The Many Layers of Migraines
Do you experience migraines or know someone that does?
Please read, share and reach out if this resonates with you and you need some help.
The Many Layers of Migraines
Keep peeling back the layers to understand your migraines so that you can establish the steps to take to greatly reduce their occurrence and severity. Migraines can be debilitating and severely impact quality of life, and the ability to carry on in day to day activities.
Today we will look at what a migraine essentially is, the different types of migraines, the associated influences and triggers on migraines, and therefore work out what you can do to manage and find relief from migraines.
A migraine is the most common neurological disorder that involves dysfunctional sensory processing with defined associated risk factors and triggers. A migraine essentially involves vasodilation, a dilation of the blood vessels in the brain. It is defined as an episodic headache with a throbbing pulsating pain that is usually experienced one-side of the head. The migraine associated features include sense sensitivity (light, sound or movement), with possible loss of appetite, nausea and vomiting. 70% of migraine sufferers are women.
Types of Migraines
Migraines are typically classified as either ‘classic’ or ‘hormonal’ migraines, but of course when it comes to health it is not as black and white as that. In fact both types of migraines are influenced by hormones.
A classic migraine historically referred to as a vascular migraine is associated with a vascular risk, an aura is most likely experienced, and occurs at times of high oestrogen (pre-ovulation and middle luteal phase ie 7 days before your bleed).
A hormonal migraine typically has no aura and occurs at the time of oestrogen drop (post ovulation and premenstrual). Migraines usually occur from puberty through to menopause and are exacerbated at times of hormonal change - puberty, premenstrual, postpartum and perimenopause.
Both ‘types’ of migraines are associated with hormonal changes and the level of oestrogen is a main influencing factor.
What is the migraine then?
In migraine sufferers the response within the brain to various stimuli and biochemical changes - hormones, neurotransmitters, stress, immune cells is different. These differences cause neuronal sensitisation and vasodilation leading to the symptoms of a migraine.
Note: The Science
A type of protein, Calcitonin gene-related peptide CGRP, is found to be elevated in all migraines, CGRP is involved in pain transmission, and causing vasodilation and muscle relaxation. It is released by neuro stimulation and triggers an inflammatory response and vasodilation.
As oestrogen receptors are highly expressed in CGRP-positive neurons, hormone fluctuations can modulate excitability, meaning that oestrogen plays a key role in migraine initiation
The Risk Factors & Triggers
There are known risk factors associated for both experiencing and triggering the onset of a migraine:
mental health cognitive risk factors: stress, anxiety, a bidirectional relationship with depression, and depression associated with migraine onset, schizophrenia, bipolar, ADHD
glucose metabolism: insulin sensitivity, fluctuation, diabetes
gastrointestinal conditions: Helicobacter pylori, IBS, inflammatory bowel disease, coeliac, dysbiosis occur at a higher rate in migraine sufferers - the symptoms associated can include nausea, vomit, dyspepsia, and bowel disturbance
environment factors: bright light, strong odors,
fatigue, stress, exercise, muscular tension of back or neck
foods - chocolate, caffeine, aged foods/cheese, nuts, citrus, tomatoes, sugar, simple carbohydrates, high glycaemic foods, additives, alcohol
Histamine Association with Migraines
Histamine is a known trigger of vascular and hormonal migraines. Histamine receptors are located throughout the central nervous system (and many other areas), and there is a dose dependent relationship between histamine and oestrogen and migraines. Due to the hormonal association there is an increased risk of occurrence and severity with the menstrual cycle, and, especially during the hormonal changes of perimenopause.
For more information and the effects and interactions of histamine read the previous journal article on histamine.
Medical Interventions Available
Primarily involve the use of pharmaceuticals working on anti-inflammatory pathways, neurotransmitter pathways, CGRP suppression and hormonal treatments.
NATUROPATHIC TREATMENT
Naturopathic medicine dives deep to investigate the type of migraine you have, the main factors that trigger, sustain and cause the recurrence of migraine for you, and therefore the specific and unique treatments that can assist you.
This is what we work through in naturopathic consults - the hormonal influence, your nutrient status, your gut and metabolic health, the detoxification pathways, possible histamine implications.
Each influence on your migraine will then determine a unique treatment strategy.
Dietary Recommendations To Improve Migraines
Anti-inflammatory diets that assist to mitigate neuroinflammation have been found to improve migraines. The low carbohydrate mediterranean diet has been well researched as an anti-inflammatory diet and is essentially a diet that focuses on whole foods - 5-6 cups of above ground fibrous vegetables, sufficient grass fed meats and wild fish, good fats, and whole grains.
There is also evidence of dietary influence on hormone levels with the use of phytoestrogens, especially soy isoflavones, that reduce the oestrogen receptor activation initiation of migraines. It is recommended that the days preceding the usual onset of your migraine and for the duration til the predictable decline of your symptoms to consume 60-70 mg of soy isoflavones. As a guide this looks like approximately 100g tempeh, 200 g tofu or 100g cooked soy beans.
Your Migraine Wellness
Herbal Medicines, nutrient supplements and diet work to ensure adequate detoxification pathways, manage neurotransmitter and hormone levels, gut and microbiome health and support methylation pathways all to reduce migraine initiators and mitigating the resulting blood vessel response and the onset and severity of the migraines experienced.
Please reach out if you think naturopathic treatment can assist and guide you back to wellness.
See me in naturopathic clinic or at the apothecary for nutrient and herbal medicine to support the nervous system, gut health, hormonal health, stress, detoxification and methylation pathways.
