What Happens During a Migraine?

Nov 15

My dearest migraine sufferer -

In my last blog I outlined the three conditions inherent to migraineurs per the working theory of the tri-migraine complex by Angela Stanton Ph.D. They are summarized (by me) as:

1. Your brain is special and sensitive to sensory inputs (aka migraine brain).

2. The stress from the sensory inputs causes stress hormones to be released, which is detrimental to the biochemistry of the brain. (biochemical imbalance)

3. The anatomy and function of the brain’s response to sensory stimuli leads to the quick uptake of voltage and subsequently the brain is left out of homeostasis and unable to meet the brain’s energy needs, so a migraine ensues. (Cortical Spreading Depression) (1).

In this blog I'll discuss what occurs in the body to cause a migraine, addressing numbers two and three above. This information is critical to understand in order to make the Migraine Prevention Lifestyle make sense to you.

Let's refresh our vocabulary to ensure you get the most out of what I'm sharing here.

Biochemistry:

bi•o•chem•is•try bī″ō-kĕm′ĭ-strē

n. The study of the chemical substances and vital processes occurring in living organisms; biological chemistry; physiological chemistry.
n. The chemical composition of a particular living system or biological substance.
n. The chemical study of living matter; also, physiological chemistry.

Electrolyte:

e•lec•tro•lyte ĭ-lĕk′trə-līt

n. A chemical compound that ionizes when dissolved or molten to produce an electrically conductive medium.
n. Any of various ions, such as sodium, potassium, or chloride, required by cells to regulate the electric charge and flow of water molecules across the cell membrane.
n. A compound which is decomposable, or is subjected to decomposition, by an electric current.

Ion:

i•on ī′ŏn″, ī′ən

n. An atom or a group of atoms that has acquired a net electric charge by gaining or losing one or more electrons.
n. In physical chemistry, one of the particles, bearing electric charges, which carry electric currents through the air or other gas.

Voltage:

vol•tage vōl′tĭj►

n. A measure of the difference in electric potential between two points in space, a material, or an electric circuit, expressed in volts.

Come back to these at any point to ensure maximum comprehension!

After reading about the migraine brain you now understand the working theory that we have anatomically different brains than "normie" brains. These normie people are able to live totally normal lives that don't require the discipline, sensitivity, and self-care that we do to remain healthy and functional. This does feel like a real drag, but I believe this actually puts us migraineurs at an advantage, IF you can learn to prevent migraines naturally.

I feel this way because our sensitivities to changes in our internal and external environments act like early warning signs for issues that might remain undetected by others. For example, I was having 3-5 migraine days per week in my last apartment, and after an unplugged week in Mexico on vacation I realized that I was being sickened and disabled by the wireless radiation in my apartment complex.

"Normies" didn't notice, and they still live there! I moved and removed myself from a situation that could literally cause cancer and other chronic illnesses and I never would have been alerted to the danger without migraine. The same goes with smelling spoiled food before normies, smelling a gas leak before anyone else, and other sensory-related miracles of the migraine brain.

So what happens in the brain and body to trigger a migraine?

The short answer is “stress.” I hope you’ve realized that there is no short answer that will totally explain how complex migraine is, but I’ll do my best to make it make sense, referring to Fighting the Migraine Epidemic as my reference material.

"Migraineurs have general hypersensitivity to external stimuli such as smells, sounds, lights, etc. These stimuli are inputs to brain processes that utilize the multiple sensory connections among specific neurons responsible for sensory stimulus. Thus, migraineurs' sensory organs are more sensitive and are highly integrated to alert better and faster in case of danger." (2)

You see, we are actually wired to have a more sensitive fight-or-flight response to any changes in our internal or external environment. We would have been tribe-protectors many generations ago, as our systems are so sensitive to changes and our brain always interprets the stress as a threat.

Remember, this is actually a good thing, but our brains have not evolved to tolerate the stressors of modern life. So many of us experience anxiety as a result of these flush neurotransmitters, and not "mental illness" (although the chronic anxiety on top of chronic pain can certainly lead to a depressive state).

We must see that the “migraine brain is not a sick brain, but a brain that has not been able to fully adapt to modern life: high carbohydrate foods, noise, light-on-demand, perfumes, and the many brain-stimulating tools we use, such as the computer to any screen can cause trouble to a maladaptive brain.” (3)

“In contemporary life, the ever-present lights, noises, and scents are overly stimulating to migraineurs. Our migraine-brains use up a lot of energy in informing and preparing the body for possible emergencies that never materialize. The increased energy requirement can only be satisfied with an increased level of energy transfer to neurons, which cannot take place without an increased amount of electrolyte minerals, particularly sodium.” (4)

Just to add insult to injury, today's Standard American Diet recommends a low-sodium, low-fat diet despite scant evidence to show that sodium and fat are detrimental to health. In fact, sodium and fats are imperative for migraineurs and most people suffering from neurological disorders. Migraineurs actually need 50-100% more salt in their diets than non-migraineurs because we pass at least 50% more sodium in our urine than they do. (5)

The anatomical differences of the migraine brain produce consequences when exposed to any stimuli: More neurotransmitters are created “which is a voltage expensive process that requires more energy. And the increased output of neurotransmitters relates to an earlier or higher level of alertness to stimulation.” (2)

“The Hyper sensory neurons of a migraineur are much more active than that of a non-afflicted person. The nutritional demands on a migraineur's brain are correspondingly higher to support all of the increased electrical and neurotransmitter activity. The most important nutrition components for the brain, are those that facilitate the creation of proper voltage and proper voltage gated channel functions, including the prevention of voltage leaks." (3)

What this means is that our migraine brains function differently than “normie” brains. Electrolytes and water are the nutritional components that are responsible for maintaining voltage in the brain. Not only do we need to add adequate hydration (voltage) to our body, but we must also protect against voltage leaks. More on the topic of voltage leaks in the next blog.

Now you can see that nearly anything can be a "trigger" of a migraine, because the brain is constantly pushing out neurotransmitters in response to stressors, internal or external. Those stressors cause an ionic imbalance in the migraine-brain by requiring a massive energy uptake. The requirements that need to be met for the migraine process to begin are as simple as not having enough voltage to meet the brain's energy demands.

"Every migraine begins with a prodrome that are signals of an impending migraine. These prodromes are elements of a cascade of events that lead to the pain, which starts with the initiation of an alarm status that leads to fight-or-flight response."(125) Even if there's no actual threat to you, your migraine brain will "act as if" and push neurotransmitters, beginning the energy voltage uptake cycle.

"The 'falsely triggered' cascade of events uses up available energy, depleting the available voltage. A migraineur will start a migraine unless voltage is re-established. Voltage is the driving force of the ionic electrolyte pumps that are located in the neuronal membranes, facilitating ionic exchanges between the inside and outside of the neuron." (6)

When that ionic exchange cannot be facilitated because there's no available voltage, a cortical depression (CD) occurs. CD is essentially the prodrome period - when pre-migraine signs appear but the pain and other symptoms haven't begun yet. Only one part of the brain is having this EMPTY VOLTAGE alert.

This is the critical moment! If you can re-establish voltage successfully at this moment, you can abort a migraine. Salt or electrolytes and water or potassium-rich foods and water are the very next thing you should be putting in your body - if possible, use all of them! Every body is different and Dr. Angela Stanton's book Fighting the Migraine Epidemic is a great resource for more nutritionally-based migraine abortive techniques to trial.

I help my coaching clients identify their deficiencies and build a lifestyle unique to them to maintain biochemical homeostasis - and therefore available voltage to their migraine-brains.

Strokes and migraines have a similar underlying dramatic failure that is captured well in the following quote:

“Cortical Spreading Depression (CSD) and depolarization waves are associated with dramatic failure of brain ion homeostasis, efflux of excitatory amino acids from nerve cells, increased energy metabolism and changes in cerebral blood flow (CBF). There is strong clinical and experimental evidence to suggest that CSD is involved in the mechanism of migraine, stroke, subarachnoid hemorrhage, and traumatic brain injury.” (7)

Cortical Spreading Depression (CSD) is exactly what it sounds like: once CD occurs in one part of the brain, it will spread to the rest of the brain, resulting in a full-blown migraine, presenting as a variety of symptoms. CSD acts as a slow-moving electrical wave that moves through the brain, and if it occurs in the visual cortex of the brain, the migraineur will "see" an aura. Even during a CSD episode the migraine can be aborted or dramatically reduced in length and severity if the voltage is restored in time.

The purpose of the CSD is the brain’s attempts to reset the entire brain to normal operation. Sadly, it’s too late to reverse the painful symptoms once the brain has pushed the “wake up call” of the energy wave through the entire brain after going “offline” due to lack of voltage. (8)

You know what happens if you don't get to it in time: full blown migraine. This is the exact mechanism that causes prodrome which quickly turns into migraine if voltage isn't restored. Without the proper voltage there is a "dramatic failure of brain ion homeostasis." (9)

To bring it all together, I'll share my favorite story to illustrate what happens during a migraine. Do you have a memory of the power going out due to a blown fuse in the house while growing up? I certainly do. Let's say you have a 2 bedroom 1 bath modest home, with decent electrical wiring but it might be leaky or poorly insulated (migraine brain).

Every day a group of 6 teenagers storm through to get ready for school (sensory stimuli). All 6 girls decide to blow dry, straighten, or curl their hair at the exact same time, maxing out the voltage available to the outlets (Cortical Depression). The power goes out to the whole house because there wasn't enough juice to power this ridiculous situation (Cortical Spreading Depression).

Now in a house, the breaker can be reset and the fuse replaced, if needed. We have no such luxury for the brain, and must suffer through the dramatic energy failure in the brain as a migraine.

As you can see - migraineurs need ionic mineral balance at all times to prevent a migraine. So that just means take electrolytes, right? Taking electrolytes is a great start - I don't drink a single glass of water without electrolytes or salt in it to ensure I'm not dehydrated, and advise my clients to do the same. Unfortunately that's not the only thing that determines biochemical balance.

There are a few big things that migraineurs need to watch out for that, unbeknownst to us, could be causing dehydration and ionic imbalance. I'll discuss that in my next article.

XO 💋 Oriana

References:

Stanton, A. Angela: Fighting The Migraine Epidemic: A Complete Guide: How To Treat & Prevent Migraines Without Medicine. North Charleston, SC: Createspace Independent Publishing Platform; 2017.