Each day, write down in your diary all of the migraine triggers that may have occurred that day. Write down what you ate and when. Highlight each food or drink that you suspect is a trigger. The suggested format for your diary includes symbols to remind you what food groups you need to include with each meal; the number of symbols shows how many portions you should have. The symbols are: ♦ protein; ⋆; limited carbohydrate; ♥ free carbohydrates. In the beginning, it is important to avoid as many of the food triggers as possible. You should also include in your diary the amount of exercise and relaxation time you have each day. It is helpful to document migraine attacks on a calendar with every month on a single page. You can circle the day of an attack with a different color corresponding to the headache severity scale. This allows you to examine trends related to the frequency of your migraine attacks and make improvements in your migraine control.

How do I record my migraine attacks?

I recommend tracking migraine attacks with the identified triggers each day. The headache severity scale used in headache research is the most helpful way to rate headaches. With this scale, attacks are scored according to the level of disability. Headaches are rated on a 0–3 scale with 0 being headache-free and 3 a headache that prevents all activity.

  • A: Menstruation

  • B: Medical illness

  • C: Missing a meal

  • D: Too many carbohydrates

  • E: Dehydration

  • F: Stressful event

  • G: Food and drink

  • H: Schedule change or change in time

  • I: Sleep disruption

  • J: Change in eating habits

  • K: Weather change

  • L: Altitude change

  • M: Intense light, sound, or odors

  • N: Overuse of medications

  • O: Other medications

Headache disability
  • 0: No headache

  • 1: Headache with no effect on activity

  • 2: Headache interferes with activity

  • 3: Headache inhibits or stops all activity

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