If you get migraines, you may be more likely to suffer from one of these related conditions.
November 06, 2017
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More than migraines
If you get migraine headaches, you have a higher risk of also having one of several other health conditions. Or, you might be at greater risk for developing another condition in the future. Migraines have been tied to concerns ranging from depression to asthma to heart disease.
Around 18% of women and 6% of men get the severe headaches (which are often accompanied by other migraine symptoms like nausea and sensitivity to light and sound). “One of the reasons migraine is so common is because so many pathways lead to migraine,” says Richard Lipton, MD, director of the Montefiore Headache Center in New York City, “and those pathways may differ from person to person.”
That can make treating migraines more difficult; what works for one person might not work for another. But if you do happen to have migraines and another condition, you might actually have a treatment benefit: “You [may be able to] make two things better with one drug,” Dr. Lipton says.
Keep an eye out for signs and symptoms of these other conditions.
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If you have “episodic” migraines (those that occur once in a while), you have double the risk of depression than someone without any migraines. If you have chronic migraines (15 or more days a month), your risk doubles again, says Dr. Lipton, also a professor and vice chair of neurology at Albert Einstein College of Medicine.
While it’s possible that people with migraines become depressed because of the pain, the depression can also come first. This suggests the two have something in common–genes or neurology or both. “The prevailing belief is that there’s some shared underlying predisposition to both disorders, and either one can come first,” says Dr. Lipton.
Some antidepressant drugs, notably amitriptyline, can actually treat migraines. Amitriptyline affects levels of the brain chemical serotonin, which raises the possibility that serotonin also plays a role in migraines.
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People with chronic migraines are even more likely to have an anxiety disorder than they are depression: Around half of people with migraines also have anxiety, according to the American Migraine Foundation.
Like with depression, the anxiety or the migraines can come first, says Teshamae Monteith, MD, director of the headache program and assistant professor of clinical neurology at the University of Miami Miller School of Medicine. “Patients that have anxiety in life are more likely to develop migraines, and vice versa.”
Sometimes one treatment (often an antidepressant) works for both conditions; other times, people need separate treatments–medications for migraines and behavioral therapy for anxiety disorders. It’s important to find an anxiety treatment that works. People who go untreated may be less likely to stick with their migraine meds and may not respond as well to the drugs either.
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Several studies have found a link between strokes caused by blood clots and migraines with aura, the visual or other sensory symptoms that sometimes precede the actual migraine attack.
People who have migraines with aura have about twice the risk of a stroke as the general population, says Dr. Lipton, but overall, that risk is still very small. “Migraine, particularly with aura, is largely a disease of younger women and women are at a lower risk of stroke than men. Even though the risk doubles, it’s still incredibly low.”
Even so, there are ways to lower that risk even more by maintaining healthy blood pressure, blood sugar, and cholesterol levels and not smoking.
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The seizure disorder epilepsy and migraine can both involve sensory disturbances and mood changes. Having one doubles your risk of the other, says Dr. Lipton, but either can come first. ”They’re both disorders of brain excitability, where the brain is likely to react to environmental stimuli, to sleep deprivation,” he says. “Some of the specific genetic causes of migraine also cause epilepsy.”
Because of those shared causes and brain reactions, certain anti-epilepsy drugs like topiramate and divalproex sodium can treat both conditions.
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In addition to having a higher risk of stroke, both men and women with migraines (with aura in particular) also have a higher risk of heart disease, especially heart attacks. One study also found that migraine sufferers were more likely to have risk factors for heart disease, like high blood pressure and diabetes.
To keep yourself as healthy as possible, control your weight, cholesterol, and blood pressure.
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Even though asthma is a respiratory disorder and migraine is a neurological condition, the two can go together. The common denominator may be inflammation.
“In asthma, there’s inflammation and excessive constriction of the airways,” says Dr. Lipton. “In migraine, there’s excessive inflammation of the blood vessels just outside the brain.” In fact, it’s this inflammation of the blood vessels outside the brain that may cause the excruciating throbbing pain that is the hallmark of a migraine headache.
The asthma drug montelukast can also help prevent migraines, says Dr. Lipton.
If you already have migraines, excess weight can make them worse. If you’ve never had a migraine, obesity can actually trigger them. “Some studies have found that those who gain weight over time are more likely to have migraines,” says Dr. Monteith.
Like asthma, the common denominator may be inflammation, which can be caused by excess weight. Losing weight may help. One small study found that a group of obese people with migraines who underwent bariatric surgery and lost an average of about 66 pounds saw a decrease in the painful attacks.
Paying close attention to your diet can benefit not just your weight but also your migraines. Certain foods like red wine, chocolate, and processed meats can trigger attacks.
It’s unclear exactly how migraines and other painful conditions are linked. “Some people may have genetic predispositions,” says Dr. Monteith, or it might have to do with pain medications themselves. "Patients that take medications for low back pain or other types of pain may become sensitive to the pain medication and might get overuse headaches,” she says.
Treatment depends on where the pain is coming from, but cognitive behavioral therapy as well as alternative therapies like acupuncture can help, says Dr. Monteith.
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Experts believe there’s an intricate relationship between the gut and the brain–they call it the gut-brain axis. Not only does your digestive tract affect your mood, but the gut and the brain even share similar tissues and chemical messengers, says Dr. Monteith.
People with migraines have a higher prevalence of a number of GI-related concerns, including irritable bowel syndrome, inflammatory bowel disease, and celiac disease. Research has even found that babies born to mothers who get migraines are more likely to have colic as infants.
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Restless legs syndrome
Restless legs syndrome (RLS) is a disorder that causes such a strong urge to move your legs that it can interfere with daily life, as well as with sleep.
No one knows exactly why RLS and migraines are connected, but the link may have to do with dopamine, a neurotransmitter in the brain involved in both movement and migraines.
There may also be a link between migraines and Parkinson’s disease, which develops when the brain no longer produces enough dopamine. One 2014 study found that people with mid-life migraines were more likely to develop Parkinson’s later on, but more research is needed, says Dr. Monteith.
Bell’s palsy is a temporary paralysis of nerves in the face. Symptoms might include twitching, weakness, and drooping eyelids. Sometimes the symptoms happen only on one side of the face.
While Bell’s palsy symptoms might sound like those of a stroke, the two conditions are actually not related. However, one 2014 study found that people with migraines had nearly double the risk for Bell’s palsy. The researchers couldn’t say why there might be a connection but speculated that it could have to do with changes in blood vessels, inflammation, or infection, since some viruses have been linked to Bell’s palsy.