Migraines are debilitating and the number 3 cause of disability globally behind back pain and depression.  Before puberty, boys rather than girls are the greater sufferers of migraines but after puberty one in 4 women worldwide suffer from these painful headaches.  Whilst the peak of migraine sufferers are aged 25-55 years, very few women suffer after menopause.  There are different types of migraines including cervicogenic headaches driven by neck dysfunction and then hormonal migraines – ones that often occur when hormones, specifically oestrogen, starts to drop.  

Hormonal Migraines are a neurological event, whereby the brain can become flooded with inflammatory chemicals, sometimes prostaglandins also linked to pre menstrual cramps.  They can hit different parts of the brain – one area affecting sight, another causing nausea. There doesn’t seem to be an effective pharmaceutical answer but tracking and looking at what might be causing the issues can be an effective way of managing them.

The brain doesn’t like change and fluctuation – from diet, to exercise, to stress, any quick change can cause a migraine.  Even changing your sleep pattern by just one hour can result in pain.   Therefore consistency is your friend from hormones to blood sugar.  As always we need to control the controllables!

– Hormones – avoid excess oestrogens, particularly xenoestrogens found in plastics.  Don’t heat your food in plastic, and read the ingredients in your shampoos – avoid phthalates and parabens

– Good Liver Function – this feeds into hormones as it is through the liver than any excess hormones are excreted.  Your liver will prioritise removing alcohol instead of excess hormones so drinking will not help.  It does however like dark green leafy vegetables.

– Steady blood sugar – if your blood sugar drops your body releases insulin, if this happens excessively your body can become insulin resistant (a precursor to type 2 diabetes).  As before your brain doesn’t like lots of change so lots of fluctuating blood sugar levels can bring on a migraine.  So diet is key – include lots of fibre, whole foods, avoid refined carbs and keep hydrated and try to eat every 3 hours.  Food triggers are generally thought to be chocolate, citrus and cheese but everyone is unique and it takes up to 24 hours for a food to trigger a migraine.

– Gut Brain Link – studies have shown that the gut and the brain are linked – if your gut isn’t happy your brain won’t be happy.  Prebiotics, the fertiliser that keeps your gut bacteria healthy, have been shown to positively affect onset of migraines.  Dark green leafy vegetables and fibre again are key.  Also a good working gut, and no constipation are important in getting rid of excess hormones and achieving homeostasis.

– An anti inflammatory diet – the studies are still in their infancy but switching to an anti inflammatory diet is being shown to be beneficial all round.  Very simplistically inflammation is good if you’ve cut yourself.  It isn’t good if it’s out of control.  A healthy balance between the fats Omega 3 (anti inflammatory) v Omega 6 (pro inflammatory) is key.  More omega 3, needed to fight inflammation and heart disease & important for your brain and less Omega 6, which is more inflammatory but is still essential for growth and development. Omega 3 includes flaxseeds, chia seeds, nuts, algaes, oily fish.  Omega 6 – eggs, meat, as well as walnuts peanut butter and sunflower seeds.

– Stress Management – not only does stress elevate blood pressure but it also produces cortisol.  Whilst you are in the middle of the stress you will probably feel fine.  However, at the end of the event (e.g. at the end of a stressful week of work) your cortisol will drop and you could wake up on Saturday with a pounding headache. It’s therefore important to find your daily stress responses from yoga, to meditation.  It cannot all be managed with a spa break.

– Sleep Management – during sleep our glymphatic system is at work, a waste clearance system that gets rid of harmful waste proteins that build up between the brain cells. To maximise sleep, consistency is important and therefore by keeping good sleep hygiene, going to bed and waking up at the same time every day, the brain can clear optimally.  Sleeping too little in the week and too much at the weekend could upset the brain and potentially bring on a migraine. 

– Alcohol – when we are over 40 our Blood Brain Barrier (BBB) becomes thinner so alcohol can move into our blood more easily.  Plus alcohol affects are sleep, blood sugar, belly fat, moods, and constipation which can in turn affect every part of our mood and bodies, unsettle the brain and cause migraines.  (In addition to clogging up the liver and unbalancing hormones as outlined above.)

– Magnesium, B6 and COQ10 have all been shown to positively effect migraine and are also good for sleep and constipation.  A back up multivitamin is a good idea.

– Detox emotions – possibly part of your stress management system, Dr Chatterjee is a big advocate of journaling your feelings.  You don’t even have to re read or keep – you can just throw the page away if you prefer

– Exercise – here your own uniqueness will kick in.  For some yoga is the answer, for others it can bring on a migraine.  For some running deals with it.  For others it causes it.  One thing is for sure a variety of movement is important, try and take it outside in the green, and include strength training, good for blood sugar, hormone balance.

– Track track track – keep a diary of what’s going on and when your migraines kick in.  Questions to include:

  • How severe?
  • What were you doing when it kicked in?
  • What were you doing the day before?
  • What were you eating in the last 24 hours?
  • Sleep?
  • Stress Levels?
  • Day of Cycle?

As the brain doesn’t like sudden change, it’s worth making any changes gradually.  Consistency and reliability are key – track, increase your variety of plant foods and eat regularly, sleep consistently, find your stress management tools, choose a variety of exercises and find out what works for you.  A 3 month migraine management plan can work well but always see your GP if  you’re concerned, there are any changes, or if your headaches when you first wake up (as could be linked to sleep apneas)