What is a Migraine and How Do You Treat It?
Migraines are the sixth most debilitating health condition in America, and can really interfere with your quality of life. Join Nice’s Jill Gauger as she goes in-depth on what migraines are, what can trigger them, and how to diagnose and treat them–and potentially improve other symptoms in the process.
What is a Migraine?
A migraine is an intense, throbbing headache that typically lasts 4-72 hours. The pain is usually on one side of the head.
Migraines are genetic and generally chronic, affecting approximately 12% of Americans, including children. They don’t cause brain damage, but 1-2% of sufferers may go on to have a stroke.
What Causes Migraines?
We still don’t fully understand what causes a migraine, but some theories are that they’re related to blood changes in the brain during migraine attacks (vascular theory). It may be that complex events in the brain and vascular systems lead to a migraine (neuro-vascular theory). It’s also possible that electrical changes in brain cells activate nerve fibers, which trigger neurological events, pain, and inflammation, causing a migraine (cortical spreading depression theory).
Other Possible Causes:
Medication overuse (such as opioids, barbiturates, NSAIDs, or triptans)
Dysfunction in the lining of blood vessels
Histamine
Brain stem activation causes inflammation
Too much dopamine or a serotonin deficiency
Magnesium deficiency, triggering chemical reactions in the brain which cause blood vessels to expand
Migraine Risk Factors and Triggers:
Bright lights
Strong odor
Injury or head trauma
Being too hot or too cold
Lack of exercise
Not eating
Eating histamine-containing or inflammatory foods, such as caffeine, artificial sweetener, MSG, or aged meats and cheese
Inflammation
Obesity
High blood pressure
Stroke
Heart disease
Hormonal imbalance
Stress
Too much or too little sleep
Smoking
Who Gets Migraines?
Migraines affect three times more women than men, and an average of 39 million Americans. This typically includes 10% of school-aged children, as well as adults.
How Common Are Migraines?
30 million Americans have one or more migraine per year, some having as many as 15 migraines, which qualifies as a chronic condition. The cost of migraine-related workplace productivity loss is $13 billion per year.
Because migraines are genetic, you have a 50% increased risk of getting migraines if your parents have them. Before puberty, more boys have migraines than girls–but this statistic flips after puberty. After menopause, migraines typically decrease, and a new onset of migraines after 50 is rare.
Migraines are less prevalent in African Americans and Asians, and most common in Caucasians.
Migraine Symptoms
Migraine symptoms typically follow a pattern.
Premonitory Stage
Tiredness
Food cravings
Neck stiffness
Yawning
Lasts 1-4 hours
Aura
Affects ⅓ of people at least some of the time
Flashing lights, blindness, or other visual symptoms
Headache or Main Attack Stage
Severe throbbing in the head, made worse by movement, light, or sound
The pain is typically on one side but can be on both
Nausea and/or vomiting may occur
Lasts 4 hours to 3 days
Resolution
Most attacks fade slowly, but some stop suddenly.
Sometimes, a few hours of sleep may end the attack.
Recovery (aka Postdrome) Stage
Feels like a hangover, which can take days to disappear. Symptoms may mirror those from earlier stages.
Headache vs. Migraine
Headaches typically involve short-lived pain around the forehead in the form of mild, dull pressure. They’re not usually accompanied by other symptoms.
Migraines, on the other hand, involve pain on the sides of the head in the form of intense pulsing or throbbing. Symptoms can last for days, and may include nausea, dizziness, flashing lights, or even temporary blindness. Migraines may occur frequently for some people.
How are Migraines Diagnosed?
Your clinician will assess your symptoms and family history and may order a CAT scan or MRI of your head. And additional neurological and lab testing will help to rule out other conditions.
How to Treat Migraines
Migraines are complex, so they’re best treated with a multi-faceted approach. While you can’t control your genetics, you can control your genetic expression through lifestyle factors.
Some lifestyle changes that can help reduce migraines are eating an anti-inflammatory diet, exercising (which strengthens blood vessels), reducing environmental exposure from plastic food containers, toxic beauty products, mercury fillings, and other hormone disruptors, and reducing your stress level.
Reducing Inflammation
When your body experiences an injury, the immune system creates an inflammatory response to speed healing. Food additives, chronic conditions, lack of exercise, and other factors can cause the body’s healing response to go into overdrive, causing more symptoms, such as migraine headaches or even obesity.
Gut Health
Healing your gut is an important aspect of reducing inflammation in the body. For a healthy gut, avoid or reduce gluten, pesticides, food additives, preservatives, and simple sugars as well as carbohydrates in foods, which kill healthy gut bacteria. Taking probiotics will increase healthy bacterial growth, as will eating fiber-rich foods, such as black beans, quinoa, and vegetables with every meal.
The type of bacteria in your gut is responsible for many chronic diseases, including migraines, diabetes, and high blood pressure. Gut bacteria also affect chemicals in the brain, including dopamine and serotonin.
Medications
NSAIDs and triptans
Blood pressure and seizure medication
Botox
Emgality (“antibody” migraine treatment)
Combine medications with diet modification for best results
Lifestyle Changes
Sleep hygiene
Relax, stretch, and don’t watch screens before bed
Avoidance of triggers
Oxygen therapy
Exercise
Acupuncture
Physical therapy
Massage
Stress relief
Dietary Changes
An anti-inflammatory diet such as paleo, keto, or low-carbohydrate can help reduce and prevent migraines. This includes avoiding MSG and histamine-containing foods, eating lots of vegetables and moderate amounts of fruit, and eating primarily whole foods. Eating healthy fats, such as coconut oil, avocado (although not too ripe, as those can trigger headaches for some people), Omega-3 fats, and almonds can be helpful.
You may need to try an elimination diet to identify your food triggers (eliminating gluten, soy, nuts, and dairy for 2-4 weeks
Some supplements that can help with Migraines are:
Turmeric
Ginger
CBD oil
OTC allergy medication
Melatonin
CoQ10
Magnesium
D3+K
Omega 3 fish oil
Riboflavin
Nice Can Help You Recover From Migraines
At Nice, we treat the whole patient by looking at your genetics, diet, stress levels, and other lifestyle and environmental factors, as well as your symptoms. If you suffer from migraines, intense headaches, or other symptoms discussed in this webinar, we can help you get back to feeling better, fast.
To learn more about how our comprehensive primary care services can help with your migraines, click here.