no time by which a message is answered, so for a headache with any sign on that list, follow the list first and write afterwards.
