“If you’ve ever experienced the intense pain and pounding of a migraine that makes you retreat into the darkness, you know that you never want to experience that again. Yet, for many people migraines impact their quality of life and daily function to the point that they become unable to work.”

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If you’ve ever experienced the intense pain and pounding of a migraine that makes you retreat into the darkness, you know that you never want to experience that again. Yet, for many people migraines impact their quality of life and daily function to the point that they become unable to work. Others live with the pain or find ways to manage using medication or various prevention or migraine treatment strategies. 

In today’s article we are going to answer these questions:

• What is a migraine?
• What are the different types of migraines?
• What are some common migraine causes or triggers?

Then, in part 2 of this series, we will discuss the functional medicine approach to migraine prevention, with a special focus on hormonal migraines. 

Migraine vs. Headache

Migraines are a common type of recurrent headache, affecting 35 million Americans. Migraines in women are more common than in men because of the role that hormones play in triggering migraines. 

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“Migraines are considered a neurological disorder, characterized by pain in the head and other migraine symptoms including nausea, vomiting, sensitivity to light and sensitivity to sound.”

Migraines are considered a neurological disorder, characterized by pain in the head and other migraine symptoms including nausea, vomiting, sensitivity to light and sensitivity to sound. Migraine pain is often one-sided stemming from a specific point, such as behind the eye, and may last for a few hours, up to a few days. 

Type of Migraines

The two main migraine types are migraine without aura, as described above, and migraine with aura. Migraine aura appears before getting the migraine headache and includes neurological symptoms such as blind spots in vision and dizziness. It’s also possible to have an aura without developing the migraine itself. 

Other migraine distinctions include:

• Ocular migraine,also called retinal migraine or visual migraine, is a migraine accompanied by the loss of vision or a significant visual disturbance in one eye. 

• Vestibular migraine is a migraine with vertigo. 

• Hemiplegic migraine is a severe, yet rare, migraine that may cause paralysis of one side of the body. 

• Menstrual migraine refers to the timing of the migraine with a woman’s cycle, typically occurring in the few days prior to menstruation. 

• Chronic migraine refers to migraines that are experienced 15 or more days per month. 

• Refractory migraine refers to a migraine that doesn’t respond to treatment. 

Migraine Causes

Migraines are incredibly complex and typically don’t have a single cause, instead people with migraines often have many different triggers. Think of a bucket. Each trigger fills the bucket a little, but the migraine isn’t experienced until a trigger tips the stressors over the edge and the bucket overflows.  

Common migraine triggers fall into the following categories:

Foods That Trigger Migraines 

Foods that cause migraines may include:

• Fermented and aged foods
• Food additives like MSG (monosodium glutamate)
• Food sensitivities such as gluten, nuts, corn, soy or nightshade vegetables
• Caffeine or caffeine withdrawal

Migraines and Hormones

The connection between migraine and hormones explains why more women get migraines than men. Hormonal migraines may be triggered by the change in estrogen levels throughout the cycle, or the fluctuating hormone levels of perimenopause. 

Sleep, Exercise and Stress

Migraines may be triggered by changes in the daily routine. You may experience migraine from lack of sleep or from too much sleep. You may experience migraine after exercise, especially if the intensity is too much or it causes dehydration. Or, you may be more prone to migraines if not exercising enough or exercise is inconsistent. 

Stress is large trigger for migraines as well and people with migraines may experience and uptick in migraine days during or after a period of high stress. 

Blue Light and Eye Strain

In today’s world, susceptible individuals may experience migraines triggered by computer work, exposure to artificial blue light from screens and eye strain from reading or other tasks causing an eye strain migraine.

Migraines and Nutrient Deficiencies

Certain nutrient deficiencies also play a role in migraines, these include:

• Magnesium
• Vitamin B2 (riboflavin)
• Vitamin B3 (niacin
• Vitamin B12
• Vitamin D
• Coenzyme Q10
• Carnitine
• Alpha lipoic acid

Also consider the connection between the MTHFR gene mutation and migraines, that may make someone more susceptible to functional deficiencies in B vitamins. 

The good news is that many of these migraine triggers are modifiable and within our control. When we reduce the triggers that we can, we also reduce the frequency and intensity of migraines experienced. 

I’ll dive more into the functional medicine approach to migraines in part 2 of this series. Stay tuned! 

References:

1. Olla, D., Sawyer, J., Sommer, N., & Moore, J. B., 4th (2020). Migraine Treatment. Clinics in plastic surgery, 47(2), 295–303. Abstract: https://pubmed.ncbi.nlm.nih.gov/32115055/ 
2. Lempert, T., Olesen, J., Furman, J., Waterston, J., Seemungal, B., Carey, J., Bisdorff, A., Versino, M., Evers, S., & Newman-Toker, D. (2012). Vestibular migraine: diagnostic criteria. Journal of vestibular research : equilibrium & orientation, 22(4), 167–172. Abstract: https://pubmed.ncbi.nlm.nih.gov/23142830/ 
3. Hipolito Rodrigues, M. A., Maitrot-Mantelet, L., Plu-Bureau, G., & Gompel, A. (2018). Migraine, hormones and the menopausal transition. Climacteric : the journal of the International Menopause Society, 21(3), 256–266. Abstract: https://pubmed.ncbi.nlm.nih.gov/29521155/ 
4. Amin, F. M., Aristeidou, S., Baraldi, C., Czapinska-Ciepiela, E. K., Ariadni, D. D., Di Lenola, D., Fenech, C., Kampouris, K., Karagiorgis, G., Braschinsky, M., Linde, M., & European Headache Federation School of Advanced Studies (EHF-SAS) (2018). The association between migraine and physical exercise. The journal of headache and pain, 19(1), 83. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134860/ 
5. Dolati, S., Rikhtegar, R., Mehdizadeh, A., & Yousefi, M. (2020). The Role of Magnesium in Pathophysiology and Migraine Treatment. Biological trace element research, 196(2), 375–383. Abstract: https://pubmed.ncbi.nlm.nih.gov/31691193/ 
6. 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: Review. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 102, 317–325. Abstract: https://pubmed.ncbi.nlm.nih.gov/29571016/ 

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