Kathy, a 53-year-old accountant, came to see me at my clinic for the treatment of migraine headaches. Over the past two years, her migraines had become more severe and frequent, with an average of five migraines each month. She took the common migraine medicine Imitrex when she recognized a migraine start. In some cases the medication would work well, and at other times she suffered.
As a physician, I operate in some ways as a detective. Knowing an individual's medical history is really important. When talking to Kathy, I was trying to find details that would clue me into the root cause of her migraines. For example, I wanted to know if her migraines started with the hormonal changes around menopause or some big life stressor? Are her migraines triggered by stress or eating certain foods? Does she have neck or back issues that could create nervous system and muscular imbalances that cause her migraines?
In Kathy's circumstance, her migraines appeared to be related to her digestive system. Around the same time her migraines started, she was diagnosed with Irritable Bowel Syndrome (IBS). This makes sense because the gut is the largest producer of neurotransmitters. These chemical messengers are essential communicators for the brain and nervous system. There are many theories as to why migraines happen. People with migraines commonly have low or fluctuating levels of serotonin or dopamine. These neurotransmitters have different effects on blood vessel dilation as well as pain modulation. Common migraine medicines like sumatriptan (Imitrex) work by activating serotonin brain receptors. This results in relaxation of the muscles surrounding the blood vessels and reduced blood vessel dilation. Additionally, there is the decrease of pain signals by nerves in the brain area.
Interestingly, almost all migraine headaches have a direct relationship to the head. Basically, the trigger for the biochemical responses that take place which lead to headache pain is rarely due to a direct problem in the brain itself.
Because of Kathy's ongoing problem with IBS, I prevented her migraines by treating her gut. First, I tested her food sensitivities and eliminated her most problematic foods: wheat, cow's milk, and oranges. Next, I prescribed a probiotic to balance her gut flora. The results were amazing; over the next six weeks, Kathy had just one migraine. Then over the following three months, she had no migraine headaches! Also, her bloating and occasional diarrhea stopped being an issue too.
A 2019 study of people with chronic migraines found that supplementation with a probiotic for ten weeks resulted in a considerable decline in migraine attacks. Also, probiotic consumers had a significant reduction in migraine severity and migraine medication use. There were no changes for those taking a placebo. The friendly flora in the gut has been shown in recent years to balance neurotransmitters that impact the brain and nervous system.
Don't forget, migraines are actually not in your head. Instead, they are a symptom of an imbalance elsewhere in the body.
