Are you ready for ragweed season?

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.

Incidence

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.

Correlation

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.

Treatment

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.

Personal experience

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.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
View References
  1. Martin, MD, V. (2011). Allergy, Rhinitis, and Migraine Headache, American Headache Society. Retrieved September 30, 2015, from http://www.achenet.org/resources/allergy_rhinitis_and_migraine_headache/
  2. National Headache Foundation, Allergies and Headaches. (2007, October 25). Retrieved September 30, 2015, from http://www.headaches.org/2007/10/25/allergies-and-headaches/
  3. Robbins, S. (2015, September 22). Seasonal Allergies and Headache - Robbins Headache Clinic. Retrieved September 30, 2015, from http://chicagoheadacheclinic.com/seasonal-allergies-and-headache/

Comments

View Comments (2)
  • JerseyGirlMel
    3 years ago

    Correction: Singulair is not a steroid. It is a leukotriene inhibitor.

  • tammay
    3 years ago

    This is a very timely article, so thank you for writing it. This year, I’m experiencing seasonal allergies for the first time in my life. I had a lot of sinus pressure and stuffiness (including the areas you mention above and also some gum soreness, though not tooth pain) since Saturday and even though it wasn’t super painful, it was uncomfortable and persistent enough for me to go to a doctor for the first time in 3 years. He diagnosed me right away with allergies.

    Ironically, I haven’t had any real migraines or headaches but that’s probably because I’ve been taking Advil regularly every day (which does make the sinus pain go away though temporarily). The doctor gave me a prescription for both nasal spray and antibiotics, though he said that I probably wouldn’t need the antibiotics unless I started to feel really bad (like fever, etc). The nasal spray helped for the first few days but now it doesn’t really help much but the Advil does, but it’s all only temporary. So I’m going to consult with my mom (who was a nurse for 25 years) about taking the antibiotics to see if I can kick these allergies.

    Tam

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