Migraines: More Than Just a Headache

What Are Migraines and What Causes Them?

Image by luisa Munoz from Pixabay¹

16.2 % of Americans suffer from migraine headaches, making it the most common neurological condition in the US. The exact cause of migraines is not fully understood, but overexcited nervous system responses and improper mitochondrial function in the cells have both been linked to migraines.² In addition, inflammatory chemicals and changes in in the blood vessels are also part of the migraine process.³

Migraines can come in multiple phases, which include the aura, in which a migraine is developing, and symptoms can include visual changes, mood changes, excessive yawning, and abnormal energy levels. The headache itself is generally throbbing pain, can be concentrated around the eye, one side of the head, or be more general. Pain is increased by movement and over sensitivity to light, sound, and smells are common during the headache phase. Other possible symptoms are nausea/vomiting, skin sensitivity, and muscle pain. Migraines can last from a few hours to a few days and can increase in frequency. They are more prevalent in women and are commonly linked to hormonal changes in the menstrual cycle.

In general, migraines are triggered by things like food sensitivities, a strong smell, stress, lack of sleep, or missing a meal. Though it is unclear why exactly some people respond to triggers with migraines while others do not and why the same triggers to not always cause migraines in the same person, it does seem to be the body trying to maintain homeostasis, and by keeping ones eating and sleeping schedule steady, the body will not necessarily overreact as strongly to other triggers. Because of the complexity of causes and triggers, the prevention strategy for each person will be different.⁴

What Can I Eat to Help My Migraines?

There is no one best diet for everyone with migraines, but one important aspect to consider is maintaining blood sugar balance, as drops in blood sugar can be a trigger for migraines. For this reason, a low glycemic diet is a good long term option as it helps maintain stable blood sugar levels by limiting carbohydrate consumption to 40-60 grams a day and is made up of mainly foods that are below 50 on the glycemic index.⁵ The glycemic index gives a number to a food which shows how it affects blood sugar in relation to sugar or white bread. For example, mashed potatoes are 83 (high glycemic) and brown rice is 50 (low glycemic). Including a majority of low glycemic foods like non-starchy vegetables (lettuce, carrots, lima beans, etc), fruits (apples, grapes, plums, and oranges), as well as beans (kidney beans, chickepeas, etc) and whole grains like brown rice and oatmeal, as well as meat and dairy⁶ help to keep the blood sugar stable throughout the day and can help lower inflammation. In a research study, people with migraines who went on a low glycemic diet experienced reductions of both frequency and severity of migraines in three months of the dietary trial.⁵ A major challenge in following a low glycemic food plan is learning where the foods fall on the index. One way to overcome this challenge is to print out a glycemic index chart and post it on your refrigerator so you can check the foods you are going to eat against it. You will learn pretty quickly where your favorite foods rank.

Triptans are medications commonly prescribed for migraines. If you take a triptan, be sure not to consume grapefruit as that is a major interaction with triptans.⁷

Fatty fish like salmon, mackerel, anchovies, herring, etc. can help with migraine prevention due to their omega 3 fatty acids. Studies have shown that higher omega 3 intake through food alone can decrease headache frequency in 9 weeks with continued improvement over the remaining three weeks of the study and food is more effective than omega 3 supplements.³

What Supplements Can Help?

There are multiple supplements that can be helpful in preventing migraine. Two are riboflavin (vitamin B2) and magnesium. Riboflavin plays an important part in cell mitochondria function⁸ and magnesium helps with mitochondrial function as well as balancing the effects of glutamate in the nervous system. In general, glutamate excites and magnesium calms down the nerves.²

Riboflavin (vitamin B2) has been shown to be effective in preventing and treating migraine. High doses like this can turn urine a bright yellow color, but riboflavin is safe and generally well tolerated even in pregnancy.³

Magnesium aspartate has been recommended in at bedtime for the prevention of migraines. High doses can cause diarrhea, and magnesium gluconate may be a good alternative if needed.³

Who Else Can Help Me?

Because migraines can be both a cause and effect of stress, a counselor trained in cognitive behavior therapy can be help you learn strategies for managing stress. In addition, cognitive behavior therapy can help you learn to identify your migraine triggers, deal with emotions and thought patterns that may be impacting your headaches and help with managing the stress that comes along with having migraines. People with migraines who participated in cognitive behavior therapy reported less frequent migraines and better quality of life. It is important to realize that this is a process and the length of time it takes to see results will vary from person to person.⁹

One useful thing to remember when trying to prevent migraines is SEEDS: Seep, Exercise, Eat, Diary, and Stress. Finding ways to balance your life and keep a consistent eating, sleeping, and moving schedule as well as using a diary to track symptoms and manage stress can all help in preventing migraines from taking over your life.¹⁰

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References

1. Image by <a href=”https://pixabay.com/users/r_r_studio-4513738/?utm_source=link-attribution&amp;utm_medium=referral&amp;utm_campaign=image&amp;utm_content=2058476″>luisa Munoz</a> from <a href=”https://pixabay.com/?utm_source=link-attribution&amp;utm_medium=referral&amp;utm_campaign=image&amp;utm_content=2058476″>Pixabay</a&gt;
2. Kirkland AE, Sarlo GL, Holton KF. The Role of Magnesium in Neurological Disorders. Nutrients. 2018;10(6):730. Published 2018 Jun 6. doi:10.3390/nu10060730
3. Rakel, D. Integrative Medicine 4^th ed. Elsevier; 2018.
4. Burstein R, Noseda R, Borsook D. Migraine: multiple processes, complex pathophysiology. J Neurosci. 2015;35(17):6619-6629. doi:10.1523/JNEUROSCI.0373-15.2015
5. Razeghi Jahromi S, Ghorbani Z, Martelletti P, Lampl C, Togha M; School of Advanced Studies of the European Headache Federation (EHF-SAS). Association of diet and headache. J Headache Pain. 2019;20(1):106. Published 2019 Nov 14. doi:10.1186/s10194-019-1057-1
6. Johnson-Greene, Chondra. Glycemic Index Chart: GI Ratings for Hundreds of Foods

Glycemic Index Chart | Free Glycemic Index Food List (universityhealthnews.com) Accessed February 4, 2022.

1. Sumatriptan Natural Medicines Database [database online]. Therapeutic Research Center, 2021. Accessed February 4, 2022.  https://naturalmedicines-therapeuticresearch-com.scnmlib.idm.oclc.org/
2. Shaik MM, Gan SH. Vitamin supplementation as possible prophylactic treatment against migraine with aura and menstrual migraine. Biomed Res Int. 2015;2015:469529. doi:10.1155/2015/469529
3. Bae JY, Sung HK, Kwon NY, Go HY, Kim TJ, Shin SM, Lee S. Cognitive Behavioral Therapy for Migraine Headache: A Systematic Review and Meta-Analysis. Medicina (Kaunas). 2021 Dec 28;58(1):44. doi: 10.3390/medicina58010044. PMID: 35056352; PMCID: PMC8777662.
4. Gazerani P. Migraine and Diet. Nutrients. 2020;12(6):1658. Published 2020 Jun 3. doi:10.3390/nu12061658