Are you ready for ragweed season?
It's ragweed season here in North America. For many of us, all that itching, sneezing, and sniffling can mean an increase in migraine attack frequency and severity. Although there is no causal link between migraine and allergies, health care spending for migraine treatment does increase during allergy seasons. For many of us, seasonal allergies are just one more comorbid condition we need to treat.
The medical term is allergic rhinitis and is characterized by a runny or stuffy nose, itchy, watery eyes, sneezing, and increased sinus pressure in response to allergen exposure. It is diagnosed by reported symptoms plus either a skin prick test or a blood test for allergen antibodies. Migraine is 2-3 times more common in patients with seasonal allergies, but it's not always easy to diagnose. Many people mistakenly believe they are experiencing "sinus headaches" when 86-88% are actually experiencing migraine attacks. This belief is so common that even doctors will misdiagnose some patients. If you take a look at the ICHD headache classifications, there is no diagnosis of "sinus headache", only a reference to headache as one possible symptom of sinusitis (a sinus infection). In the absence of infection, "sinus headache" is relatively rare. More often, a "sinus headache" turns out to be migraine.
Seasonal allergies and migraine share some common symptoms. Both conditions can cause watering, itchy eyes, nasal congestion or a runny nose, plus pressure behind the eyes, nose, cheeks, and forehead. When symptoms overlap, diagnosis can be challenging. In response to allergen exposure, the immune system causes inflammation that releases chemicals that can also trigger migraine attacks. This inflammation may also irritate the trigeminal nerve endings. Allergic nasal congestion may also cause sleep disruptions that trigger migraine attacks.
Several studies have unsuccessfully tried to prove that daily treatment with nasal steroids like Singulair will reduce the frequency of migraine attacks. However, there some evidence that regular allergy shots may help reduce migraine frequency. Some antihistamines used to treat allergic rhinitis are also used to treat migraine. Two of the most common are Benadryl and Periactin.
I never considered the possibility of a connection between seasonal allergies and migraine even though I've had both since childhood. It wasn't until I started keeping a migraine diary that I noticed the connection. If I skipped my allergy treatments, the migraine attacks got worse and more frequent. I was getting so many attacks, I couldn't afford to avoid one small pill and a quick nasal spray. Those simple and affordable treatments protected me from unwanted attacks. Many years later, a neurologist confirmed my suspicions by encouraging me to keep treating my allergies.
If you suspect you might have undiagnosed, untreated seasonal allergies, talk to your doctor. Diagnosis and effective treatment just might mean fewer migraine attacks.
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