According to researchers from the National Institutes of Health (NIH) and the University of North Carolina at Chapel Hill, eating more fatty fish might reduce migraine headaches. For anybody who struggles with migraines, you know this is a big deal. Anything that might reduce the frequency or intensity of migraines (if it’s low risk and safe) is worth trying, right?
First, let’s learn some things about migraine headaches. They are different than tension headaches as they are a neurologic condition. Migraines may run in families and a family history of migraines is one of the key risk factors. The diagnosis is based on clinical history, reported symptoms and ruling out other more serious causes of headaches.
Classification of migraines are based on those without aura (the most common and previously known as common migraines) and those with aura which were previously called classic migraines.
The symptomatology of migraines sets them apart from other types of headaches. In fact, symptoms may begin one to two days prior to the onset of the headache itself and is known as the prodrome stage. Prodromal symptoms may include depression, irritability, fatigue, hyperactivity, yawning and food cravings.
For those with aura, other problems arise. Sufferers may notice difficulty with their vision, speech, movement and sensation. There may even be temporary loss of vision. Seeing shapes, light flashes or spots are common visual symptoms.
Following this prodrome stage is the attack phase where the migraine pain begins to appear and may even overlap with the aura. Attacks may last several hours or even several days and has varying symptoms. Other symptoms that may coincide with pulsatile and throbbing head pain include dizziness, light or sound sensitivity, nausea, vomiting and pain localized on one side of the head or localized to the front or back of the head.
After an attack has abated, some will have a postdrome phase during which mood and feelings are altered. The headache may persist but is now milder and dull in nature.
The length of these phases varies with different migraine patients. I have very infrequent migraines but when they come on, I am unable to function in any capacity. My migraines last only 2-3 hours but do not abate unless I’ve slept. I’ve had migraine attacks while driving that, in my opinion, is dangerous. I must pull over and stop as I feel like I am going to pass out.
There are a variety of techniques that help alleviate migraine headaches with most being unique to that person. Migraine sufferers tend to develop a routine to follow when an attack occurs. Those with an aura may be able to plan and initiate their routine. Again, the diagnosis is usually made by history and a health care provider can help decide if other potential causes need to be ruled out. A CT or MRI scan of the head can screen for more serious causes of headaches including tumors, abnormal brain structures and strokes.
There may be some changes in brain chemicals within the brain. Decreased serotonin levels have been identified as potentially causative. This led to trials involving selective serotonin reuptake inhibitors (SSRIs). SSRI therapy is proved to be ineffective. There appears to be some effectiveness to amitriptyline use as it is also successfully used for management of certain chronic pain syndromes. Several classes of medications are known to make migraines worse. These include the SSRIs, Proton Pump Inhibitors (GERD medications), birth control pills, estrogen in hormonal treatment for menopause, nasal steroids/decongestants and opioid induced rebound pain for those using routine opiates for managing various chronic pain syndromes.
Several known triggers have been identified that may lead to onset of migraine attacks. Most sufferers have identified these for their unique situation. Here are some common migraine triggers:
- bright lights
- alcohol use
- smoking or secondhand smoke
- hormone changes during menstruation, pregnancy or menopause
- severe heat
- loud sounds
- skipping meals or extended fasting
- use of the medications listed above
- certain foods including food additives, MSG, nitrates, sugar or aspartame
- certain smells
- intense physical activity
- sleep disturbances or changes in sleep patterns
Some over the counter medications may be helpful including NSAIDS (Naproxen seems to work the best for most people) or acetaminophen. If ineffective, there are prescription medications including injections that may arrest the attack. There is a subset of women who experience menstrual cycle related migraines. Frequently, there is a lower-than- normal level of progesterone produced by the ovaries after ovulation in menstrual migraines. Fortunately, progesterone supplementation can help alleviate these attacks.
Migraines are frequent enough that a neuropsychologist friend of mine opened a practice called The Headache Care Center in Springfield Missouri in 1996. It is still going strong where she and her physician colleagues focus only on managing headaches including migraines. From searching, there are now multiple clinics focused on treating the chronic pain associated with migraine headaches.
Although not FDA approved, there are some surgical developments that are used for migraines that do not respond to other therapies. One approach involves the use of botulinum toxin (Botox) to isolate specific nerves in an attempt to alleviate migraines. Despite advances, migraines remain incurable leaving symptom management as the only available treatment.
Here are some key points from this recent study:
- 182 adults with frequent migraines participated
- At the beginning of the study, participants averaged more than 16 days of migraines per month and more than 5 hours of headache pain per day on migraine days
- Participants were assigned to one of 3 diets with different ratios of fish and vegetable oils
- The diet high in fatty fish and low in vegetable oil reduced headache days per month, headache hours per day, and headache severity by between 30% and 40%
Fatty fish are an excellent source of omega-3 fatty acids and have become less and less common in the Standard American Diet. This study suggests that it might be worth intentionally shifting away from vegetable oils (and the processed foods where they hide) and more toward omega-3 rich foods (like fish and nuts and seeds). Sugar can lead to changes in epinephrine and norepinephrine leading to blood vessel changes and vascular headaches. Avoiding vegetable/seed oils, sugar and processed foods is a mainstay for improving your nutritional health. Fatty fish that are high in Omega-3s include albacore tuna, wild caught salmon, mussels, Atlantic herring, anchovies, swordfish, sardines, Atlantic mackerel, trout, Alaska pollock and Omega-3 fish oil supplements for those of you that don’t like to eat fish or seafood. Supplements are not as effective in heart disease reduction as actually eating your Omega-3s so keep that in mind.
I also have many additional options in my toolkit to help migraine headaches. If you’re looking for answers, I would love to help. Find me at:
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#migrainerelief #omega3 #fishoil #foodismedicine #migraines #migraineheadaches #askdrtreacy #healthwithoutrisk
Ramsden C E, Zamora D, Faurot K R, MacIntosh B, Horowitz M, Keyes G S et al. Dietary alteration of n-3 and n-6 fatty acids for headache reduction in adults with migraine: randomized controlled trial. BMJ. 2021. [link]