How to Relieve Nausea from a Migraine
Medically reviewed by Nicholas R. Metrus, MD
Between 20% and 50% of people with migraines experience nausea and vomiting with some or all of their episodes. For many adults with migraines, nausea is one of the most distressing symptoms and one that tends to accompany severe migraine attacks.
While migraine-related nausea can be managed, it can be challenging as medications may be hard to swallow when you feel like vomiting. Some of the more effective treatments include prescription antiemetics, ginger, peppermint oil, and acupressure. Migraines may also be prevented with lifestyle changes, prescription medications, and the avoidance of migraine triggers.
This article discusses the causes of nausea with migraines. It also offers tips on how to get fast relief with home remedies, over-the-counter medications, prescription drugs, and alternative therapies.
Why Do Migraines Cause Nausea?
The underlying cause of migraines is poorly understood as is the cause of migraine-related nausea. However, there are theories as to why migraine triggers nausea in some people.
Migraines are thought to be caused by a hypersensitive nervous system that overreacts to stimuli, causing abnormal brain wave activity that leads to headaches and other symptoms. The trigeminal nerve is the specific nerve involved in most migraine attacks.
The trigeminal nerve is the largest cranial nerve tasked with sending pain, touch, and temperature sensations from your face to your brain. During a migraine attack, the activation of the nerve causes the sudden dilation and/or inflammation of local blood vessels that lead to headache pain along with blurred vision and increased sensitivity to light, sound, or noise.
Trigeminal Hyperstimulation and Nausea
When the trigeminal nerve is hyperstimulated during a migraine attack, it also shoots out nerve impulses to the medulla oblongata. This is the part of the brain that contains nerves that function as the sensory relay station between the brain and the gastrointestinal tract (which runs from the mouth and stomach to the rectum).
The abrupt activation of the medulla oblongata sends the same "alarm" signals that might occur if you ate something toxic, triggering the emetic (vomiting) reflex.
The first phase of the emetic reflex is the abrupt relaxation of the esophagus (feeding tube), leading to sensations recognized as nausea. This may or may not be followed by violent contractions of the stomach and esophageal muscles resulting in vomiting.
The activation of the trigeminal nerve may also cause the sudden dilation of blood vessels servicing the inner ear. This can disrupt the vestibular system, the system of ear organs responsible for proprioception (the sense of where your body is in space) and balance. The disruption of the system can lead to vertigo (spinning sensations) and the onset of nausea.
Types of Migraines That Trigger Nausea
Nausea can theoretically occur with any severe migraine attack but is most common with a type of migraine called a vestibular migraine.
Vestibular migraines are poorly understood but are thought to be associated with certain inherited genetic mutations. They are characterized by different types of vertigo, including spontaneous vertigo (which can happen at any time), positional vertigo (caused when you shift your head or body), and visually-induced vertigo (caused by looking at a moving object).
Vertigo is a common cause of nausea as it induces motion sickness. Motion sickness occurs when your brain can't make sense of information being sent from your eyes, ears, or body, leading to stomach queasiness, nausea, and vomiting.
Vestibular migraines affect females more than males.
Home Remedies and Lifestyle
There are some simple things you can do on your own that may help your migraine-related nausea.
Loosen your clothes, especially around your stomach
Take deep, slow breaths
Apply an ice pack to your head or neck
Open a window or step outside to get fresh air
Eat a small amount of bland food, like saltines
Avoid foods with strong tastes and odors
Stay hydrated by sipping water, unsweetened tea, or clear broth
It can also help to just let yourself vomit. This can provide relief from the uncomfortable sensation of nausea.
Childhood migraines, on the other hand, may involve only nausea and vomiting. In fact, children often do not have headaches or other migraine symptoms.
Over-the-Counter Therapies
Over-the-counter (OTC) therapies can help ease nausea. These include drugs that are used for treating motion sickness, such as:
Dramamine (dimenhydrinate)
Antivert (meclizine)
Benadryl (diphenhydramine)
These drugs can also help other migraine symptoms, like dizziness.
Motion sickness drugs usually work better for migraine-related nausea than OTC treatments typically used for stomach issues.
That said, you could also try:
Pepto-Bismol (bismuth subsalicylate)
Imodium (loperamide)
Prescription Medication
If you have severe nausea with your migraines, your doctor may suggest a prescription-strength drug. Some options include:
These medications help with nausea and are available in various forms, including:
Dissolvable pills
Syrups
Suppositories
Injections
Sometimes anti-nausea prescriptions are used to treat migraines even when nausea is not a major symptom.
Related: Anti-Nausea Medications Used for Migraine
Takeaway
When you have nausea, it can be a challenge to take medication by mouth. Strategize the best way to take your migraine medications. You are the only one who can decide whether you are more likely to keep your medications down with food, with drink, or without anything.
Several migraine medications like Imitrex (sumatriptan), Zomig (zolmitriptan), and Migranal (dihydroergotamine) are available in other forms, such as:
Inhalable
Injectable
Suppositories
If you're severely nauseated, this can make them easier to take.
Complementary and Alternative Medicine
Alternative therapies can also be beneficial for migraine symptoms, including nausea.
Ginger
Ginger is a common natural treatment for nausea.
There are a few different ways to take it:
Eat a raw slice from a ginger root
Suck on a piece of ginger candy
Make a cup of ginger tea
Drink a cold ginger ale
Learn More: Easing Nausea With Ginger
Acupressure
Acupressure is an alternative medicine practice that comes from Chinese medicine. It involves the use of pressure points to relieve health problems. There is evidence that stimulating acupressure point PC6 on the forearm can decrease migraine-related nausea.
To find this point, position your arm with the palm facing you. Place three fingers horizontally at the base of your palm. Just below your fingers, feel for the two tendons in the center of your forearm. The PC6 pressure point is in the middle of those two tendons.
A Sea-Band is a wristband that puts continuous pressure on this acupressure point. Try using one on each wrist to help relieve nausea during a migraine attack.
Aromatherapy
Aromatherapy involves inhaling concentrated essential oils. It is generally considered safe, but studies supporting its effectiveness are limited. So far, it has not been scientifically proven to relieve migraine-associated nausea. Still, some people do find it helpful.
Popular oils used for migraine-related nausea include lavender oil and eucalyptus oil.
Cannabis
Medical marijuana (cannabis) has been used to treat chemotherapy-induced nausea and vomiting in states where it is legal. So far the data is not clear regarding its effect on migraine-associated nausea.
Even so, some research suggests that cannabis may help reduce migraine attacks. A four-year study involving 120 adults with migraines found that the frequency of attacks was reduced from roughly 10 per month to four after medical marijuana was prescribed.
Some studies also suggest that the non-psychoactive ingredient of cannabis, called cannabidiol (CBD), may be useful in preventing migraines and may even help abort an impending attack. Using CBD may also be beneficial as it won't lead to cannabis overuse headaches that can sometimes affect frequent cannabis users.
There are currently no guidelines for the appropriate use of cannabis or CBD in the treatment of migraines. While more people are using cannabis for a variety of health issues, make sure you know the laws in your area. There may be legal consequences of using cannabis or cannabis-derived CBD in states where it is prohibited.
Takeaway
Alternative therapies pose different safety concerns. Always ask your doctor before trying any alternative treatment for your migraine-related nausea.
Prevention
Clearly, the best way to avoid migraine-induced nausea is to avoid migraines in the first place. Here are three ways to do so:
Identify and avoid migraine triggers: If you don't know what they are, keep a migraine diary, noting everything you did, felt, ate, or experienced prior to the attack. Over time a pattern may emerge that can help you pinpoint the exact causes or causes.
Reduce stress: Since migraines are more common during times of stress, find healthy ways to manage stress levels, including routine exercise or mind-body therapies like deep breathing exercises, meditation, yoga, guided imagery, or progressive muscle relaxation (PMR).
Use preventive medications correctly: Always take medications as prescribed. If they fail to provide ample relief, other options or drug combinations may be available. Talk with your healthcare provider if you take migraine medications more than twice weekly as this can lead to rebound headaches.
Summary
Many people with migraines also experience nausea during an attack. Fortunately, there are a number of over-the-counter and prescription medications that can help with this distressing symptom.
Simple home remedies like staying hydrated and applying ice can be helpful, too. Some people also get relief from alternative medicine therapies like acupressure or aromatherapy.
Read the original article on Verywell Health.
