Migraine: Prevention

To prevent migraine, attention must be paid to reducing individual risk factors.

Behavioral risk factors

• Diet
  • Fat – A low fat intake has a positive effect on the number as well as the severity of migraine attacks compared to a diet with moderate fat content.
  • Cheese, especially its component tyramine.
  • Chocolate, especially its component phenylethylamine
  • High consumption of table salt in combination with consumption of processed meats may trigger migraine. However, the mechanism of action is not yet known.
  • Hunger
  • Food abstinence
  • Micronutrient deficiency (vital substances) – see Prevention with micronutrients.
• Consumption of stimulants
  • Alcohol, especially red wine (especially the components tyramine and sulfites).
  • Coffee – seizure risk increases from the third cup of coffee.
  • Tobacco (smoking)
  • Daily chewing gum consumption (1-6 /die)
• Psycho-social situation
  • Anxiety
  • Stress
  • Relief after stressful situations
  • Sudden relaxation (Sunday migraine)
• Change in sleep habits (or change in sleep-wake rhythm) and sleep deprivation.
• Overweight (BMI ≥ 25; obesity) – risk factor for the development of chronic migraine: there is an almost linear relationship between body weight and the severity of chronic migraine: overweight people are not affected by migraine more often than slim people, but with increasing BMI (body mass index) attacks become more severe and occur more frequently. In normal-weight individuals (BMI 18.5 to 24.9), 4% reported 10 to 15 headache days per month; in obese individuals (BMI 30 to 35), the rate was 14%, and in those with a BMI over 35, the rate was 20%.

Disease-related risk factors

• Hypoglycemia (low blood sugar)

Medication

• Taking hormonal drugs in women for contraception or menopause (menopause).
• Fenfluramine (appetite suppressant).
• Reserpine (antisympathicotonic) – drug that inhibits the synthesis or release of norepinephrine; they are used in the treatment of hypertension (high blood pressure); but have relatively many side effects, which is why they are not drugs of first choice.
• Other medications: for more information, see “Drug side effects” under “Headache due to medication”.

Environmental pollution – intoxications (poisoning).

• Flickering light
• Noise
• Stay at high altitude
• Weather influences, especially cold; also foehn
• Smoke

Prevention factors

• Genetic factors:
  • Genetic risk reduction depending on gene polymorphisms:
    • Genes/SNPs (single nucleotide polymorphism):
      • Genes: LRP1, TRPM8
      • SNP: rs11172113 in the gene LRP1
        • Allele constellation: CT (0.9-fold).
        • Allele constellation: CC (0.8-fold)
      • SNP: rs10166942 in the TRPM8 gene.
        • Allele constellation: CT (0.85-fold).
        • Allele constellation: CC (0.7-fold)