A migraine is a common and generally chronic form of headache that is believed to occur as a result of complex interactions between the nervous system and the vascular system. Therefore it is often characterized as a neurological disorder.  It was formerly believed that migraine headaches were simply caused by vasodilatation but brain imaging studies of blood flow in the brain have shown that this mechanism cannot be solely responsible for all the features of migraines.  For example it is known that certain neurological pathways of the sympathetic nervous system become sensitized and are stimulated more easily during a migraine headache causing the release of certain cytokines by nerves around the blood vessels that promote inflammation. It appears that sympathetic stimulation may also be responsible for some of the associated symptoms of migraines including nausea and vomiting.

Additionally environmental and genetic factors are also believed to be determinants in the pathogenesis of migraines. For instance about two-thirds of cases run in families. Fluctuating hormone levels may also play a role. Where migraines affect slightly more boys than girls before puberty in adulthood about two to three times more women than men suffer from them. Propensity for migraines usually decreases during pregnancy.

Several foods and food-associated substances are notoriously known to act as migraine triggers. These include wine cheese oranges MSG nitrates and chocolate among others.

More than a little evidence exists that gluten sensitivity seen in Celiac disease can also be a contributing factor in migraine development in a subset of this population. Investigating all migraine sufferers with food sensitivity testing and/or food challenges may prove to be clinically very productive.

Finally high homocysteine especially in those with the MTHFR genotype has been shown to be a probable etiological trigger in chronic migraine suffers. In this case addressing this issue with adequate vitamin B supplementation could be particularly beneficial.

Nutritional Support

Nutritionally in several studies magnesium has been determined to be low among migraine sufferers while its supplementation appears to help with counteracting vasospasm inhibiting platelet aggregation and stabilizing cell membranes.  Magnesium supplementation also can help in those women who commonly suffer menstrual-associated migraines.

Melatonin is a hormone in the body that possesses several interesting qualities while performing a multitude of physiological functions including regulation of the reproductive axis and circadian rhythms. It also possesses antioxidant activity. Several other physiological effects of melatonin in different peripheral tissues have been described as it has been demonstrated that the hormone is involved in the regulation of body weight and energy balance.

Therapeutically melatonin administration has been shown to alleviate the symptoms of jet lag after air travel across several time zones. The hormone also has potent sedative effects in humans and may be a useful hypnotic agent.

Like magnesium melatonin has been found to be lacking in migraine sufferers. Therapeutically it has shown promise as a potential tool in migraine headache relief possibly through its inflammatory effect free radical scavenging reduction of pro-inflammatory cytokine up regulation nitric oxide synthase activity and dopamine release inhibition membrane stabilization GABA and opioid analgesia potentiation glutamate neurotoxicity protection.

Lastly CoQ10 which like melatonin can act as a powerful antioxidant has also been shown to be deficient in children and adolescents with a history of migraines and its supplementation may have a beneficial impact.

Once you examine the scientific literature it becomes clear that nutrition can play a significant role in the pathogenesis and management of this type of headache. In part two we will give a brief overview of what may be some other interesting and viable options as treatments for this not uncommon malady.

Michael Fuhrman D.C.