Headaches: The Functional Medicine Approach to Why and How to Heal Them

Do you suffer from headaches? 

If so, how often? Do you just aim to treat the pain caused by the headache?

Have you wondered why you might be getting these headaches in the first place?

This is key to getting rid of them for good!

In functional medicine, headaches are considered to be a symptom of an underlying imbalance or dysfunction in the body. The approach of functional medicine is to address the root cause of health issues rather than just treating the symptoms.

Headaches can be caused by a variety of factors in functional medicine, and some of the common underlying causes include:

• Inflammation: Chronic inflammation in the body can trigger headaches. This inflammation can result from factors such as the standard American diet - after all it is the main way we interface with our environment!  It stimulates your immune system as most of it isn’t really even food but “food like substances” according to journalist Michael Pollan. Food sensitivities, gut issues such as a microbiome imbalance or dysbiosis, infections, or chronic stress. Elevated cortisol from chronic stress can mean metabolic dysregulation including glucose and insulin spikes which contribute to inflammation.
• Dehydration: Inadequate hydration can cause headaches in some individuals. This can be due to fluid and electrolyte imbalance.
• Hormonal imbalances: Fluctuations in hormones, particularly in women during their menstrual cycles, can lead to headaches. This may include imbalances in estrogen and progesterone levels.
• Nutritional deficiencies: Inadequate intake of certain nutrients like magnesium, B-vitamins, and Coenzyme Q10 can contribute to headaches. When you eat a nutrient depleted diet such as a standard American diet, you become malnourished despite being possibly overweight.
• Gut health: This is a BIG one! Problems with the gut, such as leaky gut or imbalanced gut microbiota, can impact overall health, including triggering headaches. All factors mentioned above influence this. 
• Food sensitivities: Certain foods can cause inflammatory reactions in the body and lead to headaches in susceptible individuals. Some common ones are wheat, citrus, eggs, tea and coffee. Food sensitivities often develop as a consequence of leaky gut. Many people have a leaky gut or enhanced intestinal permeability which allows partially digested foods to sneak across the gut mucosal barrier into our bloodstream. This activates our immune system and marshalls many substances that cause inflammation throughout our body. It’s ALL related. Tyramine containing foods, such as cheese, cured meats, alcohol and vinegars are common triggers, as are tannins, such as in tea and wine. Artificial sweeteners and additives such as MSG can trigger headaches in some. And sulfites in wine and cheese are well known triggers.
• Histamine Intolerance: Histamine, a necessary biological substance, dilates blood vessels. It is necessary, especially if you have an allergy to something. A big reason why someone may have a histamine intolerance is gut dysfunction. Certain bacterial overgrowths in dysbiosis can cause this as these bacteria produce excess histamine. Leaky gut including a damaged brush border in the colon where DAO, the enzyme needed to break down histamine, also contributes. Hormone imbalances involving estrogen also play a key role in histamine.
• Toxic exposure: Exposure to environmental toxins like heavy metals or chemicals can contribute to headaches. You may be bombarded with these each and every day via the food you eat, the air you breathe, the chemical laden personal hygiene and household products you use. These exposures are cumulative and all add up, especially if your drainage pathways are not working as well as they should - think pooping, peeing and sweating.
• Stress and emotional factors: Chronic stress, anxiety, and emotional tension can lead to headaches through various mechanisms, including muscle tension and altered neurotransmitter levels. Many of us do not know how to regulate our nervous systems due to early primed stress responses in childhood - since it’s the only thing we know, we often think it’s a normal response. It’s not and there are many ways to begin to help heal this chronic pattern and allow ourselves to experience the necessary rest, digest and repair state.
• Sleep disturbances: Poor sleep quality or insufficient sleep can be a contributing factor to headaches. Optimal phases of sleep is when the magic happens - it’s the time when we clear alot out via detoxification. Our liver is very active during sleep as well as our lymph systems and minds in processing emotions and toxins - both chemical and emotional.
• Neck and jaw issues: Problems with the neck, such as tension or misalignment, or temporomandibular joint (TMJ) dysfunction, can manifest as headaches. This was a factor for me. I sought orthodontia care for a malocclusion - a misaligned skeletal bite and it helped. It wasn't the only issue that caused headaches for me but correcting it certainly helped.

It's important to note that each individual may have a unique combination of factors contributing to their headaches. Functional medicine practitioners aim to identify and address these underlying causes through a comprehensive evaluation of the patient's medical history, lifestyle, and functional testing, if necessary.

Here are some steps to consider to sustainably heal from headaches:

1. Identify Triggers and Patterns: Keep a detailed journal of your headaches, including when they occur, what you were doing prior to the headache, your diet, sleep patterns, stress levels, and any other relevant factors. This can help you and your functional medicine practitioner identify potential triggers and patterns.
2. Nutritional Assessment: Diet can play a significant role in triggering headaches. Work with a functional medicine practitioner to assess your diet and identify any potential food sensitivities, allergies, or deficiencies that could be contributing to your headaches. They may recommend eliminating certain foods temporarily to see if there's an improvement.
3. Gut Health: Gut health is closely connected to overall well-being. Imbalances in gut bacteria can contribute to inflammation and other health issues, including headaches. Your functional medicine practitioner might recommend gut health assessments and interventions, such as probiotics, prebiotics, and dietary changes to support a healthy gut.
4. Hormone Balance: Hormonal imbalances, particularly in women, can be linked to headaches. Hormones like estrogen and progesterone can play a role in triggering migraines. Hormone testing and balancing strategies may be explored as part of your functional medicine approach.
5. Stress Management: Chronic stress can contribute to headaches. Incorporate stress-reduction techniques into your daily routine, such as mindfulness meditation, deep breathing exercises, yoga, or tai chi. These practices can help reduce the frequency and severity of headaches.
6. Sleep Optimization: Poor sleep quality or inadequate sleep can trigger headaches. Focus on improving your sleep hygiene by establishing a consistent sleep schedule, creating a calming bedtime routine, and creating a comfortable sleep environment.
7. Detoxification: Environmental toxins can contribute to headaches. Your functional medicine practitioner may guide you through a detoxification process to reduce your body's toxin load, potentially alleviating headache symptoms.
8. Supplementation: Based on your individual health assessment, your practitioner might recommend certain supplements that could help alleviate headaches. Common supplements for headache relief include magnesium, riboflavin (vitamin B2), CoQ10, and omega-3 fatty acids.
9. Physical Activity: Regular exercise can help reduce the frequency and severity of headaches. Engage in moderate, consistent physical activity, but be mindful not to overexert yourself, as intense exercise can sometimes trigger headaches in susceptible individuals.
10. Holistic Approaches: Functional medicine often embraces a holistic approach, considering all aspects of your well-being, including emotional, mental, and spiritual factors. Techniques like acupuncture, chiropractic care, and herbal medicine may also be explored in collaboration with your functional medicine practitioner.

Remember, each person is unique, and what works for one individual may not work for another. It's important to work closely with a qualified functional medicine practitioner who can tailor an approach to your specific needs and circumstances.