Migraine affects more than 10 percent of people throughout the world, and about 12 percent of people in the United States. It strikes three times as many women as men. Migraine is wildly under-diagnosed, however, because exactly what it is and how it works is not clear. That means that public health experts estimate that more than half of all people with migraine have never received a diagnosis. It also means there is no reliable treatment for migraine headaches. It is also difficult to research treatments because people who experience migraines show no symptoms between times.
That’s why prevention is best. As best as can be understood, migraines appear to be linked to a neurotransmitter—a chemical used by the brain for various functions—called dopamine. The exact nature of the link is not clear, but dopamine in migraines may be activated by triggers which vary from person to person. Among the most common migraine triggers are onions, alcohol, secondhand smoke, and MSG. Some chemical compounds are also common triggers, such as the nitrates used in curing meat or tyramine, which naturally forms in aged foods such as wine or certain cheeses. Stress is another frequent cause of migraines, not necessarily directly, but in the period after the stress has passed hen the body is recovering from its heightened state. That means a migraine sufferer’s best option may be to learn and avoid their specific triggers, though this can require painful trial and error
However, it may not always be possible to avoid triggers. In these cases, there are some treatments that may help alleviate symptoms. While caffeine is a trigger for some patients, in others it can improve matters. Some prescription medications also have benefits. Beta blockers, the antidepressant amitriptylene, and anti-seizure medications seem to prevent migraines from occurring. More unusual approaches have also been tried. One of these is transcranial magnetic stimulation, in which powerful magnets are moved over the skull. Although it’s not clear what effect this has, it has been shown to work for many patients. Another treatment option that helps with migraines is medical marijuana, though again, that can be a trigger for some patients.