Migraines are common and disabling to people.  They make up 5% of hospitalizations, and 20% of neurology consultations. Women experience them twice as much as men.  Those with chronic migraines can end up relying on strong pain medications.

Migraines are usually associated with other symptoms such as nausea, vomiting, dizziness, extreme sensitivity to lights, noises, and smells, lack of appetite, and disturbances of bowel function.  I am seeing more people suffering with these extreme symptoms so I wanted to break-down the different causes, testing and treatment.

Hormonal Migraines

Premenstrual syndrome can be a trigger for migraines.  Vitamin E is an effective treatment for menstrual migraines. It does this by lowering prostaglandins without any negative side-effects.

Use of an oral contraceptive pill or hormone replacement therapy can lead to too much estrogen and not enough progesterone.  This is another hormonal imbalance that can lead to hormonal migraines in menstruating women or those in peri-menopause.

A whole-food, low-glycemic diet that is high in phytonutrients with plenty of organic flax, fermented soy, and cruciferous vegetables such as broccoli, cabbage, brussels sprouts and cauliflower can help.  Avoid alcohol as it contributes to leaky gut.  Caffeine, sugar, and refined carbohydrates should be removed as well. Exercise and stress reduction techniques are also key.

Mitochondria & Cellular Health

Along with migraines you may feel fatigue, muscle aches, and brain fog.  This can be a methylation defect or simply poor cellular regeneration.  Mitochondria are the powerhouses or batteries of our cells.  Certain micronutrients like B vitamins (especially B2) and CoQ10 are essential for mitochondrial function.  Other b vitamins, alpha lipoic acid and vitamin c are also important.  An organic acids test lets us see the weak link.

Magnesium is also important for mitochondrial function. A deficiency can contribute to migraines, constipation, anxiety, insomnia and other stressors.  Feeling of irritability, noise sensitivity, muscle cramps or twitching, and heart palpitations are possible symptoms.  Magnesium glycinate is best for muscles whereas citrate targets constipation. Magnesium theonate is specific for brain health.

Chemical Triggers

The connection between migraines, constipation and liver function is well understood in Functional Medicine.  Our bodies filter chemicals and hormones the liver.  They are released through the colon.  If the liver detox capacity or digestion is impaired there is a build-up.  This toxic load often ends up in the bloodstream where it can cross the blood-brain barrier.   If you’ve heard the term ‘leaky brain’ this is what its referring to.

Chemical responses are also be triggered by certain foods.  Processed-food diet including aspartame, MSG (monosodium glutamate), nitrates (in deli meats), sulfites (found in wine, dried fruit etc) are all common chemical triggers. Tyramine-containing foods like chocolate and cheese are also worth checking.

Digestion & Migraines

Brain fog, bloating, irritable bowel syndrome, joint or muscle pain, and sinus congestion can all indicate an imbalance of the microbiome.  Whether its a food related trigger or not, an elimination diet is a good way to start.  Remove gluten, dairy and eggs. Corn can also be a problem.  Stool testing is used to assess possible pathogens or dysbiosis as well as inflammation and triggers.  Urine testing is excellent for fungal yeast, mould or bacterial imbalances.

The Conventional Approach

A diagnosis of chronic migraines is given to those where over 15 days of the month are migraine days.  Triggers are sometimes identified and a prescription of preventative medication can be taken daily.  These medications all have side effects. None of them cure migraines. Some of them have a rebound effect, meaning when the medication wears off, a rebound headache occurs.

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