A Functional Medicine Approach to Migraines

Anyone who has ever had a migraine can tell you how unbearably painful and disabling they truly are. Migraine headaches are one of the highest contributors to disability in people under the age of 50 worldwide.

The American Migraine Foundation estimates that at least 39 million Americans live with migraines. Migraines have been referred to as the “forgotten epidemic” due to the prevalence, the severity of suffering, and the relative difficulty of managing migraines in the standard medical model.

Migraines are one of the many disorders that may respond well to functional medicine’s multi-faceted and personalized approach. By searching for and addressing potential root cause dysfunctions, Functional Medicine practitioners aim to provide meaningful and long-lasting support to individuals experiencing migraines.

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Migraine Signs & Symptoms

Migraines are severe headaches that tend to have a throbbing or pulsating character. They can be located in any part of the head, and the pain can last for hours or days. Certain environmental factors, such as strong light, loud noises, strong smells, or movement, tend to worsen migraines.

Migraines are often preceded by a period of increased sleepiness, fatigue, and irritability known as a prodrome. Some individuals may experience a distinctive aura such as flashing lights, tingling, or difficulty speaking that occurs before the pain starts.

Migraines are usually followed by a postdrome phase or “migraine hangover” that causes fatigue, difficulty concentrating, body aches, and sensitivity to light. The entire migraine cycle can last for days or even weeks and often prevents someone from attending school, work, and all other daily life activities.

Migraine Possible Causes

Migraines remain a complex condition that can be influenced by an individual’s environment, genetics, and lifestyle factors. The exact physiologic dysfunction underlying migraines remains unclear but likely results from a combination of neural and vascular factors.

Migraines are thought to be a “threshold” condition and are often initiated by the exposure to multiple triggers or a single trigger experienced at a greater intensity. This accumulation of triggering events is what is referred to as the “threshold.”

When triggers are met, a wave of electric depolarization is released in the brain that activates neurons resulting in the release of chemical substances, such as calcitonin, that may contribute to widespread vasodilation and inflammation.

Some common triggers for individuals with migraines are alcohol, cheeses, coffee, poor sleep, skipping meals, and jet lag.

Functional Medicine Labs for Migraines

Food Sensitivity Panels

When removing the common food triggers doesn’t provide adequate migraine relief, a Food Sensitivity Panel can provide valuable insight into what other specific dietary changes might be helpful.

Rupa Health offers a wide variety of Food Sensitivity Panels from several different laboratories. These panels identify IgG and IgA antibodies against specific foods in the bloodstream. Practitioners can use this data to create a personalized elimination diet for their patients.

One study found that an elimination diet guided by IgG antibody results effectively reduced migraine frequency and severity and improved concomitant IBS symptoms.

Nutrient Analysis

Migraines have been associated with numerous nutrient deficiencies, including magnesium, niacin, riboflavin, cobalamin, CoQ10, carnitine, alpha-lipoic acid, and vitamin D.

Nutrient testing allows you to identify which critical nutrients are low in your patient and create a personalized supplementation plan tailored to your patient’s specific needs.

Comprehensive Stool Test

The root cause of illness often begins in the gut, and migraines are no exception. There is a significant overlap between patients who experience migraines and patients who experience IBS symptoms.

An extensive review recently outlined the interactions between the gut and the pathology of migraines and indicated that migraines improved by interventions that specifically targeted the microbiota.

A comprehensive gut health test can provide insight into underlying factors contributing to migraines.

Functional Medicine Approaches for Migraines

Nutrition

Dietary interventions are powerful tools in supporting individuals with migraines. Numerous studies have found elimination diets to help reduce migraine severity and frequency.

You can create an elimination diet based on the common migraine food triggers or tailor a customized elimination diet based on food sensitivity testing.

Another dietary intervention that may support individuals with migraines is the Ketogenic diet. The Ketogenic diet, which was first used to support individuals with seizures, has known neuroprotective effects. Ketone bodies, specifically D-BHB, are an alternate source of fuel in the brain and have been shown to alter cerebral metabolism in a way that may help manage some of the cerebral abnormalities noted in individuals with migraines.

Supplements

There are a number of nutritional supplements that have shown potential benefits in supporting individuals with migraines. Two popular options are Magnesium and Riboflavin.

Riboflavin, given at a dose of 400mg daily, has been shown to help reduce the frequency and severity of migraines and reduce the usage of abortive migraine therapies.

Numerous studies have also found that magnesium, given at dosages from 300mg to 600mg daily, may help reduce the frequency and severity of migraines. There are also combination products containing Riboflavin, Feverfew, Magnesium, Quercetin, and Coq10 all in one supplement that may be helpful and easier for a patient to take.

Summary

Migraines are an extremely painful and distressingly common ailment of modern times. Migraines are typically multifactorial, resulting from imbalances in someone’s diet, lifestyle, genetics, and environment.

The power of personalization embedded in Functional Medicine testing may help support individuals in managing migraines.

You can use food sensitivity testing, nutrient tests, and microbiome analyses to find potential root cause problems and suggest individualized approaches for your patient.