Migraine Triggers: Alcohol

I have gotten pretty good at controlling my exposure to triggers that I don’t like much anyway. Chewing gum too much can aggravate my TMJ dysfunction, which in turn can trigger a migraine—luckily I don’t much like chomping on bubblegum, so this isn’t a problem for me.

(The sugar substitute that almost every single gum brand now uses is rarely a problem in this context, too—I dislike chewing gum so am never tempted to chew a stick of minty freshness that will trigger a migraine because of the artificial sweetener.)

What isn’t as easy to control are the triggers that happen to be things I enjoy. I love staying up late on the weekends, but I know that switching up my sleep schedule too dramatically can mess with my head. I can usually refrain from altering my sleep patterns, but sometimes it’s tempting to stay out super-late at a concert. Sitting on the beach is so enjoyable to me in short bursts, but I am having such a pleasant time that I neglect to wear a big, floppy hat and sunglasses sometimes, not realizing (or not admitting?) that that sun I love so much is glaring across the beach and the water, probably triggering a migraine.

Probably highest on the list of triggers I don’t want to acknowledge is alcohol consumption. Many of this blog’s readers responded in droves to my post about saying goodbye to beer, so I’m sure just as many of you will know what it’s like to not be able to drink more than a few sips of any sort of alcohol if you go out on the town.

For a long time, alcohol didn’t seem to be a trigger for me. While I was never in my wildest dreams a big drinker, I used to be able to get tipsy with the rest of them. In graduate school, I could go out a few nights a week (consuming alcohol about half to a third of those going-out nights) and wake up the next day feeling fine and ready for class.

Things seemed to change as I approached 30. I’m now 31 and have to play it really, really safe, being careful to limit myself if I can’t resist the urge to imbibe. Even writing “can’t resist” suggests that I am some sort of out-of-control alcoholic, which is far from the case. I’d say 2-3 times a month I am out at a concert or at a party and think of how refreshing a cool beverage could be. Usually I resist.

But sometimes I don’t.

And here’s the tricky thing about the alcohol trigger—well, about most migraine triggers, really—sometimes they result in a vicious migraine attack, and sometimes they don’t. The week after my period I might be able to split a bottle of white wine with a friend and wake up ready and rollin’ to go at 8 AM. Other times (say, during my period itself) I can have half a glass of that same wine and wake up at 11 AM with a pounding, unrelenting migraine. Blame it on the alcohol (and probably the late night that went along with it!).

How do you know when to take the risk and when not to? Is it ever worth it? What have you discovered about the relationship between your migraine disease and alcohol consumption? Are any types of alcohol better tolerated than others?

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