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Syed Intisar Hussain

Moving to higher altitudes when hiking may lead to symptoms of headache. Other causes of headaches may include mountain biking, skiing, foot race, etc.

A Little More Altitude- A Little More Headache

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Saad Ullah Siddiqui

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What’s Triggering My Migraine?

Introduction

A migraine refers to a severe headache in a focused region of the cerebrum that is frequently accompanied by queasiness, spells of vomiting, and an incontinent aversion to light. It can last hours to days. Not all <a href="https://www.merisehat.pk/disease/migraines-73">migraines</a> are linked to a trigger. 
&nbsp;

If you are one of those people who are affected by what they eat, then one of the most reliable methods to not aggravate the already painful headache is to identify your triggers and avoid these as much as you can. For some individuals, that implies avoiding specific food sources.

&nbsp;

Scientists and doctors alike have been unable to trace the specific reason for migraines. Specialists concur that short, immediate, and abrupt changes in your cerebrum movement and activity are likely to blame. These also have an unpleasant influence on your veins and nerve signals. The outcome: a pounding headache that can persist for an unpredictable period, ranging from a few hours to days. 
&nbsp;

Numerous things can cause migraines, like the medication you take, an unprecedented imbalance of hormones, and an absence of rest. Your eating regimen can also have an impact. In around 10% of individuals with migraines, food is a major trigger.

&nbsp;

Understanding migraine, its common triggers and treatment

As indicated by the Migraine Research Foundation, food sources may trigger migraines. However, any trigger overall is profoundly individualized, making conclusive findings more obscure and difficult to reach. To date, there has not been any such thing as a widespread migraine trigger. Yet, there are a few normal triggers that can cause or add to migraine episodes in certain individuals.

&nbsp;

<h5>1. Caffeine</h5>

We realize that some of you are most likely disappointed when you see caffeine leading this list, yet research demonstrates that unnecessary caffeine consumption can set off headache assaults. Moreover, recent studies propose reducing those daily espresso shots to decrease migraine recurrence<a href="#accordion">[1]</a>. 
&nbsp;

If you heavily rely on caffeine for that morning boost and cannot imagine beginning your day without an espresso, certain studies suggest that a moderate dosage may help hinder migraines<a href="#accordion">[2]</a>. Therefore, it is important to note that excessively devouring coffee will not do you much good.&nbsp; We realize that the caffeine boost can feel like a lifeline at times, so we will not ask for a total ban. However, try to restrict yourself to under two cups each day<a href="#accordion">[3]</a>. 
&nbsp;

<h5>2. Chocolate</h5>

This list may contain some of your favorite foods and snacks, which is why it should not come as a shock that chocolate ranks so high within our list of food triggers. According to recent research, 22% of migraine patients held chocolate as the responsible culprit for worsening symptoms<a href="#accordion">[2]</a>. Another study claimed that 42% of their subjects blamed chocolate for triggering their migraine attacks<a href="#accordion">[4]</a>. 
&nbsp;

This is understandable as chocolate contains beta-phenylethylamine, a compound that is also found in caffeine and has been associated with triggering headaches in non-migraine patients. And to perfectly mirror the dialogue of a typical brown mom, there are fruits that you could consume in place of chocolates.&nbsp; 
&nbsp;

<h5>3. Additives&nbsp;</h5>

It is perhaps a no-brainer that any chemical enhancements or excessively processed items will have negative impacts on your health. Some of the most common additives you should avoid in the supermarket are: 
&nbsp;

<ul>
	<li>Monosodium Glutamate (MSG): MSG is a popular flavour enhancement found in canned and frozen foods, such as soups, snacks, seasonings, etc. It is the primary heading within the ingredients label in soy sauce and meat tenderizers. The chemical is occasionally labelled on preserved food sources as a natural preservative or a hydrolyzed protein. Reports demonstrate it can set off a migraine within 20 minutes of consumption. An estimated 10-15% of people suffering from migraines are affected by MSG<a href="#accordion">[5]</a>. 
	&nbsp;</li>
	<li>Nitrates And Nitrites: These synthetic substances are present in many restored and handled meats, like sausages. They release a compound called nitric oxide which, when gets into your system, expands your veins, and then triggers the nervous system to cause a migraine 
	&nbsp;</li>
	<li>Aspartame: Research suggests that artificial sweeteners play a crucial part in triggering migraines. These sugar alternatives are found in processed soft drinks, desserts, and many more. 
	&nbsp;</li>
</ul>

While studies have found a correlation between such processed foods and preservatives, there is not much difference in the pool of subjects and the placebo when introduced to these additives. But just to be safe, stick to natural alternates. 
&nbsp;

<h5>4. Aged Cheese</h5>

Cheese naturally contains a substance known as tyramine. It is formed once the cheese starts ageing and breaking down proteins. The age of cheese and concentration of tyramine are proportionally related. The more time it takes for the cheese to age, the greater the concentration of tyramine within the aged cheese. Since tyramine is linked to triggering headaches, people with migraines should look out for tyramine levels in cheese. Common types of cheeses with a high tyramine content include feta, parmesan, brie, gorgonzola, and blue cheese. Moreover, it&#39;s better to avoid cheeseburgers and pizzas when experiencing migraine symptoms. 
&nbsp;

<h5>5. Nuts And Seeds</h5>

Did you just find a recipe for peanut butter noodles? Are you fond of spreading almond butter over toast? Or do you like having nut butter straight from the jar? Well, unfortunately, these eating habits are likely contributing to the pounding sensation in your head. New information suggests that certain nuts are rich sources of tyramine, the same substance found in aged cheese. Avoid binge eating or snacking on nuts and seeds such as peanuts and pumpkin seeds<a href="#accordion">[7]</a>. 
&nbsp;

There may be a possibility that your food trigger has not been listed, or you may have more than just one. It is a frustrating and laborious task to find your food trigger. For sorting out your pain and migraine triggers, follow the basic idea of tracking and noting the food and beverages you devour in a day-to-day food migraine journal. Strictly monitor the progress and maintain entries in the journal. 
&nbsp;

You may assume a food to be delicate if you respond to it differently. If a specific food or beverage initiates a migraine consistently, 20 minutes to 2 hours after consumption, that should be marked as a trigger. 
&nbsp;

In any case, remember that even though it sounds easy to follow, figuring out potential food triggers may be exhausting and painful. As anything you consume would possess a risk of setting off your migraine. Although you will be in contact with and consume certain food triggers, you should not dismiss other factors that could be contributing to your perpetual headache. To analyze these risk factors, ask yourself the following questions: 
&nbsp;

<ul>
	<li>Are you sleep-deprived?</li>
	<li>Have you skipped a meal?</li>
	<li>When was your last menstrual cycle?</li>
	<li>Have you been hydrating yourself sufficiently?</li>
	<li>Has the weather changed since the start of your headache? Did it become sunnier?</li>
	<li>Is there a family history of headaches?&nbsp;</li>
</ul>

&nbsp;

Conclusion

While a search is still ongoing to assess the link between food triggers and migraines, it is safe to assume that no harm would come from avoiding certain foods. But it is also important to consider different aspects which may be hindering ease and causing more discomfort. Consult a doctor to find methods that work for you in a convenient and effective environment.&nbsp;

Key Points

The article was written for informational purposes rather than providing options for treatment. To summarize:<ul><li>The cause of migraines has yet not been found, but certain food triggers have been linked to aggravating them.</li><li>Foods and beverages such as caffeine, cheese, nuts, processed meats, preservatives, and citrus foods should be avoided.</li><li>Other factors also influence migraines, such as family history, menstrual cycle, sun exposure, and dehydration.</li></ul>

[1].University of Cincinnati Academic Health Center. (2022, June 21). Diet can impact migraines.

[2].Shapiro, R. E., & Cowan, R. (2017, January 10). Caffeine and Migraines. Retrieved from American Migraine Foundation:

[3].Mostofsky, E., Mittleman, M. A., Buettner, C., Li, W., & Bertisch, S. M. (2019). Prospective Cohort Study of Caffeinated Beverage Intake as a Potential Trigger of Headaches among Migraineurs. The American Journal of Medicine, Retrieved from Science Daily

[4].Gibb, C., Davies, P., Glover, V., Steiner, T., Rose, F. C., & Sandler, M. (1991). Chocolate is a Migraine-Provoking Agent. Cephalalgia, 11(2), 93–95.

[5].Diamond, M. L., & Marcus, D. A. (2016, August 13). Diet and Headache Control. Retrieved from American Migraine Foundation:

[6].Gruber, H. J., Bernecker, C., Lechner, A., Weiss, S., Wallner-Blazek, M., Meinitzer, A., . . . Truschnig-Wilders, M. (2010). Increased nitric oxide stress is associated with migraine. Cephalalgia, 30(4), 486-92.

[7].Bauer, J. (2022). Nuts and Seeds: How Food Affects Health. Retrieved from Joy Bauer:

Zarlish Kazmi

Types Of Headache

<a href="https://merisehat.pk/disease/tension-headaches">Headaches </a>can be a real pain, quite literally. We&rsquo;ve all experienced it at some point in our lives, and if you haven&rsquo;t yet, chances are you will at least once, if not more. As per global estimates, 15.8% of the world&rsquo;s population experiences a headache each day<a href="#accordion">[1]</a>. Whereas the global prevalence of headache disorders among adults was 52%<a href="#accordion">[1]</a>.

Dealing with a headache can be quite troublesome. The effects of a headache can disrupt your routine and make even simple tasks challenging. Concentration becomes difficult, and productivity takes a hit. You may find it hard to focus on your work or enjoy activities you normally love. Social situations can be tough too, as loud noises and bright lights worsen the pain. 
 
&nbsp;

Understanding Types of Headache

Headaches come in various forms, from tension headaches that feel like a tight band around your head to migraines that bring intense throbbing and sometimes nausea. While most headaches are harmless, some can indicate a more serious condition.

There are currently more than 150 types of headaches. Let&rsquo;s find out which one you have, shall we? 
&nbsp;

Disclaimer: The information provided in this article is for educational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider before making any decisions regarding your health.

Headaches are broadly classified into primary and secondary<a href="#accordion">[2]</a>.

<h5>Primary Headaches</h5>

These headaches are not associated with any underlying condition or illness, and they constitute the majority of reported cases. The following are some common types of primary headaches.

<ul>
	<li><a href="https://merisehat.pk/disease/tension-headaches">Tension Headaches</a>: These are the most common type of headaches. They typically cause a dull, aching pain that feels like a tight band around the head. Tension headaches can be triggered by factors such as stress, muscle tension, poor posture, or even skipped meals. They are usually mild to moderate in intensity and not accompanied by other symptoms. 
	&nbsp;</li>
	<li><a href="https://merisehat.pk/disease/migraines-73">Migraines</a>: Migraines are intense and recurrent headaches that often involve throbbing pain, usually on one side of the head. In addition to pain, migraines may be accompanied by symptoms such as nausea, vomiting, sensitivity to light (photophobia), and sound (phonophobia). Some individuals may experience visual disturbances (aura) before or during the migraine attack. Triggers can vary, including hormonal changes, certain foods, stress, sensory stimuli, and sleep patterns. 
	&nbsp;</li>
	<li><a href="https://merisehat.pk/disease/cluster-headaches">Cluster Headaches</a>: Cluster headaches are rare but extremely severe headaches. They occur in clusters or cyclical patterns. Cluster headaches typically cause excruciating pain focused around one eye, accompanied by symptoms such as eye redness, tearing, nasal congestion or discharge, and drooping eyelids. They are often described as the most severe type of primary headache. 
	&nbsp;</li>
	<li>Chronic Daily Headaches: This category encompasses various headache types that occur on a daily or near-daily basis for at least 15 days per month, lasting for several hours or even all day. Chronic migraines and chronic tension headaches are examples of chronic daily headaches. The underlying causes can vary, and a thorough evaluation by a healthcare professional is necessary to determine the specific type and appropriate treatment. 
	&nbsp;</li>
	<li>New Daily Persistent Headaches (NDPH): As the name suggests, these headaches start suddenly and persist daily. They can appear out of the blue, without any apparent trigger or previous history of headaches. NDPH is characterized by a constant, non-throbbing pain that feels like pressure or tightness around the head. It typically affects both sides of the head and can vary in intensity from mild to severe. Unlike other headache types, NDPH doesn&#39;t come with additional symptoms like nausea or sensitivity to light or sound. These headaches can be quite disruptive to daily life, as they persist for months or even years without remission 
	&nbsp;</li>
</ul>

<h5>Secondary Headaches</h5>

Secondary headaches arise as a symptom of an underlying condition or disease. Identifying and addressing the underlying cause is crucial for effective treatment. Examples of secondary headaches include:

<ul>
	<li>Sinus Headaches: Sinus headaches are associated with sinusitis or inflammation of the sinuses. They typically cause pain and pressure in the forehead, cheeks, and around the eyes. Other common symptoms may include nasal congestion, discharge, and a reduced sense of smell. 
	&nbsp;</li>
	<li>Medication Overuse Headaches: Also called rebound headaches, these headaches result from excessive or frequent use of pain medications for other headaches. When these medications are used too often or in high doses, they can lead to a rebound effect and cause more frequent or severe headaches. Over-the-counter medications and prescription drugs, such as opioids and triptans, can contribute to medication overuse headaches. 
	&nbsp;</li>
	<li>Hormone Headaches: Hormone headaches, often referred to as menstrual migraines or menstrual-related migraine, occur primarily in women. They are linked to hormonal changes during the menstrual cycle, pregnancy, or menopause. Fluctuations in estrogen levels are thought to play a role in triggering these headaches. 
	&nbsp;</li>
	<li>Thunderclap Headaches: Thunderclap headaches are sudden and severe headaches that reach their peak intensity within seconds or minutes. They can be a warning sign of a serious underlying condition, such as bleeding in the brain (subarachnoid hemorrhage), ruptured aneurysm, or other vascular issues. People often refer to it as the worse headache of their life. Immediate medical attention is crucial when experiencing a thunderclap headache. 
	&nbsp;</li>
	<li>Exertional Headaches: Exertional headaches are triggered by physical activity or exertion, such as running, weightlifting, or sexual activity. These headaches are often described as pulsating or throbbing and typically last from a few minutes to a few hours. While exertional headaches are generally harmless, they can be a cause for concern if they occur frequently or are associated with other neurological symptoms. 
	&nbsp;</li>
</ul>

<h5>Migraine Vs Other Headaches</h5>

Migraines stand out from other types of headaches with their intense, throbbing pain, usually on one side of the head. Unlike tension headaches that feel like a tight band squeezing the head, migraines come with additional symptoms such as nausea, vomiting, sensitivity to light and sound, and sometimes visual disturbances. Cluster headaches, on the other hand, bring sudden and severe pain focused around one eye, occurring in clusters over weeks or months. Sinus headaches mimic sinus infections, causing pain and pressure in the forehead and cheeks. Understanding these distinctions helps in accurately identifying the type of headache and seeking appropriate management strategies. 
&nbsp;

Whether you&#39;re dealing with tension headaches, migraines, or other types, here are some natural strategies to help manage those pesky head throbbers<a href="#accordion">[3]</a>.

<ul>
	<li>Mind-Body Relaxation Techniques: Practice relaxation techniques like deep breathing, meditation, or yoga to reduce stress and muscle tension. Relaxation exercises can help alleviate tension headaches and even provide relief during migraines. Find a quiet space, focus on your breath, and let your mind and body unwind. 
	&nbsp;</li>
	<li>Maintain A&nbsp;Regular Sleep Schedule: Proper sleep is essential for headache management. Therefore, one should establish a consistent sleep routine, aiming for 7-8 hours of quality sleep each night. Maintain a sleep-friendly environment, limit screen time before bed, and consider relaxation techniques to promote restful sleep. 
	&nbsp;</li>
	<li>Stay Hydrated: Dehydration can trigger headaches, so drink enough water throughout the day. Keep a water bottle handy and sip regularly. Additionally, limit your intake of alcohol and caffeinated beverages, as they can contribute to dehydration and trigger migraines in some individuals. 
	&nbsp;</li>
	<li>Identify And Avoid Trigger Foods: Keep a food diary to identify potential triggers for migraines. Common culprits include aged cheeses, chocolate, processed meats, artificial sweeteners, and foods containing MSG. If you notice a pattern, try eliminating or reducing these trigger foods from your diet. 
	&nbsp;</li>
	<li>Regular Exercise: Engage in regular physical activity to reduce the frequency and intensity of headaches. Exercise releases endorphins. These act as natural painkillers and enhance the mood. Choose activities you enjoy, whether it&#39;s walking, swimming, cycling, or practicing yoga. Start gradually and aim for at least 30 minutes of exercise most days of the week. 
	&nbsp;</li>
	<li>Manage Stress: Stress is a common trigger for many headache sufferers. Implement stress management techniques such as mindfulness, journaling, engaging in hobbies, or seeking support from loved ones. Finding healthy ways to cope with stress can reduce the occurrence and severity of headaches. 
	&nbsp;</li>
	<li>Essential Oils: Lavender, peppermint, and eucalyptus essential oils are known to help relieve headaches. These can be mixed with a carrier oil and applied to the wrist or temples. Some people may also use it in a diffuser as a form of aromatherapy. 
	&nbsp;</li>
	<li>Apply Heat Or Cold: Experiment with heat or cold therapy to find what works best for your headaches. Apply a warm compress or take a warm shower to relax tense muscles during tension headaches. For migraines, a cold compress or ice pack applied to the forehead or back of the neck may provide relief. 
	&nbsp;</li>
	<li>Herbal Remedies: Consider incorporating herbal remedies known for their calming and pain-relieving properties. For tension headaches, try drinking chamomile or peppermint tea. Always consult with a healthcare professional before starting any new supplements. 
	&nbsp;</li>
	<li>Magnesium Supplements: Magnesium supplements are effective at reducing headaches in people with migraines. The mineral plays a role in nerve transmission, blood sugar regulation, and several other functions around the body. However, magnesium supplements can cause gastrointestinal side effects, such as diarrhea. Always consult a healthcare professional before starting or stopping any supplements. 
	&nbsp;</li>
	<li>Seek Professional Help: Consult with a healthcare professional if your headaches persist or worsen despite self-care efforts. They can evaluate your condition, provide an accurate diagnosis, and recommend appropriate treatment options, including prescription medications or alternative therapies. 
	&nbsp;</li>
</ul>

It&#39;s crucial to consult a healthcare professional if you experience recurring or severe headaches, as they can help determine the precise headache type and provide appropriate diagnosis and treatment. Understanding the classification of headaches is a valuable step toward effective management and relief. 
&nbsp;

[1] Stovner LJ, Hagen K, Linde M, Steiner TJ. The global prevalence of headache: An update, with analysis of the influences of methodological factors on prevalence estimates. The Journal of Headache and Pain. 2022;23(1). doi:10.1186/s10194-022-01402-2

[2] Headaches. Cleveland Clinic.

[3] 18 Remedies to Get Rid of Headaches Naturally. Healthline.

Nimrah H. Sattar

We have all heard of motion sickness that may just be triggered in the car, on a train, or even on a bus. It&rsquo;s especially true when we&rsquo;re traveling for longer periods of time. And, then, there is also the sea sickness when the waves literally rock our bodies and its insides, making us feel sick.&nbsp;

&nbsp;

There&rsquo;s another phenomenon, quite similar to this experience prompted by sensory stimulus, which is known as altitude headache &ndash; headache that occurs due to high altitude. It is characterized by a severe, throbbing pain in the head after being exposed to a high altitude<a href="#accordion">[1]</a>. Anyone can get affected, irrespective of their sex, age, or physical fitness. 
&nbsp;

Understanding Cure For Altitude Headache

Altitude headache is a symptom of altitude sickness, which occurs when one goes to higher elevations e.g. on a skiing or hiking trip in the mountains.

&nbsp;

Altitude headache is an intense headache that is caused due to staying at high altitudes for a significant amount of time. The headache can last anywhere from a few hours to up to 5 days.&nbsp;

&nbsp;

Contrary to popular belief, it does not happen due to lack of oxygen or low oxygen saturation in the blood. This is why oxygen therapy is said to have little to no impact on the headache itself<a href="#accordion">[1]</a>. However, given that the main cause is still unknown, oxygen&rsquo;s role and the possibility of hypoxia interfering with or enhancing the headache are still not ruled out.&nbsp;

&nbsp;

What we do know about altitude headaches is that the higher we go, the higher the chances are that we&rsquo;d get sick. The chances also increase depending on our speed i.e., how fast we are going up, like climbing on a mountain as opposed to increasing the altitude through a helicopter or a ski lift<a href="#accordion">[3]</a>. 
&nbsp;

It&rsquo;s rare for people to not experience any symptoms at all while climbing or moving at high altitudes. Most of us will definitely experience some of the symptoms of altitude headache, especially if we are prone to migraines or have a family history of it. In fact, as far as family genes are concerned, it&rsquo;s possible for two members of the same family to have different triggers for altitude headaches. For e.g., it could be triggered due to long flights or it could be triggered during mountain climbing.&nbsp; 
&nbsp;

The important thing to remember here is that altitude headaches are not just limited to pain in our head. It also includes:

<ul>
	<li>Nausea</li>
	<li>Vomiting</li>
	<li>Loss of appetite</li>
	<li>Dizziness</li>
	<li>Fatigue</li>
	<li>Weakness</li>
	<li>Trouble sleeping 
	&nbsp;</li>
</ul>

Note:&nbsp;Altitude headache is treatable, but it needs to be dealt with timely and carefully. There&rsquo;s no need to get afraid and definitely no need to avoid doing activities you love. At the other extreme, there&rsquo;s no need to ignore it either; don&rsquo;t push your body to achieve more than it&rsquo;s capacity.&nbsp; 
&nbsp;

If the body is not used to the high altitudes, the trick is to take it slow and allow the body to adapt to the environment. Sudden changes cause the body to malfunction and lead to such symptoms! So, yes, the first thing is to plan the entire trip and to ensure our itinerary includes time for rest, too!

&nbsp;

Secondly, over-the-counter painkillers, like the good ol&rsquo; paracetamol or ibuprofen, can be lifesavers in this case. Furosemide, acetazolamide, and aspirin can be taken for altitude headaches as well<a href="#accordion">[1]</a>. However, it&rsquo;s best to always consult a doctor before taking any medicine; they&rsquo;ll know which medicine will be effective for a particular person.

&nbsp;

In addition to the medications, hydration is also very crucial for treating altitude headaches. If nothing works and the headache persists, there&rsquo;s no harm in halting the journey or even going back. It&rsquo;s obvious that further increase in altitude may become a serious emergency.&nbsp; 
&nbsp;

Prevention is better than cure and what could be better than salvaging the trip by taking the right precautions to avoid altitude headaches? Following ways can help prevent an attack<a href="#accordion">[2]</a>:

<ul>
	<li>Hydrate. Dehydration coupled with lesser oxygen saturation triggers headache.</li>
	<li>Travel slowly. People with a slower pace are less likely to experience the severe symptoms and effects that come with higher altitudes.</li>
	<li>Sleep at lower elevations. The most common symptom of altitude headache is lack of sleep, which also factors into causing a headache or worsening a current one.</li>
	<li>Using acetazolamide as a preventive treatment especially for people with sleeping disorders or for people who have trouble breathing while asleep.</li>
	<li>Climb a maximum of 1,600 feet a day to allow the body to slowly get used to the environment.</li>
	<li>Avoid smoking and/or drinking alcohol. 
	&nbsp;</li>
</ul>

<ul>
	<li>Altitude headaches usually occur when a person is over 8,500 feet above sea level.</li>
	<li>Traveling faster to a high altitude increases the chance of individuals getting a headache.</li>
	<li>Family history or personal history of <a href="https://merisehat.pk/disease/migraines-73">migraines </a>increases the chances of altitude headaches.</li>
	<li>Altitude headaches can be treated with the help of over-the-counter painkillers, like ibuprofen and paracetamol.</li>
	<li>Acetazolamide can prevent and reduce symptoms of altitude sickness including altitude headaches .</li>
	<li>Hydration, sleep, slower pace of travel (i.e., climbing only 1600 feet a day) are some of the ways to prevent altitude headaches.</li>
</ul>