Migraines are severe, often debilitating headaches that can be accompanied by visual disturbances called auras, nausea and dizziness. Often, migraine symptoms cause people to retreat to a dark, quiet room to rest until the headache subsides, but for many, this may not be an option.
Because people try to carry on with their daily lives despite the symptoms, which can last from a few hours to a few days, migraines are often considered a “hidden” illness. Yet, more than 40 million people in America suffer from migraines, and 80 percent are women, according to health experts.
Migraines are one of the most common types of headaches. Migraines are the most disruptive type of primary headache that is not caused by another medical condition.
Migraines are one of the body’s responses to an overload of oxidative stress, which occurs when unstable molecules called “free radicals” in the body build up.
Many factors may contribute to oxidative stress, including lifestyle factors like stress, poor diet, inadequate sleep, smoking and alcohol use, as well as environmental factors. Molecules called antioxidants help to keep oxidative stress under control, but if antioxidant levels are low, they can’t do the job.
“In addition to evaluating and treating other causes of headache, we know that people with migraines often have low antioxidant levels. When that oxidative stress bucket fills up and overflows, a migraine develops as the body’s protective mechanism,” explains Robert Bonakdar, MD, a headache and pain management specialist with Scripps Center for Integrative Medicine. “It’s your body’s way of telling you to take a break and rebalance.”
Gastrointestinal or gut health is also linked to migraines and related conditions.
“There are many reasons why the gut is known as the second brain,” says Dr. Bonakdar. “We know that it contains a lot of the neurotransmitters and chemicals related to migraine, such as serotonin. The microbiome or flora of the gut is also important in producing some key antioxidants like B vitamins.”
When gut health is disturbed for any reason, migraine symptoms may spill over into gut symptoms, such as nausea and vomiting.
Gastrointestinal conditions, such as irritable bowel syndrome, reflux or gastritis, commonly coexist with migraine. Overuse of medications to help treat migraines, such as over-the-counter anti-inflammatories, can damage the lining of the gut. This, in turn, can prevent the medication from working properly and exacerbate gut problems, creating a vicious cycle.
“Nutrition is one of the most powerful sources of antioxidants,” says Dr. Bonakdar. “Three of the most important nutrients for fighting oxidative stress are magnesium, riboflavin or vitamin B2, and coenzyme Q10 (CoQ10), a substance that works with B2 to help convert food into energy.”
Other important nutrients include omega-3, zinc, alpha lipoic acid, and vitamins B1, B12 and D. Not only are many of these often depleted in people with migraines, but the loss can start early in life. CoQ10 levels, for example, often begin to decline in the teenage years, with one study of teens with migraine showing that more than a third are deficient in CoQ10.
Dr. Bonakdar also notes to not overlook healthy spices. “Herbs like ginger and curcumin from turmeric can also act as powerful antioxidants and have also been found to help reduce migraine severity.”
The right diet is a good first step to help provide these nutrients and refill the antioxidant “tanks” in people who are deficient. Dr. Bonakdar recommends any heart-healthy, anti-inflammatory diet that contains whole grains and fiber, such as the DASH or Mediterranean diet.
Research also indicates that probiotic foods, such as yogurt, can help improve gut health.
Sometimes, people with migraines will eliminate possible “trigger” foods from their diet to see if this helps with their headaches. Dr. Bonakdar cautions against doing this without professional guidance to avoid removing foods that supply important antioxidants, such as B vitamins and magnesium.
While an anti-inflammatory diet is a good start to rebuilding antioxidant stores, many people may also need to take supplements.
Supplements contain nutrients that can be beneficial to your health and for managing some health conditions. Some can put you at risk if you take too many, or if you mix them with medication, which is why consulting with your doctor is important before you start taking them.
Testing is essential when it comes to supplements. A simple blood test can measure antioxidant levels and provide precise data to develop a personalized supplement plan, so you know exactly what to take and how much.
Additionally important is working with a professional who can recommend the highest-quality supplement brands, address any side effects, such as digestive symptoms, and monitor your progress.
“Nutrition is a powerful and often overlooked therapy for migraines and headaches. It often doesn’t take much to get started and we know that even small changes in nutrition and supplementation can have benefits,” says Dr. Bonakdar. “It may take two to three months to have full effects, so it’s important to see this as ‘slow medicine’ and give it time.”
Dr. Bonakdar is currently conducting a research study on the potential benefit of probiotics for patients suffering from both migraines and irritable bowel syndrome. Qualifying participants will receive compensation as well as complimentary treatment and laboratory/microbiome studies at the beginning and end of the trial. For more information, please contact CRSLeadership@scrippshealth.org.