A migraine extends far beyond a mere headache. People with this neurological condition can experience excruciating throbbing pain, confining them to their beds for hours to days. Although migraines can be debilitating, with proper care, this condition can be effectively managed to improve the negative impact on people suffering from it.
52% of migraines go undiagnosed. In that case, functional medicine labs can be a powerful tool for you and your patients to utilize regularly to help identify this condition, address the underlying factors, and improve your patient’s quality of life.
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What Are Migraines?
Migraines are intense throbbing head pains, usually localized on one side, often accompanied by light and sound sensitivity, along with nausea and vomiting. Migraines are considered a neurological disease and fall under the category of headaches, and there are different types of migraines. These include migraine with aura, which involves warning symptoms before or during the headache; Migraine without Aura, the most common type with no warning signs; Migraine without head pain, where only the aura occurs; Chronic Migraine, which happens on 15 or more days per month for three months; Migraine with Brainstem Aura, featuring pain in the back of the head and preceded by other symptoms; Retinal Migraine, causing vision loss and head pain; Hemiplegic Migraines, leading to temporary body numbness; and Status Migrainosus, an unusually long-lasting and severe migraine.
What Causes Migraines?
Migraines can be complex and have an array of various causes and triggers. Here is the physiological breakdown; they appear to be initiated when an inflammatory cascade spreads within the central and peripheral nervous system, causing blood vessels to dilate. Different factors can trigger this cascade. Stress or emotional stress, for example, releases stress hormones like cortisol, which can both trigger and worsen migraines. Whereas emotional stress, such as anxiety, can increase muscle tension and blood vessel dilation. Food sensitivities, especially dairy, chocolate, citrus foods, tomatoes, and nuts, can also lead to delayed migraine reactions.
Additionally, hormone fluctuations, notably drops in estrogen, are believed to be a trigger for women, leading to "menstrual migraines" before menstruation. Some other common triggers include missing meals and sensitivity to specific chemicals and food preservatives, which can also be culprits. Caffeine, when consumed excessively or withdrawn abruptly, may lead to headaches. Daily use of pain-relieving medications, certain types of light, such as flashing lights, fluorescent lights, and sunlight, can also be migraine triggers. Other physiological factors that can initiate or worsen migraines may include nutrient deficiencies, neurotransmitter imbalances, and disturbances in the gut microbiome.
Migraine Symptoms
A migraine is primarily characterized by a pounding or throbbing headache that can vary in intensity from mild to severe. Migraine attacks typically last around four hours, but severe ones may persist for longer periods. The pain may shift from one side of the head to the other or affect the entire head, including the front, back, eye, temple, face, sinuses, jaw, or neck. Other migraine symptoms include sensitivity to light, noise, and odors, as well as nausea, vomiting, upset stomach, abdominal pain, loss of appetite, feeling warm or cold, pale skin, fatigue, dizziness, blurred vision, tender scalp, and, in rare cases, diarrhea and fever.
During different phases of a migraine attack, additional symptoms may occur:
Prodrome Symptoms:
Cognitive issues, irritability, speaking and reading difficulties, sleep disturbances, nausea, fatigue, light and sound sensitivity, food cravings, increased urination, and muscle stiffness.
Aura Symptoms:
Numbness, tingling, visual disturbances (kaleidoscope-like vision, blurry spots, sparkles, or lines), temporary vision loss, weakness experienced on one side of the body, and speech disruptions.
Headache Symptoms:
Musculoskeletal pain and stiffness in the neck, mental distress, sensitivity to light, smell, and sound, nasal congestion, inability to sleep, nausea, and vomiting.
Postdrome Symptoms:
Difficulty concentrating and comprehending, decreased mood, fatigue, and sometimes a euphoric mood.
What Are The Benefits of Regular Lab Testing For Patients With Migraines?
Regular lab testing can benefit patients with migraines due to the complexity of this condition and the various underlying causes and triggers. Some of these triggers that can exacerbate symptoms, including stress and food sensitivities, can be more effectively managed through the use of functional labs and re-testing to ensure that the treatment protocols are optimized.
As previously mentioned, migraines often go undiagnosed. Therefore, testing can provide answers to chronic headaches that may have been previously misdiagnosed. These tests can help identify specific triggers and help you take proactive measures to prevent and handle migraine attacks.
Top Labs To Run Bi-Annually On Patients With Migraines
The following are the top labs used by functional medicine clinicians to help their patients with migraines:
Adrenal Stress Test
During times of stress, the body releases cortisol, a primary hormone with various effects on the body, including triggering migraines in those who are prone. By testing cortisol levels, practitioners can gain insight into the timing and quantity of cortisol release. This adrenal stress test assesses saliva samples to measure cortisol levels throughout different times of the day, giving valuable information that enables the creation of a treatment plan that includes stress-reducing activities tailored to specific times and potential nutraceutical support. Retesting these levels after treatments are implemented can help monitor the treatments' effectiveness.
Food Sensitivity Panel
Research has documented the potential role of foods as migraine triggers; however, individual food triggers can vary significantly, making a personalized care approach necessary. Food sensitivity testing can be instrumental in identifying specific foods causing reactions, allowing practitioners to design a suitable elimination diet for the patient. Unlike food allergies, which prompt immediate responses, food sensitivities may manifest up to days after ingestion, making identification more challenging. This is where food sensitivity testing becomes valuable, removing the guesswork. Notably, food sensitivities, particularly dairy, chocolate, citrus foods, tomatoes, and nuts, can lead to delayed migraine reactions.
Neurotransmitter Panel
The development of migraines can be influenced by alterations in blood flow and the release of specific neurotransmitters like serotonin. Thus, the neurotransmitter test can provide you with clear guidance into which neurotransmitter imbalances may be responsible for your patient’s migraines. Neurotransmitters play a vital role in regulating mental performance, emotions, pain response, and energy levels. This neurotransmitter panel is completed through a urine sample and can help with conditions and symptoms associated with neurotransmitter imbalances, such as mood disorders and migraines. The results of this test can facilitate integrative approaches to rebalance these imbalances resulting in improved symptoms and health outcomes for migraine sufferers.
Female Hormone Panel
Unfortunately, migraines disproportionately affect women, who are three times more likely to have migraines. Hormone fluctuations occurring monthly in cycling women are believed to be the main contributing factor to this difference. These hormone fluctuations are typical for women. For instance, estrogen is usually dominant in the first half of the cycle and progesterone in the second half. However, when imbalances of these hormones occur, it can activate a migraine. Regularly testing hormones in women prone to migraines can help pinpoint any hormonal imbalances causing the migraines, and individualized treatments and adjustments can be created to rebalance the hormones. The Female Hormone Panel is a comprehensive serum test designed to assess and address hormonal imbalances in women at every stage of life. It measures all major female hormones.
Microbiome Analysis
The term "gut-brain axis" refers to a connection between the gastrointestinal (GI) system and the central nervous system (CNS). Studies have established a connection between migraines and certain GI disorders, including Helicobacter pylori (HP) infection, irritable bowel syndrome (IBS), and celiac disease (CD). Migraines associated with these GI disorders can be improved through interventions that address the microbiome. This comprehensive stool test measures and analyzes over 300 microorganisms responsible for the balance and health of the microbiome. Disruptions in this balance can lead to GI disorders and other health issues making this test a valuable option.
Micronutrient Analysis
Nutrient deficiencies can also contribute to migraines and are another factor to consider if you suffer from migraines. There are critical nutrients such as magnesium, niacin, riboflavin, CoQ10, and Vitamin D, and deficiencies in these have been connected with developing migraines in individuals. Through nutrient testing utilizing a serum sample, you can pinpoint any deficiencies in these nutrients, which can help you and your clinician to design a personalized supplementation and nutritional plan to address your specific requirements. Knowing which nutrients to target can effectively replenish the particular requirements your body needs so you can reduce the migraines associated with these inadequacies.
Additional Labs to Check
It's important to note that migraine diagnosis is typically established with a healthcare provider after a thorough medicine history and intake of migraine-related symptoms. The provider may also order imaging such as a CT scan, MRI, or EEG (electroencephalogram) to rule out other causes of your patient’s headaches.
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Summary
Patients experiencing migraines know how it can hinder them from going to work, school, or just functioning in their daily activities. Fortunately, there are some health strategies that you can use to help your patients manage and endure these symptoms. Regular testing can help you identify the underlying triggers or causes of migraines to reduce the risk of developing migraines and associated symptoms. Functional medicine testing can help you implement the appropriate customized treatments based on your patient’s specific test results.
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