Depression is the most common comorbid disease seen in migraine patients. These two diseases have a lot in common:
• Serotonin metabolism disorders
• Sleep problems
• Western type diet
• Exposure to childhood trauma
• Increased intestinal permeability (leaky gut)
• Lack of physical activity, sedentary life style
• Vitamin D deficiency
• Vitamin B12 deficiency
• Folic acid deficiency
Like migraine, fibromyalgia pain is caused by central sensitization. Both diseases have many underlying similarities. Treatment of on disease is beneficial in the treatment of the other.
Tension type headache
Migraine patients frequently have tension type headaches; patients with tension type headaches often have migraine headaches. At times, neither the patient nor the doctor can differentiate the. Treatment for one is usually beneficial for the other.
Factors that increase both are:
• Sleep problems
• Daily chronic stress
• Depression and /or anxiety
• Jaw joint disorders
• Tooth grinding (bruxism)
• Long office hours
• Spending extended periods in badly ventilated environments
Postural disorders, bad posture
• Eye fatigue
• Too much coffee / caffeinated beverage consumption
• Metabolic syndrome
• Being overweight
Problems caused by neck and constipation can increase or reduce the pain while it is common with migraine.
Metabolic syndrome has the following 5 features:
• Insulin resistance / high blood sugar
• Abdominal obesity
• High triglyceride levels
• Low HDL cholesterol (beneficial cholesterol).
Metabolic syndrome aggravates migraine headaches by causing inflammation, insulin resistance and abdominal obesity. High blood pressure also causes migraine worsening.
As the body mass index increases, both migraine and tension type headache are more likely to be seen, and existing pain may be more severe and frequent.
Underlying factors are:
Inflammatory structure of the fat tissue
Obstructive sleep apnea syndrome and snoring
Serotonin metabolism disorders
Exposure to childhood trauma
Lack of physical activity, sedentary life style
Increased intestinal permeability (leaky gut)
HPA axis defects
Increased sympathetic system dominance
Allergies and migraines are often seen together. Having a family history and sharing similar environments have important roles in both of the diseases.
Atopic patients are genetically predisposed to both allergies and asthma. The external conditions, foods, additives and stress that triggers asthma; can also trigger or aggravate migraine pain. Asthma is sometimes defined as pulmonary migraine.
Migraine patients are genetically predisposed to cardiovascular diseases.
Obstructive sleep apnea syndrome
Western type diet
Excessive salt consumption
Intensive smoking and alcohol consumption; all can affect both migraine and blood pressure negatively.
Migraine patients have a greater risk of cerebrovascular diseases. In addition, women who have migraine with aura, use contraceptive /hormone replacement therapy, are over the age of 45 and smoke have have a higher risk of stroke.
Patent foramen ovale
This passage in the heart that usually closes during birth remains open in one of 10 people. This frequency is increased in migraine patients, the risk being higher in patients with migraine with aura; the probability of having an open patent foramen ovale is 40-70%.
Mitral valve prolapse
This congenital anomaly of the mitral valve is seen in one in 40; but the migraine patients have an increased risk; it is found in one of every 4 migraine patients.
Obstructive sleep apnea syndrome
Migraine patients frequently have snoring and sleep apnea. This association is much more frequent in patients who are overweight, have metabolic syndrome and male.
Temporomandibular (jaw) joint disorders /bruxism (grinding teeth)
Genetic susceptibility, stress and weight gain both aggravate jaw pain and migraine. An increase in migraine pain may be seen due to the close proximity of trigeminal nerve to the temporomandibular joint. Widespread can also increase migraine headaches secondary to muscle pain and tenderness.
This severe headache is more common in migraineurs than in the community; cluster headache attacks can also trigger migraine attacks.
The cortical spreading depression is thought to cause both epilepsy and migraine. Both diseases are thought occur due to nerve cell membrane ion transportation problems. Apart from this; stress, insomnia, hunger, bright and flickering lights, menstruation, using birth control pills, consuming alcohol can cause attacks of both diseases. Many drugs used and are beneficial in the treatment of epilepsy are also beneficial for migraine headaches. Patients with epilepsy often have aura migraine in their relatives.
Restless legs syndrome
Restless legs syndrome causes an urge to move the legs and a relief of discomfort on moving them. Both migraine and fibromyalgia are more common in these patients. Secondary to sleep disruption and low quality sleep, migraine and tension-type headaches and fibromyalgia pain can be triggered.
Immune system diseases:
Migraine headaches can worsen secondary to increased inflammation and increased intestinal permeability.
Hypothyroidism alone or in combination with inflammation, metabolic syndrome, and weight gain can increase migraine and fibromyalgia pain. Hypothyroidism can also cause chronic migraine headaches and treatment failure.