Ask Onix
Understanding and tracking headache patterns
Nearly everyone experiences headaches at some point, with symptoms ranging from brief, mild discomfort to days of sharp, throbbing pain that can extend to the scalp, face, or neck. For Dr. Xand van Tulleken, co-host of the BBC's What's Up Docs wellness podcast, these episodes strike monthly, describing the sensation as "feeling like someone's drilling into my eyeball."
While severe headaches often trigger alarm, Dr. Katy Munro, a GP and headache specialist at the National Migraine Centre, reassures that serious underlying causes are rare. "It's natural to worry," she acknowledges, "but the likelihood of a grave condition is very low." She advises immediate medical review only for a "first or worst" headache. For recurring, milder episodes, self-monitoring and simple adjustments may help.
Identifying personal triggers
Dr. van Tulleken emphasizes that headaches rarely stem from a single cause, making personal pattern recognition key. Keeping a basic diary-tracking frequency, intensity (on a 1-10 scale), and potential triggers-can reveal insights. "I overcomplicated mine at first," Dr. Munro admits, noting that excessive detail can feel discouraging. Instead, she suggests balancing entries with "crystal-clear days" to provide a fuller picture for medical review.
Triggers vary widely: some react to weather changes like thunderstorms, while others, like Dr. Munro, find low autumn sunlight flickering through trees particularly aggravating. "Light sensitivity is a common but overlooked factor," she adds.
Diet, caffeine, and hydration strategies
Contrary to common belief, caffeine isn't universally harmful for headaches. Dr. Munro explains it acts as a co-analgesic, enhancing painkiller efficacy-if consumed judiciously. "A small dose with medication can help," she says, "but avoid it later in the day to prevent sleep disruption." Chronic overuse (or sudden withdrawal) can itself trigger headaches, she warns.
Dietary habits also play a role. A Mediterranean-style diet-rich in protein, healthy fats, and complex carbohydrates-helps stabilize energy levels, reducing headache risks. Dr. Munro notes that skipping meals or relying on sugary snacks often worsens symptoms. While she personally benefited from eliminating dairy and gluten, she stresses individual responses vary. "Regular meals and hydration are non-negotiable," she asserts, recommending pale, clear urine as a hydration benchmark.
Lifestyle adjustments and medication guidance
Beyond diet, Dr. Munro highlights four pillars for headache prevention: regular exercise, quality sleep, stress management, and hydration. Over-the-counter options like painkillers or anti-nausea tablets can offer relief, but she cautions against codeine-containing products, which may increase headache frequency and exacerbate nausea.
For those relying on painkillers, she advises limiting use to no more than two days weekly to avoid rebound headaches. "If headaches intensify or become more frequent," she urges, "consult your GP to explore tailored medications or preventive strategies."
"Supplies of effective treatments exist, but the right approach depends on your specific pattern-tracking is the first step to regaining control."
Dr. Katy Munro, National Migraine Centre
