The vascular theory says migraines begin when cranial blood vessels constrict. This event causes the warning signs of a migraine such as the classic "aura" or visual changes like dimness and flashing lights. Sometimes a migraine sufferer also feels weak, numb, dizzy, depressed, restless. They may slur their speech or crave sweets.

As these symptoms dissipate, pain takes over, presumably due to dilating vessels. Depending on the person, nausea, vomiting, diarrhea, sweating, chills and light sensitivity accompany the pain. Many migraine sufferers are incapacitated and seek the solace of a dark, quiet room.

Like tension headaches, stress can bring on a migraine. For some, the letdown after a stressful period like the weekend, may cause a migraine. Hormonal changes such as menstruation, ovulation and birth control pills prompt migraines in some women. Pregnancy and menopause alleviates this condition in many. This might explain why women are struck with migraines more often than men.

Many of the situations that provoke general headaches, also spark migraines in susceptible people. Hunger, cold food or drink, too much or too little sleep, other bodily pain, smells, light, noise or extreme temperature changes, stress, allergies, alcohol (especially red wine) and cigarette smoke are common triggers. Donald Johns, MD from Massachusetts General Hospital reported that the artificial sweetener, aspartame, initiated migraines in one of his patients (The New England Journal of Medicine, 1986, vol 315).

Certain foods like nuts, coffee, citrus fruits, cured meats, shellfish, chocolate and cheese initiate migraines in some people (although some of these foods may be a craving not the cause.) (The Lancet, 1992, vol 339). Foods containing MSG and nitrates are also possible migraine-promoters. It's possible, particularly in children, that food allergies bring on migraines (The Lancet, 1983, no. 8355). Many naturopathic physicians use food allergy testing as the main focus of migraine treatment.

Based on the idea that blood components called platelets become more sticky during migraines, some doctors recommend vegetable oils and fish instead of meat and dairy. Garlic and onions are also suggested.

Another preventative step is feverfew, or Tanacetum parthenium. J.J. Murphy and his colleagues at the Queen's Medical Center in Nottingham, England discovered patients taking feverfew everyday for four months had fewer and milder migraines, as well as less vomiting and visual disturbances (The Lancet, 1988, July 23).

While avoiding migraines through food selection, regular meals, controlled stress, a comfortable environment and possibly taking feverfew is best, what do you do if one strikes? There are several herbs and homeopathic remedies that may, at the very least, take the edge off your pain.

For migraines with nausea and other stomach complaints, chamomile and hops are suitable. Warning, don't take hops if you're severely depressed. If stress factors into your migraine, try one of the sedative herbs like oats or skullcap.

If your migraines are preceded by visual disturbances like dimness, the homeopathic remedy Gelsemium may work. On the other hand, if your migraine is right-sided, worse in the morning, recurs, and includes nausea and vomiting as well as prodromal blurring, then Iris versicolor could be the answer.

Headaches aren't normal, nor should they be ignored. Like any health problem, headache treatment should begin by exploring its source. A headache diary complete with foods eaten, exercise, medications taken (including vitamins and herbs), sleeping habits, temperature, stress, feelings and any other environmental factors help you pinpoint the cause. Do your headaches occur after reading, on the weekend, after visiting friends or only certain times a month? Do you have other symptoms that might indicate an infection?