Exercise induced migraines: control for triggers
- Jun 22
- 3 min read
I am in a phase of life that means I get regular migraines. My biggest triggers are low blood sugar and exercise. I can’t stop exercising though as not only is it essential for my physical and mental health - according to research it also yields a significant reduction in migraine frequency, intensity, and duration. I’ve spent a few years trying to figure out how to get to an evening dance class without writing off the whole of the next day due to a migraine. I’m slowly figuring it out.
Because migraines are multifactorial there need to be a few elements in play to trigger an attack. When two or more factors are present it is thought that strenuous exercise will cause our CGRP levels to rise. CGRP is a neuropeptide that is released during migraine attacks, it transmits pain signals and causes vasodilation (or inflammation) in the brain
The most common contributing factors are - a dip or spike in hormones, tiredness, low blood sugar, thirst, electrolyte imbalance, neck tension, vestibular dysfunction, stress, and my favourite: barometric pressure. If the day feels heavy and like it’s going to rain, my head pounds in sympathy.
Also, there are two main types of exertion headaches - those that come from an increase in inter-cranial pressure and those that are caused by vasodilation. Does your exercise require straining and holding your breath? Does it leave you hot and sweaty? Do you do movements that strain your neck? Do you go upside down?
The questions you need to ask - are what are my exercise triggers (overheating for example) and what are my general triggers (low blood sugar).
If I go to a dance class hungry I can guarantee that I’ll get a migraine afterwards. I now have to make sure that I have a snack before and after class.
Though I love sweets, I don’t eat them often because they cause blood sugar levels to spike then dip. I try to eat small nutritious snacks throughout my day to maintain stable blood sugar. The best snacks combine fibre, protein, and healthy fats to slow digestion and prevent glucose spikes. Milk and Honey Nutrition is a website that has a bunch of diabetic friendly recipes that happen to be great for migraineurs too.
Because dehydration is also a migraine trigger, I pre-hydrate before exercise and replace minerals with an electrolyte drink afterwards if I get very sweaty and hot. Overheating is also a problem for me. I have a cooling damp scarf that I wear, I also have small gel ice packs, I have a bottle of ice water to drink after class too. Luckily lights and noise aren’t a trigger for me, but if you need to mitigate for these I’d consider wearing a cap or headphones to reduce their impact. If the barometric pressure is high I don’t go to a class. I don’t know how to control for this trigger yet. Heavy grey days suck.
Tiredness is a migraine trigger but I can still go to class tired and I seem to be OK as long as I’ve eaten enough beforehand. It usually makes me feel less tired and helps me sleep better. However, I will avoid high impact or jerky movements, inversions, bursts of high-intensity activity; or neck and shoulder loading positions. If I do a more intense class than anticipated and feel a little funny. I can’t explain it other than to say prodrome-y /pre migraine-y, then I take an anti inflammatory (with food). I also do a slow cool down, using a foam roller on my neck and shoulders, or I mobilise my head on a Pilates ball and I do gentle releasing movements while in a sphinx position. This video gives a few examples:
Supplements that I take (when I remember to) are
Coenzyme Q10 (CoQ₁₀) to reduce CGRP levels.
Magnesium to support my nervous system.
Feverfew and Riboflavin to help mitigate oxidative stress and neuropeptide overactivity.
And that’s my approach to avoiding exercise induced migraines. It does mean that I’m a size larger than I was. That could be middle age too. But a healthy bigger body is so much better than a slim one in pain. Health really is wealth. 💚
Oh and here's an infographic that I made for an assignment on this subject 👇🏽
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