A functional medicine guide to migraines

In health, there are conditions considered “serious”, such as cancer, diabetes or heart attacks. They are life-altering and life-threatening. Many health issues fall into the “nuisance” category. One of these is migraines. While migraines are not considered “serious,” anyone who suffers from them would beg to differ.

The term “migraine” is often used to describe a bad headache. But headaches are just one of the many neurological symptoms that migraines can induce. Here are some others:

• Vision impairments/seeing auras

• Sensitivity to light and sound

• Nausea

• Dizziness

• Neck pain

• Chills

• Brain fog

• Insomnia

• Mood changes

• Digestive issues

• Frequent urination

• Muscle weakness

Besides typical migraines, there are vestibular migraines, which affect sight and balance; ocular migraines, which may present as visual disturbance such as light flashes with or without headaches; and even abdominal migraines, common in children, which may include nausea and vomiting. What is very frustrating for those of us who suffer from migraines is that they often appear out of the blue at the worst possible time, and they are hard if not impossible to treat. And for some, they can involve hours to days of bedrest in darkened rooms. With migraines affecting 10% of people worldwide, it is hard to believe there has been so little progress or attention given to addressing them.

Currently, research on migraines takes three approaches: vascular causes (blood flow); neural events and neurotransmitter function; and nociceptive causes (pain pathways, the trigeminal nerve.) This has led to the creation of some pharmaceutical options including Nurtec, Maxalt and Imitrex. There have been a wide variety of responses to the medications, with some patients experiencing relief and others having intolerable side effects. 

Functional medicine has one of the best track records for addressing migraines, based on its premise of addressing the body as a whole and trying to remove sources of inflammation. Think of your body as a bowl: as you add in irritants, your bowl overflows and a migraine is triggered. What are some factors involved in triggering migraines?

• Food: There are a variety of issues stemming from food, and the effects vary from person to person. Dyes, preservatives and additives are known migraine triggers for some people. But for others, things like hidden food allergies/sensitivities or blood sugar imbalance can also contribute. Tyramine, a chemical formed in preserved or aged foods such as cheese, processed meats, wine or nuts, may also trigger symptoms. Many sufferers adhere to a migraine diet.

• Hormones: Three of four migraine sufferers are women. Studies have shown migraine activity to be affected by hormone shifts related to menstrual cycles.

• Stress: 70% of people point to stress for provoking migraine attacks,

• Genes: Migraines tend to run in families, with specific genes including CACNA1A, ATP1A2, SCN1A, and PRRT2. These genes are involved with how ions move in the brain. Other genes affecting migraines include MTHFR, a methylation gene, and HNMT, which affects histamine tolerance.

• Environmental factors: These may include bright flashing lights, heat or sun, certain smells, movement, or changes in weather.

• Dehydration: One-third of migraine sufferers report dehydration as a factor in their migraines.

• Caffeine: For some people, caffeine triggers migraines. Others have used caffeine as a treatment for their migraines.

In keeping with the functional medicine paradigm, the best way to prevent migraines is to reduce the irritants in your “bowl”: control what is controllable. That may mean eating cleaner foods or eliminating foods that you may be allergic/sensitive to; staying hydrated; avoiding smells or sounds that are triggering; and/or limiting or eliminating caffeine. Reducing inflammation by addressing gut health and maximizing nutrient intake also helps. Addressing these helps reduce what is in your bowl.

There are also supplements or homeopathic remedies that may help. These include:

• Magnesium: Magnesium is known to calm the brain and increase blood flow. The ideal type for migraine is Magnesium Threonate, which crosses the blood brain barrier.

• Riboflavin: Vitamin B2 supports mitochondrial function and has been found to have a preventative effect on migraines. Supplementation of up to 400 mg/day has been found to reduce the need for abortive migraine medications.

• CoQ-10: CoQ-10 has been found to reduce frequency, severity and duration of migraines at 100-300 mg/day.

• Butterbur: Studies report a 50-68% reduction in migraine frequency with butterbur. (Alkaloid-free is the safest form.) Recommended dose is 50-100 mg twice daily with meals.

• Feverfew: Studies have shown a 70% reduction in frequency and intensity of migraines. Recommended dose is 25-100 mg of dried leaves twice daily.

• Migra-Eze (Progena): This supplement combines feverfew and butterbur.

• Migra-Eeze (Life Extension): This supplement is a combination of riboflavin, butterbur and ginger.

• BHI Migraine (Medinatura): This proprietary blend includes 17 homeopathic ingredients to help reduce head pain and throbbing.

• Ice: An ice pack on the face, head or neck may help reduce the effects of migraine.