Is there a connection between gluten and migraines? Does a gluten free diet help with migraines? If so, how does it work?
In this episode, Dr. T reviews the connection between gluten and migraines – understanding it may not only help you slay the beast once and for all, but protect yourself against a whole host of other badness in the brain.
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So today’s episode, I’ll be kicking off our first dive into an incredibly important topic for those with migraines, so I’d strongly recommend sticking around for the episode. And it’s a topic that’s almost been I think entirely overlooked up until relatively recently and still almost entirely neglected in the field of migraine research.
That’s bound to change and it’s really a matter of the field catching up to what has become a rapidly evolving subject, and that is the role that our gut and the health of our gut plays in all domains of health. And in particular the extraordinarily tight linkage between the health of the gut and the health of the brain.
And just for clarification, by the gut what I’m referring to is essentially your entire system for digesting food, from the stomach to the small intestine to the large intestines. It is our most important interface with the outside world.
And as we know, migraines are a condition that in some ways can be conceived as a sensitivity to the outside world. So needless to say, it’s not surprising that this has major implications for someone with migraines. And the gut is also intimately linked to the brain and the nervous system, so much so that the gut now has the nickname as our second brain.
And the specific topic we’re going to address in this episode is the connection between gluten and migraines. I’m going to be covering what I consider to be some of the most pertinent research findings in this area and what I consider to be some very significant implications for anyone with migraines. I’ll cover what the link between gluten and migraines says about the connections between the gut and the health of the gut and migraines in general. So stick around for all that.
So a while back, I wrote an article called the Gluten Migraine Connection, What You Need to Know. It has since generated quite a bit of interest. In that piece I talked about some links between gluten and migraine that I think most migraineurs are entirely unaware of, along with critical links between the health of the gut and the health of the brain.
Now it seems that some in the Migraine community when they see this kind of title automatically assume that I’m talking about gluten as a migraine trigger. So let’s first put that myth to rest. This is not about gluten being a migraine trigger. While it certainly can play a significant role in migraines, the research here is not to portray it in that particular light, but to show you some other connections that I think are really relevant for all of us to know.
As hopefully you know, one of my first objectives in working with anyone who’s had migraines for any length of time is to help them ditch the old story of migraine, which includes this story about triggers, both because it doesn’t work very well and it also creates a really unhealthy relationship with food and the world around you. And a relationship that I think fuels migraines in some capacity.
And so the Migraine Miracle Plan is not about seeing the world as a minefield filled with all sorts of threats, but rather addressing root causes so that we fundamentally change our physiology and gene expression to provide as protection against the beast. And so that’s the idea I’ll be talking about here. The gluten and migraine connection ties into making those sorts of fundamental alterations to our physiology.
Now you may have heard people say that they went gluten free and it helped their migraines. And you may have naturally concluded that that was because they’d found another trigger. But I want you to start by abandoning that concept.
So I imagine that some of you have also been told that there were some abnormalities on that MRI scan. Your doctor may have referred to these in a number of different ways, maybe calling them white matter spots, or white matter lesions, or bright spots, or maybe just spots at the brain.
And essentially, what he or she is referring to is the presence of areas in the white matter of the brain, which is the part of the brain that contains all the nerve fibers that are connecting the various cells of the brain to each other, and those cells are containing gray matter, and the white matter is what’s connecting those areas to each other. So they’re kind of the wiring of the brain that transmit signals between different brain regions.
On certain MRI sequences in an anatomically normal and healthy brain, that white matter should be relatively dark, but in certain circumstances, we instead may see little spots of brightness. And it’s been known for quite some time that those spots are more commonly seen in people with a history of migraines, and that they also correlate with the frequency of migraines. So more migraines means more likely to have more spots. So that’s the first really important point here, that migraineurs are more likely to have these white matter spots on their brain MRI.
Now, for a long time, doctors have had no idea why those spots were there or what they represented, so the typical response has been really to just shrug them off as something insignificant. To say, “There are things in your brain that really shouldn’t be there but don’t worry because we have no idea what they mean.” So that’s not very reassuring to me, right? Or probably not to you.
And furthermore, there’s some data that should give us some pause. There was a 2010 study in the British Medical Journal that analyzed 43 trials from 1966 to 2009 and concluded that having those white matter spots on the brain “predict an increased risk of stroke, dementia, and death”. So not really reassuring, right?
So that’s the second really important point here, is that having white spots in your brain that shouldn’t be there increases the risk of some highly undesirable brain conditions. I personally like to reduce the chances of stroke, dementia, and an untimely death as much as possible, and given that there is something about migraines that predisposes me towards those spots, I personally kind of like to know what that is so that I can prevent this if I can.
And furthermore, I think there is evidence that indicates those bright spots are shining a light on something perhaps quite sinister happening in the body and brain of the migraineur, which relates to the topic of the day.
It turns out that in addition to migraine, there are several conditions where those spots are also more commonly seen, and that includes things like stroke, multiple sclerosis, and it also includes celiac disease. So as some of you may know, celiac disease, which effects about 1% of the population is also known as gluten intolerance.
In someone with celiac disease, or gluten intolerance, their immune system attacks their intestines in response to the presence of gluten in their gut. So for someone with celiac, eating gluten leads to inflammation in the intestines, which causes GI distress and breakdown of the intestinal wall. So in scientific terms, it causes what we refer to as an increase in intestinal permeability. And in colloquial terms, we refer to that as a leaky gut.
So in someone with a leaky gut, stuff that’s not supposed to get inside the body gets inside the body because the gut wall can’t keep it out. And when stuff gets inside the body that’s supposed to stay out, the body recognizes that it doesn’t belong, specifically the immune system recognizes it, and it attacks it.
That then leads to widespread inflammation in the body along with an increased risk of all manner of autoimmune illnesses. And in fact, there is an emerging theory that leaky gut is the root cause of all forms of autoimmune disease. So in addition to digestive problems, gluten for a person with celiac disease, gluten can cause a host of other problems entirely unrelated to digestion.
Now, it also turns out that people with celiac disease are more likely to have migraines, and that people with celiac disease are also more likely to have white matter spots on the brain. Especially if they suffer from migraines. So the really important point number four is that there’s a very tight link between white matter spots on the brain, migraines, and celiac disease, which as I discussed, is a condition that results in a leaky gut.
Furthermore, treatment of celiac disease with a gluten free diet, which heals the gut and repairs the increase in intestinal permeability greatly improves migraines in people with celiac. In one study where they took 10 celiac patients with white matter spots and migraines with aura, the gluten free diet led to the complete elimination of headaches in seven and significant improvement in the other two. And the tenth patient wouldn’t try the diet.
So again, this treatment had nothing to do with eliminating gluten as a trigger, but eliminating gluten for a much more fundamental problem that was going on. And in this particular study in those who lapsed and went back to gluten, the migraines returned and the MRI findings with those spots worsened.
So really important point number five is that fixing leaky gut and celiac disease leads to significant improvement in migraines and that the white matter spots on MRI are tightly coupled to changes in intestinal permeability or a leaky gut.
Here we have strong evidence for at least one situation where a leaky gut causes both migraines and white matter spots on the brain, and where both of those things, the migraines and the white spots, appear to be driven by whether or not the gut barrier is intact.
Now, we know that all the systemic effects of celiac disease occur by way of the gut. So stuff gets into the body that shouldn’t be there, and then all hell breaks loose, but the brain is supposed to be different. The brain is special in that it’s supposed to be walled off from the rest of the body through something known as the blood/brain barrier. So like this name implies, in the brain there’s a barrier between the blood and the brain, and stuff can’t get across that barrier or that wall unless it’s carried across it by special little fairies that take things across the barrier.
Now, if we opened a bad guy portal into the body, inside of the gut, those bad guys still don’t have a portal or a way into the brain thanks to this wall. And even though those white spots we see look like a reaction to bad guys in the brain, they look like something we see when the immune system is attacking something, the blood/brain barrier should keep that from happening, unless there’s a vulnerability in the blood/brain barrier.
And recent evidence shows that there are certain situations in which that wall becomes leaky, and guess what one situation is? Migraines. So migraine is a many-armed beast, as you may know, meaning there’s a whole host of physiological changes that occur when the beast arrives, and one of those changes involves what’s known as neurovascular inflammation. So essentially nerves at the base of the brain that are activated during a migraine send a signal to the blood vessels they connect with to release inflammatory substances. And the resulting inflammation then triggers breakdown in, wait for it, the blood/brain barrier.
So a leaky blood/brain barrier means that stuff can get inside the brain that shouldn’t be there. So the super important point number six is that during a migraine, the blood/brain barrier becomes leaky. Now, what happens when stuff that doesn’t belong inside the brain gets there through a leaky blood/brain barrier?
Well, the same thing that happens when stuff that doesn’t belong inside the body gets inside to a leaky gut, the immune system attacks it. So in this case, the cellular guardians of the brain, known as the microglia, are the ones that are doing the attacking, and the microglia attack as the first line of defense, and then the call for further reinforcements to finish the job, which ends up triggering more inflammation.
More inflammation means more breakdown of the blood/brain barrier, allowing more invaders in, which activates more microglia, causing more inflammation and so on. So it’s easy to see how the sinister combination of a leaky gut and migraines could lead to a state of chronic inflammation, and that these puzzling spots on an MRI are the MRI’s signature of that process happening.
Now, I mentioned earlier that it’s widely accepted and inherently obvious to the typical migraineur that the migraine brain is especially sensitive to the environment, and nowhere is this sensitivity more significant than in the food that we eat. So the last thing anyone with migraines needs is a breakdown in his or her defenses against the external environment.
From this point of view, it’s no wonder that behaviors that promote a healthy gut barrier, including avoidance of foods that disrupt that barrier, are protective against migraines. But the benefits of a healthy gut, and I consider avoiding gluten to be a critical part of that, as this discussion suggest, may extend well beyond its head pain protecting properties.
So for the migraineur, a healthy gut may spell the difference between maintaining a solid wall of defense between the outside world and your brain or rolling out the red carpet for all manner of badness to enter. So to summarize all of this, the evidence indicates that the combination of leaky gut and migraine makes one more prone to chronic inflammation and white spots on an MRI scan, which we also know to be linked to an increased risk of migraines, stroke, dementia, and death.
As I’ve outlined, this is based on the assimilation of evidence from a few different areas. Is it possible that some of these links are coincidental? Sure. But there’s plenty enough here for me as a neurologist and migraneur, especially given my work with patients implementing the Migraine Miracle Plan, seeing how this impacts gut health, seeing how it impacts migraines, it’s enough for me to consider gut health as a fundamental component, not just of migraine prevention, but of the prevention of many other forms of unwanted brain disease. So it’s plenty enough for me to avoid gluten regardless of whether doing so impacts my frequency of migraines one way or the other.
And like I said, in my work with patients over the years, especially since implementing the Migraine Miracle Plan, I’ve noted a very strong relationship between gut health and migraines. So much so that I now consider it pretty safe to assume that anyone who is experiencing frequent migraines is also suffering with leaky gut and more than likely, this is another one of the reasons why the plan works so well.
So by returning to an evolutionarily concordant diet, one that’s appropriate for humans, we’re eliminating the foods that compromise the gut barrier, and that of course includes gluten, but it’s certainly not the only thing that compromises gut barrier function. Incidentally, another thing that’s known to compromise gut barrier function is ibuprofen, or the NSAIDs. So I think becoming more and more sophisticated about gut health offers us a tremendous opportunity not only to slay the beast for good, but also to protect the integrity of the brain and the body over the longterm. It’s likely an essential foundation of health in general.
Like I said, this is a topic I’m going to dig into more in future episodes, and it’s also one we’ve talked quite a bit about in Migrai-Neverland over the past couple of years in our weekly group coaching sessions. So members can find multiple issues of the chatter devoted to that topic and devoted to the things that I consider to be central to optimizing the health of the gut. And reflecting on your own history, you may have already noted a similar link. I know there are many migraneurs who will report that they feel like when their digestion isn’t right, when bowel movements are irregular or when bloating and constipation kicks up, that the beast is more likely to visit, and I don’t think that’s coincidental.
Again, this connection between gluten and migraine is not about gluten as a trigger food, it’s actually much deeper than that, and it’s about what the research in this area is telling us about the links between gluten, gut health, migraines, and potentially a host of other things.
All right, so that wraps up this episode of The Miracle Moment. Remember, you can find this and all other episodes at MyMigraineMiracle.com/moment, where you’ll also find the transcript along with links mentioned in the episodes. And if you enjoy this podcast, it’d be great if you left a rating and review in iTunes, it really helps other people find it, and as I mentioned in the introduction, if you want to screen shot your review and email it to us, you’ll be entered into the drawing for a personalized copy of the book along with a beast slayer shirt.
In the next episode, I’ll be sharing another phenomenal success story from one of our Migrai-Neverland members, and if one day you’d like to be sharing your story of going from chronic migraine to migraine freedom without pills, then consider joining us in Migrai-Neverland to learn more about going through MyMigraineMiracle.com/EndofMigraine. So thanks so much for listening.
Now it’s time to go out and slay the beast.
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