Migraines are a complex and multi-factorial condition of the nervous system and unfortunately there is no one clear cause or solution.
As many suffers are dissatisfied with currently available treatments, tackling them may require investigation into a number of different aspects of health.
However, by approaching them holistically through changes to diet and lifestyle and supporting the health of the gut, many sufferers can see a significant improvement in symptoms, allowing them to experience a greater quality of life. For example, below are 6 steps you can take to help manage migraines.
Improve gut health
Migraines are often accompanied by digestive symptoms and there is a clear association between the prevalence of migraines and many digestive disorders. Low levels of beneficial gut bacteria can contribute to gut hyper-permeability (“leaky gut”), which is a risk factor for inflammation. It is believed that low-grade inflammation originating from poor gut health may contribute to inflammation of major pain pathways in the brain, triggering migraine attacks. Newly emerging research indicates that live bacteria supplements may be of benefit. A recent clinical trial found that the 14 strains of live bacteria in Bio-Kult Migréa, significantly reduced both episodic and chronic migraine frequency and severity and reliance on medication in as little as 8 weeks. It also contains magnesium and B6 both of which contribute to the normal functioning of the nervous system, and the reduction of tiredness and fatigue (which often accompany migraine attacks).
Stress is the factor listed most often by migraine sufferers as a trigger for their attacks. In addition there is evidence that stress may initiate the condition in those genetically predisposed to the disorder, and may also increase the risk of migraines becoming chronic.1 To make matters worse, migraine attacks themselves can act as a stressor, potentially leading to a vicious circle of increasing migraine frequency. Since the important factor is the individual’s responses to stress, rather than the stress itself, working on increasing stress management skills (eg. through cognitive behavioral therapy (CBT) or bio-feedback techniques) may have the potential to reduce the impact that stress has on those with migraine. Carving out time for yourself to relax, for example by having a bath, reading a book, spending time outdoors or re-engaging with hobbies and friends should also be prioritised.
Mindfulness has been shown to be particularly effective in controlling headaches such as migraine, with several studies reporting positive results. For example, a 2018 review of the evidence from 10 different clinical trials found that mindfulness meditation may reduce pain intensity and is a promising treatment option for patients, with an 8 week course having a significant positive effect.2 Consider looking into mindfulness courses being run in your area, or downloading a mindfulness app such as Headspace onto your mobile phone.
Evidence indicates that gentle to moderate cardiovascular exercise may be beneficial in migraine as it is thought to modulate pain pathways, potentially decreasing the intensity of migraine pain. Intense exercise on the other hand can be a trigger for migraines and headaches in some. To reduce the risk of exercise-induced migraines its best to ease into any new exercise regime gently, only exercise when well rested, warm-up properly, fuel your body with good nutrition and stay well hydrated. Being overweight can also increase the risk of migraines, whilst studies indicate that weight loss intervention may significantly reduce migraine frequency and intensity,3 so regular exercise is likely to be of further benefit.
Improve your diet
Whilst there is evidence of a genetic predisposition to migraines it is clear that diet may play an important role in some cases. For example, magnesium deficiency may contribute to attacks (especially in menstrual migraine). To increase magnesium levels focus on eating more leafy green vegetables (at least 2 portions a day), avocados, nuts, seeds and legumes an consider taking a supplement. Migraines are also linked to inflammation so following an anti-inflammatory diet, high in omega 3 fatty acids from oily fish, antioxidants from colourful fruit and vegetables and spices such as turmeric and ginger, whilst cutting out more pro-inflammatory foods such as processed and high sugar foods, vegetable and sunflower oils and excessive amounts of cereal based grains is also recommended. In addition, various foods and food additives are thought to potentially trigger migraine attacks in sensitive individuals, so keeping a food diary or carrying out an elimination diet (under the supervision of a nutritional therapist) to identify triggers may be beneficial.
Know the warning signs and how to deal with them –
Migraines are often preceded by warning signs indicating that an attack may be imminent. These ‘prodrome’ symptoms vary but may include emotional changes, urinary frequency, fluid retention, and stiff neck, up to 48 hours prior to an attack. Recognising these signals and taking steps to minimise exacerbating factors may help to fend off attacks and reduce duration and intensity. For example if you suspect an attack coming on, go home from work to rest in a room without stimulation (eg. tv/computers), drink plenty of water, eat regularly and focus on complex carb and protein rich foods to maintain blood sugar levels, massage the base of the head and temples and try warming the neck with a scarf or hot water bottle. Essential oils may also be of benefit, with lavender oil inhaled during attacks,4 and peppermint oil applied to the temples and forehead5 both reported to decrease pain and ease symptoms.
1 Sauro KM, Becker WJ. The Stress and Migraine Interaction. Headache J Head Face Pain 2009; 49: 1378–86.
2 Gu Q, Hou J-C, Fang X-M. Mindfulness Meditation for Primary Headache Pain: A Meta-Analysis. Chin Med J (Engl) 2018; 131: 829.
3 Cervoni C, Bond DS, Seng EK. Behavioral Weight Loss Treatments for Individuals with
Migraine and Obesity. Curr Pain Headache Rep 2016; 20: 13.
4 Sasannejad P, Saeedi M, Shoeibi A, Gorji A, Abbasi M, Foroughipour M. Lavender essential oil in the treatment of migraine headache: a placebo-controlled clinical trial. Eur Neurol 2012; 67: 288–91.
5 Borhani Haghighi A, Motazedian S, Rezaii R, et al. Cutaneous application of menthol 10% solution as an abortive treatment of migraine without aura: a randomised, double-blind, placebo-controlled, crossed-over study. Int J Clin Pract 2010; 64: 451–6.