Cambridge Nutritional Sciences

Food Intolerance and mIgraIne

Migraine is a disease first described in ancient times. At present, it is one of the most common idiopathic headaches. Despite the fact that it has occurred in humans for thousands of years, its cause remains unclear.

Migraine is a pulsating headache lasting from several hours to several days, often accompanied by dizziness, sleep disorders, nausea, vomiting or abdominal pain.

It is generally perceived as not being dangerous, but rather a reason for temporal mental and physical disability affecting the professional life, learning ability and general well-being/comfort. Interestingly, migraine may be complicated by migraine-ischemic stroke, depression and other emotional disorders, particularly in women of childbearing age. Moreover, in the case of the migraine condition (migraine attack lasting for more than three days), there is a risk of water and electrolyte balance disorders due to persistent vomiting and diarrhoea.

PharmacotherapyVarious medications are suggested in both immediate and preventive therapy of migraines. However, pharmacotherapy is not a causal therapy. Non-specific drugs (non-steroidal anti-inflammatory drugs and simple pain-killers) used at the beginning of an attack, in appropriately high doses, may reduce headache intensity, but fail to reduce symptoms associated with the alimentary tract. This may be due to the fact that vomiting, diarrhoea and reduced motility of the alimentary tract hinder not only the administration of a medication, but also its absorption. However, alternative administration routes may be used: per rectum or injection.

Of course, other complaints associated with migraine require additional medication. Patients are not always aware that some of these drugs may be abused - particularly those available over the counter - causing a secondary, drug-induced headache. A warning must, therefore, be issued to patients to inform them that a therapy should not be used for more than 15 days a month.

If non-specific drugs fail to bring relief, a patient is faced with the choice of a specific therapy. However, this may not be an option for some patients due to the numerous contraindications and adverse effects associated with particular therapies. Paradoxically, pharmacotherapies that do not target the underlying causes of migraine, are often recommended as a preventive therapy.

ProphylaxisProphylaxis involves keeping a migraine diary to record when episodes occur, identification of pain levels, accompanying symptoms, duration and names/doses of drugs taken. This is then followed by optimisation of pharmacotherapy to achieve a satisfactory therapeutic response: reduced frequency and duration of migraine attacks.

A willing cooperation and reliable reporting is rewarded with the precise definition of disease advancement, identification of possible (unintentional) drug abuse and an objective evaluation of efficacy of the preventive therapy. If a patient is satisfied with the efficacy of that therapy, they may use it for up to 6 months.

However, that does not guarantee a complete discontinuation of a drug. Moreover, with some luck, they may count on personalised emergency drugs in case of recurrence. Those not lucky enough, have to continue their search for an optimum drug: considering anti-depressants, anti-epileptics and, for the very determined, an injection of bacterial toxin in the forehead or temporal area (the same therapy as for wrinkle reduction).

Diet and NutritionBefore starting pharmacotherapy as a preventive therapy, we have to eliminate any modifiable migraine-provoking factors such as physical strain, odours, emotional stress, tobacco smoke, journeys, bright light, high ambient temperature and fungal toxins. However, despite the fact that headaches may be triggered by various non-alimentary factors, approximately 75% of migraine cases are caused by abnormal processes occurring in the gastrointestinal tract - often associated with unhealthy eating habits and food hypersensitivity.

Migraine symptoms usually develop the day after a meal is eaten. Therefore, food intolerance tests based on the detection of food-specific IgG antibodies, is crucial for overall diagnostics. It has been demonstrated that adoption of a diet depleted of non-tolerated foods is an effective and safe method of treating migraine.1,2,3

Dietary therapy ensures proper function of the alimentary tract, reduces the risk of allergic and pseudo-allergic reactions, provides optimum digestion and absorption of nutritional elements, reduces permeability of mucosa for potential allergens and bacterial toxins and protects homeostasis of intestinal bacterial flora.

It is also worth noting that dietary migraine therapy may be used as a supplemental measure or may replace the pharmacotherapy. Nutrition optimisation and elimination of non-tolerated foods from the diet is not only effective in combating migraine, but also constitutes a prevention of autoimmune, metabolic and even neoplastic diseases.

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1Alpay K et al. Diet restriction in migraine, based on IgG against foods: a clinical double-

blind, randomised, cross-over trial. Cephalalgia 2010; 30(7):829-837

2Carlos M et al. Food allergy mediated by IgG antibodies associated with migraine in

adults. Revista Alergia México 2007;54(5):162-8

3Trevor Rees et al. A prospective audit of food Intolerance among migraine patients in primary care clinical practice. Headache Care. 2005; 2(2):105–110