We are going to discuss the gut-brain connection and how it influences migraine. The gut microbiome (the bacteria in our digestive system) is one of the most critical factors that affect our mental and brain health, including stress, anxiety, depression, and migraine.
The main goal of this blog post is to present you with all the latest research about what triggers migraine headaches so you'll know how to proactively take control of your migraines to prevent them from occurring.
Many people do not consider the impact that their gut health can have on their migraines, but what they don't realise is that everything that your brain needs to operate well comes from your gut and your lungs. If you are not putting in what the brain needs or you don't have the right internal environment (microbiome), then the brain will not function properly.
The gut-brain connection is not a new concept, but it has been proven to be an essential link in the pathogenesis of migraine. As many as 90% of people with migraines report gastrointestinal symptoms such as nausea, diarrhea or constipation before experiencing their headaches. This can indicate a direct correlation between the two, but even if your only symptom is migraine, you still need to consider the role of the gut.
Today, even psychologists increasingly see the difference that healthy gut bacteria and the right food can have on mental states such as depression and anxiety, as well with ADHD, autism, Cognitive decline and migraine.
The Enteric nervous system - the second brain
The nervous system in your gut (called the enteric nervous system) has been called the "second brain" because it can be a potent regulator of emotions and behaviour. It is an important system to understand when looking at the connection between anxiety, stress, diet and migraine.
The gut-brain-microbiome connection starts with your vagus nerve, sending information from the enteric nervous system in your gut (think about this as a second brain) to your central nervous system (brain). This process happens all day long without you even realising it!
The brain manages the gut by sending signals to it through nerve cells called neurons. The connections between the brain and the stomach are known as part of our "gut-brain axis" which is a communication pathway that regulates digestion, hunger, moods and emotions. It can also affect how we feel pain. For example, people with irritable bowel syndrome (IBS) often have more severe abdominal pain than healthy individuals do when they experience stress or anxiety.
The vagus nerve is a large nerve that connects your enteric nervous system in your gut to your central nervous system. It has a role to play in the two way communication between the brain and the gut. Research has sown that direct stimulation of the vagus nerve can prevent and relieve migraine and devices have now been approved in America specifically to help with migraine that act on the vagus nerve.
The sympathetic and parasympathetic nervous systems are also important in the gut-brain connection. When you experience stress or anxiety, your body gets ready for flight or fight by releasing epinephrine (also called adrenaline) - a hormone that raises heart rate and blood pressure. This happens through activation of our vagus nerve which connects to the brainstem, where it stimulates these two branches of the autonomic system: sympathetic and parasympathetic. The activity in one branch will inhibit activity in the other, so there is no overstimulation; this restores the balance between them! These nerves also stimulate stomach contractions, leading to nausea and vomiting when we're stressed out about an upcoming exam or presentation at work etc..
What is the gut-brain-microbiome connection?
The microbiome is the bacteria that live in our intestine. They perform a host of essential functions for us to be healthy, including providing a barrier to inflammation, synthesising vitamins and anti-inflammatory compounds, regulating the immune system and behaving as an endocrine organ. There are so many different types of bacteria that live in our bodies because we each have a slightly different mix based on what you eat, your environment and even your genetics.
What does this mean for us? The microbiome can affect mood by influencing neurotransmitters such as serotonin or dopamine. 90% of the serotonin in your body is produced by bacteria in your gut. Proteins that you eat are broken down into amino acids which are then converted to serotonin and other hormones and neurotransmitters. If you don't eat the right amounts of protein, then you may become deficient in these.
Migraines do seem to be linked to changes in serotonin levels - an essential hormone for regulating sleep cycles and mood - which may occur because of chronic inflammation from bacteria in your intestines. The most common migraine medications ( triptans) work on increasing serotonin levels in the brain, so we know a link between serotonin and migraine. If you initially found the triptans were helpful for you ( the effects may have waned after long term use), then it may be the fact that you have low levels of serotonin or its precursor tryptophan.
The gut-brain-microbiome connection is a 2-way street, so anxiety, stress or depression can have a big impact on the microbiome which in turn impacts your brain health!
How does an unhealthy gut microbiome lead to making your migraine worse?
Migraine sufferers have a different mix of gut bacteria that could make them more sensitive to certain foods, scientists have found. They had higher levels of bacteria that are known to be involved in processing nitrates, which are typically found in processed meats, leafy vegetables and some wines. Therefore, how you respond to different foods may depend on what mix of bacteria you have in your mouth and your gut.
A healthy gut microbiome is diverse and has a good mix of all different bacteria. When the mix moves out of balance, people may start to have problems, which is what we see after antibiotic use, and diets based on only a few food groups like pasta, rice and potatoes, processed foods, and chronic stress.
The latest findings raise the possibility that migraines could be triggered when nitrates in food are broken down more efficiently, causing vessels in the brain and scalp to dilate.
We often see that people eat a very limited range of foods, we are, of course, creatures of habit. But this can lead to the microbiome becoming less diverse and overpopulation of certain bacteria.
What are some dietary changes to help with migraines?
Aim for half of your grains to be whole grains. Whole grains have more fibre and vitamins than white bread, white rice, and pasta. Try to change things like these in your diet to whole grains.
Aim for incorporating more fruits and vegetables into your diet. Half of your plate should be filled with these items every time you eat.
Try to eat healthy fats and not low fat or trans-fat foods.
Limit your consumption of saturated or sugary products when you can, increase your seafood intake, as this is high in omega 3 fatty acids that are essential for your brain health.
Stay away from processed foods and salty snacks, limit sodium intake to less than 2300 mg per day.
Make eating "from scratch" or avoiding processed foods a priority.
Take supplements known to have a beneficial effect on migraineurs. Magnesium, Coenzyme Q10, omega 3 fatty acids, Vitamin B's.
Everyone must consider their gut health regarding their overall health and wellbeing, especially if you have migraine. Making the right changes to your diet and mental and emotional wellbeing can significantly help your migraines.
Dr Damian Poustie (osteopath)
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