Seasonal Migraines and Triggers
One day it is raining. The next, 95 and sunny. The next day we are getting smoke from wildfires. Then it’s cool and foggy. Then…well you get the picture. This is in sharp contrast to our predictably mild Mediterranean climate.
We had a recent heat wave here in California, with record-setting high temperatures. It was over 100 degrees in San Luis Obispo. The heat is forecasted to be displaced by rain in the coming week. It is a barometric roller coaster.
Seasonal trigger #1: weather…
The evidence connecting changes in weather, specifically barometric pressure, to migraine symptoms is pretty compelling. An overwhelming majority of migraineurs polled here on Migraine.com identify weather as a trigger.1
The weather is going to do what the weather is going to do. Short of traveling to avoid each high- or low-pressure system, or follow predictably good weather, there is not much we can do to limit our exposure to unpredictable environmental triggers.
On the other hand, I’m not real excited about predictability, either. This is the third or fourth year I have had a spate of migraine symptoms at this time of year. (I wrote about a three-week-long migraine episode last year at this time.)
My courtship with seasonal migraines, like the certainty of shorter days, Trick or Treating, and pumpkin pie, I now realize is a predictable partner each fall.
While I have long known that weather is a trigger for me, some internet research revealed some possible triggers I had never considered.
Allergies and migraines…
First, my fall migraines may be connected to allergies. I have had some stuffiness and sneezing along with my usual migraines symptoms, which for me include vertigo, tinnitus, double-vision, and some serious migraine brain.
Jonathan Field, MD, Director of the Allergy and Asthma Clinic at New York University School of Medicine makes a bold statement in a medically reviewed article on everydayhealth.com: “The most common cause of a migraine is allergic sinusitis.”2
I’m not sure about Dr. Field’s basis for that claim, but my one-person study (of myself) suggests there is a correlation between my sneezing and my migraine episode…I am sneezing a lot, and I have migraine symptoms.
Seasonal affective migraine?
Second, and far more interesting, is the notion that migraine and brain chemistry, specifically serotonin levels, are related. This is not new information. A quick search of Migraine.com revealed several pages of articles that describe the link between serotonin and migraine.
My research partners at Google turned up some simple descriptions. This one from Johns Hopkins’ online Health Library: “…chemical compounds and hormones, such as serotonin and estrogen, often play a role in pain sensitivity for migraine sufferers.
“When serotonin or estrogen levels change, the result for some is a migraine.”3
How does that inform how I feel this fall? Is the fall season a migraine trigger?
Researchers studying Seasonal Affective Disorder (SAD) have made the connection between serotonin and SAD as reported at medicalnewstoday.com.
“…When the nights grow longer during the autumn, the SERT levels increase, resulting in diminishing active serotonin levels.” (SERT is a protein that inhibits the travel of serotonin across neurotransmitters.)4
So, it may be that my fall migraines are similar to SAD. For me, they may be Seasonal Affective Migraines. The days get shorter, and the SERT protein increases, blocking serotonin transmission. Less serotonin is a known cause of migraines.
While not addressing serotonin or SAD directly, Dr. Josh Turknett weighs in on depression and migraine: “…A significant change in headache frequency is a common sign of depression, either from major depressive disorder or a reaction to a traumatic life event (death, divorce, etc.).”5
Obviously, this is all anecdotal evidence, including survey data available here on Migraine.com. One survey on our site asks, “Are your migraine symptoms worse during particular seasons?” More than 8,000 respondents acknowledge some seasonal influences, mostly occurring in the spring—34%. Fall comes in second with 29%.6
The Balloon theory
While my fall migraine episodes are reliable, I cannot point to one obvious trigger. Weather, allergies, shorter days, and serotonin levels may all be triggers. Most likely, it is the combination of triggers that cause these episodes. And most are unavoidable.
Turknett, whose book was helpful to me in altering my diet to stem symptoms, uses the analogy of triggers like helium-filled balloons. Each tripped trigger inflates a balloon. The more trigger balloons get inflated, the greater the likelihood of a migraine.7
My balloons may be filled with allergies, changes in brain chemistry, weather conditions, lack of sleep, stress, diet, exposure to heat and sunlight… The list goes on. They are not that difficult to track.
The trouble with seasonal episodes is that they are difficult to track, year-to-year. It took me several years to even notice the annual pattern. But it certainly appears that my balloons keep filling up each fall and I hover above the migraine threshold for weeks at a time.
Can you tell when a migraine attack is coming?