Substances Dietary Migraine attacks are often triggered by certain substances, usually in food and drink. This is not an allergy, but a sensitivity. (Allergies are reactions of the immune system.) Individual patients vary as to what triggers a migraine in them, but certain substances are commonly found as triggers: Tyramine is a substance contained in red wine, aged cheeses, yeasts, yogurt, and some preserved fishes. Chocolate Alcohol Nitrites (found in bacon, wieners and other preserved meats) MSG Aspartame (Nutrasweet, Equal) Caffeine (although in some people it can abort a headache) It is a good idea for any migraine patient to prepare a diary in which is recorded all food and drink along with each migraine attack. Then, going back and analyzing the diary may allow discovery of a relationship between ingestion of a particular substance and migraine attacks. Another alternative is to go on a diet free of substances known to cause migraines. Click here for a look at such a diet. Medications Medications can often make migraines more frequent. Here are some to consider: Estrogens such as found in birth control pills or estrogen replacement thereapy (e.g. Premarin). Vasodilator drugs given for high blood pressure or heart disease. Examples are nitroglycerin, isosorbide (Isodur, Isordil), hydralazine, some calcium channel blockers. Bronchodilators given for asthma (e.g. theophylline, theodur). Analgesics can paradoxically make migraines more frequent and more chronic. Click here for an explanation. Sleep Lack of sleep or even too much sleep can trigger migraines. Migraine patients who stay up late or rise late on weekends or holidays may have their day off spoiled by a headache. Stress Everyone suffers from some stress. But stress can trigger migraines by liberating vasoactive body chemicals such as epinephrine (adrenaline) and affecting sleep, etc. Hypoglycemia Mild hypoglycemia due to skipping meals can trigger migraines in some people. Physical factors Lights. (Bright or flickering lights.) Odors. (Strong perfume, smoke, fumes.) Low barometric pressure. Motion sickenss (often patients with migraine also had carsickness as children) Patterns (patients with migraines often react to certain patterns). Click here to see a pattern which probably won't trigger a migraine, but migraine patients don't like to look at.)