The Riskiness of Stacking Triggers

Until I went to an incredible complementary care doctor a few years ago, I never gave much thought to the idea of stacking triggers—in fact, I’d never heard the term. Either it’s become more common in the last year or two or I was tuned out to it beforehand.

I loved the way my doctor described it. Using hand gestures, he indicated to me how full he wanted my reservoir to be. By exercising regularly, eating healthily, taking vitamins, keeping stress as low as possible (and/or responding rather than reacting to it), and taking care of my mental health, I would fill my personal reservoir to the brim. With a full reservoir, one might be able to encounter a tried-and-true trigger—say, sugar substitute or fluorescent lighting for hours—without actually having a migraine attack set in. That trigger just took a little bit out of your reservoir but did not deplete it to the migraine threshold.

But combine or stack lots of triggers at once and the migraine will be less easy to evade. Skipping meals and not sleeping well during the week depletes your health reservoir to the point that even one mild trigger of yours—say, having aged meats or cheeses, or drinking just one glass of wine—can spin you into migraine hell. Often it’s not any one trigger that has spurred a particular migraine, it’s a so-called perfect storm, a stack of triggers combined together.

So this is why it’s important for us to take it easy. Women are especially encouraged to avoid stacking triggers during certain times of the month. If you are susceptible to menstrual-related migraine, it’s especially important that prior to, during, and shortly after your period you take it easy and limit your exposure to your personal triggers as best you can.

Have you ever noticed this phenomenon? If so, do you have a term for it? Have you had a certain food or situation trigger a migraine one month but be fine the next?

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.

Comments

View Comments (32)
  • Carolyn
    2 years ago

    I’ve just come to notice ”tis is true for me. My goal now is stacking anti-triggers. It’s working for me. I just keep piling up things that prevent and I finally feel like I might be winning. Check out my article on here called Stacking the Deck in Your Favour.

  • Jeff
    4 years ago

    I had to explain my migraines on a medical questionnaire recently and said many of the same things I read in this article. It’s great that the medical community is taking an interest in migraines and their causes. There are times that I can eat something that can be a trigger for me and it won’t cause any problems. I’m not sure that’s a good thing because it means I don’t always avoid my triggers like I probably should. Still, there are some triggers that can’t be avoided. I would bet that I never get a migraine with just one trigger but that’s hard to prove since the triggers are not always easy to identify. Stress does seem to be one of the blocks that can bring the whole thing crashing down fast. Others are intense sunlight, physical exertion (oddly, a workout or run at the gym almost never brings a migraine–though it may intensify one that is already started), missing the noon meal, a road trip (sunlight?), a let up in stress… I’ve had migraines since i was 6. Only now am I starting to get smart about them–not saying I didn’t try before. The earlier I catch one coming on the better chance I have of thwarting it before it spins up to the knife-in-the-eye pain and at that point almost nothing can control it. I tried so hard to deny that my migraines were altering my life. The fact that any one trigger didn’t bring on an episode encouraged me in my denial.

  • Sandy
    4 years ago

    Thank you. Apparently my resivior or blocks stay high daily with 2 triggers light and sound. 3 times during my monthly cycle it tips it over the edge.

  • diannawatkins
    6 years ago

    A few years ago the medical department at the company I work for denied my MDs application for Family Leave and made me see a neurologist of their choosing . Luckily for me he was an amazing Doctor and a specialist in migraine disease . I had always known there were certain events that often preceded my attacks , for instance I almost always got the the day before of day of my menstrual cycle but also when storms moved through the areas ( Dallas ) I often get sick too . Add to this I work for an airline with 24/7 365 operations so when a weather session moves in it means 12 to 16 days of working all-out with hardly any food breaks and interrupted sleep patterns . THis Dr helped me piece it all together with the stacking theory although he used the words threshold , stay above the threshold . So if it;s a beautiful day in the middle of my cycle , a glass of wine on the patio might be ok . But if it’s been a long stormy night at work and I;m almost due to start and I haven’t eaten all day , it would be a very bad idea .Also , I have noticed that a day before almost every migraine , my neck becomes very stiff and will even pop out of place , and I never know if the tight muscles cause the migraine or if they are the result of changes that occur because of the migraine .

  • Nancy Harris Bonk moderator
    6 years ago

    Hi Holly,

    Thanks for sharing Holly. Have you kept a migraine journal? This is a great way to identify and manage our triggers, which is a important part of a migraine management plan. There are lots of apps for smart phones, and laptops, or even the “old school” pen and paper way. The Migraine Meter is one you might want to take a look at here; http://migraine.com/migraine-meter/.

  • Holly
    6 years ago

    I knew that ‘stacking’ could happen, but didn’t know how to keep it from happening till now. But I can’t afford to see a specialist so I’ve had to deal with my migraines on my own with what info abt them that I can find on the internet. The first ‘stacking’ I remember having was when I was abt 20 years old and in a days’ time I had somewhere between 14 and 16 deja vues that each caused a migraine. It was the most horrible migraine experience I’ve had in my life. I’ve been afraid of deja vues since, but only a couple have triggered a migraine. Still, I am wary of situations I find familiar and try to focus on something else. I know most of my triggers other than that and can either avoid them or prepare for them. Now I know how to better prepare by ‘filling my reservoir’. Thanks for your story. 🙂

  • Janene Zielinski
    7 years ago

    For me it’s not only “not stacking triggers”, it’s keeping “white space” on the calendar if at all possible. I never schedule back-to-back meetings anymore or any socializing after work, I “single task” at work and home. I’m in “slow motion” most of the time. If I try to speed up at all – the train derails… if you know what I mean. I guess it’s just another way of saying the same thing. It’s very frustrating when your level of tolerance is so low you feel like you are an old lady before your time. In fact, I don’t feel like I’ve ever been able to be young and free. The regimentation of my life to avoid triggers has me trapped. One half step over the line and I’m down for the count.

  • Beverly J Militello
    7 years ago

    This is the first time I’ve heard of the “Stacking theory” and building your Own reservoir. My internal medicine MD is very good of taking care of me and keeps current with all the new treatments. Unfortunately my migraines are chronic and I’m allergic to almost all of the medications for migraines. I know some of my triggers but unfortunately those have changed also. How do you “rate” your triggers? I know one of my biggest triggers is weather change, another is strong smells. I can’t tolerate any perfume specially floral based. Also I can’t tolerate taking vitamins everyday. So I already have a lot stacked up against me. I would love any help or advice any of you can give me. I’ve been doing this by myself for over 20 years except for my present MD. Beverly J Militello.

  • Melissa White Land
    7 years ago

    Wow is this article interesting! I haven’t thought about stacking triggers til I read this articles and there are so many more of my migraines that make sense! Thank you for another well written article full of great info.

  • Karen Klein Crow
    7 years ago

    I have not heard this term before, but am very familiar with the concept of multiple triggers being piled on at the same time, creating a migraine that is almost impossible to treat. These are some of the nastiest migraines that I have dealt with. Thanks for the reminders of things that we can do to be proactive during the time(s) that we are either pain free, or are low on the pain scale to help work with days that we are unable to avoid our triggers.

  • Suzanne Johnson
    7 years ago

    Very interesting. Now I know why several of my triggers cause a migraine and sometimes not. I also have a hard time accepting a migraine attack when I don’t know/can’t figure out the trigger. For some odd reason knowing the trigger helps lessen my stress. So I find this trigger stacking to actually be a relieving. Whatever works, right!

  • Christi Nielsen
    7 years ago

    I have been getting them since I was 18, and they are getting worse as I get older. I thought they would decrease with age? I have taken so many Imitrex pills. I never really know if it is stress, allergies, some food I have eaten. My doctor suggested anti-seizure medicine? I am so tired of migraines and wonder if the botox shots help?

  • Vicki Thompson
    7 years ago

    Wow, this is fascinating! Isn’t it great when you have thoughts in the back of your mind, and other people have the same basic thinking! Most of the time, at the very least, I have ‘head pressure’, and I know I’m more susceptible to getting to the next step if I’m not careful. Trouble is, a lot of things are out of our control.

  • Mark Westley
    7 years ago

    been here done this rode that storm not good.

  • Laurie Guerrettaz
    7 years ago

    Yes. This is what I always tell people. Many people try to tell me that the main trigger is stress. I know it’s a variety of factors and sometimes I get migraines when stress is very low. TMJ, allergies, weather patterns, and stress are 4 factors that clearly can trigger a terrible migraine.

  • Beverly J Militello
    7 years ago

    I can’t get my family to believe me that it’s not just stress that causes it. That laugh at me when I tell them the weather is changing. So I completely understand where you’re coming from Laurie.

  • Ellen Schnakenberg
    7 years ago

    When my son (now 26) was a baby, his allergies were life threatening. Our doctor called his susceptibility to multiple allergens “The Block Theory”. He also began having Migraines before he could walk. The stacking analogy was again used and called “The Block Theory”. So, we called it the block theory for all those years. Early on in my blogging this is also what I called it.

    The way it was described to us was that these triggers or allergens (depending on if you’re talking Migraine or allergy) were like building blocks. We all know you can only pile *so many* blocks on top of each other before the tower comes tumbling down. In this case, One trigger may be worth 1 block, where another trigger may be worth 3 or 4. Knowing how many blocks your triggers represent is important. Because I have so many Migraine triggers, some that are impossible to stay away from (weather, light, etc) I have to remember how many blocks each of those triggers is worth. I can then calculate from day to day how many blocks I have left before my tower falls down.

    Your reservoir theory is also really good. If I’ve had a bad week, the number of blocks my tower can hold will be lessened. If it’s been a good week, the tower might go a little higher.

    This is an especially good VISUAL way to teach kids – even small ones – about their triggers. It is also very good to use when describing triggers to adults who don’t have Migraine themselves. Everybody has stacked blocks and everybody has seen what happens when you get too many on your pile… they come crashing down.

  • Val Inman
    7 years ago

    I spoke too soon about Ernie not having any cluster headaches in 3 yrs. they started up again a couple days ago. We just went to Walmart to pick up some Melatonin because he hear from to take it as a preventative measure just in case he wakes up at 2:00am again with a headache or the beginning of one. I do hope it works for him because I can only imagine the pain he feels comparted to how my migraines feel. 🙁

  • Daria Dan
    7 years ago

    Hope you’re feeling better.
    I wish I knew a doctor capable of understanding such complex things. I think I ‘m doing all right.. Smt. I think it’s my body regaining life force. When there’s too much stress and I don’t stop in time. It does for me.

  • Ellen Schnakenberg
    7 years ago

    Daria Dan I don’t know, but if you’re concerned about it, can you talk to your doctor??

  • Daria Dan
    7 years ago

    I must read this. every month i either have a migraine and end up throwing up or a an allergy of a very weird origin — it starts with my throat getting swollen so it feels like a cold. and when it ends it ends abruptly unlike a cold. and because i take Thiamazole every day I’m a bit concerned. The leaflet says you have to be careful whenever your throat gets sore. But my throat has always been my weak spot so I don’t know if I should worry.

  • Ellen Schnakenberg
    7 years ago

    My guess is that the majority of Migraine patients also suffer other headache disorders as well. The most common is Tension Type Headache. There are over 100 different headache disorders

  • Ellen Schnakenberg
    7 years ago

    Val Inman I have several diagnoses. Chronic Cluster is another of them. I haven’t had any in a long time, though the obnoxious 02 tank still clutters up my kitchen and bedroom, lol.

  • Val Inman
    7 years ago

    I thought you had cluster headaches like Ernie?

  • Luke Polson
    7 years ago

    Very educational. I hadn’t heard of this before, thanks for sharing!

  • Laura
    7 years ago

    Yes – I have tried several preventatives including Topomax, but nothing has worked so far. Thanks for the reply though. Good to know I’m bot alone.

  • Vicki
    7 years ago

    Laura, you are not alone! I’m pretty much the same way. My headaches take almost everything out of me. I’ve wondered how much life I’ve lost because of them. Have you tried a preventative, like Topamax? If I didn’t have it, I would be in much worse shape. For some folks, it knocks out MOST of theirs! Good luck!

  • Laura
    7 years ago

    “By exercising regularly, eating healthily, taking vitamins, keeping stress as low as possible (and/or responding rather than reacting to it), and taking care of my mental health, I would fill my personal reservoir to the brim. ”

    I have chronic daily headache in addition to migraine. I come home from work every day exhausted. Weekends all I do is sleep or try to keep my social connections up (which suffer greatly because of migs & cdh). I don’t have time to do the things I know I should do like exercise, meal planning, and grocery shopping, much less clean the house or do laundry. My life is just about waking up, finding something to wear, dragging myself into the office and coming home, feeding my cats and finding something for me to eat – then collapsing. Other than my cats I live alone – which is good & bad. Good because I don’t have to take care of anyone else, but bad because there is no one to take care of me. Any advice from other folks with CDH about how to get ahead of the curve to “fill my persona reservoir”?

  • Aaron Day
    7 years ago

    I think “perfect storm” sums it up, skipped meals, lack of sleep, odors, heat, weather fronts, stress increase/decrease, lack of caffeine, etc can get stacked up and cause all kinds of hell.

  • Larry Sanders
    7 years ago

    Stacking triggers causes you to believe that the last trigger caused your migraine when in fact one of the triggers in your stack could have had more of an affect than just the last one. Makes identifying your triggers hard.

  • Diana Lee
    7 years ago

    I’m a KU grad, too, Larry. School of Law class of 03!

  • Brenna B Mitchell
    7 years ago

    triggers were stacked up…pretty much, all of mine. still learning the hard way.

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