If you or someone you know suffers from migraines, you know how painful and disruptive they can be. When a severe migraine strikes, the pain and other symptoms can be so bad that everything else must stop so you can attend to the headache. You might miss work, social functions or family gatherings; you have no choice.

Symptoms vary among sufferers and episodes. Some people have nausea and vomiting, while others become very sensitive to noise or light. Some experience visual disturbances, called aura, and some people even have the rare silent migraine, in which there is no pain but many other symptoms are present.

Whatever the symptom set, migraines have a way of intruding on the lives of their sufferers, and painkillers tend to offer little relief. That’s why prevention is the best medicine.

READ MORE: What Qualifies as Preventive Care?

Keep a Headache Diary

Just as symptoms vary widely between migraine sufferers, so do the triggers, or what brings on the headache. Knowing your triggers is the first key to migraine prevention, so many doctors suggest keeping a diary. In a typical migraine diary you’ll record the date, time, severity, symptoms before and during the episode, and all possible triggers. Some people also record methods for relief and the duration of the migraine. After you’ve collected enough information, patterns should start to emerge; you can learn from these.

Many people find that it’s alcohol or a certain food that emerges as the culprit. Alcohol is the most common migraine trigger, especially beer and red wine, due to a component called tyramine. Certain foods containing tyramine, like aged cheeses and smoked or cured meats, also trigger migraines.

Not everybody is sensitive to tyramine, however. Some people learn that weather patterns, loud noises or fasting can set off a migraine. Caffeine and tobacco are also possible triggers.

Stay Healthy

As with nearly every health condition, living a healthy lifestyle and avoiding obesity help lessen symptoms and complications. This means eating a healthful diet and incorporating aerobic activity into your schedule, but for migraine sufferers it also means eating protective foods.

Foods rich in magnesium, such as nuts, whole grains and dark leafy greens, can help prevent migraines. The herb butterbur has shown promise in clinical trials as a preventive, and other herbs are under study as well; many doctors recommend supplements as a course of preventive action.

READ MORE: 10 Ways Healthy Eating Can Change Your Life For the Better

Manage Stress

Like obesity and poor diet, stress is a well-known culprit behind a host of medical ills, and migraines are no exception. Stress can cause tension in the neck and shoulders, leading to tension headaches that escalate into migraines. Stress also causes hormonal fluctuations, and—you guessed it—certain hormones can trigger migraines. Yoga, meditation, prayer and breathing exercises are all common relaxation techniques; experiment to see what works best for you.

READ MORE: Managing Stress and 4 Other Health Commandments to Adopt Now

Sleep and Eat on a Regular Schedule

Clinical trials have shown that migraines can be triggered by irregular sleeping or eating patterns, so sufferers are advised to stay on a schedule. Lack of sleep can be a trigger, but so can getting too much sleep, so experts recommend aiming for 6 to 8 hours a night. Since fasting has also been associated with migraines, people with this trigger should eat first thing in the morning and avoid skipping meals.

Preventive Medications

When natural remedies fail to prevent migraines, or don’t do enough to help, there are some medications that can help. Most of these drugs were originally formulated to treat some other disorder, like seizures, depression, or high blood pressure, and were found to lower the incidence of migraines or lessen their severity. If you have more than three migraines per month or have episodes so severe you cannot work or carry out normal activities, your doctor may be able to prescribe a preventive medicine.

READ MORE: The Most Commonly Prescribed Drugs

Botox

You’re probably familiar with the wrinkle-reducing effects of botulinum toxin type A, commonly referred to by its brand name, Botox. Not everyone is aware of its clinical implications, however. Botox has been shown to effectively reduce muscle spasms, excessive sweating and, most recently, migraine headaches. It works by paralyzing the muscles that tighten during certain types of migraines so they can’t tense up and cause pain, reducing both frequency and severity of episodes. Since this method is the most expensive and may not affect certain types of migraines, it’s not for everybody, but it has been a great relief to some sufferers.

Lacie Glover writes for NerdWallet Health, a website that helps people reduce their medical bills.