Migraines & Headaches Explained: Why Blocking the Pain Isn’t the Same as Solving the Problem

Are your migraines or headaches still running your life—despite normal scans, multiple medications, and endless “try this” advice?

In this research-backed Q&A, Dr. Spencer Zimmerman breaks down why migraines and chronic headaches are far more complex than most people are told. Instead of focusing on labels, he walks through the four core arenas that must be evaluated to truly reduce frequency and intensity:

• Immune system & inflammation (CGRP, histamine, gut health, autoimmune links)
• Vascular factors & autonomic regulation
• Mitochondrial energy and metabolic efficiency
• Brain connectivity (cerebellum, vestibular system, trigeminal pathways)

You’ll learn:

• Why normal MRIs don’t mean “nothing is wrong”
• How medications like CGRP inhibitors work—and why they don’t solve the root cause
• The hidden role of magnesium, riboflavin, omega-3s, and ketones
• Why gut health and brain health are inseparable
• How caffeine and common OTC medications can perpetuate rebound headaches
• Why no one is looking at brain connectivity—and why that matters

If you’ve been told to “just manage it,” this episode will challenge that narrative and give you a systems-based framework for understanding what’s actually driving your migraines.

Because the goal isn’t to block pain.
 The goal is to prevent it.

If you’re ready to understand your headaches differently—and explore what’s actually possible—this episode is for you.

https://peakbrainandbody.com/

Transcript

Hey everyone, welcome to this week's Q&A. Now, as always, we are going to have a dedicated topic where I'm going to review the research and go through it. But even though there is a dedicated topic, that does not mean you cannot ask questions on anything you care to, okay? As long as it's something where I feel I can provide some education and give an answer, I absolutely will. But with that being said, Go ahead, start typing in your questions. I will get to them when I see them. I'll make sure to do the best I can to answer it. This week, though, I chose to do migraines and headaches, which we are really just going to lump it together as an entire thing. Now, the reason why we're going to lump it together is because there are those who have headaches where it's actually really a migraine. There are those who have you know, migraines, and it's not really a migraine as a headache. So there's lots of confusion on what something is versus what it's not. So we're not really focused so much on the diagnosis itself. We're focused on what you actually can do to get your life back. That at the end of the day is what really matters is how do you actually start getting answers and solutions for these migraines and headaches that plague so many different people. Before we dive into the research, we're just going to go through this roadmap. And so this is a graphic that I created. Ultimately, when we're looking at headaches and migraines, there's this spectrum of what's causing it. So, for example, if we really want to increase the amount of people that we can help. So at my clinic, Peak Brain and Body, I'm going to help eighty, ninety percent of those who come in with headaches and migraines. They are going to leave substantially better than they come in. Some people, it's a fifty percent improvement. Some it's gone completely. But this is the lens that I use. So this is a lens that can be used on everyone. And as you listen, you're going to get a better understanding of what I mean. This is a lens versus this is the treatment, because if you've worked with me, if you're one of my patients who's watching this or else, if you've consumed a lot of my content on YouTube and other places on social media, you would know that I'm anti magic bullet guy. I'm anti this is the only treatment for whatever because the reality is it's never quite that simple. When we look at this though, we really ought to look at four arenas that need to be worked through and evaluated when we're dealing with chronic migraines and headaches. One is going to be the immune system and inflammation. And that's why when we look at a lot of the migraine medications, neurotech, all of those, they go after CGRP, which we'll go into that a little bit more. But these are a list of different things that can contribute to inflammation, which we are going to go into foods and how that plays a role. We're going to go into gut health as well. We're not necessarily going to go as deep or anything in infections, mold, stress, and sleep. but those are all there also anything vascular right a lot of migraine medications are given to change the blood vessels to allow more blood flow and oxygen areas but you can have right anything vascular related okay if you have cardiovascular disease guess what it doesn't stay in your heart it can impact your brain as well therefore increases the likelihood of headaches and migraines. Hypertension, elevated blood pressure that's too high can do it. But also on the other side, I treat a lot of people who get diagnosed with dysautonomia and orthostatic hypotension. Not getting enough blood flow and oxygen to an area can also contribute to headaches. Then we have our mitochondria and metabolic side. Basically, what's the efficiency of the cells in the brain? How efficiently are they functioning? What can impact it? Very much like a car with gas mileage, the better the gas mileage, the further you can drive without refilling. Same exact thing in this arena. And then lastly, brain connectivity. This for me is a no brainer, but it's just because I've done this work for over a decade. But I can also tell you as someone that's done this work for this long, no one's looking at brain connections. no one okay there there's a very very small subset of providers across the entire united states that are doing it you definitely have a lot more people looking at your vascular and your mitochondrial base and that immune system is kind of somewhere in between and we're going to go into this a little bit not tons but ultimately eye movements oculomotor cervical spine sensory processing or trigeminal so all migraines involve the trigeminal nerve and that whole system and then also vestibular influences and like i've said if you do have questions feel free to ask them to me i will answer them when i can and even though i am focusing this on migraines and headaches if you ask anything i don't care if it's about concussion pots autoimmunity how things are tying in that's okay feel free to ask it and I will address it as I'm able to. Now what we're going to do is we're going to start diving though into the research now that you understand that framework of there's a lot of different things that can go wrong to contribute to headaches and migraines. So first, let's just go here. Okay, National Institutes of Health. This is the migraine page. So ultimately, Migraines impact millions of people a year. It costs billions of dollars in not only migraine treatment, but also missed days from work. Now, one of the things when we're really looking here at migraines, it says several things can trigger a migraine attack. There's a lot of these, okay? There are a lot of things that contribute a, right? You see blood sugar issues, you see head trauma. So some of the people develop migraines post concussion or brain injury. You even have medications can cause migraines. You have hormonal changes, motion sickness. That's gonna be your eye movements and your vestibular system can do it. Too much physical stress, like sleep. There's a lot of things that ultimately contribute to migraines. Now, your migraine may have aura. It may not have an aura. So it doesn't overly matter, but it happens. Now, for some people, migraines are genetic, but I don't want to focus on the genetic side because... The goal, you can't change your genetics. The goal is to change the way the environment and all the other factors interact with your genetics. Because not everyone with the genetics has migraines and headaches. So we shouldn't reduce it down and say, oh, well, it's just genetic. Well, that's really unlucky. We do know that females are at a higher likelihood of having migraines compared to males. There are things that can happen right in pregnancy, menstrual cycle, and other things like that. But once again, just because migraines are more common in females compared to males does not mean it's something that you have to live with. If someone tells you that, hey, migraines, you're a female, it's just the way it is, that's not true. Or at least I can tell you clinically, as someone that's treated migraines and headaches for over a decade, Very few people don't see tremendous progress. And normally their case is kind of weird from the beginning. We're looking for patterns and clues. Now, once again, we're not going to the diagnosis a lot, but I do want to make sure people understand this. So you may end up having a MRI or CT scan performed. The purpose of an MRI or CT scan in a neurological evaluation for someone with migraines is as it says, right? I'm going to read this. If they suspect the person might have another condition that causes headaches and other symptoms of migraine. So I don't order an MRI because of a migraine. I order it because maybe, right, was there a stroke that happened? Is there a demyelinating disorder? Because as you're going to find out, if you have multiple sclerosis, you're more likely to have migraines. Is there a tumor, right? Is there something like that that would explain the migraines and the other symptoms coming with it? That's it. So as a whole, that's why it's being done. And so if you get told that your CT scan or MRI is normal, that's great, right? That means, hey, it doesn't look like there's multiple sclerosis. It doesn't look like there's been a vascular injury. It doesn't look like there's a tumor, anything in that arena, okay? So wanted to cover that. Now, when we next look, we're not gonna go in all these, but basically you'll see, There are right for this article, fourteen types of migraines, and we're not going to go through all these types. The most common ones, tension, migraine and cluster headaches. Those are the most common headaches. There are those that are due to infections and allergies. There are severe ones that are related to someone's having a stroke. But we're going to go after what's actually pretty common. Now, you see all these different places that you can have the head pain and head pressure, which we're not going to get into. The one thing I wanted to show here is when we are looking at these secondary types of headaches, did you know that caffeine can actually give you headaches? And you may be like, wait, but I thought caffeine treated headaches. Well, kind of, kind of. Um, I get a lot of people who decide they're going to stop coffee. They're going to stop caffeine and their brain revolts on them, right? So people who have frequent migraine headaches are at risk of triggering a headache due to caffeine use. Now, when we scroll down a little bit more, we're going to see this, um, Headaches are likely to occur anytime over-the-counter medications are used more than fifteen days in a month. And they're also common with medications that contain caffeine. So any of your medications that are comboed with caffeine are more likely going to give you headaches. And this isn't something people are thinking about. It's not something that they're usually being told about. But using ongoing acetaminophen, ibuprofen, other NSAIDs, everything in those families can actually give you rebounding headaches from using the medications too frequently and for too long. And that's why it's so important that we really take the time to understand where these migraines and headaches are coming from. Because It's one thing if you have a headache every few months and you're just taking an over-the-counter med and it's not that big of a deal. But it's a whole nother thing if you are doing migraine medications or these over-the-counter meds all the time because it's the portal of entry. These are cheap medications that you can just pick up on your own, doesn't require a doctor's visit. But if you're pounding it, the constant use can be the sole reason why you are continuing to have headaches. and getting them to the level you've got it. Now, I don't want to spend too much time on that because my average patient does come in. They've tried a variety of medications over the counter, but also prescriptions. We're not going to go into the efficacy rate of the different medications, even though realistically the efficacy is all over the place. And with this framework, In my clinical experience, you have a much higher likelihood of seeing significant improvement in your migraines than you do with any of the medications you could ever be prescribed. And it's because the medications is just one thing. That's it. Versus let's really start to understand what's happening with the complexity of migraines. one of the things we shared on the map is it was immune system and inflammation so this first article from september twenty twenty two immunologic okay so the immune system aspect of migraine a review of the literature ultimately there's a lot of different things that play a role okay calcium calcitonin gene related peptide that's the one where all the medications are being made for even though you see there's many beyond that here, right? Neurokinin, neurotensin, substance P, histamine, all of those can play a role. And ultimately, if you're able to reduce the inflammatory load, get the immune system down, now the likelihood of you having migraines does go down. So when we look at this, right, they've got a couple graphics that we're going to dissect a little bit. Ultimately, this is where the triptans come in. So whenever people are doing like sumatriptan or imitrax, that's meant to impact serotonin receptors. So that's what five HT is. But you can ultimately get barrier blood brain barrier. So that's the BBB. You get peripheral immune cells that makes its way into the nervous system. This can cause a wide variety of things to happen. You've got inflammatory markers, which goes everywhere. and you get release of calcitonin gene related peptide it's going to sensitize the neuron and now all of a sudden you're going to end up with headache pain and we see mast cells playing a role we see histamine issues we're seeing a lot more people who are dealing with allergies mcas related issues compared to what we've seen in the past now one of the things that we shared in the last q a we did was the role of iron deficiency and if you have low iron you are more likely going to have histamine related issues. And so anemia, once again, can be a player in this. Now, when we go down a little bit more on this, we're going to see the associations. Now, some research agrees with this, others don't. So for example, say it's a diabetes, they didn't really find a risk. But you'll find plenty of people who've got migraines and headaches where the better their diabetes is controlled, the better the headache and migraines are. So I don't agree with that clinically. But then when we really look at anything autoimmune, rheumatoid arthritis, psoriasis, multiple sclerosis, any inflammatory bowel disease and celiac, so ulcerative colitis, Crohn's, all of those, have an increased likelihood of having migraines. The only autoimmune disease that they're talking about here that didn't was lupus, which kind of makes sense because psoriasis, RA, IBD, all of those are highly, highly inflammatory. The more inflammation you have, the more calcitonin, gene-related peptide you're going to get that's going to be dumped, goes and hits your trigeminal nerve system and next thing you know, there is your migraine. Here, this is just showing it from a different perspective, right? Migraine is going to cause issues with your blood-brain barrier, and it messes with ultimately the regulation of your immune system. And this is from more of a multiple sclerosis model. And as we keep going through this, friendly reminder, if you have questions, feel free, type them in the chat. I will answer them the best I can. and if at any point you're like wow this stuff's awesome i would love to work with you feel free to visit my website peakbrandonbody.com i'm used to seeing very complex and tough cases who need the extra work who need people to go beyond what others will for them to help them get the answers and solutions they are looking for now neurogenic inflammation again right so we see once again inflammation When we look at phases of migraine, right? You've got the initial phase, prodrome, then you've got aura, then headaches, then post-drome. Now, this is going to be your migraines with aura. But, right, once again, you see all this, right? Mass cells still playing a big role. You got all these inflammatory markers hitting it, messing with the blood vessel. and this is why they try to impact some of these different places here in the brainstem with different medications to try to deal with things. We're gonna keep working through this, not gonna beat a dead horse too much. This here shows you just kind of all the different medications that they're doing. NSAIDs, triptans, you know, ergotamine, CGRP is really popular. You know, they're doing monoclonal antibodies. They're doing all sorts of things to try to figure it out. And despite that, the meds are still really struggling. And it's because... What do you do when you have three or four different pathways that you're trying to correct? And the question that people aren't asking unfortunately is, well, we know if calcitonin gene-related peptide impacts your ability to have migraines, they're saying, how do we block it? But that's not the right question. The question is, how do we prevent as much calcitonin gene-related peptide from being produced in the first place? Because when you do that, you have a more effective way. Because most of these medications, yes, some of them are meant to prevent future headaches, but you still have to take them from an ongoing basis. Others, guess what? They're not meant to prevent any future headaches, right? They're only going to do it as long as you're taking it, and then it's back to square one. So what are things that we should know about what's happening in the body that's playing a role in migraines? And like before, if you do have questions, feel free to type it in the chat. I will do my best to answer it. And let's keep working our way through the research on what we should know. So in the natural health community, a lot of people have a love fest with the gut. And it's not to say the gut's not important because it is. And what we're going to look at is why people talk about the gut so much. important to understand that your gut produces neurotransmitters okay serotonin gaba gaba is ultimately what they try to you know what they're doing pharmaceutically if you've got like xanax but you get a lot of things that get produced in your gut lipopolysaccharide this is a inflammatory marker that creates a lot of bad things and then you have short chain fatty acids which actually play a very positive and beneficial role so depending on what's happening with your gut Guess what? These things, lipopolysaccharide is going to break open your gut, increase permeability, whereas short chain fatty acids, specifically the short chain fatty acid butyrate, is going to help reduce permeability. now when you start looking at these mechanisms right um you've got brain inflammation again you get neurotransmitter issues you also get changes in essentially sensitivity of how things are being processed hormone issues right insulin resistance and so forth play a role in migraines now looking at this from a little bit different of a perspective Here's the bidirectional communication of the microbiotic gut-brain access. Ultimately, you have what's called a circadian rhythm. It's a normal clock as to how things function in the body, digestion, immune response. All that plays a big role there. Regular exercise is super important, right? Balance of an inhibitory neurotransmitter GABA and glutamate balance. We're going to talk about this a little bit more when we look at magnesium mood regulation right you get good diversity of your microbiome you get short chain fatty acids as we've said lipopolysaccharide goes down and ultimately you have a healthy communication from your gut to your brain but then also your brain gets to tell your gut to be healthy as well this is where a lot of people miss it in the gut world is they're trying to fix everything from the gut without realizing what the brain does to the gut in return Whereas on the other side, stress, drugs, whether they're things like alcohol, tobacco, or medications, mess with this. Inflammation, glutamate, reduced serotonin. And then, of course, the wonderful standard American diet until recently was highly inflammatory, especially all the ultra processed foods. This destroys our gut lining, increases inflammation, and wrecks the balance of our gut microbiome, creating more issues. Now, when we leave this diet does play a role. Okay. Um, like, like look at this, right? Chocolate. I know people love chocolate and someone's probably crying out there, but chocolate triggered migraines in. Twenty-two percent of children likely due to the changes in nitric oxide levels. Okay. Um, leading to vasoconstriction caffeine. this was linked to twenty eight percent of headaches either as a trigger or withdrawal and this is where it gets very dangerous when we become very dogmatic about migraines and things that people say they do that works you have a twenty five percent chance actually slightly more right when you have migraine maybe from that so hey Let's be careful. Now, elimination diet is very beneficial because guess what? Some of the thing that impacts you isn't going to impact anyone else. Now, I really do like what it says here, though. It may not be the food itself that causes the problem, but other possible biases such as stress, a lack of adequate rest, and dehydration. Foods are considered triggers if they consistently provoke migrants in greater than fifty percent of cases within a day of consumption. This is super important because I get patients who come like, well, you know, I mean, like I eat this sometimes. I'm OK. This other times I'm not. And I like the way that they are dissecting this because this is what we do clinically. It's like. Well, if it's not there all the time, what do you notice makes you tolerate it versus not? How was your stress that day? What about physical and cognitive exertion? What about your sleep the day before, right? There's all of these factors that impacts the resting level of your immune response that day. And so if you have more stress, now all of a sudden a food that maybe is borderline, you react to. But if you don't have stress, your immune response is much more appropriate. Guess what? Now, all of a sudden, there is no issue. Low glycemic diet. Once again, there's all these different things with bacteria, probiotics, B vitamins that could possibly play a role in helping people with their headaches and migraines as well. All right. I hope this is helping people. Hope it's making sense. As always, if you do have a question, feel free to comment. And once again, I'm Dr. Zimmerman. I'm a dual licensed nurse practitioner and doctor of chiropractic who's been treating this for over a decade. And I've got a clinic in Tampa. Now, some of the foods we cause a lot of histamine responses, but we're also seeing more impaired histamine responses in general as allergies and many other things have continued to sky over the years. Now there's different hypothesis on what happens when histamine levels go up. Part of it is that, you know, histamine drives calcitonin gene related peptide. Other part is that it activates part of the nervous system, right? There's a lot of different things. Needless to say, Increased calcitonin gene-related peptide increases histamine, leads to a migraine attack as it impacts your trigeminal nerve system. Once again, calcitonin gene-related peptide, right? This is what it is. And as we said, right, is involved in pain transmission and release from trigeminal termini during migraine attack. Now, there's still more that they're trying to figure out. But as we said, we are better off trying to figure out what causes and leads to the release of calcitonin gene-related peptide compared to, well, guess what? Let's just simply block it. Because if you block it, you never... get the results you want long term because you haven't really figured out where the mess is coming from right you always will be better off when you find what's happening yeah thanks thanks for the comment you know you're absolutely welcome that's why i do this i want people to find benefit and like i said if people have questions feel free to ask it if not i'll just keep going along the research but feel free to ask it um Once again, migraine, diet sensitive, you know, we already covered that. Ultimately, there's a lot of things playing a role there. And so if people say diet doesn't matter, honestly, they need to step back. They need to go and read something. Just be honest. There's enough research out there. And I understand the last article did a great job as well. But there are things worth pulling out of the diet okay and i know there's stuff in here where it's like pull gluten pull corn pull dairy there's a wide variety of things worth trialing and see how you do because guess what plenty of people you do that their life changes there's others it may not do anything for but it still beats being on a medication that costs over a thousand dollars a month so we've talked about the gut brain access and how the gut's playing a role. But what are some things that you could do if you have a migraine and a headache? Now, this is going to be looking at some of these supplements that people could be taking. And as always, disclaimer, if I was treating you in my office, the underlying framework that I gave you at the very beginning, that holds. What doesn't hold are these supplements that I'm going through because looking at things that are going to help ten, twenty, thirty, forty percent of the people and having the results that we see in our clinic, eighty to ninety percent are very, very different things. And it's because we're not trying to find the one thing we're trying to find what things when we add it together does the best to address the underlying neuroimmune issues at play and alter physiology in the body. Riboflavin, riboflavin is a vitamin And what's its role? Parkinson's disease and migraines. Ultimately, you know, what do they say? They emphasize the role of riboflavin in neuroprotection, elaborating on its proposed neuroprotective mechanism, an opposite to the pathogenesis when it comes to migraines as well as Parkinson's. So it's a, you know, it's one of the B vitamins, it's B two overall, it's pretty safe. They go through what it does, you know, Parkinson's, dopamine, mitochondria, reduces inflammation, same side, migraines, oxidative stress. So inflammation levels, mitochondrial dysfunction, but want to click here. So you ultimately have this cycle that just kind of goes and goes and goes. Riboflavin helps with oxidative stress through the glutathione pathway. It also helps here through both vitamin D and through changing NF-kappa B, some nuclear factor. Kappa beta is a highly inflammatory byproduct that creates a ton of inflammation, mitochondrial issues. Ultimately, riboflavin increases the ability of the microchondria to function well. Homocysteine issues create a lot of things. Now riboflavin can be used to get homocysteine levels down. There's other things such as methylated B-II, methylated hydrofolate, and glutamate toxicity. Glutamate is one of the main neurotransmitters in our brain. It's the excitatory neurotransmitter. We're going to come back to glutamate, and we're going to save that for when we actually talk about So we'll get there in just a second. Here, ultimately, this is all the different research on it. But at the end of the day, guess what? Riboflavin is really safe. It's a supplement that can have benefits for reducing migraines. Now, as I said, I wanted to save magnesium and talk about glutamate. So Right, migraines, once again, goes to what it is, light sensitivity, noise sensitivity, nausea, vomiting. Maybe there's an aura, maybe there's not. You know, they still don't really understand everything that's happening in migraine. Okay. But one of the big things that's happening. Right, it shows normal magnesium function. Magnesium acts as a plug right here. Okay, so you've got your receptors. This allows, right, so that's pre, here's post. Magnesium's that plug right there. When that plug's removed, excess calcium flows in. Excess calcium flows in, that causes extra firing. It's spontaneously firing, which isn't going to lead to anything good, which is where you see here when you have not enough magnesium, Guess what? It leads to dysfunction of that NMDA receptor. And that's why magnesium levels can help as a pre to prevent it from occurring to begin with. It's not necessarily as good as an abortive because guess what? You've got to do things to get those levels up. Here's another picture when you look at it, right? So you ultimately have NMDA receptors. You have glutamate comes here. It says, oh, let's ping calcium dumps in. Well, magnesium, when there's enough there, you know, magnesium blocks that preventing the excess, which is super important because this is a big thing when you really look at magnesium levels. from anything neurodegenerative it's all about nmda receptors what's happening there wild type ample receptors and so forth um you know what's different things that people have that's causing their magnesium levels go low okay i've heard things as high as eighty percent of people are deficient in magnesium so like everyone should just be on it You've got genetic things that aren't super common. You have diabetes, causes it. Hypertension causes it. Malnutrition causes it. Alcohol abuse, so two, three drinks a day causes it. If you're female, even one is going to do it if you do it daily. Diarrhea, you've got those. And then you have celiac disease, pancreatic issues. And then you have all this, right? Diuretics. proton pump inhibitors. So your nexium, your Prilosec, what everyone gets put on when they struggle with their diet and that's causing acid reflux, that's going to cause you to be deficient in magnesium. Drugs that impact your kidneys will do it. Bariatric surgery will do it, right? So there's a lot of different things that tanks people's magnesium levels and is going to predispose them because One of the mistakes that people make when they think about migraines, they say, oh, I've got a migraine. What do I take now? The reality is it's not about what you take then. It's about what should have been addressed after your last migraine that would have prevented the next one from coming. When you do that, that is where you get the magic. Now, what's pretty cool when you come here and look at magnesium, Right? We've been talking about casetone and gene related peptide, but magnesium is an NDA receptor. It's substance P it's inflammation. Like it hits a lot of different things. CGRP doesn't, it literally just hits CGRP, which is why there's people who are like, I love my neurotech. And then there's people like, uh, I don't notice anything. You know, I, I did a post on this and I had people were like, this is amazing. And then I had the other half of people were like, oh, it did nothing for me. It was, it was such a waste. you have magnesium you have riboflavin what else well you have omega-three fatty acids okay there's all sorts of different things in here but ultimately omega-three fatty acids offer cardiovascular neurological psychiatric benefits due to anti-inflammatory anti-nose-susceptive so pain antioxidant inflammation okay it's going to help all those ultimately It's not something bad to try. There definitely needs to be more research on essential fatty acids and migraines. And really, if we're going to be honest, essential fatty acid research in general is pretty horrendous when they do it. We would be much better served if they did people's, so you can get what's called an omega check where we can tell you exactly, hey, here's your omega-three, here's your omega-six, here's your ratio. And then we can also tell you, here's your amount of DHA and here's your amount of EPA. When we can do that, now you can make sure people are actually getting therapeutic doses. What we don't know is, are you getting the dose you need? And so a lot of the research that's saying like, well, you know, we don't really don't know if this is helping someone. It's due to the fact that they just need to do better research. And nutritionists have this issue for a long time where they're not making sure people are getting therapeutic doses. They're just giving them a set dose saying, how do you do versus saying, where were you at? Where did you get up to? Because we should only say something isn't working when we're truly giving it the right research. Now, when you look at essential fatty acids, know once again there's mood chain benefits that can happen with it inflammation you have mitochondrial based benefits and then you have specialized pro resolving mediators so your omega-threes will get converted into that which also does a really good job now when we go back and we start looking at migraines and nutrition once again right we've already talked about caffeine it talks about chocolate nitrates monosodium glutamate msg so unfortunately lots of foods have msg a lot of seasonings do okay those are things that are playing a big role you have people who will get migraines from head from alcohol Another big thing, you know, I'm not going to go into all those here, but I do like this graphic where it shows you from alcohol to nitrates to MSG to tyramine to caffeine, chocolate. These can do it through a variety of mechanisms, neuroinflammation, mast cell related issues, how it impacts glucose metabolism and utilization, impact receptor channels, vasodilation, calcitonin gene related peptides, sympathetic nervous system activation, because Guess what? When your nervous system is orally activated, it becomes skewed and the parasympathetic part gets downregulated and your parasympathetic plays a major role and it fires down to your spleen to actually cause the release of anti-inflammatory byproducts from your spleen. So there's lots of stuff in here, right? And then they're like, well, we've got the bad side on the left and then we've got the good side on the right. Omega-three rich foods, Mediterranean diet, vitamin D sources. lots of veggies and fiber hydration. And I think it's important here though, when they say nitrates and nitrites, it's the, it's the really processed meats. Okay. Um, I don't think grass fed grass finished has near the issues as the other side comparatively. All right. So that's like. That's the holistic functional medicine side, right? We're going to look and say, what's driving your inflammation? What's impacting your mitochondrial function? Is it your thyroid? Is it anemia? Is there blood sugar issues? Is there food sensitivities? Are there foods you're eating that are giving you issues? Is your gut a wreck? Are you stressed? What about your sleep? And then I said there was the part that no one looks at, and that's going to be brain functionality. Because at the end of the day, no brain, no migraine. No brain, no headaches. You just can't get it without it. And you've got a part of the brain that's responsible for coordination of movement, mood, all of that. And that's going to be your cerebellum. And when you look at it, okay, it starts here. Migraine is a disabling neurological disease characterized by moderate or severe headaches and accompanied by sensory abnormalities. photophobia so that's light sensitivity aledinia pain when you shouldn't have any vertigo we should all say dizziness and it's going to impact about fifteen percent of people worldwide um ultimately the cerebellum plays a big role in processing okay it has circuitry involved in pain processing emotions it has circuits involved down to your brain stem which is where a lot of the Neurotransmitters are released to help with pain. Okay. Emotional regions. It has things that go to eye movements and balance. I mean, it integrates it all. And so cerebellar dysfunction can absolutely be a reason why people have headaches and migraines, especially when we say those people, they maybe get a little bit of benefit with chiropractic care or any network, and then they lose it. It's usually because their cerebellum is not as healthy as it needs to be. And it's like, nope, sorry, I control this. I'll figure out why I'm doing what I'm doing. Now there are those who have dizziness with it. They get vertigo and they do get diagnosed with vestibular migraines. So when we look at vestibular migraines, Okay, that goes to the criteria, but ultimately doing vestibular base testing, balance, eye movements is super important and it's off. It can be treated and help people get to a better spot. Here's another one, vestibular migraine, right? They really talk about the challenges because people aren't really doing a lot. A lot of the medications are very hit or miss on it. And, you know, they're just here just briefly looking at, hey, here's how the trigeminal issues is going to impact the vestibular system and how the vestibular system impacts trigeminal system. Because it is bidirectional and that's going to impact people as well. Now, this side you'll notice I'm more of introducing it and not going into as much detail because in the world of neurological evaluations and neurological rehab, it has to be very tailored to the individual and the testing tells us what we need to do. Now, one of the things that's become really popular is vagus nerve stimulation. So, a non-invasive vagus nerve stimulation for migraine. Here's a review of some of the research. Now, anything that's non-pharmaceutical, as it's going to point out in the article, oh, well, we still need more research. We need bigger sample sizes. And you're right. There's not as much funding behind it. So the sample sizes aren't as big. But ultimately, did say that it does show promise in helping migraine management and i've got a variety of vagus nerve stimulators in my office and there's definitely benefits that are seen some people respond more than others some don't respond at all but as i've said the reason why clinically i see eighty percent ninety percent get significantly better it's because we're not trying to find the one thing we're trying to find what actually matters for that individual Now, another thing that people don't think about, it's dental health. So how many of you think, huh, my gums are causing my headaches or my migraines? I bet the answer is probably one percent of people. Think that, right? One percent. And the reason why is because it's like, oh, well, dental's its own arena. You know, dental's not medicine. It's on its own side. But the reality is our dental health plays a massive role. And periodontists link to increase calcitonin gene-related peptides. This goes back to what I've said numerous times up to now. You will be better served by figuring out what's driving your calcitonin gene-related peptide levels than purely going in there and blocking it with a medication. As long as we're blocking with a medication, you have to be on that medication the rest of your life to get benefits. But if you can address what's causing your calcitonin gene-related peptide levels to go up, you now have a solution that fixes something versus being a band-aid. And for me, it's not a slide on anything. It's just the way I describe stuff. A band-aid is something that you have to do perpetually or else it won't do anything for you. And that specifically is when we're talking about things like medications and even supplements that you don't necessarily need to be on if everything else was done right. I don't consider exercise a band-aid. I don't consider sleep a band-aid. It's things that we do to make up for other things. That does it as well. Then just a little bit of a bonus. Because when we look at these migraines, it's due to energy failure in the nervous system, excitatory-based issues. There's Ketones, okay? There's ketones. There's the ketogenic-style diet. That plays a big role, right? So ketogenic diet, beta-hydroxybutyrate salts show promise in reducing migraine frequency and intensity, often reducing monthly headache days by fifty percent or more. due to addressing brain energy deficiencies and reducing inflammation, okay? Ketones, honestly, with what they can do, it is awesome, okay? And look at this, patients who responded to ketogenic diet and those who did not had no difference with respect to weight or fat mass loss. So people are like, oh, they're doing ketogenic diet to lose weight. No, ketogenic diet is the best thing we have out there for seizures. There's nothing else that has the success rate No medication, to my understanding, that has the success rate of a ketogenic diet. Ketogenic diet is fantastic for brain injuries. Ketogenic diet is fantastic for anything neurodegenerative. But because there's no medication for it, guess what? There's no money for people to make. And because there's no money for people to make, people aren't talking about it. But at the end of the day, look at this. Look at this, right? You can go and get a good quality ketone powder for under a hundred dollars a month versus self-pay Nurtec, fifteen hundred a month, right? So a fifteen times difference. Nurtec is only going to come in here and try to reduce inflammation through calcitonin, general peptide. Here's beta hydroxybutyrate. It's going to help reduce inflammation, support the gut microbiome, improve digestive health. Glucose transporter one, mitochondrial function, decreased excitability, which we talked about with glutamate and what magnesium does. Stabilizes glucose, reduces inflammation, helps energy production utilization, and then cortical spreading depression is CSD. That's what happens in glucose. auras okay which is basically a domino that gets pushed and so even though you finish with one migraine you're already starting your next one because of issues and whenever you're researching i really just like going that right to images typing what i know i'm looking for and then i go in there and say huh you know which graphics look good i'm looking for mdpi i'm looking for frontiers you know and just anything in that arena nature that is beneficial right here's another one initial findings of the study suggest that metabolic ketogenic therapy may provide some benefit in treating migraines and encourage further studies but once again like yes there definitely needs to be more research but like A trial for a couple of months can be very profound. And when you look at the benefits of ketones, like ketones and brain, it's insane. Ketones and immunology, like it's insane, right? Like, huh? Let's click here. Ketones and brain metabolism. Neurodegenerative conditions. Everything it does there, which is not going to go into all the nuances. Glucose hypometabolism, energy efficiency, oxidative stress, right? Like ketones, are they a cure-all? No. No, they're not. But NeurTech, you have to give it anywhere five to twelve people to get one person who's going to benefit. And when you look at the research on men, it's barely better than placebo. And so what I hope people take from this is that Yes, migraines and headaches are very common and they impact a lot of people. But there's so much out there that can be done to help people figure out what's actually driving their headaches and migraines. And they just need to find the right help. They need to have the right education so they know how to advocate for themselves. Because while there's not a magic bullet, there are plenty of things that we know that drive migraines and headaches. That if you take a complete picture, you get multiple of these things addressed together as a whole unit. you can see results with that approach that you will not see with any other approach there will you know probably never be a medication that can do it as efficiently just because you'll never get a medication that can hit so many different pathways and receptors as when you do it right okay so for like us We're often hitting neuroplasticity with neurological-based rehab, gut health, make sure hormones, anemia, blood sugar, all of that stuff is dialed in appropriately. Because when you do that, you figure out the pieces to someone's puzzle, that's when they get their life back. And so last time, if you do have questions, feel free to ask them. if not we are wrapping this up and then we'll keep doing this again if you're watching the replay please leave comments if you have areas you want me to focus on we've talked about concussions and pots now we've done migraines and headaches and we'll talk about other things because ultimately it's about how the brain and body connects together as a whole unit we're not looking for the magic bullet looking to optimize physiology okay neurology what's happening throughout different systems and organs of the body get your immune system back on track so you can live your life in the way that you truly can and not live your life around the issues you're dealing with so until next time i'm dr z and i'm known as the brain guy