What is Causing This Migraine Attack?

By Tonya Henry

3 min read

Just like many people out there, I have migraine disease. I know that I have this, but it can be difficult, at times, to figure out why that particular migraine started. Trying to figure it out is frustrating, but with some work, it can be done. Well, most of the time, we can eliminate possibilities and find the source. The reasoning is that if I can figure out why I have it, then it may make treating it much easier.

Is it hypoglycemia?

I deal with hypoglycemia regularly. I am not a diabetic, but like myself, many with absorption issues have this problem. One of the first things I do when I start feeling lightheaded, nauseated, or have gotten the inklings of a migraine is check my blood sugar. If it is low, I know that hypoglycemia is causing the symptoms. I start getting symptoms when my blood sugar is 72 or below. If I drop below 60, the symptoms are worse, though. I must get that under control soon. I have to suck on something like a lifesaver hard candy or a piece of peppermint. I cannot tolerate drinking anything or even eating sugar to bring it up. If I do not bring it up, not only will the hypoglycemia cause an ER visit, but I will also be sick with a full migraine headache and accompanying symptoms for days.

Is it hypotension?

My next step, if my blood sugar is ok, would be to check my blood pressure. Having multiple conditions is hard. I have to weed out what could be causing the current issue. My blood pressure stays around 97/58. At times though, it may drop to the 80s/40s. These are the times when I will start getting the pounding in my head, which is the start of a migraine from the low blood pressure. I will also have vertigo, nausea, and possible syncope (fainting). I definitely do not like the last symptom. I thought my migraines were bad already, but fainting brings on a different type of pounding all over my head, face, and whatever else I hit. I have to treat it soon, so I will not get all the other symptoms. Resting with my legs elevated, taking Midodrine if I have not already, and fluids are my go-to to treat my low blood pressure.

Is it dehydration?

Chronic dehydration is another one of my issues that can cause my migraines to act up. It is hard to stay hydrated when you cannot drink liquids, like most people. Liquids are usually harder than food for me. Water is the worst. I get extremely nauseous from the liquids sloshing around in my stomach. Having gastroparesis makes food/drinks difficult to have. I do have IV fluids to help with this. Dehydration can be a common trigger for those with migraines. Oftentimes, I find myself dehydrated even though I get TPN (IV nutrition) daily plus IV fluids, as needed. The heat or sickness makes matters even worse, so I do extra IV normal saline.

Can I always figure out my migraine trigger?

Each of the conditions mentioned above can cause me to have a migraine. I do not always get to the root cause while I am going through it. For someone with chronic illness, the symptoms can often mimic each other, further complicating things. If I know what is causing the issue, though, I can act to treat the symptoms caused by it. The hope is that if I treat the main issue, I can also stop the secondary problem. Having a complex health history may be hard, but it will not defeat me!!

If you also struggle with the conditions I mentioned, check out this article on common devices to monitor your health at home.

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.

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Psittacus Member
Hi there I feel you, trying to work out what is the cause of a migraine can be a confusing struggle. Do you have any information you could provide on why hypoglycemia can happen when you are not a diabetic? You mentioned absorption issues? Hypoglycemia often brings on a migraine for me. Any links to more info would be greatly appreciated, as this is something I deal with as well, and I have never understood it and multiple doctors have not been able to help with the issue. Thx! PJ
1. wirr Member
 <inline-mention username="Psittacus" user-id="4581642"/> As I've already written elsewhere in this thread, there seems to be internal bodily activity that triggers migraine attacks. Very interesting, because I've never read anything like that, nor have I met anyone. And I now have several 1000 hours of research behind me. Is that the only connection you found or is there more?
2. Tonya Henry Moderator & Contributor
 <inline-mention username="Psittacus" user-id="4581642"/> hello there! Here is an article that may help you about non-diabetic hypoglycemia. <a href='https://www.endocrine.org/patient-engagement/endocrine-library/hypoglycemia' target='_blank' rel='noopener noreferrer ugc'>https://www.endocrine.org/patient-engagement/endocrine-library/hypoglycemia</a>. You may also want to check out our sister community, <a href='https://type2diabetes.com' target='_blank' rel='noopener noreferrer ugc'>type2diabetes.com</a> for more articles on hypoglycemia. I was surprised to see that medications with aspirin in it or liver issues, can affect blood sugars. I have a stomach condition in which my stomach does not work properly. I have found that many with Gastroparesis, have hypoglycemia without diabetes. We commonly have issues where our bodies do not absorb nutrients (food) or medication normally. This is why I used to have a jejunal feeding tube and now am on iv nutrition. If you have not researched, with doctors, into stomach/absorption issues, I would check there. I hope that you find the cause for yourself soon. Hang in there. (Tonya, <a href='https://migraine.com' target='_blank'>migraine.com</a> contributor).
MyHeadfirst Member
I suffer from 24/7 Tinnitus! Anyone have information on having chronic migraines due to the Tinnitus ?
1. wirr Member
 <inline-mention username="Tonya H" user-id="4506979"/> Ah, now I understand you. I guess I translated my birthday extremely badly, sorry! Thinking is always a thing in an attack. I woke up this morning and it clicked. Silly me -.-
2. Tonya Henry Moderator & Contributor
 <inline-mention username="wirr" user-id="3682405"/> good evening. I'm sorry I misunderstood you earlier. I do not like waking up with migraine symptoms. I hope as the day has gone on, your symptoms have subsided. Sunglasses are good for any day when you have a migraine. I hope it's not too cold. Hang in there and hopefully, you'll get some rest. (Tonya).
wirr Member
Hello Tonya, this topic is very interesting for me because I have not yet met anyone whose triggers are related to a physical trigger, so to speak. I don't have mundane triggers like other migraineurs, such as light, smell, food and so on. A unique selling point for me is that I get acne in a limited area of my face with every attack. Haven't met or read about anyone who has anything similar. The attacks come punctually, like the German railways once did, and intervals only change over many months. I'm now assuming a hormonal or some other internal trigger that I can't influence in any way. Since I'm male, this can't have anything to do with the female cycle or menopause. Although, as I have read, men also suffer from a different kind of menopause. However, I've had this form of migraine for more than 30 years, so that factor can be ruled out. In 2015, I suffered multiple persistent migraine auras that lasted 6 years. At some point I realized that I was on the verge of hypertension that almost needed treatment and my resting heart rate was 85-95. I checked these daily. After five years both problems disappeared within a day, nay, within a moment! While this doesn't quite fit your story, it is a physical reaction associated with migraines. And as I wrote above, you are the first one I read that has such internal triggers.
1. Tonya Henry Moderator & Contributor
 <inline-mention username="wirr" user-id="3682405"/> thank you for sharing your migraine symptoms. I am sorry that you get acne. The only time I got that, was while doing Botox. I definitely can understand how migraine would cause someone blood pressure or pulse to increase. I have lots of triggers, but these three that are in the article, are some of the more problematic ones. Unlike you, smells and lights, are big triggers for me. Those, I can kind of eliminate though. I hope that today of all days, you do not have a migraine. (Tonya, <a href='https://migraine.com' target='_blank'>migraine.com</a> contributor).
elizabeth9 Member
What was your experience with Botox? Was it ok to go through? Or horrible? Was it effective? And why did you stop? 
1. Holly Harding Moderator & Contributor
 <inline-mention username="pianomom" user-id="3673606"/> Just a quick note as to cost- there is a "botox savings program" that covers the cost of botox (up to a certain extent) to make up the difference of what insurance won't cover -(unless you have Medicare in which they won't help you, unfortunately). It may be something you could try just once and see if it makes a difference enough to continue to pursue. Warmly- Holly <a href='https://-migraine.com' target='_blank' rel='noopener noreferrer ugc'>-migraine.com</a> team.
2. Tonya Henry Moderator & Contributor
 <inline-mention username="Holly Harding" user-id="3755969"/> thank you for sharing about the Botox Savings Program. There are probably many who did not know that existed. I hope that people are using it and finding it helpful. Take care! (Tonya)