This week I have been seeing several patients with migraines. It can be a very debilitating condition when recurrent and disrupts not just work, family life but has wider impact on mental wellbeing as well. In fact, migraine headaches are the commonest leading cause of disability in under 50’s globally.
Neurology Professor, Professor Gaodsby, from King’s College London, states:
“Migraine is an inherited tendency to have headaches with sensory disturbance. It’s an instability in the way the brain deals with incoming sensory information, and that instability can become influenced by physiological changes like sleep, exercise and hunger.”
Migraine headaches can last from few hours to up to four days in some people. Common symptoms include head pain usually on one side of the head, sickness, nausea, visual problems like seeing flashing light, tiredness and being sensitive to light, sound and smell.
Migraines can present without aura or with aura. When you have a migraine without any warning and it just starts suddenly, it is called migraine without aura. This is the most common type. The migraine with aura tends to have warning signs which most commonly affect vision in the form of seeing zig zag lines, having blind spots, seeing coloured spots or lines or temporary blindness. This can seem very scary when it happens the first time. Speech can also be affected. Sometimes people may feel confused or disoriented too. An aura gradually starts and can last for five minutes to an hour.
I often see how patients are not able to do their day to day chores. They have to stop everything to deal with the migraine attacks. The medical treatments are available for both prevention and acute management, however there are lifestyle changes which can improve and reduce the migraine attacks too. It is also good to look at the root cause of why the migraines are actually happening. This is where a personalized Lifestyle medicine plan can be helpful.
The exact pathophysiology of migraines is unclear however there is some evidence that overall inflammatory and oxidative stress as well as mitochondrial (organelles in each cell which generate the power for each cell to function properly) dysfunction maybe linked. Migraines have been associated with stress, environmental triggers, allergies, as well as chronic inflammatory disease which include obesity, type 2 diabetes and gastrointestinal problems.
Is our metabolic health linked?
Several studies are showing that migraines are closely linked to our metabolic health, specifically to insulin resistance. Obesity has also been associated with increased risk of migraines. Certain micronutrients when deficient can also aggravate the symptoms or recurrence of migraines. These include vitamin D, B, omega three fatty acids, coenzyme Q10, L-carnitine and magnesium.
I am sure you would agree that most of these can be improved by making better lifestyle choices. Let’s have a look at what may help.
Evidence based Lifestyle tips to help support your Migraine journey
- Have a routine where waking up, sleeping and eating times are mostly similar. This supports the circadian rhythm which will help regulate various hormone functions and keep them in harmony.
- Stress management is a priority and this is what I see many people ignoring. I have previously written a blog about stress management which has some practical tips.
- Keep a symptom diary. There is nothing more powerful than awareness. If you are able to keep a regular symptom diary – including what you ate, stress levels, energy levels as well as the number of hours of sleep, just for 4-6 weeks it may lead to you to triggers which you have not been aware of. Once you know, you may be able to manage those triggers accordingly.
- For women the cyclical hormone changes can be a trigger for migraines and often symptoms would be worse during premenstrual period or during peri-menopause.
- Poor posture is something which I have started advising all my migraine patients about. With the current culture of long working hours on the laptop, or hours of scrolling on the phone the neck and upper back muscles become very stiff. Simple neck and upper back exercises can have a huge impact. If you feel this is an ongoing issue I would urge you to consider seeking support from a physiotherapist.
- Medication-certain medications can cause migraines to be triggered and commonly these include contraceptives as well as HRT.
- Hydration is something I have discussed previously in my blog but it is such a simple thing to fix. It will help reduce the toxin load of the body which then reduces inflammation as well as oxidative stress, both of which have been associated with Migraines.
- Sleep for at least 7-8 hours. I recently have seen so many youngsters who work late during the night and are constantly on their laptop for work demands, striving to work to global timings compromising sleep. Then when the migraine attacks kick in, they are forced to stop working for few days.
- Exercise for at least 15-20 minutes every day as this will improve stress levels, metabolic health as well as help maintain weight.
- Diet. This can be a whole blog in itself!
- Unprocess the food as much as possible.
- Have a more plant predominant diet.
- Reduce saturated fat and stick with cold pressed organic extra virgin olive oil.
- Add healthy Omega three sources to your diet in the form of chia seeds, linseeds and walnuts.
- Take your vitamin D supplement regularly to make sure healthy levels are maintained throughout the year. 1000-2000 IU per day is sufficient for an adult.
- Magnesium rich diet which would include nuts and seeds, green vegetables like spinach, Swiss chard, brown rice, amaranth grains as well as legumes like black bean and edamame beans.
- Include spinach, cauliflower, cabbage as well as nuts and soya in diet to get healthy doses of Coenzyme Q10.
It sounds like an exhaustive list but to simplify I would begin with symptom diary and hydration. Then pick up other options week by week depending on what the diary reveals. With diet, I am sure you can easily see that if one follows a whole food plant based diet it automatically reduces the toxins, inflammatory elements as well as the saturated fat.
If you feel you would like personalised support, please do contact me.
Have a good week ahead.