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Exertional Migraines

I have had chronic migraines for the past 12 years. I am now 42 and before 30 years old did not suffer from any migraines. I now take Aimovig, which has reduced the amount of migraines per month extensively. The biggest trigger/issue I still have is exertion leading to migraines. Every time I work out too hard or long (connected to my heart rate I believe) I get "over-heated" and a migraine ensues. This of course makes staying in shape difficult. Exertion is the only trigger I have that is completely black and white....meaning exertion leads to migraine....every time. I'm curious if others have thoughts, stories or medications that might be working for them specifically for exertion migraines. Relief would bring so much benefit to my daily life and of course would be good for staying healthy too. Thank you all!

  1. ,
    Thank you for sharing your journey with us. You're not alone in experiencing this. Having said that, it must be very frustrating. I'm sure others will be along shortly to share their stories. In the meantime let me share this information with you I hope helps; https://migraine.com/search?s=exercise%20induced.
    Will you let me know what you think? Wishing you a low pain day, Nancy Harris Bonk, Patient Leader/Moderator Migraine.com Team

    1. Unfortunately I do not have a clean solution. I am still experimenting with Sumatriptan, Aimovig, Nurtec, etc. Just sharing - if I have the footings of a migraine lurking and I go on my run, it typically kicks in to a full migraine within an hour or two. Additionally, when I go to Colorado to ski, I pretty much have a migraine every day that I have to knock back with Sumatriptan. I assuming it is the change in blood flow during intense exercise that kicks it in as it does not happen if I go light in my run or bike. And I am also assuming, at least in my case, the change in altitude when I ski CO also kicks it in. I have not examined the physiology of that, but I'm sure there is an obvious reason. Changes in barometric pressure seem to also have causal links, but not especially apparent for me. My advice would be very, very systematically and very, very gradually increase your exercise regiment with the hope that your body will adjust over time.

      1. My trigger is working out too. I get migraines with aura. Especially when I do a lot of cardio (Soccer, Leg day, Crossfit). I do drink a lot of water but overheating is inevitable. My neurologist gave me Naxopren 500mg which works sometimes. She also made me change my diet (nothing that is processed, nothing that has preservatives. No soy sauce, no chocolate, no alcohol, no cheese, no peanut butter). It is very hard to avoid all those things! My general practitioner gave me Sumatripan. Both medications work to make my migraines tolerable. I am still trying to find the right combination of things I can do to avoid them altogether...
        Good luck!

        1. Have you tried any of the CGRP class of drugs yet? These may be worth a try for you- they have a high level of success for many (the percentage of that success varies, of course). But again, may be worth a try. One thing I've learned from a lifetime of migraine is that there is no major cure -but rather a combination of medications can work together to decrease the intensity/severity and frequency of my attacks. At any rate, I would encourage you to do some research on CGRPs, if you haven't already, to discuss this with your doctor: https://migraine.com/cgrp-new-direction-migraine-treatment.
          We're here for you to provide support and information anytime. Warmly- Holly -migraine.com team.

      2. Hi, I've suffered with migraines for 40 years and exercise is also a big trigger for me. My migraines are now under control and almost gone and have been for several years. The cause of mine, and I honestly believe for the majority of migraine sufferers is chronic dehydration, emphasis on chronic.. i.e. long term daily dehydration. I notice Augusto above mentions he drinks plenty of water but I suspect it isn't at the right times, i.e. he maybe drinks fluids just before or during exercise. To solve this issue you have to believe totally that dehydration is your issue ALL THE TIME and put in place a structured fluid intake plan. People talk about triggers, of which exercise is one, but I believe that triggers are not the cause they are just the final straw.. the underlying cause is CHRONIC dehydration i.e. you don't drink enough fluids at the right times through the day.. remain fully hydrated and the triggers don't work. Many, many triggers that people mention are actually things that make dehydration worse (exercise, hot weather, caffeine, starchy foods, long journeys especially air travel, hormone fluctuations in women .. women get more migraines than men.. coincidence?). Why do more migraines happen in the morning.. morning is the time when you are most dehydrated after 8 hours or more without a drink, you go for a run or a workout first thing after you wake up and bang, migraine. I suffered for years without making the connection until a change of circumstances at work resulted in me working in an extremely hot, humid environment.. my migraines went through the roof from once a month to almost daily which worried me no end as I couldn't work and I thought there was something seriously wrong. It resulted in a lot of soul searching and analysing of what was going on. This is a long post because I'm trying to convince people to change their long held beliefs about what is going on which is incredibly hard to do, people are not easily open to ideas that conflict with what they believe especially when what is being suggested is so simple.


        Anyway, here's the solution for anyone who wants to try... please give it a go.


        Monitor and manage your fluid intake (water preferably) all day, every day. Drink at times when you need to drink, even if your not thirsty. The quantities I suggest are for an average 170 pound man, you can adjust them if you are significantly smaller or larger than that but NOT THE TIMES you drink, you must stick to the plan.


        1. First thing in a morning drink a large glass of water BEFORE you do anything else, before your coffee or breakfast etc. It should be at least 0.5 litres (1 pint). You are dehydrated after sleeping.


        2. Drink a large glass with or after every meal. Eating dehydrates.


        3. Drink a large glass, at least, before you go to bed. This is perhaps the most important one of all. Eight hours sleeping dehydrates. You may need to get up in the night, in fact you SHOULD have to get up in the night if you are fully hydrated, grab another quick drink while your up.


        4. Drink a large glass BEFORE you drink alcohol and after if you drink a lot.


        5. Monitor your hydration levels through the day. This isn't difficult, look at the colour of your urine, it should be pale to clear and you should need to go every couple of hours.. 4 hours is too long between visits. If it's yellow you are dehydrated and need more fluids, it should never be dark yellow.

        This is all in addition to your normal drinks, coffee etc. If the weather is hot be even more careful with your hydration.


        It sounds too simple to be true but it works. Also it may be simple but it isn't easy to implement. You will get lazy and forget your drink first thing in a morning or late at night, you will lapse back into your old lack of drinking habits and you will get a migraine.. but if you do get one, have a think about your fluid intake that led up to it, I'll bet you lapsed.


        Good Luck.













        1. Thank you very much for all this information! I will try this method and get back with updates. You might be onto something. A recent blood test suggested I have dehydration, even though I carry a bottle of water with me all the time and I drink water during exercises, but not before, now that I am thinking about it. I will make sure to drink water in the morning before anything and before I start my workout. I really appreciate your time and it shows how much you want to help people like me, that suffer from these migraines. πŸ™πŸ»πŸ™πŸ» Thank you!!

        2. Ok, I am very happy to say that I tested your suggestions on two separate occasions and so far no migraines after Crossfit and Leg day! I only had to change that tall glass of water in the morning before coffee, because the rest of the day I keep myself Hydrated (I actually carry a bottle with me all the time). You were absolutely right in the sense that I will drink lots of water during exercises, but not before, and that is right after the 8 hours of sleep. So I exercised dehydrated and with all the sweating plus the Miami weather I put my body under terrible stress without realizing it. I will continue this practice and check back to thank you once more for this life-changing advice. I also performed better both days, now I don't know if was just for that glass of water, or the lack of fear of the episode, maybe both. Thank you again! πŸ™πŸ»πŸ™πŸ»πŸ™πŸ»

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