Migraines—What Causes Them, and How You Can Best Address Them

Migraines—What Causes Them, and How You Can Best Address Them

August 22, 2013 | 71,069 views

By Dr. Mercola

I am thankful I have never had a migraine or, but migraine headaches are one of the most common health conditions in the world—more prevalent than diabetes, epilepsy and asthma combined.1 They're also one of the top 20 causes of disability among adults.

More than 37 million Americans suffer from migraines; nearly five million of them experiencing at least one migraine attack per month.2 In all, an estimated 13 percent of the world’s population suffer with migraines to a greater or lesser degree.

The condition is more prevalent among women, with about 15-18 percent of women worldwide getting them, compared to six to seven percent of men. About 60 percent of women affected have menstrual-related migraines, meaning they tend to coincide with their menstrual cycle.

Despite its prevalence, migraines are still one of the most poorly understood medical disorders out there. Part of the problem has been that the experiences of those suffering from migraines vary greatly.

Aside from throbbing, searing pain, which may or may not be one-sided, some experience “auras” prior to onset, while others do not. There may also be nausea, vomiting, fever, chills, sweating, and/or sensitivity to light, sound, and smells.

Those who have never had a migraine before can be quite frightened by the neurological symptoms, which can simulate a stroke where you start to have disturbed vision, and even short term visual loss and/or seeing spots or wavy lines, and/or tingling in your arm or leg.

Migraines May Be Linked with Abnormal Blood Vessel Structure

One long-held theory was that a migraine is caused by vascular changes in your brain, from initial blood vessel constriction and a drop in blood flow, followed by dilation and stretching of blood vessels, which activates pain-signaling neurons.

Newer research has negated this theory however, as researchers eventually determined that migraines are not preceded by constriction and decrease in blood flow, but rather by a blood flow increase of nearly 300 percent. Despite that, circulation appears normal, or even slightly reduced, once the attack is in full swing.

Most recently, a small observational study3 found that so-called migraineurs—people who get migraines—tend to have a different blood vessel structure in their brains compared to those who do not get migraines.

Three types of test subjects were included in the study. Out of 170 subjects, 56 had migraines with aura, 61 had migraines without aura, and 53 were included as controls.

Using Magnetic resonance angiography, the researchers examined the structure of blood vessels and the changes in cerebral blood flow, focusing on a system of arteries that deliver blood to the brain called "circle of Willis."

They found that an incomplete circle of Willis was significantly more common in those who get migraines, with or without aura, compared to the control group (73 percent and 67 percent versus 51 percent respectively).

As a result, compared to those with a complete circle of Willis, those with an incomplete circle had greater asymmetry in hemispheric cerebral blood flow. According to one of the authors of the study, Dr. John Detre, M.D., a professor of neurology and radiology:4

“Abnormalities in both the circle of Willis and blood flow were most prominent in the back of the brain, where the visual cortex is located. This may help explain why the most common migraine auras consist of visual symptoms such as seeing distortions, spots, or wavy lines.”

Other Hypotheses

There are other hypotheses as well. For example, a meta-analysis of 29 genome-wide association studies recently identified five genetic regions linked to migraine onset and 12 genetic regions linked with migraine susceptibility.5, 6 In addition to that, they also found a whopping 134 genetic regions that appear to heighten migraine susceptibility.

Another study7 published earlier this year suggests that the searing, throbbing pain that is the hallmark of a migraine may be due to overactive pain-signaling from sensory neurons in your brain.

A third hypothesis is that a migraine arises as a result of a disorder of your nervous system, most likely in your brain stem.8 Although most regions of your brain do not register or transmit pain signals, a network of nerves called the trigeminal nerve system does. Pain is relayed through the trigeminal network to an area in your brain stem called the trigeminal nucleus.

From there, it is conveyed to the sensory cortex in your brain, which is involved in your awareness of pain and other senses. What first activates your trigeminal nerves, setting off your migraine, however, is still under debate, but some researchers believe that a wave release of neurotransmitters across your cortex can directly stimulate your trigeminal nerves, setting off the chain reaction that ends in the transmitting of pain signals. No one hypothesis has yet emerged to explain the occurrence of migraine in all sufferers. Besides those already mentioned, other theories include:

• Changes in the brain chemical serotonin. When levels drop, blood vessels including those in your brain become swollen and inflamed, which can lead to migraine pain.
• A disruption of the subtle energies circulating throughout your body, along with unresolved emotional issues that manifest in your body as headaches.
• Vitamin B deficiency. In one study,9 vitamin B6, B12, and folic acid supplements were found to produce a two-fold reduction in migraines over a six-month period. Previous studies, such as a 2004 study in the European Journal of Neurology,10 have also reported that high doses of B2 (riboflavin) can help prevent migraine attacks

Common Migraine Triggers

Environmental factors appear to play a significant role in triggering a migraine attack. While there are many potential triggers (and what triggers a migraine for one might not trigger it in another), the following are some of the most commonly reported:

Food and Drink: Many people experience migraines when they eat certain foods, especially: wheat, dairy, sugar, artificial preservatives or chemical additives, cured or processed meats, alcohol (especially red wine and beer), aspartame, caffeine, and MSG. Caffeine can also trigger an attack - and sometimes excess nuts	Changes in sleeping cycle: Both missing sleep and oversleeping can trigger a migraine	Hormones: Some women experience migraines before or during their periods, during pregnancy or during menopause. Others may get migraines from hormonal medications like birth control pills or hormone replacement therapy
Allergies: Including food allergies and food sensitivities, and chemical sensitivities	Stress/Post-stress: Any kind of emotional trauma can trigger a migraine, even after the stress has passed	External stimuli: Bright lights, fluorescent lights, loud noises and strong smells (even pleasant ones) can trigger a migraine
Dehydration and/or hunger: Skipping meals or fasting are also common triggers	Physical exertion: Extremely intense exercise or even sex has been known to bring on migraines	Weather changes, and/or changes in altitude

Are Food Allergies Causing Your Migraines?

Searching the medical literature in PubMed.gov using the search terms “migraine” and “food allergies” will provide you with nearly 160 different studies11 of this kind, so do yourself a favor and don’t dismiss this potential connection. One randomized, double blind, cross-over study published in 201012 found that a six-week long diet restriction produced a statistically significant reduction in migraines in those diagnosed with migraine without aura. Some of the top migraine-inducing foods identified include:13, 14

Wheat and gluten	Cow’s milk (including yoghurt and ice cream)	Grain cereals	Cane sugar
Yeast	Corn	Citrus	Eggs
Aspartame	MSG

I’d advise you to avoid as many processed foods as possible, as they contain a variety of food colorings, flavors, preservatives, and other additives that might promote headaches and migraines, in addition to other food allergy symptoms. Questions that can help you determine whether or not you might have a food sensitivity or allergy include:

• Do you experience bloating after meals, gas, frequent belching, or any kind of digestive problems?
• Do you have chronic constipation or diarrhea?
• Do you have a stuffy nose after meals?
• Do you have low energy or feel drowsy after eating?

If you answer yes to any of these questions, you may want to investigate further. Keeping a detailed food diary is the easiest way to start tracking down potentially migraine-inducing foods. Keep in mind that eliminating your migraines is not the only health benefit you can reap from identifying food allergies or sensitivities. Eliminating food antigens is also critical for gut health. I’ve written extensively on this topic, as medical science is now beginning to realize just how important your gut is, not just for physical health, but emotional and psychological health as well.

One of the best things you can do if you believe you are suffering from a food allergy is to do a diet elimination challenge. Simply remove all foods that contain what you believe you are allergic to and see if your symptoms improve over the next several days. If you don’t have an idea of what foods you are allergic to, you can stop all the ones in the chart above. Keep in mind that depending on your typical migraine frequency, you may need to avoid the suspected food(s) for a few weeks in order to evaluate whether it had an effect or not.

To confirm the results, you’ll want to reintroduce the food or drink (on an empty stomach). If the suspected food is the culprit you will generally be able to feel the allergy symptoms return within an hour, although migraines can sometimes have a longer lag time than, say, bloating or drowsiness.

Beware of Aspartame and MSG

Both aspartame and MSG are notorious for causing headaches and triggering migraines. Aspartame can also trigger other neurological symptom such as visual disturbances and tingling in the extremities. I actually diagnosed my sister, who was also my office manager when I started practicing, with a migraine. She had the visual aura that is common and makes you feel like you are having a stroke. She was highly reactive to aspartame and if she even sniffs any she will get a migraine.

One of the primary problems with aspartame is the methanol it forms in your body. Methanol acts as a Trojan horse, being carried into susceptible tissues in your body, such as your brain, where an enzyme called alcohol dehydrogenase (ADH) converts it into formaldehyde. This in turn can wreak havoc with sensitive proteins and DNA.

All other animals have a protective mechanism that allows methanol to be broken down into harmless formic acid, but according to aspartame expert Dr. Woodrow Monte, there's a major biochemical problem with methanol in humans, because humans simply do not have this protective metabolic mechanism. Migraineurs will likely recognize several of the symptoms of methanol poisoning, which include headache, throbbing migraine, ear buzzing, dizziness, nausea, gastrointestinal disturbances, weakness, vertigo, chills, memory lapses, numbness and shooting pains in the extremities, behavioral disturbances, and neuritis.

Diet for Migraine Relief

Quite a few people have reportedly rid themselves of migraines on the Paleo diet, which can be summarized as “any food that can be eaten without being processed.” That means no grains, bread or pasta, and no pasteurized dairy, but does include lots of fresh fruits and vegetables, some nuts and oils along with wild caught fish, organic poultry and grass-fed lean meats.

I believe a return to “real food” is one of the most profound interventions for the 21st century. We've strayed so far from the foods we are designed to eat, going back to basics and refocusing your diet on fresh, whole, unprocessed, "real" food can improve just about anyone's health, regardless of what health issues you need to address. You can easily mold your diet around the principles of Paleo eating by following my nutrition plan. The full details are described in the plan, but generally speaking, the following key factors apply to anyone seeking a “healthy diet”:

Eliminate all gluten products	Organically grown produce, and grass-fed or pastured animal products that are free from additives and genetically engineered ingredients
Eliminate all artificial sweeteners, especially aspartame. My sister is one of many who will get a guaranteed migraine if she consumes any aspartame. Obviously, even if you don’t have migraines, there simply is no reason to ever consume aspartame	Carbohydrates primarily come from vegetables (except corn and potatoes, which should typically be avoided). Dramatically lowering your intake of non-vegetable carbs could improve leptin and insulin signaling which could also improve migraines
Focus on unprocessed, whole foods, eaten raw or only lightly cooked (ideally, try to eat at least one-third of your food raw, or as much as you can manage)	Food from high-quality, local sources

Quick, Natural Tips to Relieve a Migraine

Preventing migraines begins by avoiding the triggers. Most often this means eating healthy whole foods (avoiding most processed ones) and managing your stress effectively. Following my eating plan seems to reduce migraines by about 80 percent, although it does take some time to work. It’s a lifestyle switch, not a quick and easy fix. Avoiding wheat, grains, sugar and all fluids but water seem to be particularly effective.

Regular exercise may also help to keep migraines at bay by improving your response to stress along with the underlying inflammatory conditions that can trigger migraines. Ideally, those are the things to focus on so that you can reduce your migraines altogether. That said, should a migraine strike and you need immediate relief, you could try one or more of the following:

Stimulate your body's natural painkilling ability. By putting pressure on a nerve just under your eyebrow, you can cause your pituitary gland to release painkilling endorphins immediately	Emotional Freedom Techniques (EFT). Newcomers who use this simple process by themselves achieve relief 50 percent to 80 percent of the time and, in many cases, the relief is complete and permanent. More sophisticated uses by an EFT expert may be required for some migraine sufferers
Take 10 teaspoons of cayenne pepper in a glass of water. Endorphins are released by your brain when the cayenne hits your stomach lining. Another alternative is to swallow a dollop of wasabi paste	Green apple scent. One study found that the scent significantly relieved migraine pain. This may also work with other scents that you enjoy so consulting with an aromatherapist may be beneficial
Hot/Cold compress: Alternate hot and cold compresses on your forehead and/or behind your neck	Massage your ears, ear lobes, and the "crown" of your head -- the ring of muscles that circle your head where a crown would sit

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