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Are Migraine Headaches and Poor Weight Control Related?

I am not a migraine sufferer but I treat many patients that are afflicted with this potentially debilitating condition.  The “classic” migraine headache includes a one sided, throbbing headache often associated with nausea, vomiting and photophobia (lights bothering the eyes).   A number of people report an “aura” before the headache occurs, such as an abnormal smell, dizziness, visual disturbances and/or ringing in the ears.  These vascular-type headaches can last from a few hours to over a day.  During the times the headaches are present, many people cannot function effectively at work.  The word “miserable” is often used to self-describe how the migraine sufferer feels during these bouts.

Migraines are most often seen in people 25-55 but all age ranges may be impacted.  The cause of the headaches appears to be some sort of inflammatory reaction that produces dilation and inflammation around the arteries and nerves in the cranium.  Certain foods, weather conditions, stress and hormonal changes during a woman’s cycle are often precipitating factors.

So, to the question:  Does poor weight control impact migraine headaches?  The research seems to point toward a one-way association.  Being overweight does not cause migraine headaches BUT the people that are prone to migraine will have more episodes and higher severity of the attacks if they are overweight/obese.   When overweight/obese people lose weight, the frequency and severity of migraine attacks lessen.

Interestingly, one of the classes of migraine medications, called the “triptans” (such as Imitrex, Maxalt, Relpax and others) work by serotonin mechanisms.  There is a class of serotonin receptors called the “5-HT-1D receptors” that when stimulated, produce the cranial artery vasoconstriction that will often terminate the migraine headache.  The triptans bind to these receptors and activate them as if they were serotonin itself.  These serotonin receptors have nothing to do with appetite, cravings or mood so the triptans have no role in weight control.

For those migraine sufferers out there that have weight control issues:  Yet another great reason to stay steadfast and focused on your weight control efforts.

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