It’s not All in Your Head: What Really Causes Migraine

Migraine affects 1 in 5 women and over ten percent of the population overall. Those who don’t have it cannot imagine the suffering it brings. And though it has long been considered a neurotic disorder, new research shows that its causes are quite physical.

Image Credit: PhotoAlto / Michele Constantini / Getty Images

Much worse than a headache

Migraine is very different from a normal headache: while the latter is caused by constriction of blood vessels in the head, the former is caused by their dilation. A migraine attack consists of several stages: the first, called prodrome, includes seeing flashes of light and colours, craving certain foods, mood swings, etc. The attack itself can last up to 72 hours and is characterized by unbearable pulsing pain, nausea, and sensitivity to light and noise. Often people are in such pain that they literally cannot move, talk, or eat.

Triggers are not causes

Lots of things can trigger a migraine, but none of them actually causes it – a very important distinction when discussing the root of an illness. Common migraine triggers include:

  • Certain foods (chocolate, wine, cheese, processed foods), alcohol, coffee;
  • Bright light and loud noises;
  • Hormonal changes (a lot of women get migraines during their period, when their estrogen levels drop – more on the topic here);
  • Stress;
  • Lack of sleep or, on the contrary, oversleeping;
  • Physical exertion;
  • Certain medications that dilate blood vessels (e.g. birth control pills and nitrates, taken for chest pain).

Of course, most people do not develop a migraine when they drink wine or exercise. The actual causes have long remained a mystery, and doctors believe that migraines stem from “bad nerves”, especially since the disorder mostly affect women, who are supposedly prone to anxiety. However, recent studies paint a very different picture.

Discovering the origin of migraines

There seem to be several true causes of migraines, making this a hard disorder to study.

  • Genetics. It is known that migraines often run in the family, but in a recent study scientists managed to identify 17 specific genetic regions linked to migraines. Unfortunately, there is no cure for such patient (until new gene therapy methods are developed): they will need to keep relying on pain relief drugs.
  • Nitrate absorption by bacteria. We have written about the gut-brain axis and microbiome imbalances as a root of many illnesses. Surprisingly, migraine may be one of them. It is a known fact that many migraine patients experience attacks after eating foods that contain nitrates, such as bacon and chocolate. A new study shows that certain species of gut bacteria are particularly good at processing nitrates and making their absorption easy. As it turns out, migraine sufferers have much higher levels of these bacteria. This may be another proof of the deep links between our gut and brain.
  • Serotonin imbalances. Research shows that many people suffering from migraines have low levels of neurotransmitter serotonin, which constricts blood vessels.  As we have written in our article on the gut-brain axis, 95% of serotonin are made in the gut, and the microbiome plays a key role in this process.

These unexpected results give new hope to millions of people suffering from migraines. In a few years we may have safe and affordable probiotic remedies to balance the microbiome, thus preventing migraine attacks. It will be a true victory for science – a century-old debilitating disorder defeated thanks to pioneering research.

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