Lindsay was 23 years old, fresh out of college and working at her dream job in Washington, D.C., as a congressional aid. Working in Congress, 10-hour days are the norm and for Lindsey, typically the first to arrive in the morning and last to leave in the evening, that was a short day.
She was in charge not only of the Senator’s schedule but also required to be at his side taking notes at all his meetings, as well as keeping him informed as to who he was meeting with and why.
Young, energetic, with an excellent memory and a gift for attention to details, Lindsay was a rapidly rising star in the highly competitive world of Capitol Hill. When we met, Lindsay was clearly intelligent, completely charming, and terrified that everything she had achieved could be completely undone by progressively debilitating migraines.
She had suffered with migraines since she was 16 and the headaches had become more frequent and debilitating within the last year. She had seen several physicians including neurologists.
Despite trials of numerous medications, her headaches had become relentlessly worse. According to the Migraine Research Foundation, over 35 million Americans of all ages suffer from migraines. Women are disproportionately affected, impacting approximately 18% of American women versus 6% of U.S. men.
For most migraine sufferers, the attacks occur one to two times a month or less, but about 14 million people agonize with a migraine 15 days or more a month. Migraine is regarded as one of the top 20 of the world’s most debilitating medical illnesses.
Most physician treat migraine as a disease, when in fact, it may be a symptom. By this, I mean that if you go to your doctor complaining of headaches that are diagnosed as migraines, the appointment typically ends with a prescription for medications to either prevent the occurrence of the headache or treat the acute headache, with little if any testing.
Rarely is any consideration given as to why you get the headaches. What is the underlying cause? If you can find the cause, potentially you can find the cure. While this is not always possible, here are five frequently overlooked causes of migraines that when treated result in cure of the headaches.
1. Celiac disease and gluten intolerance
Celiac disease is an autoimmune disease to gluten, a protein found in the grains wheat, barley and rye. About 1% of the population suffers with celiac disease and unfortunately it's estimated that over 80% of the people with celiac disease are undiagnosed.
Gluten intolerance (GI) affects about 6% of the American population. GI, while not associated with the damage to the lining of the small intestines as seen in celiac disease, can make you almost as sick as celiac disease.
Because eating grains causes celiac disease and GI, we tend to think that this is an intestinal problem and expect to see people complaining of abdominal symptoms such as bloating, diarrhea and abdominal pain. In fact, both these diseases can present with minimal or no gastrointestinal symptoms and a large number of other symptoms including migraines, peripheral nerve damage, seizures, anxiety disorders, depression and even schizophrenia. This was documented in an excellent review published in 2012.
You can screen for celiac disease with a simple blood test but we do not have any reliable testing for GI as of yet. Treatment for both conditions is elimination of all gluten-containing foods from your diet. Lindsey was suffering with gluten intolerance and once all the gluten was eliminated from her diet, her migraines dramatically improved.
2. Magnesium deficiency
This may play a role in the occurrence of migraines in up to 50% of the people who suffer with this condition. (An excellent summery of this research was published in 2012.)
Magnesium is essential for a wide range of functions in the body and unfortunately, it's easy to become deficient in magnesium and difficult to measure with a blood test.
Low nutritional intake, excess consumption of coffee, sodas, and alcohol, chronic stress, chronic illness, and intestinal problems (such as celiac disease creating problems with absorption of magnesium) can all lead to deficiency.
The foods highest in magnesium — halibut, mackerel, boiled spinach, bran breakfast cereal and nuts such as almonds, cashews and pumpkin seeds — are not foods that typically make up much of our diets.
I encourage my patients suffering with migraines to make the necessary dietary changes and to supplement with between 250 and 500mg of magnesium a day.
One of the side effects of taking magnesium is diarrhea. If you develop diarrhea while taking magnesium, decrease the dose or try switching the type of magnesium you are taking. We also treat many of our migraine patients with IV magnesium and in Lindsey’s case, this further reduced her migraines.
3. TMJ disorder
The temporal mandibular joint (TMJ) is the joint where your jaw connects with your skull. The joints are located in front of your ears on either side of your face. If your teeth are misaligned or you grind your teeth, a condition called bruxism, you can develop dysfunction and pain at the TMJ.
Symptoms of TMJ dysfunction include popping of the joint, pain at the joint, difficulty opening your mouth and headaches. Proper diagnosis and treatment requires that you see a dentist familiar with this condition. The headaches caused by TMJ can be misdiagnosed as migraines and TMJ can be a trigger for migraines.
4. Thyroid disease
Both low and high thyroid levels can cause headaches. Thyroid disease, usually associated with fatigue, dry skin and hair loss when thyroid levels are low, and rapid heart rate and anxiety when thyroid levels are high, may present with migraine as the only significant symptom. This so-called subclinical presentation of thyroid disease can also be seen in adults and children. Diagnosis can be made with a simple blood test.