Over 39 million Americans live with migraine.1 If you’re one of them, you know firsthand it’s way more than just a “bad headache.” It’s a debilitating neurological disorder that affects roughly 12% of people worldwide.2
Migraine is the third most common disease and the second leading cause of disability on the planet. And while migraine is common, it’s a complex disorder – and its biological cause remains unclear.
Genetics plays a role, while environmental and lifestyle factors can trigger attacks. But no two migraineurs have the same triggers. So one-size-fits-all treatment often fails.
That’s why many migraine sufferers are turning to functional medicine for a more personalized approach. Instead of focusing on symptoms, functional medicine finds the root causes that are contributing to migraine.
We spoke with Dr. Meg Mill, a Functional Medicine Practitioner, Doctor of Pharmacy, and migraine expert, to get the inside scoop on functional medicine’s approach to migraine treatment – and how it differs from the standard medical model.
How Does Conventional Medicine Treat Migraine?
“The conventional approach primarily focuses on pain management and often overlooks the investigation of the underlying causes,” said Mill.
“This results in many individuals continuing to experience migraine while relying solely on pain medicine for relief without truly eliminating the problem,” she adds.
The list of potential migraine meds Mill refers to is lengthy. Acute meds include triptans and NSAIDs, while preventative medications include beta-blockers, anti-seizure medications, calcium channel blockers, and antidepressants.
These medications may offer relief. But they come with a long list of side effects and present long-term risks. For example, NSAIDs can cause severe digestive issues while triptans may increase blood pressure.3
That’s why many are searching for alternatives to conventional migraine treatment.
Functional Medicine’s Approach to Migraine Treatment
Mill says, “The cornerstone of the functional medicine approach in treating migraine is to identify the unique imbalances present in each individual and work towards restoring them to a state of balance.”
Imbalances that may contribute to migraine run the gamut. Some of the most common ones include mitochondrial dysfunction, hormone imbalances, inflammation, and food sensitivities.
In addition, migraineurs often have deficiencies in key nutrients. According to Mill, the most common deficiencies include:
- Magnesium: This mineral helps regulate neurotransmitter function and blood vessel tone. Studies show magnesium levels are often lower in migraineurs than in those without headaches.4
- Riboflavin: Also known as vitamin B2, riboflavin deficiency is also linked with migraine. Research shows taking 400 mg of riboflavin reduces migraine frequency.5
- CoQ10: This antioxidant helps your mitochondria produce energy – and it’s often low in those with migraine. Studies show CoQ10 supplementation can improve headache frequency and disability.6
- Omega-3 fatty acids: Found in foods like salmon and nuts, omega-3 fatty acids have potent anti-inflammatory powers. Research shows diets high in omega-3s reduce migraine frequency and severity.7
A key piece of functional medicine’s approach to migraine is to identify and correct these deficiencies. This alone may help prevent future migraine attacks – or lessen their severity at the very least.
Rather than simply managing pain, “Functional medicine aims to address the root causes of migraine and provide long-term relief and improved quality of life,” Mill added. And the first step towards getting there is to pinpoint each patient’s unique triggers.
How Does Functional Medicine Find the Root Cause?
Functional medicine practitioners are the detectives of the health world. Rather than prescribing generic protocols, they take a deep dive to find each patient’s underlying causes of migraine.
A comprehensive health assessment is the first step. These typically last at least 60-90 minutes to allow plenty of time for investigation. Compare that to traditional doctor visits, which average anywhere between 13-24 minutes.8
“During our meeting, we meticulously review their health history, symptoms, and lifestyle factors,” said Mill. “Our thorough analysis encompasses a wide range of factors, including nutrition, hydration, sleep patterns, hormonal balance, nervous system function, environmental influences, gut health, and more,” she added.
Often the health history alone can help uncover imbalances. For example, if a migraineur has muscle aches, constipation, and anxiety, magnesium deficiency could be a culprit. But keep in mind, many people with migraine will have more than one underlying cause.
In some cases, functional testing may be needed to identify imbalances. Hormone testing and food sensitivity testing may offer clues about underlying triggers. Stool analysis can also help uncover infections that may be causing inflammation.
“By delving into these essential aspects, we can gain a holistic understanding of their health and craft personalized strategies to address the root causes of their migraines,” said Mill.
The Role of Diet in Migraine Prevention
According to Mill, “Navigating the dietary aspect of migraines can be complex due to the extensive list of potential trigger foods.”
Some of the most common migraine trigger foods include:9
- Aged cheeses and other foods containing tyramine (e.g., cheddar, blue, Swiss, parmesan, provolone)
- Foods containing MSG (monosodium glutamate)
- Artificial sweeteners, such as aspartame
- Processed meats (bacon, ham, salami, and other foods containing nitrates)
“It’s important to recognize that triggers can vary among individuals, and the quantity of a specified food consumed may play a role,” says Mill. For example, you may be able to handle a glass of wine now and then – but having one every day (or two or three) may trigger an attack.
While the list above are the usual suspects, migraineurs may have other unique food sensitivities as well. One common way to pinpoint them is to do an elimination diet.
As the name suggests, elimination diets involve removing potential trigger foods for a set time. This often means getting rid of gluten, dairy, eggs, corn, yeast, and processed foods for a few weeks. Foods are then reintroduced one by one while noting any specific foods that cause adverse reactions.
Research shows elimination diets can significantly reduce the frequency of migraine attacks and the number of headache days.10 This is likely because food sensitivities trigger the release of IgG antibodies. These antibodies create chronic inflammation, which is linked with migraine.
The DASH (dietary approaches to stop hypertension) diet also shows promise for migraine. While this diet aims to lower blood pressure, studies show it reduces the severity and duration of migraine attacks too.11 This diet prioritizes mineral-rich foods while limiting salt and saturated fats.
There is also evidence that the Mediterranean diet, hailed for heart health, may also benefit migraine. One study found that people who followed the Mediterranean diet had lower headache severity, frequency, and duration.12
The Mediterranean diet focuses on wholesome, high-fiber foods such as fruits, vegetables, beans, nuts, seeds, and whole grains. Olive oil is the main source of fat, while moderate amounts of fish and dairy are included as well.
How Lifestyle Affects Migraine Management
Just as shifting your diet can help manage migraines, the same is true for lifestyle. That’s why functional medicine practitioners often prescribe lifestyle habits as part of their migraine treatment plan.
As Mill says, “Certain factors, such as dehydration and lack of sleep, are commonly identified as independent risk factors for migraine across the board.” She adds, “Addressing these fundamental aspects can play a crucial role in managing migraines.”
Some simple lifestyle habits that can help manage migraine include:
- Staying hydrated: Dehydration is a major migraine trigger. So drinking two liters of water a day is a must. But keep in mind, if you exercise or live in a warm climate, you’ll likely need more.
- Get plenty of sleep: Lack of sleep can also trigger migraine attacks. Most health experts recommend getting at least 7-9 hours of sleep each night. If you have trouble snoozing soundly, practicing good sleep hygiene may help. Sticking to a consistent sleep schedule, avoiding electronics for 1-2 hours before bed, and creating a relaxing bedtime routine can all help you get more Zzz’s.
- Destress: “Stress can act as both a trigger and perpetuating factor for migraine,” said Mill. So getting your stress in check is key. Mill recommends adopting stress reduction techniques such as mindfulness, meditation, and relaxation exercises to keep stress at bay.
“By focusing on these foundational aspects, we lay the groundwork for better overall health and potentially reduce the frequency and severity of migraine attacks,” said Mill.
Due to migraine’s complex nature, treatment can be tricky. Conventional treatment relies on medications to suppress symptoms. Unfortunately, these drugs act as band-aids and don’t identify the root cause.
In contrast, functional medicine’s approach to migraine is one of education and empowerment. It aims to identify each person’s unique triggers and imbalances, so they can take active steps to manage their migraine. As Mill says, “By equipping clients with the knowledge and tools to thrive, we aim to empower them to take control of their migraines and lead fulfilling lives long-term.”
Dr. Meg Mill is a Functional Medicine Practitioner, Doctor of Pharmacy, and migraine expert. She’s helped hundreds of clients transform their health through her virtual Functional Medicine Practice and is the host of the highly-rated podcast “A Little Bit Healthier.” You can learn more about her work here.
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