According to the Migraine Research Foundation, 18% of women, 6% of men, and 10% of children in the United States experience migraines. This results in a 70% higher healthcare cost for families with a migraine sufferer compared to non-migraine-affected families.1 In addition to the financial impact, migraines incur significant quality-of-life costs for both the sufferer and those close to them. Although the definitive causes of migraine are not completely clear, this article will briefly review the current understanding of the relationship between the gut microbiome and migraine. The potential for effective gut-brain-targeted probiotic therapy is also discussed.
The Gut-Brain Axis
The gut-brain axis is a bidirectional communications network involving the central nervous system (CNS: brain and spinal cord), the autonomic nervous system (ANS: responsible for automatic functions like breathing and heart rate), the enteric nervous system (ENS: the network of nerve cells that controls gastrointestinal function) and the hypothalamic-pituitary-adrenal axis (HPA: a hormonal feedback loop). Surprisingly, the communication between the gut and the brain is mostly initiated from the bottom up. Signals in the form of nerve cell conduction, microbial molecules and metabolites, immune cell activity, and neurotransmitters generated in the gut are constantly informing the brain. In turn, the brain “speaks” to the gut largely through the longest nerve in the body: the vagus.
Gut-Brain Mechanisms in Migraine
Clinical studies have confirmed the fact that migraine sufferers commonly complain of gastrointestinal (GI) disorders.2Gut microbiota activities have also been identified as contributing factors in migraine attacks. A few of the proposed mechanisms in this microbiome-migraine relationship are outlined below.
Inflammation in the Brain
An increase in inflammatory molecules have been implicated in migraine pain.3 It is well understood that gut hyperpermeability (a.k.a. “leaky gut”) can stimulate inflammation and overactive immune response.4 Because gut microbes produce short-chain fatty acids (SCFAs) that are responsible for maintaining intestinal barrier integrity and providing brain-protective compounds, a decrease in microbial diversity can negatively impact both gastrointestinal and neurological function. A decrease in microbiome diversity is commonly associated with illness, poor diet, use of certain medications and alcohol consumption. It appears that this decreased diversity, or dybiosis, may be a factor in migraine frequency and intensity.
The Happiness Hormone
Gut microbes produce precursor molecules of serotonin.5 Amazingly, 95% of the body’s serotonin is manufactured in the gut with the help of good gut bacteria. Beyond its impact on the brain and mood, serotonin also has a direct impact on the gastrointestinal tract (including abdominal pain) and the gut-liver axis.6 A reduction in available serotonin is also associated with systemic inflammation that can affect the brain.6 This fact helps to explain why medications that support increased serotonin levels have been shown effective in treating migraine.7
Migraine patients typically demonstrate lower GI microbial diversity and less than optimal short chain fatty acid (SCFA) production.8 These individuals are also more likely to have potentially pathogenic microbes residing in their gut, including Clostridium species. In contrast, healthy individuals exhibit more functional gut-metabolic interactions as well as healthier gut-brain interactions.8
Can Probiotics Help?
Although human clinical studies are limited, investigations have demonstrated the potential for probiotics to effectively treat migraine. The probiotic organisms achieve this feat by increasing short chain fatty acid production in the gut, strengthening the intestinal barrier, and right-sizing inflammation.9
Clinical Research on Migraines and Probiotics
Our OMNi-BiOTiC® HETOX probiotic was tested in two clinical studies with migraine patients. One study was an observational study with 1,020 participants who regularly experience migraines.
Patients took Omni-Biotic Hetox daily for eight weeks and reported migraine frequency, intensity, accompanying symptoms and painkiller use. Patients reported a 58% reduction in the frequency of migraines and a 33% reduction in the intensity. Accompanying symptoms such as aura, nausea and vomiting declined by 70% and more, depending on the symptoms. Painkiller usage decreased by almost 50%.
In a smaller study of 29 migraine patients, participants took Omni-Biotic Hetox for eight weeks. Results in this study were similar: intensity and frequency of migraines decreased significantly. The Migraine Disability Assessment Scale (MIDAS) score improved by 33%.
Selecting an Effective Probiotic for Migraine
When selecting a probiotic formulation for a specific condition such as migraine, well-designed and controlled clinical studies are very helpful to illustrate likely efficacy in humans. This is because not all strains demonstrate the necessary mechanisms for positive outcomes. In the case of migraine, there is a very limited number of these studies available.
However, laboratory testing can be helpful to determine whether specific probiotic strains are capable of strengthening the intestinal barrier, generating useful short chain fatty acids, balancing inflammation and immune response, and producing neurotransmitters including serotonin.
Fortunately, our Omni-Biotic Hetox formulation has both the probiotic laboratory analyses and the formal clinical studies to substantiate its role in effective migraine mitigation and management.
1. Migraine Research Foundation. About Migraine. Available at: https://migraineresearchfoundation.org/about-migraine/migraine-facts/. Accessed May 23, 2021.
2. Aamodt AH, Stovner LJ, Hagen K, Zwart JA. Comorbidity of headache and gastrointestinal complaints. The Head-HUNT Study. Cephalalgia. 2008;28(2):144-151.
3. Ramachandran R. Neurogenic inflammation and its role in migraine. Semin Immunopathol. 2018;40(3):301-314.
4. Marchiando AM, Graham WV, Turner JR. Epithelial barriers in homeostasis and disease.
5. Gao J, Xu K, Liu H, et al. Impact of the Gut Microbiota on Intestinal Immunity Mediated by Tryptophan Metabolism. Front Cell Infect Microbiol. 2018;8:13.
6. Stasi C, Sadalla S, Milani S. The Relationship Between the Serotonin Metabolism, Gut-Microbiota and the Gut-Brain Axis. Curr Drug Metab. 2019;20(8):646-655.
7. Aggarwal M, Puri V, Puri S. Serotonin and CGRP in migraine. Ann Neurosci. 2012;19(2):88-94.
8. Chen J, Wang Q, Wang A, Lin Z. Structural and Functional Characterization of the Gut Microbiota in Elderly Women With Migraine. Front Cell Infect Microbiol. 2020;9:470.
9. Arzani M, Jahromi SR, Ghorbani Z, et al. Gut-brain Axis and migraine headache: a comprehensive review. J Headache Pain. 2020;21(1):15.
10. de Roos NM, Giezenaar CG, Rovers JM, et al. The effects of the multispecies probiotic mixture Ecologic®Barrier on migraine: results of an open-label pilot study. Benef Microbes. 2015;6(5):641-646.
11. de Roos NM, van Hemert S, Rovers JMP, et al. The effects of a multispecies probiotic on migraine and markers of intestinal permeability-results of a randomized placebo-controlled study. Eur J Clin Nutr. 2017;71(12):1455-1462.
12. Martami F, Togha M, Seifishahpar M, et al. The effects of a multispecies probiotic supplement on inflammatory markers and episodic and chronic migraine characteristics: A randomized double-blind controlled trial. Cephalalgia. 2019;39(7):841-853.