A Functional medicine approach to migraines
My Dad suffered from migraine as a child. In addition to head pain he experienced changes in vision, nausea, vomiting and being unable to leave a darkened room.
Migraine is best understood as a primary disorder of the brain. About 15% of the population suffers from migraine at some stage in their lives, disproportionately affecting women (22% vs 10%) with the highest prevalence between 35-45 (1).
Fortunately my own experience with migraine is limited. I suffered an attack whilst at university. Firstly losing the clarity of the words on the page followed by a rather embarrassing public projectile vomit on the train ride home.
Migraine involves dysfunction of brain-stem pathways that normally modulate sensory input. Certain ‘triggers’ lower the threshold to activate the trigeminovascular system. This system relays signals from blood vessels in the brain to higher centres of the central nervous system. When activated, sensory nerves trigger the release of molecules that widen and cause leakage of the blood vessels. The resulting neuroinflammation is thought to contribute to the development of a migraine attack. (2)
Pain is characterised by severe and frequent throbbing on one side of the head and may be accompanied by nausea, vomiting, or sensitivity to light, sound, and movement usually lasting between 4-72 hours (2).
Current treatment involves the avoidance of migraine triggers including stress, dietary triggers, and dehydration, in addition to the preventative and/ or acute medications targeted at altering the biochemical imbalances that may prevent or abort a migraine attack.
Functional Medicine is a science based, whole systems approach that focuses on identifying and addressing the root cause of presenting symptoms or disease. It emphasises an evidence-based nutritional and lifestyle approach to improve the function of bodily systems to create an environment that promotes self healing.
Rather than asking “how do we treat themigraine?”, it asks “what’s causing the migraine?”
Migraines have been associated with inflammatory diseases and changeable risk factors including obesity, comorbid pain conditions, and sleep problems. However, causes of migraine vary for each individual patient and hence the best treatment and prevention is also individual.
Some potential Migraine causes:
- Metabolic imbalance
- An imbalance of energy demands of the brain and the bodies inability to meet them may be a trigger leading to migraines (3)
- Gastrointestinal problems
- Migraines have been associated with IBS, celiac disease and low levels of vitamin D (4)
- Mitochondrial dysfunction
- Increase in the levels of the destructive free radicals with and a poorer antioxidant capacity to help mitigate this. (5)
- Trace minerals and Heavy metals
- Appear to have a role in the genesis of increased production of free radicals in migraine attacks (6)
- Hormone imbalance
- Abrupt drops in estrogen occurring just prior to mensturation and during menopause have commonly been observed to trigger migraines (7)
- Musculoskeletal
- Dysfunction of joints and muscles in the neck have been observed in patients with migraine (8)
By taking a thorough medical history, examination, interpreting and utilising specific functional testing, a functional medicine approach helps to narrow in on a root cause and provide specific individualised treatment and management recommendations.
Some strategies employed may be:
- Dietary changes to improve blood sugar regulation, mitochondrial function and antioxidant capacity
- Developing supportive exercise programs, sleep hygiene and stress management strategies
- Use of supplementation to improve micronutrient status, energy production and reduce inflammation
Functional medicine is complementary and works alongside your conventional medical approach. As your body heals, you can work together with your medical provider to gradually reduce your reliance on medication and pain relief.
If you would like more information on how a functional medicine approach may be able to assist your migraines please contact the clinic and schedule a free discovery call.
References
- https://headacheaustralia.org.au/wp-content/uploads/2018/08/MigraineFactSheet.pdf
- Spekker, E., Tanaka, M., Szabó, Á., & Vécsei, L. (2022). Neurogenic Inflammation: The Participant in Migraine and Recent Advancements in Translational Research. Biomedicines, 10(1), 76.
- Gross, E. C., Lisicki, M., Fischer, D., Sándor, P. S., & Schoenen, J. (2019). The metabolic face of migraine—from pathophysiology to treatment. Nature Reviews Neurology, 15(11), 627-643.
- Cámara-Lemarroy, C. R., Rodriguez-Gutierrez, R., Monreal-Robles, R., & Marfil-Rivera, A. (2016). Gastrointestinal disorders associated with migraine: a comprehensive review. World journal of gastroenterology, 22(36), 8149.
- Nattagh-Eshtivani, E., Sani, M. A., Dahri, M., Ghalichi, F., Ghavami, A., Arjang, P., & Tarighat-Esfanjani, A. (2018). The role of nutrients in the pathogenesis and treatment of migraine headaches. Biomedicine & Pharmacotherapy, 102, 317-325.
- Gonullu, H., Gonullu, E., Karadas, S., Arslan, M., Kalemci, O., Aycan, A., … & Demir, H. (2015). The levels of trace elements and heavy metals in patients with acute migraine headache. J Pak Med Assoc, 65(7), 694-7.
- Reddy, N., Desai, M. N., Schoenbrunner, A., Schneeberger, S., & Janis, J. E. (2021). The complex relationship between estrogen and migraines: a scoping review. Systematic Reviews, 10(1), 1-13.
- Castien, R., & De Hertogh, W. (2019). A neuroscience perspective of physical treatment of headache and neck pain. Frontiers in neurology, 10, 276