Migraine

If you struggle with migraines you’ll know that the symptoms of this condition can be incredibly debilitating. In fact, migraine is now classed as the seventh most disabling disease in the world. 

Little is known about the exact cause of migraine, however, some studies show that certain foods and lifestyle choices can affect the severity and frequency of migraine attacks. 

According to The Migraine Trust, migraine affects one in seven of us, and over 19,000 attacks take place every day in the UK. Let’s take a look at migraine in further detail and explore how we can introduce specific diet and lifestyle changes to help manage migraines.

Migraine symptoms

How can you tell if you have a migraine and not just a normal tension headache? The main differences are as follows:

Factor Tension headache Migraine
Intensity Mild to moderate - distracting but not debilitating. Severe throbbing or pounding that can be debilitating.
Location Both sides of the head (equal distribution of ache). One side of the head only, or the front.
Other symptoms None Numerous accompanying symptoms, including nausea and vomiting.
Sensitivity Heightened sensitivity to light and sound is rare. Heightened sensitivity to light and sound is common.
Warning signs No warning signs, just a headache. 'Aura' (warning signs) before a headache.

'Aura' is the term used to describe the warning signs that one-third of migraine sufferers experience before an attack, usually 15 minutes to an hour before the actual headache occurs. Symptoms of aura include: 

  • Problems with sight: flashing lights, blind spots, or zigzag patterns.  
  • Stiffness or tingling: a pins and needles sensation in limbs, neck, or shoulders.
  • Bad coordination: a feeling of disorientation or loss of balance.
  • Difficulty speaking: slurred words, stammering.

What causes a migraine attack?

Historically, it was thought that migraine occurs when a drop in serotonin levels causes the blood vessels to dilate. However this was discredited, and it is now accepted that migraine occurrence is more likely due to brain mechanisms.

A person who suffers from migraine can attribute some of these attacks to genetics, but genetics is not the sole cause. No one particular gene will cause a migraine, but a host of inherited genes working together, coupled with various environmental factors, can cause a migraine attack. Therefore migraine is known as a complex genetic disorder.

Even if your genes have dealt you a poor hand, many of the factors resulting in migraine onset are eminently modifiable. Smoking, oral contraceptives and poor sleep patterns are thought to increase frequency and intensity of attacks; while several studies note that obese individuals are three times as likely to have an attack than those of regular weight.

- Nutritional therapist and metabolic coach Sally Parr on managing a migraine.

Migraine triggers

Some sufferers notice patterns to the frequency and occurrence of their migraines after eating certain foods, taking specific medicine or changes to their emotional state. Examples of migraine triggers include: 

Emotional triggers

Physical triggers

  • lack of sleep and fatigue
  • bad posture or muscle tension
  • hormonal changes e.g. menopause
  • low blood sugar levels

Environmental triggers

  • smoking
  • bright lights
  • flickering screens - televisions or computers
  • climate changes - humidity or temperature

Medicinal triggers

  • certain types of sleeping tablets
  • hormone replacement therapy (HRT)
  • contraceptive pill

Dietary triggers

  • dieting
  • dehydration
  • alcohol
  • irregular meals
  • tyramine (an amino acid found naturally in certain foods)
  • caffeine (e.g. tea, coffee or energy drinks)
  • chocolate, cheese or citrus fruit

Woman with migraine

Menopause and migraine 

Half of all women suffering from migraine say that their menstrual cycle directly affects the severity or frequency of their condition. Scientists believe there are strong connections between the female sex hormones oestrogen and the hormones involved with migraine.

The hormonal changes that occur in the female body during the menopause can also have significant effects on migraine. Several studies have identified that the menopause makes migraine worse for nearly half of all women studied, suggesting menopause cause migraine attacks to happen more often, or to become more severe. 

Treatment for migraine

There currently isn’t a cure for migraine, only different methods of symptom management. There are three different levels of migraine treatment, known as:

  • Preventative: Sometimes, migraines can be tackled before the full onset of an attack. Preventative medication is usually only taken as a temporary measure to break severe migraine cycles (between three and 18 months).
  • Acute: Acute treatment is designed to tackle the migraine attack while it is happening.
  • Rescue: If your acute treatment doesn't work, you may need more relief. This is known as rescue medication and could consist of anti-inflammatory, anti-nausea, or painkilling drugs.

Mild exercise for migraine

New research shows that mild forms of aerobic exercise as a preventative treatment can have a therapeutic effect on symptoms, and can significantly reduce the number of days you suffer from migraine. 

When you exercise, your body releases endorphins and enkephalins. Endorphins are natural pain-killers and enkephalins are anti-depressant hormones. A well-planned exercise programme including swimming, cycling and walking could also help you to lower your need for migraine medication.

Migraine diets

Certain types of food are widely known as common migraine triggers such as too much caffeine, alcohol or foods containing MSG, but each migraine is unique, and these may not apply to you and your attacks. It can be helpful to keep a migraine and food diary so you can pinpoint and, with the help of a nutrition professional or your GP, effectively eliminate or reduce your intake of the foods that trigger migraine attacks.

Gluten-free diets are often cited as plausible diets to follow when suffering from chronic migraine, however, there is little good-quality evidence to back this up. Going gluten-free may actually cause some significant side effects that may make you feel worse.

If you think gluten may be contributing to your migraine attacks, keep a diary to identify any patterns and discuss this with a nutrition professional or your GP.

As there is little evidence to suggest one certain diet is ideal to follow to reduce migraine, the process requires trial and error. Making certain adjustments to your diet based on scientific evidence, and with the support of a professional, may help reduce the frequency of migraine attacks.

You could consider: 

1. Reducing foods that have a high nitrate count

Research shows that individuals who suffer from migraine may have higher levels of bacteria in their oral cavity that are involved in processing nitrates (food preservatives). Subsequently, sufferers have more nitric oxide in their bloodstream which is linked to headaches.

Foods containing nitrate include processed meats such as bacon and ham, wine, beetroot and chocolate.

After giving up meat for six months, I remained migraine-free. And, two years later, I’ve only suffered from two migraines – as opposed to my monthly attacks, prior to making my diet change.

- Find out how going meat-free changed Katie’s migraine struggle for good.

2. Reducing foods that are high in tyramine

Tyramine is a naturally occurring amino-acid in certain foods, particularly aged or fermented foods. In our bodies, we have an enzyme, monoamine oxidase (MOA), that breaks down tyramine. If you don’t have enough MOA in your body, you may notice frequent migraine attacks after eating foods rich in tyramine such as cured meats, aged cheese, dried fruits and sauces including soy sauce.

Research into a low-tyramine diet is still in its infancy, but studies are indicating high levels of foods rich in tyramine could directly impact migraine attacks.

Nutritional therapy for migraine

Managing migraine will be unique to the individual and the triggers and symptoms that are associated with an attack. If you suspect that food is a major trigger, speaking with a nutrition professional should ensure that whatever you do is right for you.

A nutrition professional will be able to offer knowledge, experience and support to help you enjoy food, and suggest healthy habits and lifestyle choices while avoiding the debilitating effects of migraine.

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