If you’ve been living with chronic migraines, you’ve probably asked yourself: “What’s triggering this and how can I stop it?”
Most conventional care focuses on managing symptoms with medications, but as a functional medicine practitioner, I see migraines differently. They are a symptom of deeper imbalances and to truly heal, we need to uncover and address the root causes.
Over the years, I’ve compiled a comprehensive list of migraine contributors. Think of this as a menu of possibilities – clues to help you finally understand why your migraines persist.
Migraine triggers I look at with my clients
These are grouped into functional systems that often overlap. The goal isn’t to address all of them at once, but to find your unique combination.
1. Hormonal imbalances
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Thyroid dysfunction (especially underdiagnosed hypothyroidism)
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Estrogen and progesterone imbalances (too high or too low)
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Cyclical migraines tied to menstruation may indicate autoimmunity to sex hormones
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Birth control or hormone therapies
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Adrenal dysfunction: high cortisol, poor stress tolerance, irregular cortisol rhythms
What to do: Get a full thyroid panel (TSH, Free T3, Free T4), track your cycle, and assess adrenal health through symptoms or saliva testing.
2. Sleep disturbances
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Sleep apnea
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Low melatonin production
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Genetic issues or neurotransmitter imbalances
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Thyroid-related poor sleep quality
What to do: Prioritize a consistent sleep schedule, reduce blue light before bed, and assess melatonin or neurotransmitter support if needed.
3. Genetic & Detox pathway dysfunction
Certain gene variations can affect how your body handles inflammation, neurotransmitters, and toxins:
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MTHFR, MAOA, COMT
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NOS3, DAO (histamine breakdown)
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GST, GTX (detox genes)
What to do: These don’t determine your fate, but they offer insight into why you may be more sensitive to certain foods, toxins, or stress. Nutritional support can help compensate.
4. Dietary triggers
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Common culprits: MSG, nitrates, sulfites, artificial sweeteners, dyes, processed foods, gluten, dairy, corn, eggs
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High-histamine, glutamate, or tyramine foods (aged cheese, wine, fermented foods)
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Blood sugar instability
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Dehydration
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Nutrient deficiencies or excessive food restrictions
What to do: Keep a food and symptom journal. Focus on whole, unprocessed foods and balance your blood sugar with protein, fat, and fiber at each meal.
5. Gut dysfunction & infections
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SIBO, H. pylori, Candida, EBV, Lyme
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IBS, constipation, or abdominal pain
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Celiac disease or malabsorption
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Leaky gut and gut-brain inflammation
What to do: Address gut health with targeted testing if needed. Support regular digestion, and avoid foods that cause GI distress.
6. Lifestyle factors
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Overuse of caffeine, alcohol, nicotine
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Medication overuse (especially for migraine relief)
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Poor breathing habits or shallow breathing
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Inadequate movement, chronic tension, or sedentary lifestyle
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Poor stress management
What to do: Begin with small, sustainable lifestyle upgrades. Movement, breathwork, and reducing medication reliance (with guidance) can make a big difference.
7. Neurotransmitter imbalances
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Shifts in serotonin
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Drops in dopamine or norepinephrine
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Low GABA (calming neurotransmitter)
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High glutamate (excitatory)
What to do: Balance comes from nutrition, sleep, gut health, and often, nervous system support. Testing can help guide targeted support.
8. Environmental & structural factors
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Barometric pressure sensitivity
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Blood pressure instability
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Toxin exposure or heavy metals
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Mitochondrial dysfunction
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Structural issues: neck tension, misalignment, posture, or injury
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Post-concussion syndrome
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Low antioxidant status or blood-brain barrier compromise
What to do: Reduce exposure to environmental triggers where possible. Movement, lymphatic flow, and mitochondrial support can be powerful tools for healing.
You don’t have to solve this alone
This list may feel like a lot, because migraines are complex. But with the right investigation, resources, and support, we can uncover the puzzle pieces that are driving your migraines.
If you’re ready to dig deeper into the root causes behind your symptoms and create a step-by-step plan to support your healing, I’m here to guide you.
Let’s work together to turn your migraine story into one of clarity, relief, and resilience.