Headaches

What Triggers Headaches? (cont'd)

Drinking 8 to 10 cups of brewed coffee (1 gram of caffeine) in a row would begin to endanger your health. You could actually die if you ingested 10 grams or more.

Other foods. A number of other items are sometimes implicated in headaches. They include: citrus fruits, dairy products, soybeans, wheat products, onions, fatty foods, seafood, and artificial sweeteners (aspartame or NutraSweet).

Medications

Some medicines used to treat illnesses may actually trigger headaches. If you are taking any of the following medications, talk with your doctor about possibly switching to another non-headache-provoking drug. Don't, however, stop taking any of these medicines on your own!

• Nitroglycerin (for heart disease)
• Medication for high blood pressure
• Medication used to dilate blood vessels
• Medication used to treat ulcers
• Antiseizure drugs

Oral contraceptives (the Pill) may or may not cause headaches, and may or may not make existing headaches worse, depending on the individual. Because most women who take the Pill are in the age range for headache onset, the Pill might be “guilty by association.” On the other hand, headaches could be triggered by the Pill formulation itself or the varying levels of estrogen delivered by triphasic oral contraceptives (those supplying different doses of hormones each week).

Studies of the Pill and headaches have shown mixed results. Some show relative increases in the frequency of headaches among Pill users while other studies show no difference. In one study, women who were told they were receiving the Pill reported high headache frequency, even though they were receiving a placebo (a dummy pill).

The Rebound Headache. Many people who suffer from headache tend to abuse either over-the-counter (OTC) or prescription drugs that can stop or control their pain. Overuse of these drugs can actually perpetuate and worsen headaches, leading to what is considered an analgesic-rebound headache. Overused OTC pain relievers (analgesics) include aspirin and acetaminophen (Tylenol, Panadol). The prescription headache drug ergotamine (Cafergot) is also often overused.

The first study to identify this problem was carried out in 1982. People who had daily chronic headache were divided into two groups. One received the antidepressant drug amitriptyline (Elavil), while the other group did not. Half of each group was allowed to use pain relievers. The group of patients taking both amitriptyline and a pain reliever showed an overall improvement of 30 percent over four weeks, but the patients taking only amitriptyline showed an overall improvement of 70 percent. Those patients taking only pain relievers improved by 18 percent and those patients taking nothing at all improved by 43 percent.

This study not only proved that eliminating pain relievers could help headache patients recover, but also showed that pain relievers could actually block the effectiveness of other headache medications. Confirming the results, another researcher found that 77 percent of chronic headache patients who were hospitalized and taken off pain relievers either became headache-free or had far fewer headaches. Still another researcher was able to show that 80 percent of hospitalized patients stopped getting headaches within 2 weeks of giving up pain relievers.

Eating and Sleeping Patterns

Fasting or missing meals is a major headache trigger. Researchers found that for the majority of more than 2,000 women who experienced a migraine, the lack of food for 5 hours during the day or 13 hours overnight was a primary factor in triggering their headaches.

No one completely understands why this is so. Presumably, fasting can affect the level of neurotransmitters; and low blood sugar from lack of food can cause blood vessels to dilate, leading to headache.

Nighttime sleep and naps during the day also may play a role in the headache process. Too much sleep or too little sleep can trigger headaches in the headache prone.

Environmental Factors

What you do for a living and where you spend your time can also lead to headaches. You might have already had experience with this type of environmental trigger if you work in a place where you inhale fumes or toxins. Some environmental substances that can lead to headaches include: turpentine, carbon tetrachloride, benzine, formaldehyde, heavy metals (especially lead), and carbon monoxide.

Other workplace conditions to consider are bright lights, glare, noise, and eyestrain.

Vision-Related Headaches. Although headaches related to eye disorders occur much less frequently than is generally supposed, eyestrain and diseases of the eye can lead to headaches. Straining your eyes through excessive reading or squinting at a computer screen, for example, will fatigue muscles controlling eye movement. You also may suffer vision-related headaches if you habitually work under flickering fluorescent lights.

It's difficult to separate eyestrain headache from tension headache. Sitting in the same position for extended periods of time, while reading or typing on a computer, will certainly strain neck and shoulder muscles as well as the eyes.

Narrow-angle glaucoma, a rare eye disease, can cause pain around the eye, forehead, or temple region. Its symptoms mimic those of migraine or cluster headache, so if you have either problem it's important to get your eyes checked, both for this condition and for general vision impairment.

Other Factors. Some headache sufferers experience head pain during or after such exertion as playing tennis, jogging, jumping rope, playing handball, and sexual orgasm. Changes in the weather can change body chemistry, and have been known to trigger headaches. Heavy cigarette smoking and motion can also lead to headache.

Next: The Headache Diary