A migraine can cause severe, often throbbing pain usually on just one side of the head. It is often accompanied by nausea, vomiting, sensitivity to light and sound, and worsening of symptoms with activity. Although a single episode of migraine lasts 4 to 72 hours those with Chronic Migraine experience a minimum of 8 migraine days per month and at least 15 days per month of headache of any kind.
Warning symptoms known as “aura” may occur before or with the headache. These can include flashes of light, blind spots, or tingling on one side of the face or in your arm or leg. Migraine can mimic the symptoms of stroke, and leave a stroke in its wake, or be associated with a seizure. More complex presentations of migraine may not have headache as a prominent symptom. These have been called “Late Life Migrainous Accompaniment,” but despite their name they can affect those as young as 40 years of age. More modern terminology has been adopted in the classification system known as The International Headache Society ICHD-3 Beta. Vertigo (a false sense of motion), slurred speech, ringing in the ears, double vision, staggering gait, and loss of consciousness can be associated with migraine with brainstem aura.
A combination of genetics and environmental factors appear to play a role in migraine. Migraine may be caused by changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway. Imbalances in brain chemicals – including serotonin, which helps regulate pain in your nervous system – also may be involved. Serotonin levels drop during migraine attacks. This may cause your trigeminal nerve to release substances called neuropeptides, which travel to your brain’s outer covering (meninges). The result is migraine pain. Other neurotransmitters play a role in the pain of migraine, including calcitonin gene-related peptide (CGRP).
Environmental factors that have been associated with migraine include imbalances in hormones, food sensitivities, chemicals, alcohol, stress, changes in the wake-sleep pattern, physical factors, and changes of weather or barometric pressure. When using a functional medicine approach it is important to recognize the role of the gut. This includes a role for the microbiome (including nitrate-reducing bacteria in the mouth) because migraine sufferers have a different mix of gut bacteria that can make them more sensitive to certain foods, for example. This, in turn, activates the gut-associated immune system and alters gut permeability (“leaky gut”). Interestingly, low levels of serotonin in the gut, where most serotonin in the body is produced (by gut bacteria), appear to be linked to migraine.
Since functional medicine evaluates the causes of chronic illness the functional medicine approach is ideal for addressing migraine at its roots. To accomplish this goal, it uses the Functional Medicine operating system. This consists of the Functional Medicine Timeline, The Functional Medicine Matrix, and the Therapeutic Lifestyle Factors (Sleep & Relaxation, Movement & Exercise, Nutrition, Stress, and Relationships). Functional Medicine Matrix, based on a scientific framework known as “systems biology,” allows the practitioner to evaluate imbalances at the cellular level. This helps sort out why the disease has occurred in the first place. By understanding each of these imbalances the person with migraine is empowered to make changes to correct them. Each part of the Matrix is called a “node,” and there are 7 nodes on the Functional Medicine Matrix. You can read about them here: Assimilation, Defense & Repair, Energy, Biotransformation & Elimination, Structural Integrity, Transport, and Communication.