I was recently asked for my advice about migraines and I was struggling unsuccessfully to give a few sentences. So, here’s a brief brain dump on my experience with migraines and my thoughts.
About twelve years ago I started having periods of nausea with headaches. For the first year, I assumed it was thyroid related and did a bunch of labs / trials involving thyroid hormones without any success. I then went to a neurologist who diagnosed migraines and prescribed Sumatripitan and Aleve with every headache. She said that I should always take them together because one addresses the neurotransmitter issue and the other the inflammation (taking one without the other would leave one of the issues and likely lead to a rebound migraine). That medication combo has worked for me for over a decade. But, she had no idea what caused the migraines and no suggestions except to take the meds and work to identify my personal triggers. I discovered that gluten was either a cause or powerful trigger for me; my migraines went from several headaches a week to several headaches a month. I found heat, motion sickness, poor sleep, stress, menstruation, and synthetic fragrances were triggers for me. I work to minimize those issues as much as possible. Luckily, all the other common food triggers including red wine, cheese, and chocolate were not triggers for me. I have not found whever cause(s) remain that make me susceptible to migraines. Migraines are a symptom diagnosis. Like hypertention, a symptom is described but not its cause.
Difference between causes and triggers
Whatever has lowered the threshold in my brain so that I still experience 3-4 migraine headaches each month is the cause of me getting migraines. It is likely multifactorial, so I should say, those combined factors are the cause. I do not know what they are. Over the last decade I have eliminated or ruled out many of the typical causes, but I have not found anything that has cured my migraines. I have identified many triggers that can start a particular migraine headache and minimizing those has definitely made a huge difference in lowering my frequency of ill days.
Complicating factor: Mast Cell Activation Syndrome
According to my labs, I have Mast Cell Acgtivation Syndrome (https://mastcell360.com/what-is-mcas/). I have not found following that path very useful because the end advice is to focus on eliminating the cause for the immune system’s mast cells being overactive. I am already looking for the cause of the migraines, so I haven’t found this path to useful, but others may.
I have a treatment (that medication combo) that patches my migraines and I am overwhelmingly greatful to pharmaceutical companies and conventional medicine for rescuing me from hundreds of days of pain, nausau, and misery over this last decade. I have worked with a functional medicine doctor to gradually explore a huge variety of potential causes. In my case, my migraines are not causes by heavy metals, SNPs (https://ghr.nlm.nih.gov/primer/genomicresearch/snp), mold toxicity, parasites, Lyme, Epsein-Bar, root cannal infection nor a host of other common issues that are found to be root causes. I will continue to search for root causes and work with my awesome functional medicine practitioner: https://kresserinstitute.com/meet-the-adapt180-health-team/ I will not puruse the more extreme treatment interventions that can have massive side effects, because I have a current treatment that has been working beautifully for me for a decade.
So, if you’re dealing with the agony of migraines. I would suggest seeing a neurologist and getting some kind of medication that can rescue you. I would suggest finding a functional medicine doctor that will help you work through the process of hopefully identifying a root cause. (May you have more luck than I have!) I would be deeply kind to yourself because this is a symptom diagnosis that can be tricky to pinpoint and so frustrating. I would focus on your values and the wonderful things that bring you joy in life because tracking a symptom illness that can be patched with medication is only worth so much of your time. Happy living!