This is the second post in a series about migraines. Start with the first post, about hormonal triggers.
Migraines from gut barrier dysfunction
There are many ways that gut disease can trigger a migraine. However, all have one common mechanism at play. . .
A permeable (leaky) gut barrier
You may have heard the term leaky gut, aka intestinal permeability. In a nutshell, leaky gut means your intestinal lining has lost control over the junctions between its individual cells. This lining is thin to begin with, just one cell in depth. You need tightly controlled junctions in order to discern between nutrients to absorb, and undesirable things to keep out. Leaky gut means your barrier function is impaired.
What leaks through that shouldn’t?
- Food protein molecules that are not completely broken down. Your immune system can tag these as antigens (invaders) and create antibodies against them. This creates a systemic inflammatory response, which can trigger a migraine. If you have migraines and food intolerances, you may have a leaky gut.
- Toxic bacterial byproducts from your gut bacteria, called LPS endotoxins. These cause widespread inflammation, pain, and migraines. If you have migraines and unresolved pain, you may have a leaky gut.
What causes leaky gut?
Dysbiosis, which is an imbalance of gut microbes, is the primary cause. This could be overgrowths of inflammatory microbes, not enough beneficial bacteria, or both. Dysbiosis affects your gut lining in many ways:
- Beneficial bacteria secretions build your healthy mucosal lining! So lack of beneficials = impaired mucosal barrier.
- Dysbiosis makes your lining irritated, inflamed, damaged, and permeable.
- When you restrict carbohydrate and fiber too much, bacteria can feed on your own protective mucosal gut lining, which is damaging.
- Fungal overgrowth can embed into your gut lining.
- Beneficial bacteria make short-chain fatty acids, such as butyrate, that are natural lining anti-inflammatories.
There’s another way dysbiosis can cause migraines. You can have an overgrowth of bacteria that turn nitrates into nitric oxide, a headache trigger. In fact this study showed that nitric oxide was higher in the bloodstream of migraine sufferers.
Other causes of leaky gut
- Alcohol: Alcohol damages your gut lining, and allows endotoxins to leak through. Measurements of LPS endotoxins are higher with alcohol disease damage.
- Medications: The most common are:
- Nonsteroidal anti-inflammatories (NSAIDS) like aspirin, ibuprofen, and prescriptions like meloxicam.
- Opiate and pain medications
- The birth control pill.
- Antacids, H2 blockers and proton pump inhibitors.
- Gluten: In all people, gluten increases a protein called Zonulin, which signals a loosening of your intestinal cell tight junctions (TJs). Anyone with gluten intolerance (Celiac or non) is at risk for gluten proteins to leak through and trigger inflammation.
- Other inflammatory foods for you, determined on a case-by-case basis.
- Stress: There is a myriad of explanations and studies as to how stress affects gut permeability.
- Constipation: This is likely due in part to microbiome imbalances. This 2017 study is the first that shows how treating constipation improves leaky gut.
What to do for leaky gut?
Get a comprehensive assessment of food intolerances and dysbiosis. Fortunately, there are excellent tests that influence individual treatment, such as the GI Map, the SIBO breath test, and food intolerance tests like the FIT.
After an assessment, your practitioner will apply the four “Rs” of gut treatment:
- Remove food irritants and microbial overgrowths
- Reseal your gut lining
- Reinoculate beneficial bacteria through food, PREbiotics, and specific strains of probiotics
- Restore functional digestion
Migraines from brain barrier dysfunction
Your blood brain barrier (BBB) is similar in structure to your gut barrier. Both are composed of endothelial cells with tight junctions. In addition, the cellular junctions in both are regulated by the same signaling proteins.
When your blood-brain barrier is disrupted, then neurotoxins can leak into your brain and cause inflammation. This includes LPS endotoxins, inflammatory cytokines, food antigens, chemicals, histamine, and nitric oxide. Brain inflammation can trigger migraines.
When your BBB is leaky, other types of neurological symptoms can occur, including dizziness, brain fog, anxiety, and depression. Over time, neurological degeneration can occur, including cognitive impairment and dementia.
Causes of leaky brain
- All of the causes of leaky gut apply to leaky brain!
- Nerve pain increases enzymes called matrix metalloproteinases (MMPs). These enzymes are really important in the development and flexibility of your nervous system. However, nerve pain can raise MMP levels too much, which then causes a breakdown in your BBB. In fact, the latest research shows higher MMP levels in migraineurs.
- Blood sugar imbalances including high or low blood sugar disrupt the integrity of your BBB.
- Systemic infection and/or inflammation disrupt your BBB through many pathways (cytokines, prostaglandins, NF-kB, MMPs, and more). This recent 2017 study outlines all of these pathways.
- Traumatic brain injury (TBI) is shown to disrupt the BBB.
- Oxidative stress (think rusting) disrupts the BBB and causes neurodegeneration.
What to do to seal your blood brain barrier
First of all, strengthen your gut barrier. Your gut and brain barrier control mechanisms are the same. Therefore when you improve your gut barrier you will improve your brain barrier. Secondly, assess brain inflammation and oxidative stress with the organic acids test. Work with a functional medicine practitioner to improve these markers. Lastly, apply approaches to seal your BBB. Some of my favorite research-based blood-brain barrier sealers include turmeric and resveratrol.
It’s worth mentioning that glutathione is an important antioxidant for the brain. Also, a good brand of CBD can cross your blood-brain barrier to reduce inflammation.
I welcome your comments and questions below,