What Makes You Susceptible to Migraines?
- Barbara Van De Keer
- Jan 25, 2024
- 7 min read
Updated: Mar 15
Introduction
Migraine is a complex interplay between neurotransmitters, cytokines, and the trigeminal nerve. The trigeminal nerve, also known as the fifth cranial nerve, is a major nerve in the head and facial area. It has three main branches responsible for transmitting sensory information from the skin, muscles, and mucous membranes of the face to the brain. This nerve plays an essential role in regulating sensations such as pain, touch, and temperature in the face and mouth. Excessive stimulation and sensitivity of the trigeminal nerve is a significant factor in migraine attacks. When the trigeminal nerve is overstimulated, cytokines are produced, which trigger an inflammatory response.
In this article, we aim to explain in an understandable way why you may be susceptible to this. Note that this is only an overview of possible factors and is not exhaustive. Each patient is different and will have a different cocktail of factors.
Methylation Problems
Methylation is a chemical process that plays a crucial role in various bodily processes, including building or breaking down certain neurotransmitters, detoxification, the breakdown of estrogens, and many others. A disruption in the ability to methylate can result from missing (co)factors such as B12, B11, B6, and choline, or genetic variations on certain genes such as MTHFR or COMT.
For example, if you have chronic stress, this can strain your methylation capacity because the large amount of stress hormones produced must also be broken down. Given that capacity is not infinite, this can negatively impact other processes in your body that require methylation.
If this process does not go well, or it comes under too much pressure, you will get, among other things, a buildup of toxins in your body. One of these 'toxins' are the pro-inflammatory forms of estrogens, often causing problems such as "estrogen dominance" and even breast cancer. These toxins can penetrate the blood-brain barrier and/or activate the trigeminal nerve. When the blood-brain barrier is penetrated, an inflammatory reaction will take place, which - in addition to triggering migraine - may make the barrier even more permeable to other toxins, leading you into a vicious cycle. When they 'only' irritate the trigeminal nerve, this also triggers the production of, among other things, the neurotransmitter CGRP, resulting in inflammation and migraine.
Insulin Resistance
The liver is responsible for detoxification - rendering substances harmless. These substances can be produced in your own body, have entered through food, through the skin, through your lungs... Methylation is one of the ways the liver can do this.
When you are insulin resistant, your liver can no longer detect how much energy is present in your blood. In response, it will release and/or create glucose itself to ensure that your brain does not run out of glucose. However, this costs the liver a lot of energy, which does not have enough energy to perform all its tasks at the same time and therefore must prioritize. Since the glucose level is crucial for survival, but a toxin usually does not kill you immediately, the priority is often given to the production of glucose. If this is short-lived, it is not a problem, but if you have become chronically insulin resistant, you may also have a chronically larger amount of toxins in your body. As described above, these toxins can again penetrate the blood-brain barrier and/or overstimulate the trigeminal nerve.
Energy Supply in the Brain
We already said it, the glucose level is crucial for survival. Although your muscles can do without glucose for a while (you feel that when you are sick and can barely climb the stairs), your brain cannot. This dependence on glucose makes the brain vulnerable to energy shortages when glucose levels drop. Such an energy shortage can activate the trigeminal nerve and initiate 'cortical spreading', leading to aura and migraine.
You may notice such an energy shortage yourself when you get an afternoon slump. The 'brain fog' also falls under this. When your metabolism has become accustomed to a constant supply of carbohydrates, it becomes inflexible, and you get dips in your glucose level a few hours after you have eaten. Your brain gets less energy at this time, and this energy shortage is an important step towards migraine. Moreover, a flexible metabolism can also feed your brain with ketones and lactate, making it less sensitive when less glucose is available. In addition, ketones also work anti-inflammatory and can, therefore, have a healing effect on a previous inflammatory reaction.
Hyperexcitability of the Brain
Chronic stress in the first 7 years of your life (including pregnancy) can put you in a state of constant vigilance for the rest of your life. This can lead to excessive production of the neurotransmitter 'glutamate'. Glutamate activates your 'NMDA receptors', which means that it has an enormous activating effect in the brain. In other words, your brain becomes hyperactive or 'hyperexcitable'. These large amounts of glutamate are neurotoxic. Moreover, neurons, when they are hyperactive, consume much more electrolytes. When these are depleted or no longer in the right balance, neurons can get into trouble, which can be an important factor in developing an attack.
Note that glutamate can also be found in foods as a flavor enhancer, in the form of MSG. Many migraine patients know that this works as a trigger for them.
Mitochondrial Dysfunction
Mitochondria are the energy factories in our cells, both in our body and in our brain. When these do not work optimally, you logically get problems with the energy supply of the neurons. The function of mitochondria becomes weaker when too many oxidants have built up, and there are too few antioxidants to remove them. We call this "oxidative stress," and in addition to triggering inflammation, it also ensures that your energy factories work less well. These oxidants arise when you need to produce a lot of energy, so when your brain is very active. They are necessary and unavoidable, but they must always be able to be captured in time.
Thus, you probably understand that a cocktail of a hyperexcitable brain, poorly functioning mitochondria, a shortage of glucose, and perhaps even a shortage of electrolytes, can cause a perfect storm.
Leaky Gut
A permeable gut or, colloquially, 'leaky gut' can have multiple causes. For example, stress 'by default' opens your gut to draw in as much water, glucose, and sodium as possible so that your body is fully ready to launch the attack or run away (fight or flight response). When this is short-lived, it is not a problem, but when it is chronic, it is. Other causes of a leaky gut are, for example, gluten and other specific proteins in foods. Also, a gut infection can temporarily make your gut more leaky.
When your gut is 'leaky', proteins, pathogens, and toxins from your diet can travel through the intestinal wall into the bloodstream. You obviously still have an immune system and a liver to solve this, but you understand that when this is chronic, this system comes under pressure. Your immune system is constantly activated, which will require more energy. Energy that is withdrawn from your brain. Your liver will again prioritize producing glucose to provide the immune system with energy, instead of rendering toxins harmless. The result is even more toxins in the blood. We are now in the phase of "low-grade inflammation". This is an important path to chronic insulin resistance as mentioned earlier.
When these toxins have entered the gut and circulate in the blood, they also arrive at the blood-brain barrier. An intact blood-brain barrier will still be resistant to this for a while, but when it is already permeable, for example, due to a previous migraine attack, it will not be able to stop everything, and a new attack is lurking....
Protection of the Trigeminal Nerve
The trigeminal nerve is surrounded by myelin. Myelin is a kind of insulation layer around the nerve. Myelin has several functions, but what is important to remember is that myelin ensures that less energy is needed to conduct the electrical signals through the nerve, and that myelin protects the nerve against damage.
When the myelin of the trigeminal is damaged, it is, therefore, more susceptible to irritation. When the barrier of your face, nose, or mouth is also not optimal, toxins can directly irritate the trigeminal nerve through that route. These barriers may be more permeable due to certain genetic variations, but also, for example, due to the use of aggressive face creams, use of cortisone inhalers, ...
For a good build-up of myelin, the right nutrients are necessary. Moreover, methylation is also an important step in building myelin.
Conclusion
We have listed a number of important factors here. Although this list is incomplete, it should already be clear that these factors also clearly reinforce each other. For example, a poor methylation capacity will ensure a weaker myelin sheath, more stress, more toxins... But also, insulin resistance will ensure a poorer methylation capacity and the absence of extra backup energy in the form of ketones and lactate.
At the Migraine Clinic, we turn this to our advantage. If multiple factors can reinforce each other, this also means that we have a choice of interventions to eliminate those factors. These interventions are also inherently health-promoting, and you will soon notice that they can not only help to get your migraine under control, but that other complaints can also disappear, which you were often not even aware of anymore.
Want to get started?
At the Functional Migraine Clinic, it is our mission to help you get your migraine under control. With great attention to your life and complaints as a whole and over your entire life course, and supplemented with blood or DNA research where necessary, we identify which building blocks can lead to migraine in your case. With both quick wins and structural, personally determined, adjustments, we work together to ensure that your sensitivity is drastically reduced. You will receive intensive guidance to implement the adjustments and monitor their success. Every day won for you is a moment of happiness for us.
Start slow with the Migraine Building Block Analysis or Book your Intake.
Commentaires