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Gut Health and Migraines

Gut-Brain Axis and Migraines

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First published: 30. Jan.2025

Overview

There is growing evidence that shows a link between an altered gut microbiome (dysbiosis) and migraine.
Lack of bacterial diversity in the intestines and overgrowth of some species leads to "leaky gut", inflammation, immune responses, and reduced synthesis of short-chain fatty acids (SCFAs) which affect the brain and promote migraine.

In this article, we explore the mechanisms by which the gut and brain interact, the effect that the gut-brain axis has on migraine, and the potential therapies that could relieve migraine by modulating the microbes in the gut.

In this Article (Index)

brain and gut linked with arrows
The gut-brain axis and migraines. A. Whittall

Migraine

According to a recent health survey in America, 15% of adults suffer from migraine. It is more prevalent in women (21%) than men (10.7%). It is the first leading cause of disability among adult populations, and its direct economic cost exceeds 9 billion dollars per year. (1),(2)

Migraine Symptoms

Migraine symptoms encompass unilateral pulsating pain that is worsened by physical activity, photophobia, phonophobia, nausea, vomiting, and diarrhea. Migraine attacks can last between 4 and 72 hours.
There are two main categories of migraine, with and without aura. The latter affects 15-20% of migraine sufferers causing sensory disturbances, visual changes, and numbness before the attacks, a phenomenon called aura. (1),(2)

What Causes Migraines?

The underlying causes of migraine are still unclear despite being studied since the 1800s. But, multiple factors play a role in migraine, including the gut-brain axis. (1),(2)

Migraine and its Link to Some Gastrointestinal Diseases

Different studies (4) report an association between gastrointestinal diseases like Inflammatory bowel disease (IBD), celiac disease (CD), Irritable Bowel Syndrome (IBS), and migraines. Below is a summary of its prevalence:

Celiac Disease & Migraines

Patients with celiac disease have a higher prevalence of migraine than healthy subjects. Roughly 25% of CD patients have migraine.

IBS & Migraines

IBS patients have a 40–80% higher risk of migraine, depression, and fibromyalgia compared to healthy subjects, and around 17% of IBS patients had migraine vs. 8% of non-IBS subjects.

IBD & Migraines

Research shows that headache prevalence is higher in IBD patients vs. the control group (46% vs. 7%) and so is Migraine (21.3% vs. 8.8%). Alterations in the gut lining ("leaky gut"), autoimmune-inflammatory responses, and immunosuppressive treatments may be involved in the migraine-causing effects of IBD.

The Gut-Brain Axis

There is an intimate two-way link between the gut and the brain. The brain regulates the normal function of the gut using hormones and sensory impulses sent through the nervous system. The gut affects how the brain works through different chemicals like stress hormones, immune and inflammatory compounds, and metabolites from the digestion of food by the gut microbiota.

Scientific evidence using human and animal studies shows that alterations in the gut-brain axis caused by disruptions in the gut microbiota (or dysbiosis) are involved in several neurological diseases such as Alzheimer's disease, multiple sclerosis, and migraine. (2)

red outline of man hand to head, brain flaring
Migraine pain.

Gut Microbiome Dysbiosis

A Mendelian randomization (MR) study by He Q. et al., (2023) (2) found "that gut microbiomes may exert causal effects on... migraine with aura (MA), and migraine without aura (MO)."

The study identified several bacterial strains that were associated with migraine like Coprococcus, and Anaerotruncus. On the other hand, bacteria like Bifidobacteriaceae and Bifidobacteriales promoted a preventive effect against migraines. (2)

Similar effects have been reported in other studies which revealed a lower diversity in elderly women with migraine, and that a higher presence of Firmicutes and especially Clostridium species was detected in those suffering from migraines.

Other studies (5) confirmed that a higher proportion of Alcaligenes species reduced migraine attacks, while higher levels of Clostridium and Eggerthella lenta are linked to migraine attacks.

Microflora

Microscopic fungi (microflora) like Candida and Micromycetes were more abundant in patients suffering from migraine than in the control group. (5)

Episodic and Chronic Migraine

A study (3) also found that Tissierellia, Tissierellales, and Peptoniphilaceae were more abundant in both migraine groups at the class, order, and family levels compared to that of the controls. Agathobacter abundance was linked to a lower severity in headache intensity.

This evidence suggests that acting upon the microbiome can help treat migraine.

Treatment: Improving Microbiome Health

Different studies have shown that treatments that target the gut microbiota like special diets, probiotics, and vagus nerve stimulation can bring relief(1)

Mechanism: How is the gut microbiome linked to migraine

Inflammation and immune response can be caused by alterations in the lining of the gut, these alterations are caused by dysbiosis. Stress and nutrition can alter the gut microbiome. Some chemicals produced in the brain (neuropeptides) like CGRP, SP, VIP, and NPY have an antimicrobial effect in the gut. Also, as mentioned further up, some gastrointestinal diseases like celiac disease, IBS, and IBD are associated with migraine.

Some proinflammatory factors like TNF-α and IL-1β, IL-6, and IL-8, are linked to pain mediators in migraine.

Short-chain Fatty Acids or SCFAs are produced by bacteria in the gut and they promote gut-barrier integrity, they also have neuroprotective and anti-inflammatory effects. They also suppress the production of TNF-α. This shows that ensuring a healthy SCFA-producing microbiome through diet can enhance their anti-migraine effects. (2)

Probiotics

Experiments with animals have shown that probiotics relieve migraine-like effects in mice.

Human studies reveal that Bifidobacterium "may be a vital therapeutic target for migraine ... the dysbiosis could be restored using probiotics." (2)

Probiotics can relieve migraine attacks by increasing the output of SCFAs, repairing the gut barrier, and lowering proinflammatory cytokine output. They also improve the emptying speed of the stomach, which helps prevent bloating and vomiting, a common symptom among people who suffer from migraines. (4)

Carbohydrates

A study reported that eating a dietary fiber as part of a high-fiber diet, and carbohydrates with a low glycemic index reduced the frequency of migraine attacks after 30 days, and their severity after 90 days, in a similar way to a control group that was treated with medications (propranolol, flunarazine, amitriptyline or topiramate). (4)

Omega-3 fatty acids

Omega-3 (ω-3) promotes the growth of beneficial bacteria like Lactobacillus and Bifidobacterium which in turn produce more SCFAs, which could relieve migraine symptoms.

A study reported that "Individuals on high omega-3/low omega-6 diet experienced higher improvement in their headache compared to migraineurs on low omega-6 diet". (4)

A high intake of Omega-6 (ω-6) has shown negative effects as it increases the risk of cardiovascular disease, diabetes, cancer, and obesity. While a higher intake of omega-3 has positive health anti-inflammatory effects.

Vitamins

Supplementation with Vitamin D3 reduced the Helicobacter species count in healthy individuals, and some studies show that low vitamin D serum levels could increase the risk of migraine. Vitamin D deficiency could trigger migraine. (4)

Weight Loss

A 202 meta-analysis confirmed that obese individuals have a 29% increased risk of suffering from migraines compared to normal-weight individuals and stated that "obesity can be appropriately considered as an overall risk factor for migraine headaches." (8)

Obesity can influence the composition of gut microbiota which could explain why there is evidence that obesity increases the risk of migraine, and weight loss helps reduce frequency, duration, and intensity of migraine attacks. (4)

Weight management programs include a healthy diet and physical activity.

Visit our Weight Loss page for more resources.

Diet

There have been few studies on the effects of diet on migraine, but it seems that the dietary approaches stop hypertension (DASH) diet and the Ketogenic Diet can also protect against migraine. (2)

A study followed 23 migraine patients following a Ketogenic Diet for 3 months and "observed a reduction in monthly headache days (12.5 vs. 6.7) and in days of acute medication intake (11.06 vs. 4.93)... These data corroborate the utilization of KD as a preventive treatment for migraine." (6)

Another trial used the DASH diet and reported "that a higher DASH score is associated with a lower migraine attack frequency and migraine index score," suggesting that a better adherence to the DASH diet reduces the severity and frequency of migraine events. (7)

Based on their beneficial effects on the gut microbiota, a diet that includes dietary fiber, is low in refined carbohydrates and omega-6 fatty acids, and is rich in omega-3 fatty acids, probiotics, and vitamin-D precursors and that also promotes weight loss, could be effective for migraine management. (4)

References and Further Reading

(1) Crawford J, Liu S, Tao F. , (2020). Gut microbiota and migraine. Neurobiol Pain. 2022 Apr 9;11:100090. doi: 10.1016/j.ynpai.2022.100090. PMID: 35464185; PMCID: PMC9018445

(2) He Q, Wang W, Xiong Y, Tao C, Ma L, Ma J, You C, (2023). International Headache Genetics Consortium. A causal effects of gut microbiota in the development of migraine. J Headache Pain. 2023 Jul 17;24(1):90. doi: 10.1186/s10194-023-01609-x. PMID: 37460956; PMCID: PMC10353251

(3) Yong, D., Lee, H., Min, HG. et al., (2023). Altered gut microbiota in individuals with episodic and chronic migraine. Sci Rep 13, 626 (2023).

(4) Arzani, M., Jahromi, S.R., Ghorbani, Z. et al., (2020). Gut-brain Axis and migraine headache: a comprehensive review. J Headache Pain 21, 15 (2020). https://doi.org/10.1186/s10194-020-1078-9

(5) Kopchak O, Hrytsenko O., (2022). Feature of gut microbiota in patients with migraine and healthy individuals. Georgian Medical News. 2022 Jun(327):13-17. PMID: 35959927

(6) Valente M, Garbo R, Filippi F, Antonutti A, Ceccarini V, Tereshko Y, Di Lorenzo C, Gigli GL., (2022). Migraine Prevention through Ketogenic Diet: More than Body Mass Composition Changes. J Clin Med. 2022 Aug 23;11(17):4946. doi: 10.3390/jcm11174946. PMID: 36078876; PMCID: PMC9456603

(7) Hajjarzadeh S, Bakhshimoghaddam F, Behrouz M, Nikniaz Z, Mahdavi R, Shalilahmadi D, Karandish M., (2024). The relation of adherence to the DASH diet with migraine attack frequency and pain intensity in Iranian women: a cross-sectional study. Nutr Neurosci. 2024 Apr;27(4):353-360. doi: 10.1080/1028415X.2023.2193766. Epub 2023 Mar 28. PMID: 36976732

(8) Hatami M, Soveid N, Lesani A, Djafarian K, Shab-Bidar S. , (2021). Migraine and Obesity: Is There a Relationship? A Systematic Review and Meta-Analysis of Observational Studies. CNS Neurol Disord Drug Targets. 2021;20(9):863-870. doi: 10.2174/1871527320666210713114840. PMID: 34259152

About this Article

Gut Health and Migraines, A. Whittall

©2025 Fit-and-Well.com. First Published: 30.Jan.2025. Update scheduled for 30.Jan.2028. https://www.fit-and-well.com/fitness/gut-health-and-migraines.html

Tags: gut, migraine, microbiome, microflora, omega-3, probiotics, vitamin D, weight loss, IBS, IBD, celiac disease, diet, ketogenic diet, brain, carbohydrates, gastrointestinal health

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