Migraines, a primary headache disorder, are characterized by throbbing pain that is usually located unilaterally and where the pain is exacerbated by physical exertion. They can be accompanied by aura, which is a visual flickering light, spot, or jagged line, frequently causing nausea, and typically result in extreme sensitivity to light. Migraines tend to onset around adolescence and are most prevalent between the ages of 25-55 years old, where women are twice as likely to suffer from the condition, likely due to increased hormone fluctuations.
An average of only 4 hours of medical school education are assigned to headache disorders and only about 7 hours are dedicated to nutrition. The inadequacy of providing future healthcare providers with vital foundational knowledge to potentially help identify root causes of health concerns is an entire post all together. This approach however, results in the frequent prescription of “quick fix” medications, automatically disabling the exploratory process of possibilities for finding long-term relief. In the 2013 Global Burden of Disease Study, migraines were found to be the “sixth highest cause worldwide of years lost due to disability (YLD),” meaning that substantial suffering contributes to significant impacts and deterioration to quality of life and making this condition an increasing concern in public health.
Being a migraine suffer myself since about 14 years old, I have always been innately very curious as to the causes behind the condition and pinpointing contributing modifiable factors. I experimented with sleep cycles, regulating/eliminating caffeine intake, dietary environmental eliminations of commonly cited trigger foods (chocolate, red wine, strong scents), kept a running diary of potential hormonal fluctuations, but was never able to identify a pattern. In 2014, I ended my 12 years as a vegan to explore a Paleo lifestyle. This meant transitioning from a diet that is rich in legumes, grains, fruits, and vegetables, (and any vegan desserts I could find), to a diet still based on fruits and vegetables, but supplemented with meat, eggs, cured cheese, and nuts. I completely eliminated all grains and all refined sugar. I had read that the Paleo diet was powerful at maintaining consistent energy levels throughout the day, and despite considering myself “a healthy vegan,” I always experienced energy spikes and dips throughout the day which wasn’t conducive for the productivity I wanted. Over the four years I have been testing this theory on myself as the primary test subject, I found that when adhering strictly to the Paleo lifestyle, my once debhilitating migraines, completely vanished, and return within a few days of introducing a slice of bread, for example. I’m not 100% sure yet about the science behind this finding but this morning I found a study conducted by David Geffen School of Medicine at UCLA, that identifies the critical role of gut bacteria on anti-seizure effects when following a Ketogenic Diet. This diet and the Paleo Diet are almost identical, (Keto is more restrictive of fruits with high natural sugar content).
So what’s the relationship? Both migraines and seizures are neurological episodic disorders that share pathophysiological mechanisms. Glutamate, which is the most abundant neurotransmitter that nerve cells use to send signals to other cells and is responsible for over 90% of the synaptic connections in the brain. In both seizure and migraine, glutamate is a critical mediator of neuronal hyperexcitability within the brain, where imbalances are often triggers for both conditions. While the have distinct clinical manifestations, they share common characteristics in the underlying pathophysiology. In fact, some antiepileptic drugs prevent the occurrence of migraine attacks.
The gut microbiome is an entire universe that still being discovered and contains over 100 trillion bacteria that help to regulate almost every bodily function. In the referenced study by UCLA, they used germ-free mice, (which have been raised in completely sterile environments and therefore void of any microorganisms enabling researchers to identify how external factors contribute to disease and physiology), to analyze the relationship between diet (namely, the gut microbiota) and seizures. They found that the germ-free mice were only protected against seizures if administered the appropriate gut bacteria and in less than four days, the epileptic episodes in mice following a strict ketogenic diet had significantly fewer seizures. This is due to the increase in beneficial bacteria resulting from the ketogenic diet, which “alter levels of biochemicals in the gut and blood in ways that affect neurotransmitters in the hippocampus”.
While these findings have not yet been translated from mice to humans, they are extremely positive and encouraging for further research to be conducted in managing migraines through diet.
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