Understanding and Recognizing Pre-Migraine Symptoms

Migraine is more than headaches. It’s a neurological condition that impacts more than 36 million Americans, according to the American Migraine Foundation. Migraine can cause severe pain and interrupt your daily activities.

Pre-migraine is one of the four stages of a migraine attack. Pre-migraine symptoms may occur before a migraine attack begins. You may be able to take steps to avoid a painful migraine attack if you can recognize the pre-migraine stage.

What are pre-migraine symptoms?

Migraine has four distinct states. Pre-migraine, called the prodrome stage, consists of a symptom or group of symptoms which let you know that a migraine attack is coming. It can begin anywhere from a few hours to several days before a migraine attack occurs.

The prodrome stage, sometimes also called the pre-headache or premonitory phase, doesn’t occur before every migraine attack, but learning to recognize pre-migraine symptoms can help you take preventative action. It’s also important to know that not everyone who has a prodrome stage will experience the exact same symptoms.

Pre-migraine symptoms may include:

  • Mood changes. You might feel depressed, anxious, or irritable without a pinpointable cause.
  • Muscle pain. Stiffness and cramping in your neck and shoulders is a common pre migraine symptom.
  • Food cravings. You can have strong cravings, especially for sweet foods, before a migraine attack.
  • Difficulty concentrating. You might have trouble focusing and feel foggy or confused.
  • Fatigue. Even if you had a good night’s sleep, you can feel extra tired leading up to a migraine attack.
  • Excessive yawning. Finding yourself yawning frequently throughout the day can be a migraine attack symptom.
  • Digestion trouble. You might experience constipation or diarrhea before a migraine attack begins.
  • Increased urinary frequency. Needing to visit the bathroom more often than normal is a common prodrome symptom.
  • Sensitivity to light and sound. You might have a low tolerance for bright lights and loud sounds before and during a migraine attack.

What to do if you have pre-migraine symptoms

You can start to take action if you recognize pre-migraine symptoms. If you’re being treated by a doctor for migraine, they can help you come up with a pre-migraine management plan that could prevent a full migraine attack from occurring. Try these common steps that can help during the prodrome stage:

  • Take pain-relieving medication. It can help to take pain-relieving medication before a migraine attack begins. You can use over-the-counter (OTC) options such as Excedrin, or prescription options. Follow the doctor’s instructions carefully when taking prescription medication for migraine.
  • Take any prevention medications. Be careful to not skip a dose of any prevention medications you’ve been prescribed if you’re having prodrome symptoms.
  • Avoid any known migraine triggers. It’s always a good idea to avoid anything that triggers your migraine, but taking extra care to avoid triggers when you notice pre migraine symptoms can help prevent a full migraine attack.
  • Rest and relax. Taking time to rest and relax can help you prevent a full migraine attack. If you can, try taking a nap or going to bed early. Meditation or other relaxation techniques can be especially useful.
  • Find a dark room. It’s best to avoid loud, bright, and stressful situations when pre migraine symptoms occur. Relaxing in a dark and quiet room can help prevent a migraine attack.
  • Take a hot shower or bath. A hot shower or bath can help relax your muscles. You can also try warm compresses.
  • Try ice packs. Ice packs are a good way to numb your pain and help you rest.
  • Drink a caffeinated beverage. Small amounts of caffeine can help relieve pain and can enhance the effects of some OTC pain relief medications. It’s a good idea to stick to a small amount, such as a single cup of coffee or can of soda. Too much caffeine can lead to withdrawal headaches and make it difficult to sleep.

What are the other stages of migraine?

There are three other migraine stages. Not everyone will have every stage during every migraine attack. The migraine stages are:

  • Aura stage. For individuals who have an aura with migraine, they usually occur about an hour before a migraine attack. Auras symptoms can vary but often include blurry vision, seeing flashing lights, visual hallucinations, vision loss, numbness, dizziness, and changes in hearing and speech. About one-third of people with migraine experience aura.
  • Headache or attack stage. The headache stage is when moderate-to-severe head pain that’s normally concentrated on one side of your head occurs. Pain is often throbbing and can become more severe when you move. The attack stage can last anywhere from a few hours to 3 days and also includes migraine symptoms such as nausea, vomiting, trouble sleeping, and sensitivity to light, sound, and smells.
  • Postdrome or resolution stage. This stage occurs once the migraine attack has faded and can last for a few hours to a few days. Symptoms at this stage often include feeling drained, fatigued, dizzy, and achy. It’s best to continue to avoid triggers and rest as much as you need during this stage.

The takeaway

The pre-migraine stage can start anywhere from a few days to a few hours before you have a migraine attack. Symptoms can vary, but often include:

  • confusion
  • fatigue
  • urinary frequency
  • sensitivity to light and sound
  • mood changes
  • neck pain
  • food cravings

Learning to recognize pre-migraine symptoms you experience can help you manage migraine and avoid an attack. Talk with a doctor if you’re having migraine attacks frequently. They can help identify your pre-migraine symptoms and the steps you can take during pre-migraine to avoid an attack.

A natural peptide could help tackle obesity and diabetes

  • Peptides are smaller versions of proteins that have a range of purposes, such as the potential to reduce the signs of aging, relieve inflammation, or promote muscle growth.
  • In 2015, researchers discovered a type of peptide called PEPITEM, and recognized its function in the adiponectin-PEPITEM pathway, which regulates the onset and severity of autoimmune or chronic inflammatory conditions.
  • Now, new research in animal models reveals that this peptide has the potential to offer a groundbreaking solution for many diseases.
  • The peptide may decrease the chances of developing type 2 diabetes and other conditions associated with obesity, such as fatty liver disease, the study indicates.

Obesity leads to significant changes in adipose (fat) tissue metabolism, harms the pancreas, impairs insulin sensitivity, and eventually causes hyperglycemia (high blood sugar), which is the foundation of type 2 diabetes.

Additionally, it triggers a low-grade inflammatory reaction throughout the body, which promotes the infiltration of white blood cells into numerous tissues, including fat deposits located deep within the body that surround organs, such as the liver and gut — called visceral adipose tissue — and the peritoneal cavity, a delicate membrane that encloses the gut.

According to a new study, published in Clinical and Experimental Immunology, the adiponectin-PEPITEM pathway provides a link between obesity, the accompanying low-grade inflammatory response, and modifications in the pancreas that occur prior to the onset of diabetes.

Using a mouse model of obesity, the researchers administered the peptide PEPITEM using a slow-release pump, to see if it could prevent or perhaps even reverse the impacts of a high-fat diet on the pancreas.

The researchers found that administering PEPITEM to mice that were following a high-fat diet resulted in a significant reduction in the enlargement of insulin-producing cells in the pancreas and the number of white blood cells in the visceral adipose tissue and peritoneal cavity when compared to the control group.

Scale of problem in diabetes

Diabetes is a non-communicable disease (NCD) where the amount of glucose in the blood is too high. Type 1 diabetes is an autoimmune disease whereby the body is unable to produce any insulin, and Type 2 diabetes develops when the body stops producing enough insulin or the body’s cells stop reacting to insulin produced.

Type 2 diabetes is associated with lifestyle factors – being overweight or obese is the major modifiable risk factor for Type 2 diabetes. The onset of Type 2 diabetes can be delayed or prevented through support to change behaviour around lifestyle choices. Type 1 diabetes is not related to lifestyle issues, and at this point cannot be prevented.

Risk factors for Type 2 diabetes

The obesogenic environment and associated lifestyle risk factors

The increasingly obesogenic environment we live in makes it harder for individuals to avoid unhealthy lifestyle choices. The obesogenic environment can be considered to be at the root of the prevention challenge in Type 2 diabetes.

From childhood, people are exposed to ultra-processed, energy-dense, nutrient-poor foods, which are cheap and readily available. Opportunities for physical activity, both in and out of school and the workplace, have been reduced and more time is spent on screen-based and sedentary leisure activities. As a result, high proportions of children and adults have increasingly been defaulting to unhealthy lifestyle choices including unhealthy diets, low levels of physical activity, and sedentary behaviour. These all give rise to higher risk of Type 2 diabetes:

  • overweight or obesity with a body mass index (BMI) of 25 or more
  • a large waist circumference – more than 80cm or 31.5 inches in women and 94cm or 37 inches in men