CAUSES OF MIGRAINE
A genetic alteration of the place where a migraine sufferer is very vulnerable with regard to various endogenous or pathogenic agents.
There is a wide variety of factors that can trigger a migraine, and these triggers are not necessarily shared by all migraine sufferers. Situations of a physical nature can have an influence, as can those of a biological or psychological nature.
As a complement to treatments for the pain, which are not intended as a cure, a wide range of drugs and new anti-migraine medication is available. However, the single aim of all of these is to increase the interval between attacks and to decrease their intensity. Recognising that the factors that trigger a migraine in one person might not be the trigger for another migraine sufferer, it is clear that a personal analysis of the triggering factors needs to be carried out. By finding out which factors trigger migraine in each patient, we can control the root of their illness and minimise its effects.
The following are generally recognised as trigger factors:
For us, food is a determining factor. However, it is not simply a matter of recommending a good overall diet or eliminating a list of typical foods. Migraines should be understood as a possible food intolerance and treated accordingly.
The solution is not to create a list of food that migraine sufferers cannot tolerate, or recommending restrictive diets for migraine suffers. The food intolerance should be studied personally for each patient. Our experience tells us that in these cases migraines may be markedly reduced.
Migraine due to "Food-induced histaminosis (histamine intolerance)"
The migraine starts due to the present of histamine in one or more anatomical areas, and is perpetuated by the presence of serotonin.
There are two well-known mechanisms that explain the accumulation of histamine:
A) It is released from inside of cells by an allergic or non allergic mechanism and the causal agent is a food protein. If the food is detected, the release of the histamine can be avoided as well as the symptoms, and the immunological memory of the abnormal response is also erased.
B) Due to histamine intolerance syndrome (enteral histaminosis).
Histamine is a vital (necessary for life) molecule both in animals and plants, as well as in micro-organisms (fungi, yeasts. etc). This vital nature of histamine means that it is present is all food products but in different quantities, varying from one species to another and in different anatomical areas within the same organism.
Diamine oxidase is an enzyme capable of neutralising histamine from food by methylation, which changes its size and shape in such a manner that it no longer fits into its receptor and therefore cannot activate the nerve ending of the receptor.
Some drugs inhibit the action of diamine oxidase in which case this enzyme is no longer able to deactivate food histamine and so whatever food is eaten triggers the symptoms. Fermented and cured food products contain high concentrations of histamine are more pernicious, but drugs too have a scale of how active they are as diamine oxidase inhibitors.
How can we approach this problem?
Pathway 1.- Eliminate the consumption of drugs as much as possible.
Pathway 2.- Follow a low histamine diet.
As a general rule, these two pathways may be combined in one overall plan of minimising the use of drugs and following a very low histamine diet for one or two weeks. Once this phase has passed, other foods can be gradually added to the diet. In addition, any food known to be a trigger has to be avoided.
All anti-migraine drugs try to block these intermediary mechanisms.
Fasting has been shown to cause migraines.
c.- Sleep disturbances
Sleep disturbances, especially the lack of routine sleeping habits, is also a very common trigger. This is a trigger that the migraine sufferer can control once he/she is aware of it. It is advisable to go to bed at the same time every day and to sleep the same number of hours every night.
d.- Life style
Migraine sufferers are often very active people, which means that their life styles can change depending on what they are doing. As far as possible, migraine sufferers should try to follow a routine lifestyle, avoiding disorder.
Closely related to the previous point, stress is a much debated trigger factor among migraine sufferers. However, this is probably another trigger factor that the patient can control.
f.- Hormonal disturbances