Altitude and Migraines

Question

I have a friend who is training to climb Mt. Rainier (14,410’) next month.  She has pre-existing migraines.  We have trained a few days on the mountain – up to 10,188’ this past week.  Every time she goes, it triggers a migraine.  She is even taking some migraine meds as a preventative before she goes.

Do you have any advice?

Answer

There is very little objective evidence on this subject. It has been reported that those people who suffer from migraines have an increased risk of high altitude headache but there are no studies to prove this. There is possibly a similar mechanism behind the two conditions.
One study has shown that migraines can be triggered by low levels of oxygen leading to dilatation of vessels. Other evidence points to both altitude headache and migraine being linked to the activation of a particular neuro-vascular system (the trigemino-vascular system).
It is important to distinguish a migraine headache from an altitude headache. Altitude headaches do not usually have any neurological type symptoms like an aura, sight problems or being unilateral however they can cause vomiting, significant incapacity and irritability.
There is no contraindication for taking migraine prophylaxis at altitude. The UIAA recommends those who suffer from migraine should carry analgesic drugs that have previously proven effective for their migraines as well as preventatives.
Please remember Any answers we give are general: since we do not have access to your friend’s health records we are unable to make specific recommendations about her health or treatment.I would suggest your friend sees her physician. Your email and any answer will be published at altitude.org/mountain_doc.php. If you do not agree to this then please rsvp. 
I hope this helps.

Dr Kitty Duncan

| April 18th, 2014 | Posted in Questions to the mountain doc team |

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