The truth about migraine triggers

The Truth About Migraine Triggers

Could focusing on migraine triggers be undermining your efforts to reach migraine freedom?

In this short episode, you’ll learn a new way of thinking about triggers to help ensure that doesn’t happen.

Episode Transcript

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Welcome to the migraine miracle moment. I’m your host, Dr Josh Turknett. I’m a neurologist, migraines, specialist, migraines suffer and author of the book The Migraine Miracle. In this podcast, you’ll learn all about how to find your path to migraines. Freedom without pills. Let’s get started.

Howdy Beast Slayers. Welcome to another episode of The Miracle Moment. So in the world of migraine, triggers are a big topic and by triggers I mean, things that you do or things that you eat that tend to be associated with the onset of migraine. And so, not surprisingly, they are an area of significant concern for many migraineurs. Now, I’ve talked about the past, that the typical approach to migraine care amongst doctors and other health care providers. It’s first and foremost about choosing a drug. And I’m sure many of you know this and are familiar with this approach. So when you go to see your doctor, including your neurologist, that’s more than likely going to be the primary or only focus. What drug or combination of drugs you should take for your migraines? And in many cases, unfortunately, that’s where the migraine care starts and ends. If there is any discussion about the role of lifestyle with respect to migraines, it’s almost certainly going to be around the idea of migraine triggers. So, again, things that you eat or things that you do that tend to bring on a migraine or seem to increase the chances that you will get one. So in this case, you might be given a list of possible triggers to consider avoiding. You might be encouraged to keep a migraine diary in hopes of finding what your triggers are or if there are ones that are particularly relevant for you. And that really is the sum total of the traditional approach to migraine care in 2020.

And you know as well as I do that that approach has left a lot to be desired. And I would claim that this is because we’ve missed the big picture of migraine. And that also includes thinking about this idea of triggers in the wrong way. And hopefully by the end of this episode, I imagine many of you will reframe how you think about triggers, hopefully in a way that hopefully makes it much more likely that you will advance down the road to migraine freedom. Now, one of the reasons I think that we’ve missed the big the big picture of migraine here is that there’s this false narrative that migraines are this inescapable genetic condition, which I think still remains the dominant bias. And that has kept us from digging, digging deeper into the root causes of what’s going on. And, of course, as I’ve talked about in prior episodes, we know this isn’t the case. We know that it is not purely genetic condition. Far from it. There may be certain genes that render you more susceptible. But genes alone are not enough to lead to migraines. But this idea that they are sort of inescapable and inevitable has kept us from asking if perhaps there are some deeper, fundamental root causes that were driven by our environment beyond this whole idea of triggers. And this has led to this typical conversation about the role of environment and diet and lifestyle centering on these relatively minor details that become largely irrelevant once they’re placed in the broader picture.

And so placing triggers within the context of this broader picture is what I’m going to be talking about in this episode. And one of the reasons for doing this episode is because I see a lot of people get hung up on the concept of triggers, and it’s hard for them to kind of reframe or reorient how to think about them in the context of the migrant miracle plan. And that’s because many people have been thinking in these terms for so long. And as I’ve talked about before. One of the biggest barriers to reaching migraine freedom is kind of this old story that’s so pervasive and hard to let go of. And I talk about, you know, ditching the old story in favor of the new story as one of the most important parts about moving towards migrant freedom. So I’m going to begin this discussion with a thought experiment. So imagine that you’ve just gone through chemotherapy for blood cancer. And as you probably know, the goal of chemotherapy is to kill the cancer cells inside the body. However, one of the major downsides is that it often kills some of your body’s own cells as well. And one particularly vulnerable part of the body are the cells of your immune system. So it’s not uncommon after undergoing chemotherapy for the immune system to be severely weakened. And when that happens, you have germs or microorganisms that you normally encounter every day, that you can typically fight off with ease. That never caused any infections or problems, but that now pose a threat in the face of your compromised immune system.

And so you have to be very cautious, much more cautious than normal. And so in general, you will do things that you wouldn’t ordinarily do to minimize the chances that you will encounter one of these germs that are now dangerous for. Now, you wouldn’t consider that strategy a treatment of a compromised immune system. Right. It’s just that meat means of damage control. It’s a way of making do as best you can in the face of a compromised immune system. If your condition was fixed and permanent. In other words, if there was no chance that this that your immune system was going to recover in any way, then that may be the best that you could do. But it’s still not treating the root cause. Treating the root cause would be rebuilding the immune system either, you know, allowing it to recover over time. If it can do so or by doing something like a stem cell transplant, those would be root cause solutions. Now, as long as you do have a weakened immune system, it’s prudent to avoid the germs or microorganisms that would lead to an infection that you could fight off easily with a healthy, robust immune system. And then once your immune system has recovered, you no longer need to do so to that degree. You can now handle those microorganisms. So now how does this analogy or this thought experiment relate to migraines? In this case? The migraines is like the immunocompromised patient in that he or she has been rendered vulnerable to these recurring attacks of debilitating head pain that can be brought out by environmental exposures and behaviors that don’t pose an issue for other people or don’t pose an issue for that same individual when they’re not in that vulnerable state.

And so in this case, triggers are analogous to the germs that someone with a healthy immune system can fight off easily. And so the key takeaway here from this analogy is that if we’re interested in a long term solution, a root cause solution, then the most important thing to focus energy on isn’t the triggers, but rather the reason why the brain has been made vulnerable to those triggers in the first place. And again, if you think this vulnerability is just an inherent property of some brains that some brains have and others don’t, then it doesn’t make sense to do do this. But if you realize that this is not the case, that there is something deeper at work, there is something environmental that is producing this vulnerability, then it makes sense for the primary focus to shift towards addressing that underlying factor or factors. And so while avoiding trigger triggers is a sensible strategy in the short term, you can see that viewing it as your primary long term strategy would prevent you from addressing the most important factors of all that are driving the whole process. And that allows us to separate environmental factors into the things that may trigger a migraine or increase the likelihood of one in the face of this heightened vulnerability.

And then there’s other category of things that produce the heightened vulnerability in the first place. And those are two separate, entirely separate categories. That’s a super important point to understand. Now, after you’ve reframed it, the next question, of course, is what factors are causing this heightened state of vulnerability? And this, of course, is the primary focus of the Mogra medical plan and of this podcast. But I think it’s important to frame it in this way so that we can disentangle it from the discussion around triggers, which I know it can be a point of confusion for people. And so, broadly speaking, if we’re talking about the things that lead to this heightened vulnerability, it is environmental mismatch. And what I mean is mismatch between the present environment that we live in now and our an ancestral habitat where the habitat and the environment where our biology evolved for almost the entirety of human evolution. Now, mismatch is a broad term and encompasses many things. It encompasses a great many environmental exposures and behaviors. And those mismatches have consequences in several key ways that make us vulnerable to migraines. Some of those ways are known, or at least we have a pretty good handle on, and some are surely yet to be determined at this point. I think you can make a very strong case that there’s likely a combination of inflammation in the gut and in the brain. We have talked about in prior episodes that’s brought about by impairments in the permeability of the gut barrier and the blood brain barrier, as well as metabolic inflexibility or the inability to readily shift between glucose or sugar and fat as our fuel source.

And those two things, metabolic inflexibility, as well as impairments in gut permeability, inflammation in the gut and blood brain barrier, as well as systemic inflammation, are all strongly driven by environmental mismatches. And these are some of the key processes that we’re trying to impact when we are making these diet and lifestyle adjustments in order to lessen or eliminate this state of vulnerability. And I shouldn’t. Also neglect the significant role of the medications themselves, the board of medications and significant role of rebound and its direct impact on pain circuitry and sort of the maladaptive changes that occur over time with chronic exposure to those medications, as well as the direct impact that nonsteroidal antiinflammatory medications like I’m Provan and Naproxen have on the gut, as they have been shown to directly increase gut permeability. So that’s another means by which they likely can help in the short run, but then make things worse in the long run. So if you put all these things together to try to create a model for how this state of heightened vulnerability comes to be, we have these food and lifestyle factors that impair gut for mobility, which leads to the absorption into the body of foreign proteins that then activate the immune system that cause inflammation, that inflammation is linked to impairments in the blood brain barrier, which then leads to the brain being exposed to foreign, since the substances that are inflammatory, which then produces this state of heightened vulnerability to migraines.

And then you couple that with the excessive strain on the hypothalamus, the part of the brain where the evidence indicates migraines begin from challenges to maintaining homeostasis that are a direct result of our modern environment, such as the challenge of maintaining energy homeostasis. When you have a diet that’s high in refined carbohydrates or when you have significant disruptions in sleep wake cycles and circadian alignment and so forth, and so it is the combined effect of all these things that then put the puts the brain into this state of heightened vulnerability where now triggers that we commonly think of are relevant. And so if your goal is a long term lasting solution for migraines, the strategy should be to focus on the things that are resulting in that heightened state of vulnerability rather than the triggers themselves. And that’s precisely what we’re focusing on with the micro miracle plan. And the Ketu for migraine plan, addressing those factors that over time lead to this heightened state of vulnerability. And so the ultimate reason for reducing mismatch in our lives by doing things like eliminating refined carbohydrates and gluten, grains, increasing sunlight, physical activity and so forth, is in order to bring our lives back in line with what’s evolutionarily appropriate, not because we’re trying to reduce triggers, it’s because we’re trying to make it so that we’re no longer vulnerable to those triggers, just as the things that we would do to boost our immune system is also targeting the underlying reason why we’re susceptible to infections by germs that are normally harmless.

And so for those of you who are putting the plan into action or just getting started or whatever, and you’re thinking about all the facets of the plan and the things that build the three pillars, don’t make the mistake of lumping them in in the same way you’d think of triggers. And the whole reason for writing the book and doing this podcast is because this is the big thing that we’ve been missing, the missing piece that has allowed so many people take to take their lives back. That is not currently part of the conventional conversation about migraines, but desperately needs to be. And so this means that when you’re putting these things into action, you are doing so for the long term. These are long term changes that you are trying to promote in the body to ultimately eliminate this underlying vulnerability, which is very different than avoiding a trigger that might provoke a migraine in the next few hours. All right. So hopefully that analogy and discussion will help to kind of clarify the differences between the traditional approach to migrant care and avoiding triggers and the migraine miracle plan. As always, if you enjoy this podcast to be great, if you left a rating and review in items, it really does help other people to find it.

I will be back in the next episode with another fantastic success story. So something to look forward to. If you are looking for more resources, resources into how to put the miring miracle plan into action, you can head over to the Web site micrometer. Com and click on the resources tab on the top. All right. That’s all for this episode. So now it’s time to go out and slay the beast.

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