THE MIGRAINE SOLUTION
Welcome everyone, I’m Dr. Trish Murray. I am a physician, author, and a Health Catalyst Speaker. It is my passion to help people just like you feel your best. Migraine pain is like no other. Migraines can stop you in your tracks, keeping you from experiencing the daily joys. Many of us are told there is no solution, that we’re just one of the unfortunate ones who have to suffer through. But folks, this talk will cover many of the possible underlying causes of migraines and give some suggestions for treatment. Before I get started into all the detail, I would like to ask you to write down the answers to a few specific questions. Just jot down what first comes to mind.
- How often are you having headaches?
- For how long do your headaches last?
- Where are they specifically in your head? Are they on the right, left, forehead, behind your eyes, back of your skull?
- Why do you think you’re having headaches? What do you think is the underlying cause?
As I go through this information, ask yourself, does one of the possible root causes resonate with you more than another? If it does, be sure to seek out the appropriate evaluation and treatment that I’m going to suggest for that particular cause.
The Migraine Solution can significantly improve your migraine headache complications for good. The Migraine Solution can significantly improve your migraine headache complications for good.” But here’s the catch, The Migraine Solution doesn’t work unless you do! The Migraine Solution is only recommended for people who:
- Understand that serious lifestyle changes lead to migraine freedom
- Believe they can actually achieve freedom from their migraines
- Have a positive, encouraging community for support as you make the changes that may be necessary
- Can fully commit to taking control of their migraines are going to have the most suggest
Migraines can be categorized as various subtypes. First, the major subtypes are migraine with an aura and a migraine without an aura. Next, are the root cause subtypes. Some of the ones are post-traumatic, facial, thyroid hormone, structural, adrenal hormone, glucotoxicity or related to elevated blood sugar, reproductive hormones, and environmental toxicity. We’re going to be going through all of these subtypes.
Major Migraine Subtypes
The first major type, migraine with aura, is a headache that strikes after or along with sensory disturbances called an aura. You can have visual auras that might include blind spots or “scotomas” which are sometimes outlined by simple geometric designs. You also could have zig zag lines that gradually float across your visual field. You could get shimmering spots or stars. You could also have changes in your vision such as blurry vision or actual vision loss. And you can get flashes of light in your vision. Additional sensory auras include feelings of numbness, typically felts as tingling in one’s hand or in their face somewhere; difficulty with actual speech and language, slurring speech, or inability to get a word out; or even muscle weakness.
A migraine without these auras is more than just a headache. The pain is debilitating and often accompanies nausea and vomiting for some people. This type of migraine actually accounts for the majority, about 75% of all migraines. Headache pain is typically localized in the front of the head and can last anywhere from 4 – 72 hours. Associated symptoms include:
- low blood pressure
- feeling hyper or wired
- sensitivity to light, sounds, or even motion
- dark circles under one’s eyes
The Root Cause Subtypes
One of the root cause subtypes of migraines is a post-traumatic headache. This is defined by the International Headache Society as “a headache developing within seven days of some type of injury or if someone lost consciousness after regaining consciousness.” Because post-traumatic migraines are associated with an injury, it’s important to identify and understand the nature of the injury for treatment. Following traumatic injury, at least 25% of people with mild traumatic brain injury do not seek medical attention.[click_to_tweet tweet=”It is really important to realize if you have ever suffered a head injury, even if you thought it was minor, it could be connected to your chronic migraines.” quote=”It is really important to realize if you have ever suffered a head injury, even if you thought it was minor, it could be connected to your chronic migraines.”] Migraines can occur due to any of the following related to the trauma:
- displacement of structures within the skull
- decreased blood flow and/or metabolic changes
- increased muscle tension in the head or the neck
- inflammation or irritation of the layer of the connective tissue coating the brain called the dura or the meninges
- increased pressure within the skull (if you’re not draining blood, for example, out of the skull that can cause increased pressure)
Musculoskeletal headache is the most common cause of head discomfort or headache after trauma and is often one of the most overlooked. Osteopathic manipulative treatment (OMT) is one my primary specialties and is very effective in evaluating and treating headaches caused by traumatic events. If you have ever suffered a head injury and you have chronic migraines, then you owe it to yourself to find a provider who can evaluate and treat you structurally. What I suggest you do is find either an osteopathic physician like myself or a therapist that is certified in what’s called craniosacral manipulative therapy.
The next subtype, facial subtype, is associated with a root cause happening in the face. Typical causes of facial-related headaches include:
- dental issues such as a chronic infection
- temporomandibular joint dysfunction (TMJ)
- if you clench your teeth or grind your teeth (bruxism)
- sinus problems, chronic sinusitis
- irritation of a facial nerve
Each cause of these different facial types has its own treatment plan. Depending on your specific cause, an individualized and personalized treatment plan can be developed. “You’re going to need to work with a provider who is willing and able to take an extensive history and talk in depth with you about your symptoms and narrow down with you what the possible root cause it. This is what functional medicine providers do! You’re going to need to work with a provider who is willing and able to take an extensive history and talk in depth with you about your symptoms and narrow down with you what the possible root cause it. This is what functional medicine providers do! We take a full lifetime history of your entire life, called the timeline, in order to look for patterns or triggers to your present state of health. If you do not feel you have worked with a provider that has fully listened to your symptoms and asked about your diet, lifestyle, habits, and past medical, emotional, physical, and metabolic concerns then you owe it to yourself to seek out a functional medicine provider and dig deep for the most possible root cause for your migraines.
Next, let’s talk about another subtype – thyroid hormone subtype. Imbalances in the thyroid are linked to numerous conditions including migraines. Lab work can be done to access the function of your thyroid gland to determine if this subtype may account for your chronic migraines. Of all the different thyroid conditions, “hypothyroidism” or low/sluggish thyroid function is the most frequent associated with migraine complications. The symptoms of a sluggish thyroid gland include being cold all the time, dry skin, hair falling out particularly if you’re always cleaning hair out of the drain in your shower, irregular menstrual cycles, weight gain, slow heart rate, and constipation. However, an overactive “hyperthyroid” gland can also be associated with migraines. The way you find out is bloodwork to assess the function of a person’s thyroid. This can show if this may be a root cause of your migraines.
What I want you to understand is that out there in the traditional medical model, the typical primary care physician will only check what’s called your TSH level. TSH stands for thyroid stimulating hormone. This hormone comes from your brain, from what’s called the pituitary gland. It does not come from your thyroid. If you’re really trying to get a sense of the full function of the thyroid gland itself, you need to do more lab work than that. The TSH alone does not give information about the full function of the thyroid gland. To fully assess your thyroid function, you should ask your primary care provider or find a provider that’s willing to test the following list of things:
- Free T4 (the hormone that is actually put out by the thyroid gland)
- Free T3 (the active hormone that causes us to be vibrant, have good temperature regulation, not lose hair, move our bowels, etc.)
- Reverse T3
- If your immune system is creating any antibodies against your thyroid gland. The most common cause of hypothyroidism or hyperthyroidism is an autoimmune condition during which your immune system is attacking your own thyroid gland and creates antibodies against it.
The next subtype is the structural subtype. Structural migraines are linked to various localized pain in different structural parts of the head or neck and do not have to have been initiated by any specific trauma. Structural migraines are linked to various localized pain in different structural parts of the head or neck and do not have to have been initiated by any specific trauma. Common structural conditions include:
- neck pain and shoulder tension
- at the base of the skull is an area called the sub-occipital area, if the muscles and tissues just below the base of your skull are tight, they can be blocking appropriate blood flow in and out of the head and pinching on important nerves to the head and face
- chronic position stress, like working on a computer or at a desk job all day long
- strain in your shoulders, upper back, or neck
Correcting the source of pain in a structural-related migraine will effectively reduce the intensity of a migraine. Craniosacral manipulation is one of many osteopathic manipulative treatment modalities. It can quiet the muscle tension or structural imbalances in the head and neck that could be the root cause of your migraines. Massage and acupuncture are also useful techniques for treating structural migraines. Stretching on a daily basis and physical therapy can also help balance structures and quiet strain patterns to help improve and correct posture and eliminate pain.
If you are not stretching every day, I suggest you go to my website discoverhealthfmc.com and on the home page of the website, go across the horizontal menu and click on the Health Library. In the drop-down menu, click on what says Exercise Videos and in there the very first thing you’re going to come to is Level 1 Stretching. It’s perfectly free! Just go to Level 1 Stretching, watch my video, and do the stretches every day. I challenge you to do the stretches every day for the next 21 days and assess what effect is has on your migraines. If it starts to improve them, then your subtype may very well have an aspect of structural migraine related to it.
Let’s talk about adrenal hormones. The adrenal glands are tiny organs that sit on top of your kidneys. They are part of your hormone system and regulate stress, metabolism, and a variety of other functions. Cortisol and another hormone named dehydroepiandrosterone (DHEA) are the stress hormones produced by the adrenal glands. Chronic stress causes the adrenal glands to produce excess levels of cortisol and DHEA and can lead overtime to exhaustion of your adrenal glands. DHEA is perhaps the most abundant steroid hormone in the body and is connected to one’s vitality. If it decreases in level, this can be very detrimental to your overall wellbeing and lead you down the path of exhaustion and chronic migraines.
Adrenal dysfunction is diagnosed best with saliva tests with multiple samples. In order to do this testing, what you do is you essentially spit in a tube at four different times on the day of your testing. These multiple samples assess what is called the circadian rhythm of your cortisol. Your cortisol is supposed to be highest in the morning when you first wake up because we need to wake up for our day and we need to be vital. The cortisol rises very high first thing in the morning. Then the cortisol is supposed to decrease gradually throughout the day and be the lowest at bedtime, so we can go to sleep and not stay awake.
There are three different stages to adrenal dysfunction and this salivary cortisol test where you spit in the tube four times in the day is necessary to identify if your adrenal glands are dysfunctioning and what stage of dysfunction you may have. I have done a podcast in the past specifically on the adrenal glands, entitled Stress and the Adrenal Glands. During that podcast, I go into great detail about the appropriate testing even further and the appropriate treatment for your adrenal fatigue depending on which stage it is. For any stage of adrenal fatigue or adrenal dysfunction, the most important therapy is stress reduction and relaxation. If someone is having migraines caused by adrenal hormonal imbalances, calming activities can be particularly helpful. Stretching as well as daily breathing techniques can be a very important step in quieting the mind and improving adrenal balance.
Melatonin, which also is a hormone, is supposed to be at its highest level at night to help us sleep. This can be supplemented to help correct your sleep cycles which can also be altered from under or active adrenal hormones. Taking melatonin, which is really simple to do, as a supplement can over time help to balance your cortisol levels and maybe bring your adrenal glands into better balance.
If you have been under increased stress for a prolonged time and you think your adrenals may not be functioning properly, the very first step is to focus on techniques to quiet your mind such has deep breathing and meditation. A trial of taking low doses of melatonin (3mg) at bed time. If you’re doing this and this is only helping a little, then remember you owe it to yourself to find a functional medicine provider and do the salivary cortisol test to specifically identify your stage of adrenal fatigue and how to appropriately treat it further.
Glucotoxicity is a condition in which your blood sugar level remains high for prolonged periods of time. Glucose is a toxin to your body; it is a neurodegenerative chemical that causes inflammation that’ll take you down a horrible path of illness and chronic disease. Glucose is a toxin to your body; it is a neurodegenerative chemical that causes inflammation that’ll take you down a horrible path of illness and chronic disease. Glucotoxicity, or high blood sugar indicators include:
- insulin resistance
- symptoms of metabolic syndrome such as high fasting blood sugars
- increased abdominal fat right around the belly
- high cholesterol
- systemic inflammation
- more frequent headaches
- neurodegeneration causing slow and progressive memory problems
If you are experiencing an increasing amount of brain fog, this can be a sign of elevated blood sugar levels and may be the underlying cause of your migraines. Opposite of a high blood sugar causing one’s migraines, it could be possible that you have low blood sugars on a regular basis that too could be the cause of your headaches. Especially if a person’s blood sugar is crashing such as in the late afternoon, late morning, or sometimes in the middle of the night. This is typically due to a person’s diet being too high in grains and carbohydrates because when we eat grains or carbohydrates it all get converted quickly to sugar. Your sugar load goes up really fast but then your body puts out insulin and takes the sugar down really fast. If that happens you can have high and low crashing blood sugars up and down all day long which could be related to your headaches. The answer could simply be making sure that you decrease the amount of grains in your diet and add in protein and healthy fats in order to get a better balance in your blood sugar.
Migraines related to glucotoxicity require repairing the balance of your blood glucose. If this is thought to be a possible cause, then the blood sugar can be tested, and a person’s diet can be explored and changed to bring more balance. The standard American diet today, the acronym SAD, is full of far too much sugar and carbohydrates and grains that all get converted to sugar in the body. In my book, Make a D.E.N.T. in Chronic Disease, I explain in great detail the concepts of what I call the “rainbow diet.” This an optimal diet to keep your blood sugar under good control.
Migraines related to the reproductive hormones like estrogen, testosterone, and progesterone are more common among women due to the predominance of estrogen. The fluctuation of estrogen, specifically plummeting levels, is most often associated with ovulation, menstruation, and perimenopause. The hormone progesterone can also have some effect, but estrogen is often a stronger contributor. Estrogen is believed to be the main reason why women have more migraines than men, which is why women tend to have them right before or after their periods, when their estrogen level drops to its lowest level of the month. In the functional medicine paradigm, we are trained that it is actually best to look upstream from the reproductive hormones to the adrenal glands and the thyroid, but if the thyroid and the adrenals are functioning normally, then the reproductive hormones should also be assessed.
Magnesium is especially helpful if you’re prone to monthly headaches. Magnesium is especially helpful if you’re prone to monthly headaches. Try to get between 250 – 450mg of magnesium every day from foods like spinach and Swiss chard but also you could take a supplement of magnesium of 250 – 450mg. Other good sources of magnesium are sweet potatoes, bananas, sunflower seeds, and sesame seeds. The one thing about taking magnesium as a supplement is that if you’ve ever had a colonoscopy, you’ve taking magnesium and a lot of it. Remember that if you take a lot of magnesium or one that is combined with certain things, it may increase loose stools and may give you diarrhea. There is a supplement called magnesium glycinate (because most minerals are bound to something in order to take them as a supplement) at around 250mg a day is the least likely compound to cause loose stools or problems with your bowels.
Environmental toxicity can be a tricky diagnosis as we are constantly exposed to various toxins. Some of the most common toxins include:
- organic toxins such as fungicides in the farming industry
- heavy metals such as mercury, arsenic, cadmium, and lead
The treatment varies depending on the type of environmental toxin responsible for your migraine. For heavy metal toxicity, a detox cleanse can help release toxins stored in your tissues and remove them from the body. One of the best ways to detoxify from heavy metals is to sweat. To take an infrared sauna is one of the best ways to sweat and release toxins from the stored places in your body. If mold is thought to be the cause of migraines, there are home mold kits that can be used to determine if you are being exposed to mold in your immediate home environment. Depending on the type and extent of mold infestation, professional removal may be required. Limiting the chemicals around your home can also reduce exposure to organic chemicals. For example, changing lawn care products to natural alternatives and opting for organic and local produce can help limit your exposure. There is a wonderful organization called the Environmental Working Group and this non-profit organization can help a lot in learning what foods need to be bought organically and which do not and what consumer products are safest for you and your family.
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I hope you have a better understanding of the various causes of migraines. What I’d like you to do is look back at what you wrote down for the answers of the questions I asked at the beginning. Did one of the different subtypes of the migraines resonate with you more than another? If it did, then you should go with your gut and create an action plan for looking further into that possible root cause of your migraines and for treating your migraines for good! If anyone would like additional information, please do not hesitate to reach out.
- Discover Health Functional Medicine Center
- Environmental Working Group
- Make a D.E.N.T. in Chronic Disease
- Sign up for your FREE 30-minute phone consultation
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