A migraine arises due to neuronal hyperexcitability caused by genetic or environmental factors. The usual forms of migraine are probably caused by polygenic inheritance. However, there is a very rare form of migraine called familial hemiplegic migraine and it is inherited as an autosomal dominant trait. In this rare form, the auras are often of the motor type and the mutated genes encode ion transporters.
The common migraine with aura is an expression of a transient occipital cortical dysfunction, which starts with a visual or sensory disorder and spreads step-by-step until it results in a so-called cortical spreading depression.
IMPORTANCE of exogenous factors
Some of the factors that predispose and trigger migraines are known to the patient. These include:
anger, stress, or sudden relaxation situations (“weekend migraine”)
sensory factors, such as flashing lights, striped decoration in a room, noise, odors.
In the case of overweight persons, the risk of developing a chronic headache is three times higher than that of a person with a normal BMI.
Nutrition as a key factor
According to the National Headache Foundation, certain foods can trigger migraines. Among the most cited here are: chocolate, alcohol (white wine), coffee, cheese, meat, meat products, glutamate, aspartame, etc. Some people with gluten intolerance or celiac disease (gluten allergy) are subject to migraine attacks after eating wheat products, but the migraine food trigger is individually different for all sufferers.
There is a strong suspicion that food intolerances are a major trigger for migraines and this is still being intensively researched. These studies, however, are currently delivering conflicting results – they neither provide clear evidence of a unique effect mechanism, nor do they enable the clear identification of specific foods as triggers for the onset of a migraine attack.
In 1984, Monro et al (1) put forward the hypothesis that migraine is an allergy.
Food allergies caused by immunoglobulin E (IgG) or by vasodilation due to a histamine intolerance are highly probable factors – but not all migraine patients suffer from an IgG-based allergy. The measurement of IgG by means of specific foods has been used since 2005 as a new marker to identify foods that could potentially trigger migraines (2,3).
Nevertheless, it is important to understand that not all foods with a high specific IgG automatically trigger migraine attacks, because there are individual differences. A food IgG test can identify personal risk foods and support an elimination diet, although this approach is not without controversy. This realisation convinced the National Health Service (6) and the American Migraine Foundation (7) to recommend IgG tests on food allergies to potentially help migraine sufferers. This was followed by more studies, which investigated the relationships between specific foods as potential migraine triggers.
Although it is clear that the nature and the history of every migraine must be considered as an individual case, it would seem that nutrition and obesity have to be addressed when analyzing the origin and severity of migraine attacks. The American Migraine Foundation (7), for example, recommends the use of IgG tests on food allergies to help migraine patients. To obtain more detailed knowledge, however, the ongoing research must be continued. During the course of the Metabolic Balance® program, we have often observed a reduction in the frequency and intensity of the migraine attacks of our patients, due to our choice of foods and the patients’ subsequent weight losses.
Dr. Didier Souveton
Head of the Medical Advisory Board of Metabolic Balance
(1) Migraine is a food allergy disease. Monro J., Carini C., Bostroff J., Lancet 1984 Sep.29;2 (8405): 719-721
(2) A prospective Audit of food intolerance among migraine patients in primary care clinical practice. Trevor Rees,David Watson, Susan Lipscombe, Helen Speight, Peter Cousins, Geoffrey Hardman, Andrew Dowson. (2005), Headache, Vol 2 No.1 11-14
(3) Food allergy mediated by IgG antibodies associated with migraine in adults. Arroyave Hernandez CM,Echevarria, Pinto M, Hernandez Montiel HL. Rev Alerg Mex (2007); 54: 162–168
(5) IgG-based elimination diet in Migraine plus irritable bowel syndromeElif Ilgaz Aydinlar et al. Headache 2012
(6) http://www.nhs.uk/ipgmedia/national/migraine action/assets/migraineandfood.pdf