A New Approach to Migraine Treatment

By Kulreet Chaudhary, M.D., Scripps Memorial Hospital La Jolla

According to an old saying, you are what you eat. Now, according to new research, your migraine headaches might be a result of what you eat, too.

In one sense, this is nothing new. Most migraine sufferers, as well as neurologists who manage migraines, know there is a connection between food and the onset of these extremely painful headaches. Many people who have migraines know that certain foods act as triggers; the most common culprits include chocolate, red wine, cheese, and other foods high in nitrates. Neurologists, in turn, will tell people to simply avoid these foods. However, until now we haven’t taken the next step of studying the greater relationship between digestion and migraine—a relationship that a study in the medical journal Headache suggests is highly significant.

The research came about almost by accident. A pharmaceutical company commissioned a study to determine how to better manufacture one of its migraine drugs to increase the drug’s bioavailability, or ability to be used by the body. The researchers approached the task by examining the gastrointestinal system of migraine sufferers to analyze what happened to the drug as it passed through the digestive process. It was already common knowledge that during migraine attacks, people often have nausea, vomiting, and loss of appetite. This research, however, showed that abnormalities in the digestive tract occurred not only during migraine attacks, but between them as well.

The implication that improving gastrointestinal function might help better control migraine headaches was groundbreaking. It suggested a whole new approach to treating migraine: advise patients on what they should be eating and drinking instead of just what they shouldn’t.

This is exactly what I have found in my practice. I have yet to encounter a patient who has migraine headaches and normal digestive function. As I started to ask my patients about their digestive symptoms during as well as between migraine attacks, I heard them mention symptoms such as gas, bloating, sleepiness after eating, constipation or diarrhea, or feeling like they never fully digested their food. Now, in addition to asking patients about their headaches, I take a detailed history of their diet. Based on the type of migraines and any other health issues they have, I make recommendations about what type of diet they should be choosing. Invariably, patients have been able to reduce the number of headaches they have and begin tapering off of their migraine medications. (In fact, many migraine medications impair digestion and actually exacerbate the problem.)

So what is the best “migraine diet”? There isn’t one. Everything you eat translates into a biochemical and neurochemical phenomenon in your body and is influenced by other physiological factors. Dietary recommendations are highly individualized to the patient and his or her specific health conditions. Someone who has migraines and also has diabetes or thyroid disease has very different nutritional needs than someone who only has headaches. Even the type of migraine headache makes a difference. We create a detailed diet for each patient that is not only specific to her physiology, but also changes over time as her physiology changes.

What we’re learning from this “accidental” research has been well understood for thousands of years in ancient medical traditions. In Chinese and Ayurvedic medicine, for example, the approach to migraine treatment always begins with diet. By focusing on the science of migraine headaches and how lifestyle factors such as diet, environment and stress influence your physiology, we are on the path to discovering “natural” cures for migraine headache.

Kulreet Chaudhary, M.D., is a neurologist at Scripps Memorial Hospital La Jolla. Join Dr. Chaudhary for a free presentation on traditional and alternative treatments for migraines on Wednesday, Feb. 4, at 6 p.m. in the Schaetzel Center on the Scripps La Jolla campus. For more information or to register, please call 1-800-SCRIPPS.

Media Contact: Lisa Ohmstede
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