Functional Medicine Migraines

Migraines are debilitating headaches that affect millions of people worldwide, often significantly impairing their quality of life. In fact, migraines are the second leading cause of disability worldwide (1). Functional medicine offers a holistic approach to understanding and treating migraines by addressing the underlying causes rather than merely managing symptoms. 

In this article, we’ll review our functional medicine migraine approach, including possible root causes and treatment options. 

Migraines are a type of headache characterized by intense, throbbing pain, usually on one side of the head. They often come with additional symptoms such as nausea, vomiting, and sensitivity to light and sound. Migraines can last from a few hours to several days and can be classified into several types:

This is the most common type of migraine, featuring headache pain with the possibility for nausea/vomiting, and sensitivity to light and sound.

Also called a classic migraine, migraines with aura include visual or sensory disturbances such as flashing lights, blind spots, or tingling sensations before the headache begins.

Chronic migraine is defined as having headaches on 15 or more days per month for more than three months, with at least eight days involving migraine-like headaches.

There are other classifications for migraines including menstrual migraines and migraines related to other conditions, like PCOS migraines. 

Unfortunately, there is not one underlying cause for all migraines. However, functional medicine aims to identify and address the root causes of migraines, which can vary from person to person. Understanding these underlying factors is crucial for developing an effective treatment plan. 

Hormonal fluctuations, particularly in women, are a common trigger for migraines. Changes in estrogen levels, such as those occurring during menstruation, pregnancy, or menopause, can provoke migraine attacks. Low serotonin levels and reduced serotonin production in the brain may also trigger migraines (2). Serotonin is known as the “happy” brain chemical. It is believed to act as a mood stabilizer among many other important functions.

Deficiencies in certain nutrients, such as magnesium, riboflavin (vitamin B2), and coenzyme Q10, have been linked to an increased risk of migraines. Ensuring adequate levels of these nutrients can be beneficial in migraine prevention and management.

Researchers suggest that oxidative stress also plays a significant role in causing migraines. 

Oxidative stress occurs when there’s an imbalance between harmful molecules called reactive oxygen species (ROS) and the body’s ability to neutralize them or fix the damage they cause. High levels of ROS can damage cells and tissues, including in the brain. This can lead to inflammation, which can trigger pain pathways and make the trigeminal nerve more sensitive, a major factor in migraines. 

Functional medicine offers a range of treatment options aimed at addressing the root causes of migraines. These treatments are often personalized to meet the specific needs of the individual. 

Our functional medicine dietitians may recommend dietary changes to incorporate nutrient-rich foods. An anti-inflammatory diet rich in antioxidants is particularly beneficial in supporting mitochondrial function and reducing oxidative stress. Plant-based foods, like fruits and vegetables, are generally the best sources of antioxidants. Learn more about a mitochondria diet. 

We may also suggest appropriate supplements to further boost antioxidants and reduce oxidative stress, like CoQ10 and/or Omega-3 fish oil. A large review study found that people taking CoQ10 had reduced migraine days per month and reduced migraine duration than the control group (3).  Omega-3 has been shown to reduce migraine duration and significantly increase antioxidant levels (4, 5). 

Some individuals may also experience sensitivity to blood sugar fluctuations. To help maintain balanced blood sugar levels and potentially prevent migraines, we recommend incorporating protein, healthy fats, and fiber into each meal and snack. 

Common food triggers for migraines are aged cheeses, processed meats, chocolate, and alcohol (especially red wine). These foods typically contain higher levels of histamine, which can trigger migraines in certain individuals. Caffeine can also be a trigger, especially when consumed in large amounts or when regular caffeine consumption is suddenly reduced. We recommend gradually reducing or eliminating caffeine. Keeping a “migraine diary” can be helpful in identifying food and lifestyle triggers for migraines. 

Magnesium is an essential mineral that plays a crucial role in reducing migraine headaches. Studies have shown that people who suffer from migraines have lower levels of magnesium (6). Additionally, a large review study found that people who took magnesium supplements reported significantly less migraine frequency and severity compared to the control group (7). 

There are many different types of magnesium sold over the counter. The most common form is called magnesium oxide. While this can be effective in reducing migraines, this form of magnesium can also cause digestive side effects like cramping, diarrhea, and abdominal pain in certain individuals. Plus, studies show that magnesium oxide is not well absorbed. We recommend a better absorbed and well tolerated form called magnesium glycinate. 

Certain B vitamins have shown to significantly reduce migraines. For example, riboflavin (vitamin B2) has shown significant promise in research studies for preventing migraines. A large review study found that taking 400 milligrams (mg) of riboflavin every day for at least three months significantly reduced days, duration, frequency, and severity of migraine attacks (8). Niacin, folate, and vitamin B12 are also suggested to help treat migraines (9). While we often suggest a separate and higher dose of riboflavin than is typically found in multivitamins, you can find the rest of these B vitamins in our B-complex supplement. 

Poor sleep is associated with migraine headaches. Improving sleep hygiene and addressing sleep disorders can significantly impact migraine frequency and severity. Taking your magnesium supplement before bedtime can support better quality sleep in many individuals. Consider reducing screens at least an hour before bedtime and implementing a relaxing bedtime routine at the same time every night. If you have any symptoms of sleep apnea (loud snoring, excessive daytime fatigue, morning headaches, etc.) consider asking your primary care doctor about requesting a sleep study. 

Migraines are complex and require a comprehensive approach to treatment. Functional medicine offers a promising pathway to preventing and treating migraines by addressing their root causes. Through personalized treatment plans that incorporate nutritional therapy, supportive supplements, lifestyle changes, and other holistic approaches, individuals can find relief and improve their quality of life. 

If you suffer from migraines, learn about our functional medicine program to explore these options and develop a tailored plan to address your unique needs.