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I'll be honest, I've never personally endured a migraine. I've certainly had my share of intense headaches, but I've been fortunate enough to avoid those excruciating migraines that can drive someone to seek refuge in a dimly lit room while battling the urge to vomit. However, I've had the privilege of assisting numerous clients in significantly reducing the intensity and frequency of their migraine and headache episodes. Today, I'd like to share some crucial insights that may be of great help.
It's important to understand that there are underlying causes that need to be identified and addressed. Migraines not only severely disrupt a person's quality of life but also elevate their risk of experiencing life-threatening events. Migraine sufferers are at a significantly higher risk of cardiovascular incidents, such as heart attacks and strokes. Cardiovascular disease and strokes are the leading global causes of mortality.
In women, the risk of a cardiovascular event is double that of non-migraine sufferers! (1)
Scarily, there is a 9 X higher stroke risk for women migraine sufferers who are also on the contraceptive pill. (2)
In a study of over 20,000 men, there were 42% more heart attacks in those with migraines. (3)
One fundamental underlying factor is compromised gut health, which has reached epidemic proportions owing to the stress-laden lifestyles we lead. This includes the pervasive use of medications, exposure to harmful chemicals, and the consumption of heavily processed, sugary foods and beverages. This issue exerts a significant influence for a variety of reasons:
Absorption of vital nutrients and quality of diet.
Your gastrointestinal (GI) tract, or simply your gut, extends all the way from your mouth to your anus. After the respiratory system, the GI tract boasts the second-largest surface area, akin to the expanse of a tennis court! This is the vital site where you break down the food you consume, extract its crucial nutrients, and transport them into your bloodstream for your body's essential functions. Without these nutrients, your body cannot properly operate, heal, and repair.
Nutrient supplementation has been found to be beneficial for migraine sufferers.
Studies have shown:
Magnesium can reduce the frequency and severity of a migraine. (4, 5, 6)
High dose riboflavin (Vitamin B2) of 400 mg per day decreased migraine frequency from 4 x per month to 2 x per month and decreased the need for abortive migraine pharmaceuticals. (7)
Pyridoxal-5-Phosphate (P5P) or vitamin B6 at 80mg daily decreased severity, duration and frequency of migraines. (8)
Omega 3 fish oil may also be beneficial. Migraine sufferers were found to have a decrease in number and function of endothelial progenitor cells (EPCs). (9). These cells help repair damaged blood vessels. What can increase the number of EPCs and improve the regenerating capacity of the blood vessel lining (endothelium)? Omega 3 fish oil (10), a Mediterranean diet (11) and even walnuts (12).
These investigations indicate that deficiencies in essential nutrients might contribute to the occurrence of migraine headaches. Consequently, adopting a nourishing diet and maintaining a properly functioning gut, capable of efficiently absorbing these nutrients, is crucial for reducing their frequency and duration, or even eradicating them entirely.
The gut's role in DAO enzyme production and keeping histamine levels in check.
Histamine is thought to play a crucial role in the development of a migraine. (13) This compound is released by the body in response to injury and in allergic and inflammatory reactions. It's a normal process and an important part of our immune system response. However, if excessive histamine is released or if it lingers too long without being broken down, symptoms can occur. Symptoms of a histamine intolerance include:
headaches or migraines
nasal congestion or sinus issues
itchy eyes
fatigue
hives
digestive issues
nausea and vomiting
Hay fever symptoms are also due to excessive histamine, which is why anti-histamines are used for relief. The root cause, however, often stems from poor gut health! (See "How to beat hay fever and seasonal allergies naturally & for good"!)
A recent study found that nearly 90% of migraine patients have a DAO enzyme deficiency. (14) This enzyme breaks down histamine in the blood, so a deficiency may increase histamine levels leading to nerve inflammation. With migraines the trigeminal nerve is thought to be involved. (15,16)
Supplementation with DAO may therefore be beneficial. (17) But so too, could improving the health of the gut lining where DAO is produced, and nutrients such as omega 3 fish oil. (18)
Flavonoids found in brightly coloured fruits and vegetables have also been shown to lower histamine release. (19) As a supplement, the flavonoid quercetin is commonly used. (20)
Avoiding medications that block DAO production, like amytriptyline may also help. (21)
Plus, it is recommended to stay away from high histamine food and drink like alcohol, vinegar, fermented foods, cured meats, aged cheese and even chocolate!
The role of a "leaky" gut, food sensitivities and inflammation.
Along with its role in digestion, absorption of nutrients and elimination of toxins, the gut is a barrier between the internal and external environment. It is designed to keep undigested food particles, toxins, bad bacteria, and other infectious agents from entering the blood stream. The walls of the gut act as a selective physical barrier, however if it becomes damaged or "leaky" these toxins can enter the blood stream triggering a immune response and an inflammatory reaction.
Anything that drives chronic inflammation in the body is best avoided for migraine sufferers.
Inflammatory markers like high sensitivity C-Reactive protein (hsCRP) have been shown to be higher in those with a migraine diagnosis. Elevated hsCRP from blood tests is also a known risk factor for cardiovascular events. (22)
Common causes of a "leaky" gut (or increased intestinal permeability) are medications (like non-steroidal anti-inflammatories (NSAIDs) and Omeprazole), physical and emotional stress, poor nutrition, poor digestion (often due to low stomach acid), infections and food sensitivities. Many go hand-in-hand creating a vicious circle of gut damage and systemic inflammation.
Food allergies and intolerance's are known triggers for migraine sufferers. In one small study, eliminating ten common foods resulted in a dramatic fall in the number of headaches per month, with 85% of patients becoming headache-free. The 25% of patients with high blood pressure even found their blood pressure normalized! (23)
Food elimination based on IgG antibodies in patients with both migraines and irritable bowel syndrome noted a reduction in symptoms from both disorders. (24)
Those with Inflammatory bowel disease, gluten sensitivity, irritable bowel syndrome (IBS) and coeliac disease are all statistically more likely to suffer from migraine headaches than those without the conditions. (25, 26)
Migraines can be one of the earliest symptoms of coeliac disease, so it is important to rule out this serious autoimmune disease.
The gut's role in detoxifying our body.
Detoxification is your body's ability to remove harmful chemicals, heavy metals and even excess hormones. Your gastrointestinal tract, along with your liver, skin, lungs, and kidneys enable us to detoxify.
However, when these organs are overloaded or dysfunctional, free radicals remain causing oxidative stress, inflammation and damage to the body's cells and their energy producing organelles called mitochondria. Mitochondrial dysfunction and damage have been implicated in the pathophysiology of migraines. (27, 28, 29)
Perhaps that's why therapies aimed at mitochondrial support tend to decrease the frequency and intensity of migraines. Supplements such as CoQ10 and alpha lipoic acid have shown to be beneficial. (30, 31)
Overloading the detox organs with toxic chemicals is therefore not a good idea.
Chemical sensitivities are common with migraine sufferers and are potential triggers.
Artificial sweeteners, air pollution and odorants, especially perfume have all been shown to increase the risk of migraines. (32, 33, 34, 35)
For that reason, it is wise for migraine sufferers to look to reduce the number of chemicals they're exposed to daily in their home and work environment. Consider:
cigarette smoke,
factory pollution,
paint fumes,
pesticides and fertilizers,
nail and hair salon chemicals,
off gassing from new furniture or carpet,
perfumes and household fragrances,
the washing detergent you use and
the antiperspirant you spray on your body every day.
The process of methylation is another way your body detoxifies. It also protects and repairs your genes and cells, converts food into energy, and is important for brain, heart, muscle and hormone health. Methylation reduces many key chemicals, such as oestrogen, histamine, arsenic and certain neurotransmitters.
A hormonal imbalance between oestrogen and progesterone is also thought to play a role for some women migraine sufferers, especially if cyclical or menstrual migraines occur. (36, 37). Vitamin E supplementation may then be helpful. (38)
Although 85% of methylation occurs in the liver. Anything that overloads the liver, like a leaky gut or an increased toxic burden, will reduce its ability to do its job effectively and efficiently.
Poor methylation can lead to a rise in homocysteine in the body. This nasty amino acid increases the risk of heart disease, dementia, cancer, strokes and migraines! (39, 40, 41, 42, 43)
Unfortunately, around 30-40% of the population are thought to have a genetic mutation impacting their ability to methylate. Those with the MTHFR gene mutation have a 2-4 x increased risk of migraines. (44, 45) Methyl folate (not folic acid) and vitamin B12 (methyl B12) supplementation may prove beneficial in this case. (46)
Long standing migraines may result in long term damage. So please don't ignore. Healing your gut is an essential component to addressing any and all disease. On top of an improvement in your migraines you're likely to enhance your mood, sleep, digestion, immunity, skin health and more!
Need help uncovering and addressing the root causes of your migraines and chronic health issues? Please check out how you can work with me here or book a free discovery call.
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