Migraine and Vomiting Together: Causes & What to Do

Key takeaways:

• Vomiting can often accompany a migraine, which can be triggered by hormonal changes, stress, or dehydration. Knowing when vomiting with a migraine is serious can help you decide when you should get medical advice.
• Migraines with vomiting are sometimes a sign of a more severe condition. Recognizing additional symptoms such as dehydration, blood in your vomit, or having recurring episodes is important in getting appropriate treatment.
• Addressing both your migraine and vomiting symptoms promptly can provide relief. In many cases, medication plus hydration can significantly improve your symptoms.

Having a migraine is distressing enough, but when combined with nausea and vomiting, your headache can escalate to an exhausting condition that severely impacts your day-to-day life. Unfortunately, nausea and vomiting are frequently seen in migraines. Research has shown that there may be a connection between having migraines and some gut disorders, as people who have migraines are more prone to develop gastrointestinal problems.

Let’s explore some of the possible causes of migraines and vomiting together, discuss when you should get medical attention, and then look at treatment options to help effectively manage your symptoms.

Common causes of migraines and vomiting at the same time

In some people who suffer from migraines, nausea and vomiting can occur before pain even begins.

But for most people, episodes of nausea and vomiting with migraines can be traced back to pain causing an activation in certain areas of the brain. Several conditions can lead to having a migraine along with vomiting. Here are some common triggers:

Dehydration

Although the reasons behind this are not fully understood, dehydration is one of the most frequent triggers of migraines and vomiting.

The lack of fluids in your body can lead to salt and mineral (electrolyte) imbalances, contributing to nausea and the onset of a migraine. Dehydration has also been shown to make pain feel worse and can ramp up the intensity of your headache.

Hormonal changes

For many women who suffer from migraines, hormonal fluctuations, particularly those related to estrogen, can trigger a migraine. Hormonal changes can also cause the onset of nausea and vomiting in migraine.

This is why some individuals experience migraines with vomiting around menstruation, pregnancy, or menopause​. It’s also why migraines are primarily a women’s ailment, and for most people who suffer from migraine headaches, they begin after the onset of the person’s menstrual period and decrease or disappear after the completion of menopause.

Stress and anxiety

Chronic stress can cause tension headaches that can escalate into a migraine. This stress can also stimulate your body’s nausea response, leading to vomiting. The combination of mental tension and physical symptoms can make it difficult to manage both.

Food and caffeine sensitivities

Some people who suffer from migraines don’t appear to adequately process foods that contain tyramine, an amino acid. Foods such as many cheeses, such as Swiss, blue cheese, Parmesan, feta, and aged cheddar are rich in tyramine and can trigger migraines in susceptible people.

The excess caffeine found in coffee and some colas can also be a trigger. For some people, red wine or other forms of alcohol can also bring on a migraine, but the exact mechanism behind this is not clearly understood.

Common causes of migraine and vomiting with other symptoms

Sometimes, migraines and vomiting come with other symptoms, and these may provide a clue to the underlying issue. Here are some combinations to be aware of:

Migraine with vomiting and diarrhea

If you experience diarrhea with a migraine, you may have gastroenteritis (stomach flu) caused by a viral or bacterial infection.

Your body’s reaction to a digestive upset can increase your headache and vomiting symptoms, especially if you get dehydrated due to loss of fluids.

Migraine with vomiting blood

If you see blood in your vomit, you should get immediate medical attention. Blood in vomit could indicate a severe gastrointestinal issue such as a bleeding ulcer that requires immediate treatment​.

Migraines while pregnant

Migraines can intensify during pregnancy due to the natural hormonal changes in your body.

Vomiting during migraines can sometimes be confused with morning sickness, but consistent or severe vomiting should prompt you to see your doctor to rule out other problems.

Migraines with a sore throat

If you have a sore throat as well as a headache and vomiting, you could have a strep infection. A throat infection with strep is a common cause of headache, along with nausea and vomiting.

Although there is little evidence that a strep infection can trigger a migraine, if you develop a sore throat along with a headache, nausea, and vomiting, you might mistakenly attribute your symptoms to a migraine if you suffer from them.

If you have a sore throat with these other symptoms, you should get medical care, as untreated strep can sometimes lead to serious complications.

When you should see a doctor about a migraine and vomiting

You should see a doctor if:

• You experience vomiting with nearly every migraine you have
• Vomiting with a migraine lasts more than 72 hours
• You cannot keep any fluids down

You should go to the emergency room if:

• You vomit blood
• You have a severe headache with fever, confusion, or a stiff neck
• You have muscle weakness or numbness
• You have trouble speaking clearly or walking
• You experience vision loss or double vision
• You experience a sudden, severe headache that feels different from your usual migraine
• You have a loss of consciousness

Questions to ask your doctor about migraines and vomiting

When getting medical care, asking questions helps to make sure you get the most effective treatment. Consider asking:

1. What is the most likely cause of my migraines with vomiting?
2. Do I need any specific diagnostic tests?
3. What treatments do you recommend to help with both the migraine and the vomiting?
4. Are there any dietary or lifestyle changes that could help me to reduce the frequency of migraines and vomiting?

Common treatments for migraine and vomiting

Migraines and vomiting may be able to be treated at home. In some cases, these symptoms may need medication or medical attention in order to get relief.

Hydration

If you become dehydrated due to vomiting, the dehydration can worsen both your migraine as well as the vomiting.

If you are able to keep fluids down, drinking an electrolyte solution such as a sports drink or Pedialyte can help. If you are unable to retain fluids due to vomiting, getting IV fluids can help to manage your symptoms.

Medications

While medications such as triptans (like the brand name Zomig) don’t prevent or cure migraines, they can work well when taken early in an attack.

Also, anti-nausea medications are often prescribed for migraine sufferers who if you are also experiencing vomiting with a migraine.. These medications can help relieve headaches and vomiting and greatly reduce your discomfort. Remember that migraine medications work best if they are taken as soon as you notice the first signs of an impending headache.

Relaxation and stress reduction techniques

Practicing stress-reducing techniques, such as meditation, deep breathing, and being sure you get plenty of sleep, can help reduce migraine frequency and severity.

It’s best to become familiar with a particular stress reduction technique of your choosing before a migraine attack, such as mindfulness meditation or practicing purposefully slowing your breathing. This will enable you to put the technique into action automatically without the additional stress of trying to remember how to do it correctly while you are in pain.

Frequently asked questions: migraines and vomiting

Is it normal to throw up from a migraine?

Yes, it is relatively common for severe migraines to cause nausea and vomiting due to the migraine’s effect on your body’s neurological and digestive systems. More than two-thirds of people who suffer from migraine also experience vomiting with their headaches. Episodes of vomiting seem to increase with the severity of the headache pain.

What should you do immediately after vomiting if you are already experiencing a migraine?

As soon as you can, you should focus on getting and staying rehydrated by sipping on water or an oral rehydration solution such as a sports drink or Pedialyte™.

In addition, resting in a dark, quiet place can help alleviate the migraine and nausea.

What should you eat or drink after a migraine and vomiting?

Start with light, bland foods such as toast or some saltine crackers. You should avoid foods that could trigger another migraine, like those with caffeine or highly processed foods. If you are sensitive to tyramine-containing foods such as aged cheeses, avoid those as well.

If red wine or other alcohol is a trigger for you, avoid them. Even if alcohol is not a specific trigger for your migraines, it is best avoided during migraine episodes, as alcohol is a well-known stomach irritant. Chocolate and citrus fruits are also best avoided, as for some people they are also a trigger.

Managing a migraine and vomiting

Migraines with vomiting can be very uncomfortable, but understanding the potential causes and knowing when you should reach out for medical care can make a big difference in your symptoms. If you experience vomiting with migraines regularly, you should consult a healthcare provider to get their advice on targeted solutions for both your migraines and the associated vomiting.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Lane Thaut, DO.

Sources

Arca, Karissa N, and Rashmi B Halker Singh. “Dehydration and Headache.” Current pain and headache reports vol. 25,8 56. 15 Jul. 2021, doi:10.1007/s11916-021-00966-z https://pmc.ncbi.nlm.nih.gov/articles/PMC8280611 Accessed 17 Oct. 2024.

Cámara-Lemarroy, Carlos R et al. “Gastrointestinal disorders associated with migraine: A comprehensive review.” World journal of gastroenterology vol. 22,36 (2016): 8149-60. doi:10.3748/wjg.v22.i36.8149. https://pmc.ncbi.nlm.nih.gov/articles/PMC5037083 Accessed 17 Oct. 2024.

Láinez, Miguel Ja et al. “Optimal management of severe nausea and vomiting in migraine: improving patient outcomes.” Patient related outcome measures vol. 4 61-73. 11 Oct. 2013, doi:10.2147/PROM.S31392 https://pmc.ncbi.nlm.nih.gov/articles/PMC3798203 Accessed 11 Oct. 2024.

Maniyar, Farooq H et al. “The origin of nausea in migraine-a PET study.” The journal of headache and pain vol. 15,1 84. 3 Dec. 2014, doi:10.1186/1129-2377-15-84. https://pmc.ncbi.nlm.nih.gov/articles/PMC4266549 Accessed 17 Oct. 2024.

Rothrock, John, and Deborah Friedman. "Triptans." American Headache Society, https://americanheadachesociety.org/wp-content/uploads/2018/05/John_Rothrock_and_Deborah_Friedman_-_Triptans.pdf. Accessed 17 Oct. 2024.

Sacco, Simona et al. “Migraine in women: the role of hormones and their impact on vascular diseases.” The journal of headache and pain vol. 13,3 (2012): 177-89. doi:10.1007/s10194-012-0424-y https://pmc.ncbi.nlm.nih.gov/articles/PMC3311830 Accessed 17 Oct. 2024.