The Mindful Migraine

Ugh – I suppose that a blog writer who writes about migraines is going to have to expect to get a migraine from time to time. But I’m back – it’s 2.30pm in Australia and now that I’m up and at it, I thought I’d send you some notes I saved from the recently finished Migraine World Summit. For this edition, Dr Elena Gross, a neurologist, gave her understanding of the relationship between metabolism and migraines.  As a trained architect currently studying metaphors, I was way out of my depth when watching this biology-based discussion.  I’ll do my best, however, to summarize the key takeaways below.  Remember, I’m not a doctor, so it’s important that you speak to a health care provider before you make any significant changes to your treatment plan.

Metabolism, Dr Gross explained, is the process in which the food you eat is converted into energy.  This conversion takes place in a long process of steps from ingestion, to digestion, through to a cellular level.  Metabolic disorders are those in which people have a problem converting food into energy, and this problem can occur at any of the steps along the way.

The brain, she explained, is not a battery; it does not store energy, it needs to be continuously ‘fed’ new energy – “it needs fuel”.  The energy ‘sunrays’ that the brain likes to feed on include glucose (derived from sugars), ketones (derived from fats), and I think a couple of other small-cell sources.  It gains this fuel through blood-flow and through the blood-brain barrier which is a membrane that acts as a shield to our brain tissue.  Only small-cell substances such as ketones and glucose (and lactate?) can seep through.

She noted the migraine-brain is hyper-excitable, doesn’t habituate well to change, and seems to both use and need more energy than a non-migraine brains. 

As such, her research suggests that the migraine-brain is affected by an access to energy problem.  Combined with the notion of metabolic disorders, it is possible that there is a disfunction in the amount of energy required versus what is received in the brain.

[Which is a weird throw-back to the post I wrote intuitively on how migraine-brains seem to have a different fuel tank to non-migraine-brains and we ‘run on empty’ more often than not.]

Dr Gross mentioned that insulin is the ‘taxi driver’ that moves glucose to the cells, and that in migraine patients this action is overreactive; too many taxis turn up, and they all turn up late. 

She said that the stressors that trigger a migraine brain all link back to ‘oxidative stress’ which is a free radical imbalance.  She noted that triggers that create oxidative stress include: alcohol; altitude; exercise; blue lights from our phones (which goes through our eyes and skin); perfumes, skin care, and cleaning products that go through our skin and nose (and thus sneak through the only breachable spot in the brain-barrier).  [I also read smoking, pollution, and UV lights are also sources.]

(image source: Oxidative Stress – The Definitive Guide | Biology Dictionary)

Dr Gross refers to these oxidant stresses as ‘bombs’, whilst antioxidants are the ‘bomb disposers’ that help neutralize the oxidants.  For migraine people, we seem to have an imbalance of more bombs than bomb disposal experts.  [Ah; the ‘migraine minefield’… I’m sure we can all relate].

In terms of signs that you might have metabolic issues, she noted fatigue, food cravings, exercise making you feel worse not better, and waking up feeling sick.  [Uh oh.]

She briefly discussed migraine history and how in the 1930s migraines were considered a ‘hypoglycemic (blood sugar) headache’, in other words, potentially metabolism related.  But then there was a shift towards it being a neurovascular (blood flow) disease, and more recently a neurogenic (nervous system) issue.  So, whilst she thinks her approach might seem new and untested, it’s actually a ‘re-ignition’ of old thinking.

There was a long discussion about Keto diet, (which mimics fasting and increases your ketones), as an alternative energy source to your brain.  Whilst it was agreed some people have benefited, it was also acknowledged it is a very strict diet and needs to be done under supervision.  It was also discussed that you should have your liver checked to make sure you don’t damage an organ that is already under stress from high medication use.  One of her few cautions around metabolism was related to fasting and rapid weight loss; both apparently mess with your metabolism, and if I heard right, cause your fat cells to release toxins during the process.

Dr Goss noted that every migraine person is different, and there are so many contributing factors surrounding migraine, that even if metabolism was a component of why we get sick, it is unlikely to be the entire answer for everyone.

She put a positive spin on the way a migraine-brain acts the way it does, noting that pain is a warning signal that there are other physical, chemical or emotional problems at play.  The migraine is a like a ‘reset’ button that is attempting to HEAL you, not HURT you.

Overall, she recommended reducing the chemical, physical and psychological stressors (i.e. triggers) in your life as much as possible to improve your overall health. 

“Clean up your life” was how she referred to it; environment, diet, attitude.

Dr Gross has a website and YouTube channel with lots of extra information – they’re worth a look:

Welcome – Master your Migraine here! (youtube.com)

Dr Elena Gross • Mastering Migraine: Learn how I mastered my migraine.

Take care everyone, and stay energised.  Linda