Why are some people more likely to get migraines?

Genetic and environmental factors that increase the risk of migraine headaches

Anyone can have a migraine headache, however, some people just have a higher risk compared to others. The reason why some people are more likely to get migraines is based on a combination of genetic and environmental factors. A simple way I explain it is by describing everyone’s risk to having a migraine based on different sizes drinking cups. The larger the cup, the more it takes to fill the cup and thus the harder it is to get a migraine.

The cup size is determined by genetic factors. It is well known that migraine headaches have a very strong genetic component. Such that, 70% of people who have migraine headaches have a 1st-degree relative who also suffers from migraine headaches. This genetic predisposition is believed to be due to a mitochondrial dysfunction that results in a hyper-excitable or sensitive brain. Thus, in people who have a family history, it does not require as many triggers to cause them to have a migraine. Or with the cup analogy, they have a smaller cup, to begin with, thus they do not need as many triggers to push them over to the point of having a migraine.

The thing that ‘fills your cup’ is the environmental risk factors or triggers. Common triggers include hormonal changes, stress, changes in sleep patterns, certain foods (MSG, red wine, sulfates), strong odors, certain medication, and changes in weather patterns. Typically it requires a combination of these triggers, or enough to fill the cup to cause a migraine.

Unfortunately, what I am seeing, as a headache specialist, is that more people are experiencing more frequent headaches. They describe it to me as if they always feel on the edge of having a migraine, and things that typically would not trigger a migraine now are. I like to describe this as ‘the cup is already half full’ so it takes less ‘water’ or triggers to fill the cup and cause a migraine. I believe this is due to increased inflammation in our bodies.

Things that increase inflammation in our bodies are very similar to what triggers a migraine in the first place along with some that you would not expect to see. Common causes of this increase inflammation include chronic stress, obesity, narcotic pain medications, food allergies and sensitivities (gluten, dairy, eggs), processed foods, sugars, refined carbohydrates, and omega 6 fatty acids in vegetable oils. Exposures to any of these factors over time can cause an increase in the inflammation in the brain that then results in more frequent migraines.

So to decrease your risk for migraine headaches you need to limit the triggers and things that can cause inflammation. I typically make these recommendations to my patients.

  1. Decrease stress, if unable to decrease stress than at least find healthy ways to deal with it such as regular exercise.
  2. Get off processed foods, and stop using artificial sweetener,
  3. Stop using vegetable oils and use more olive oils and coconut oils to cook with
  4. Consider eating a low carbohydrate, high fat ketogenic diet.

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