Migraine: mind your mitochondria 

Migraine can affect anyone. Never mind how common migraine is, it still remains a misunderstood, underdiagnosed, undertreated and debilitating disorder. Getting a greater understanding of the different underlying mechanisms in migraine may lead to the future development of tailor-made pharmacological treatments. In the meantime, millions of migraine sufferers (‘migraineurs’) may still be able to alleviate their symptoms through nutritional and lifestyle changes.

Migraine: more than a simple headache

Migraine is the third most common disorder worldwide and according to the 2015 Global Burden of Disease study the seventh most disabling disorder worldwide, particularly for people under 50. It affects more than 14 per cent of the UK population.

Not only does migraine reduce the quality of life of the sufferer but it places a social and financial cost on society. With 190,000 migraine attacks in the UK every day, this disorder costs the NHS £150 million every year. School and workdays lost are huge due to absenteeism.

Migraine tends to run in families and is more prevalent in western populations. This disorder targets three times as many women as men.

Migraine can present itself differently in each sufferer but one of its primary characteristics is mild to severe throbbing pain on one side of the head which can also be accompanied by sensory disturbances, nausea, sensitivity to light or sound. Not only do different types of migraines exist but the experience of symptoms is very varied.

The diagnosis of migraine is clinical and doctors use the International Classification of Headache Disorders to categorise it according to the symptoms reported by patients.

Conventional medicine provides migraine relief by stopping the attacks through over the counter or prescription treatments such as anti-inflammatory painkillers, anti-nausea medication or vasodilators but their efficacy depends on how quickly they are taken after the first signs of a migraine.

In a bid to reduce the severity and frequency of headaches, improve response to acute treatment, reduce disability, medication overuse and healthcare costs, preventative migraine treatments may also be prescribed and medications normally recommended to treat depression, cardiovascular disorders or seizures are used. However, an incomplete understanding of the complex migraine mechanisms has so far led to the use of drugs which may have low efficacy, adverse side effects, contraindications or which create dependence and overuse.

It is therefore of little surprise that as many as 82% of migraineurs are now looking into alternative, natural, more gentle options such as nutritional and lifestyle interventions to address the root cause for their migraine.

The old vascular theory vs the role of mitochondrial dysfunction

The mechanisms of migraine are not fully understood. The theory behind migraine was that it was primarily a vascular phenomenon (relating to blood vessels). If changes in blood flow during a migraine are one part of the puzzle, recent research now shows that mitochondrial dysfunction may have a role to play.

Our brain is indeed high maintenance because it needs lots of energy to function properly. Mitochondria, the tiny specialised structures within our body cells, are in charge of producing cellular energy from the food we eat through a series of biochemical reactions which work as an energy assembly line. When mitochondria work well, they convert glucose and to a certain extent fatty acids, into energy.

Mitochondria have their own DNA (mtDNA) which is inherited from mothers. Some people are born with faulty mitochondria, indicating a genetic aspect to this disorder. 

Aside from genetic problems, poor nutrition and nutritional deficiencies may also directly contribute to mitochondrial dysfunction as these nutrients are needed in the assembly line to produce energy.

Mitochondria, like any factories, generate by-products called free radicals (damaging unstable electrons). Although their production is normal as part of energy production and generally counteracted by antioxidants, a poor diet low in antioxidants and nutrients, exposure to environmental toxins (alcohol, processed foods, pollution or drugs) and a faulty mitochondria may enhance the formation and leakage of free radicals. This may further damage mtDNA, mitochondrial cell membrane and complexes, compromising the production of energy, causing inflammation in the brain and the sensation of having a brain on fire.

How to reduce migraine and naturally support your mitochondria

1. Identify your migraine triggers and exacerbating factors

When the brain is hypersensitive, any internal or external stimulus are likely to trigger or exacerbate migraine. First, identify what triggers the migraine by keeping a headache diary. Specific foods may trigger migraine and temporarily removing them from a diet may reduce migraine pain or frequency. The most common triggers and exacerbating factors include:

• aged cheese
• milk
• gluten, baked goods
• citrus fruits
• chocolate
• monosodium glutamate (a flavour enhancer in Chinese food)
• aspartame
• alcohol, wine
• processed foods
• banana
• caffeine (coffee and tea)
• nitrates (cured and processed meat: bacon, sausage, hot dog, salami)
• stress
• hormonal fluctuations
• medication
• exercise
• skipping meals, hypoglycaemia
• dehydration
• bright lights, loud noises
• weather
• tobacco
• obesity
• irregular sleep patterns (sleep deprivation or oversleeping)

2. Add mitochondria supporting nutrients to your diet and adjust your lifestyle
Some specific nutrients and lifestyle adjustments have been shown to support mitochondrial function and reduce inflammation.

• CoQ10: Eat CoQ10 rich foods such as offal (liver or kidney), poultry, fish (sardines or mackerel), fruits, vegetables, nuts and seeds.
• Magnesium: Eat magnesium-rich foods such as green leafy vegetables (collard green, swiss chard, spinach), wholegrains (brown rice) and nuts (almonds, cashews, brazil nuts, pecans, walnuts). Adding Epsom salts (magnesium sulfate) to a bath once or twice a week will not only provide relaxation but also magnesium through skin absorption.
• Riboflavin (vitamin B2): Eat riboflavin rich foods such as offal (liver and kidney) almonds, mushrooms, wholegrains beans (soy, haricot, pinto, red, black eyed beans) and green leafy vegetables (collards, kale, parsley, broccoli, mustard greens).
• Omega-3 fatty acids: increase consumption of fatty fish (mackerel, anchovies, salmon) to three portions a week. Include a palm-full of nuts (walnuts) and seeds (flax) every day as these are rich in omega-3 fatty acids as well as CoQ10, magnesium and vitamin B2.
• Eat the rainbow. Colourful plant foods are full of vitamins, antioxidants and protecting chemicals. Vitamin C found in apples, grapes, oranges, grapefruit, pomegranate, kiwi, strawberries, berries, tomatoes, peppers, green leafy vegetables (kale, broccoli, collard greens, brussel sprouts, watercress, cauliflower, cabbage, spinach), asparagus and onions, can help reactivate vitamin E found in nuts and seeds, such as almonds, hazelnuts or sunflower seeds.
• Stress reduction, regular sleep patterns, adequate hydration and exercise may also help to reduce migraine.

Final words

Very little is known about the exact cause of migraine and the mechanisms underlying this disorder. There is no specific diet or magic cure for migraine nor is there research directly comparing the use of more natural options with conventional drugs. When used alongside traditional preventative migraine medication, small adjustments in the way we eat (real nutritious food) and live may be beneficial in reducing migraine frequency, duration and severity.