Migraine Comorbidities: Allergies

Have you ever wondered why you have so many allergies? Did you know that allergies are comorbid with migraine, so you are not alone! Environmental allergens such as pollen, dust, pets and mold can trigger allergic rhinitis or hay fever, a common condition causing inflammation of the nasal mucosa.[1] People who have allergies are more likely to have migraine,[2] and allergies can increase the frequency and intensity of migraine attacks.

Overlapping Conditions

Both allergies and migraine have many overlapping symptoms. These include head pain and various central autonomic parasympathetic symptoms such as nasal congestion and lacrimation—and both may worsen with weather changes and exposure to allergens.[3] It has long been thought that histamine may trigger migraine attacks [4] and because allergic rhinitis is a histamine-driven syndrome and the nasal passage is close to the central nervous system, allergic rhinitis may be a migraine trigger.[5] But allergies can also trigger migraine attacks due to the increased inflammation, nasal congestion and sleep disturbances that often come along for the ride. These symptoms can also cause pressure and make head pain feel more severe during an attack.

Since people with allergies so often have headaches, many will self-diagnose themselves with sinus headaches. But true sinus headaches are fairly rare, and it is more likely that migraine is the culprit.[6] In addition, due to the similar location of the pain, people are often incorrectly diagnosed with sinusitis, which can lead to inappropriate treatments like antibiotics.[7]

Treatment

There is little research available about how anti-histamine medications or low histamine diets may help treat migraine, but it stands to reason that treating allergies may help reduce the frequency of migraine attacks[8] for some people.

In addition to maintaining a healthy lifestyle for migraine management, doctors may also recommend certain allergy medications to take alongside migraine medications. If your allergies are having a major impact on your life, you may even be sent to an allergy specialist for testing. In the meantime, here are some things you can try for relief:

• Avoid usual migraine triggers
• Drink a lot of water to thin mucus secretions
• Use a hot or cold compress on the head and face to soothe pain from sinus congestion
• Download an allergy tracker to keep on top of local pollen counts and avoid being outdoors for long periods of time on high count days
• Keep windows closed during allergy seasons
• Shower at night before bed and/or after spending time outdoors
• Vacuum and declutter the home regularly to rid the environment of pet dander and dust
• Consider hardwood floors instead of carpet
• Use an air filtration system such as a HEPA filter
• Use a neti-pot to rinse the sinuses

Tell us! Do you have allergies and migraine? Do seasonal allergies bring on an increase in migraine attacks for you? How do you manage both conditions?

Sources:

1. https://aacijournal.biomedcentral.com/articles/10.1186/s13223-018-0280-7
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3634285/
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4762930/
4. https://pubmed.ncbi.nlm.nih.gov/28862769/
5. https://www.jacionline.org/article/S0091-6749(04)04054-0/fulltext#relatedArticles
6. https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/headaches-connected-to-allergies-and-sinus-problem