It’s common to lose your appetite, feel nauseous, or even vomit during a migraine attack. These are well-known symptoms of migraine. For some people, nausea and vomiting can be just as disruptive as the head pain itself. They can also make it harder to get through the day or keep food, fluids, and medicine down.

Members of MyMigraineTeam have reported nausea and vomiting with migraine attacks. Many explained that it comes with other migraine symptoms. “Migraine pain 6/10, extreme nausea, blurry and double vision,” said a member. Another said, “Spent maybe one hour last night staring at the ceiling, because my head hurt so much, plus I had more vertigo and nausea.”

Fortunately, medications and lifestyle changes may help relieve nausea and vomiting during a migraine attack. If you have these symptoms with your migraine attacks, here’s what you need to know, including what causes them, how you can address them, and when they could be a signal of something else.

How Common Are Nausea and Vomiting With Migraine Attacks?

Nausea and vomiting are common migraine symptoms. Healthcare providers may describe these as digestive symptoms linked to migraine. These symptoms are so common that doctors may use them to help diagnose migraine, especially if they’ve happened with your headaches at least five times.

Up to half of people with episodic migraine have nausea. For many of them, it happens during more than half of their headache episodes. Vomiting occurs in about 30 percent. Studies from the journal Cells have found that the majority of people who have nausea with a migraine attack are women. Forty percent of people who constantly report nausea with episodic migraine went on to develop chronic migraine within two years.

Why Do Migraine Attacks Cause Nausea and Vomiting?

Researchers are still unclear why migraine attacks may cause nausea and vomiting, or how the two are related. One theory is that during a migraine, the nausea center in the brainstem is activated. Some doctors think the link between the gut and the brain may play a role.

This connection may involve the autonomic nervous system, which affects heart rate, digestion, and how food moves through the gut. Other researchers believe nausea and vomiting may happen when you have a migraine because of how sensitive your body is to light, sound, or other triggers.

A Nervous System Reaction

For example, if your nervous system is very sensitive to triggers like light or sound, it may not only contribute to a migraine attack but also make you feel nauseous or cause vomiting. One idea is that when the trigeminal nerve is overstimulated, it can trigger both head pain and stomach symptoms like nausea or vomiting. The trigeminal nerve is a large nerve in your head that helps you feel pain and controls chewing.

Gastrointestinal Disorders

Researchers have found connections between gastrointestinal disorders and migraine. One study noted that people with irritable bowel syndrome (IBS) and peptic ulcers were more likely to have migraine, too. Another team of scientists found that the link between migraine and the gut could be affected by gut bacteria, stress hormones, brain chemicals like serotonin, and the foods you eat. Serotonin is a chemical messenger that helps nerve cells communicate.

Cyclic Vomiting Syndrome

There’s also a known connection between migraine and cyclic vomiting syndrome, which is a condition that causes repeated vomiting. Cyclic vomiting syndrome is considered a migraine-related condition. If you have both of these conditions, it’s likely that they have many of the same triggers and can happen at the same time.

Tell your healthcare provider if you have stomach symptoms along with your migraine attacks.

These symptoms can affect your migraine treatment plan. For example, if you’re vomiting often, your body may not absorb your medicine as well. Your healthcare provider might also suggest different types of migraine medications, like nasal sprays or anti-nausea medications, if you experience nausea and vomiting during attacks.

What Helps Relieve Nausea With Migraine?

Migraine symptoms can vary from person to person. Along with following your treatment plan and taking your prescribed medicine, here are some things you can try at home to help with nausea.

• Eat ginger or ginger-flavored products like ginger candy, ginger tea, or ginger capsules.
• Try peppermint oil, aromatherapy, or acupressure at the P6 point on the wrist to help relieve nausea.
• Practice breathing exercises to relieve nausea and ease stress.
• Find a dark, quiet place to rest and reduce distractions.
• Get some fresh air or step outside for a minute.
• Eat bland foods like crackers or English muffins to help settle your stomach.
• Avoid spicy foods and strong odors to keep nausea from getting worse.
• Drink water or clear broth to stay hydrated, especially if you’re vomiting.
• Ask your healthcare provider about taking over-the-counter anti-nausea medicines like antihistamines, dimenhydrinate (Dramamine), or supplements like vitamin B6.

When Should You Worry About Nausea and Vomiting With a Migraine Attack?

If you’ve had a migraine attack before, you probably know what to expect. If you experience symptoms that aren’t typical for you, or you suddenly have a severe headache that feels like the worst headache of your life, get immediate medical attention, especially if the headache feels like a thunderclap in your head. Though rare, these headaches can be a sign of serious medical issues.

Seek immediate medical attention if you have a headache with other symptoms such as stroke symptoms (paralysis or weakness on one side of your body and inability to speak), a fever, stiff neck, confusion, seizures, or double vision.

Other warning signs you need to be evaluated include:

• Headache after a head injury
• Worsening headache after coughing, straining, exerting yourself, or making sudden movements
• New headache pain after age 50
• Headache that’s different from what you’ve experienced in the past
• Worsening headache pain while lying down

Make an appointment with your headache specialist or neurologist if your headaches are changing or following a new pattern. You should also talk to your doctor if your treatment plan is no longer helping, especially if you take medication more than three days a week or have side effects. Let your doctor know if nausea or vomiting is getting worse or bothering you more often.

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