Migraines and fatigue may start in the gut, experts say

If you suffer from migraines, you know how debilitating the piercing pain, sensitivity to light and sound and nausea can be.

According to the Migraine Research Foundation, about 38 million people suffer from them and more than 4 million who get them on a daily basis.

What you may not realize and what your doctor probably isn’t telling you is that  migraines may be linked to your gut health. More specifically, the cause of migraines can be caused by “gut hyperpermeability,” a condition often dubbed leaky gut syndrome.

The gut-migraine link

“Migraines are the result of a perfect storm,” said Dr. Vincent M. Pedre, an integrative and functional medicine doctor in New York City and author of “Happy Gut: The Cleansing Program to Help You Lose Weight, Gain Energy, and Eliminate Pain.”

Dehydration, not sleeping well, blood sugar fluctuations, artificial sweeteners, even a glass of wine can cause migraines. For women, hormonal shifts at the beginning of their menstrual cycles can be the culprit. For men, , an age-related testosterone deficiency known as “andropause” can trigger an incident.

Yet experts agree there are also inflammatory factors at play which can lead to gut hyperpermeability.

Leaky gut is activated by zonulin, a compound that our bodies produce to open up the tight junctions or the cells that line the inside of the intestines to let nutrients through.

When those tight junctions open up too much and allow undigested food particles and pathogens to get through, it elicits an immune response that can cause migraines.

Frequent use of antibiotics, an imbalance of good and bad bacteria, an overgrowth of yeast and stress and food sensitivities can all increase the hyperpermeability of the gut.

Up to a third of people with leaky gut may not even experience GI issues, a common symptom of leaky gut syndrome, Pedre said.

What’s more, conventional NSAID pain killers like ibuprofen also increase intestinal permeability within 24 hours of taking them and also when they’re taken long term, according to a review in the Journal of Gastroenterology.

Stress, in particular, affects the production of gastric enzymes, which aid digestion. If you’re not sufficiently breaking down proteins and your gut is hyperpermeable, your immune system is exposed to partially digested proteins that lead to an immune response.

Foreign proteins can also make their way into the bloodstream because of your own unique genetic predisposition.

“Your immune system is essentially going to be attacked by those foreign proteins and your tissues could look similar to those proteins,” said Shawn Stevenson, a nutritionist in St. Louis, Mo. and bestselling author of “Sleep Smarter: 21 Essential Strategies To Sleep Your Way To A Better Body, Better Health and Bigger Success.”

The same immune response that causes migraines can also lead to fatigue, along with the auras that precede migraines by one or two days or after the migraine has passed, Pedre said.

Gluten can increase gut permeability

“Most people can eat bread and gluten for their lives and not have anything they know to be a problem but that it doesn’t mean it’s good for them,” Stevenson said.

Although food sensitivities can trigger migraines, gluten, in particular, can cause hyperpermeability of the gut whether you have celiac disease, are gluten sensitive, or not, Pedre said.

If you suspect you have leaky gut syndrome, here’s what you can do about it.

See your doctor.

Leaky gut is controversial and not typically validated by conventional medical doctors so you should try to see a functional medicine doctor, integrative physician or homeopath  who can help to identify the underlying cause of your migraines.

Although there’s a test—the lactulose mannitol test—to screen for gut permeability, it’s not perfect. Instead, your doctor will probably run a test to look for food sensitivities.

“If a person comes back with a whole bunch of foods they are reactive too, we know that they have a leaky gut,” Pedre said.

Do an elimination diet.

“One very powerful way to lower our inflammation in the body is through the diet,” Pedre said.

Talk to your doctor about a four-week elimination diet which excludes common food triggers and includes anti-inflammatory foods. Then slowly re-introduce the trigger foods and pay close attention to your symptoms. Although gluten might be the culprit, it can be something as inconspicuous as cinnamon, Pedre said.

Drink plenty of water.

Hydrating and re-hydrating after a workout or on a hot summer day is key to ward off migraines. When you’re dehydrated, the tiny capillaries in the brain get smaller, which makes it painful for the blood to pass through and circulate around the brain, Stevenson said.

Try bone broth.
Bone broth is trendy and experts say drinking it can help restore the gut microbiome. Chia seeds and okra are good choices too.

Take supplements

Supplements such as aloe vera gel powder, L-glutamine, deglycyrrhizinated licorice (DGL), fish oil and curcumin can help.

Eat probiotic-rich foods.

Try adding foods rich in probiotics into your diet like sauerkraut, kimchi and kefir as well as prebiotic foods like Jerusalem artichokes, garlic and onion.

Reduce stress.

It’s one of the most difficult things to make room for in your life, but stress-reduction activities like yoga, meditation and spending time in nature are important to restore gut health and prevent migraines.

“If you only change your diet but you’re still living in this rushed, stressed out way, then you’re missing part of the picture,” Pedre said.