Migraines do not cause fever on their own, but fever during a migraine attack usually signals a separate infection or illness
A migraine is a neurological event — your brain's blood vessels and nerve activity shift in ways that trigger pain, sensitivity to light, and sometimes nausea. Fever is a sign that your immune system is fighting an infection or responding to inflammation elsewhere in your body. The two processes are separate. If you have a fever above 100.4°F (38°C) during or around a migraine, something else is happening alongside the migraine, not because of it.
That said, the timing can be confusing. A viral infection like the flu or a sinus infection can trigger a migraine and also cause fever. In that case, both are real — they are just two separate symptoms of the same underlying illness. The migraine did not create the fever, but the infection created both.
Key Takeaways
- Fever is not a symptom of migraine itself; if you have a fever during a migraine, an infection or other condition is likely present.
- Viral infections, sinus infections, and ear infections can trigger migraines and also cause fever as separate symptoms.
- A fever above 100.4°F during a migraine warrants contact with your doctor to identify what is actually causing it.
- Certain migraine medications can raise body temperature slightly, but this is rare and not the same as true fever.
When an infection causes both migraine and fever
The flu, a cold, or a sinus infection can set off a migraine because these illnesses cause inflammation and trigger chemical changes in your body. At the same time, your immune system raises your body temperature to fight the infection. So you end up with a migraine and a fever, but the fever is not caused by the migraine — it is caused by the virus or bacteria.
Sinus infections are particularly common culprits. Pressure and inflammation in your sinuses can trigger a migraine, and the infection itself produces fever. Ear infections work the same way. Meningitis is rare but serious: it causes high fever, severe headache, and stiff neck, and it requires emergency care. If you have a high fever, severe headache, and neck stiffness together, go to an emergency room or call 911.
What happens if you take migraine medication with a fever
Most migraine medications — triptans, NSAIDs like ibuprofen, and others — do not cause fever. They work on pain and inflammation, not on body temperature. Taking them while you have a fever from an infection is generally safe, but it does not treat the infection itself.
If you are taking a migraine preventive medication (like topiramate or propranolol) and you develop a fever, the fever is not from the medication. However, some people on certain medications report feeling warmer or having slight temperature changes, which is not the same as true fever. If you are unsure whether a medication is affecting your temperature, call your prescribing doctor.
How to tell the difference between migraine symptoms and fever symptoms
Migraine symptoms include throbbing pain on one or both sides of the head, sensitivity to light and sound, nausea, and sometimes vomiting. Fever symptoms include a warm or hot feeling, chills, body aches, and fatigue. You can have both at the same time if an infection is present.
Check your temperature with a thermometer. A reading of 100.4°F or higher is fever. If you have this reading along with a migraine, contact your doctor or an urgent care clinic to find out what is causing the fever. Do not assume the migraine caused it.
When to contact a doctor about fever and migraine together
Contact your doctor if you have a fever above 100.4°F during a migraine, especially if the fever lasts more than a few hours or if you have other symptoms like cough, sore throat, or body aches. Your doctor can determine whether you have an infection that needs treatment.
Seek emergency care (call 911 or go to an emergency room) if you have a high fever (above 103°F), severe headache, stiff neck, confusion, or a rash. These can be signs of meningitis or another serious condition that requires immediate attention.
Other conditions that cause both headache and fever
Beyond common infections, other illnesses can produce both headache and fever. Mononucleosis causes sore throat, fever, and often headache. Lyme disease (from a tick bite) can cause fever and headache. COVID-19 causes fever, headache, and sometimes migraine-like pain. Autoimmune conditions like lupus can trigger both fever and migraine.
The point is the same: if you have fever with your migraine, something beyond the migraine itself is happening. Your doctor needs to know about both symptoms to figure out what is actually going on.
Frequently Asked Questions
Can a migraine raise your body temperature slightly without being a true fever?
Some people report feeling warm during a migraine, but a true fever (100.4°F or higher on a thermometer) indicates infection or another condition, not the migraine itself. If your temperature is below 100.4°F, you do not have fever, though you may feel flushed from the migraine's effects on blood vessels.
Is it safe to take fever-reducing medicine during a migraine?
Yes. Over-the-counter fever reducers like ibuprofen or acetaminophen are often used to treat migraine pain itself. Taking them for fever during a migraine is safe, but they treat the fever symptom, not the underlying cause. You still need to find out why you have the fever.
Can stress or lack of sleep cause both migraine and fever?
Stress and poor sleep can trigger migraines, but they do not cause fever. If you have both after a stressful period or poor sleep, an infection is likely present alongside the migraine trigger. The two are coinciding, not one causing the other.
Should I go to the doctor if I have a migraine with a low-grade fever?
A low-grade fever (100.4°F to 101°F) still warrants a call to your doctor, especially if it lasts more than a few hours or you have other symptoms. Your doctor can determine whether you have an infection that needs treatment or whether something else is causing the fever.