How spring allergies may actually be a migraine in disguise
Would you like a side of searing head pain with that wheezy cough and crippling fatigue? As if allergies and migraines aren’t difficult enough to deal with alone, the heavyweights can gang up for a one-two punch that leaves you congested, throbbing, and so not looking forward to those April showers and May flowers.
“I would have a runny nose, itchy eyes, and a headache that would last for days on end, ranging from pressure in my forehead to feeling like my eyeballs would pop out, and then feeling like my entire head was being squeezed as my ears got clogged up,” Janice Dowdy, a 42 year-old speech language pathologist from Kentucky, who experiences allergies and migraine together, shares with Yahoo Lifestyle.
While experts say the science behind the pairing is still unclear, there are medical theories. “Inflammation of the sinus and nasal mucosa can activate the trigeminal nerves that are implicated in migraine, hence triggering attacks,” explains Kerry Knievel, director of the Jan & Tom Lewis Migraine Treatment Program and a member of the neurology faculty at Barrow Neurological Institute at Dignity Health St. Joseph’s Hospital and Medical Center in Phoenix, Arizona.
Histamine is released by mast cells, which are cells found in connective tissue. They’re part of the immune system and release substances when triggered to protect the body. For example, if you’re allergic to pollen, the histamine released by mast cells can cause you to sneeze to push pollen away. Histamine is known to be elevated in migraine whether or not allergies are present, and is thought to play into the process of migraine occurring with allergies, explains Knievel.
However, allergies can sometimes be mistaken for migraine, since there can be overlap of symptoms. About 40 to 50 percent of people with migraine experience associated eye tearing and 15 to 20 percent have associated runny nose, notes Knievel. The culprit is the autonomic nervous system’s involvement in migraine. “This can appear to be allergy, but it’s often pure migraine — I find that many of my patients who come to me with allergy diagnosis from a personal or primary physician actually have migraine,” says Knievel. Additionally, it’s been reported that 80 percent of patients diagnosed with “sinus headache” actually have migraine by diagnostic criteria, adds Knievel.
A board-certified neurologist can help you figure out if you have migraine alone or migraines along with allergies, and create a preventative plan. Some options many patients find effective for preventing chronic migraine include taking daily medications such as beta-blockers, calcium-channel blockers, anticonvulsants, and antidepressants, since these chemicals can come into play with migraine as well. Other options include Botox in the head and scalp every three months, as well as the new group of CGRP inhibitor shots, such as Aimovig and Emgality, which are specifically made to prevent migraine.
Knievel says that when she has patients with migraines triggered by allergies, she treats the allergies first. The go-to over the counter method is a long-acting antihistamine like Zyrtec, Claritin, Allegra or Xyzal, which last 24 hours each, says NYU Langone Health allergist Purvi S. Parikh, MD, of the Allergy & Asthma Network. “Intranasal steroids such as Flonase and Nasacort are very effective too, but you have to be patient — they take seven days to work,” adds Parikh.
If over-the-counter options still have you feeling miserable or if symptoms affect your quality of life and productivity regularly, it’s time to see an allergist. Options at the allergist’s office include prescription medications such as nasal sprays, asthma inhalers and pills. “Allergy shots are also a great option and best long-term because it makes you less allergic over time, whereas most other medications just manage the symptoms,” explains Parikh.
Dowdy took this advice to heart, with dramatic results. “The absolute best thing I’ve ever done was start allergy shots and prescription pills,” she shares. “I feel like a million dollars now while everyone around me feels miserable — including my husband, who won’t take the time to get tested!” Dowdy says she rarely has allergy migraines anymore, and now is just left with existing hormonal migraines a few times a year. For migraine sufferers, every reduction is a celebration.
Read more from Yahoo Lifestyle:
It’s like ‘being shot in the head’: 3 women share the painful toll of chronic migraines
Here’s what you need to know about migraines and how to stop them
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