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About one in four Americans suffer from migraines, or head pain that lasts four to 72 hours, in the United States and it’s a leading cause of disability. Fortunately, by understanding how metabolic disorders affect the brain, we can use functional neurology and neurochemistry to help many people with migraines find lasting and significant relief.

Many migraine sufferers feel they miss out on much of their lives. It’s hard to make commitments to social events, concerts, picnics, or other events because they never know when they’ll be felled by a migraine. Many migraine patients are also dependent on one or more drugs to function, and some of these drugs can cause rebound migraines!

When a migraine is coming on or hits, symptoms may include not only pain but also inability to tolerate light or sound, nausea and vomiting, dizziness, numbness and tingling in different parts of the body, visual auras, déjà vu, hallucinations, and more. These symptoms are important clues in functional neurology to help us determine which part of the brain is affected during the migraine. For instance, visual auras indicate an issue in the occipital lobe, which governs vision, while déjà vu signals a migraine affecting the temporal lobe, which plays a role in time perception.

What exactly causes a migraine?

It has long been believed migraines happen when blood vessels to a region of the brain dilate, or enlarge, pressing on nerve fibers around them. However, other research suggests the pain is due not to widening blood vessels but rather extra sensitive nerve fibers surrounding them. Either way, inflammation seems to play a key role in the painful throbbing and pounding. The trick is to find out the underlying cause of the inflammation. This is where functional neurology and functional medicine come in.

Unstable blood sugar. Clinically, we see many cases of migraines significantly improve, if not resolve, simply by stabilizing the patient’s blood sugar. Most Americans are on a roller coaster of blood sugar lows and highs thanks to diets that are too high in sugars and processed carbohydrates, and too low in healthy, whole foods.

For others, they eat too little and too infrequently, keeping their body and brain constantly in a state of low blood sugar.

For these people, eating small bites of protein more frequently throughout the day can help prevent migraines.

Blood sugar lows and highs are highly stressful and inflammatory to the body and brain and a primary root cause to many chronic health disorders, including migraines. The first step in addressing migraine should always be to stabilize blood sugar and follow an anti-inflammatory diet.

Iron deficiency anemia. Anemia is another commonly overlooked cause of migraines we sometimes see clinically. If a migraine patient tests low in iron, sometimes supplementing with iron can profoundly impact migraine symptoms. Of course, you’ll want to address why you have anemia too.

Hormone imbalances. One of the more common, and complicated, causes of migraines in women is a hormone imbalance involving estrogen and progesterone. Hormone imbalances require a comprehensive functional medicine approach to address the reasons for the imbalance — chronic stress, blood sugar imbalances, poor gut health, inflammation, chronic infection, etc. Many women are low in progesterone due to chronic stress, which robs the body of the precursors necessary for progesterone to make stress hormones instead. Other common female hormone issues include excess estrogen, low estrogen, or excess testosterone. Appropriate levels of the sex hormones help regulate the immune system and inflammation.

This is a very cursory overview of some potential mechanisms for migraines, which can be different for everyone. Previous head injuries are another common factor to consider. If you have migraines, ask my office for a consultation.