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What is Causing This Migraine Attack?

Last updated: October 2022

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.

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