If you've noticed a recent increase in your migraine frequency or severity, it may be due to allergies

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June 3, 2020

If you have migraines you may have recently noticed an increase in your migraine headaches. We've been treating migraines at our clinic, Portland Chiropractic Neurology for over twelve years as Chiropractic Neurologists. We have specialized training in migraine care, concussion and vestibular rehabilitation and every year we notice mild-moderate increases in symptoms of our migraine patients during spring and fall seasons. Managing these allergy episodes can take many forms, but avoiding allergens (things you're allergic to), utilizing medications and supplements and referral to an appropriate Allergist-Immunologist can all be very helpful. We aim to treat the underlying source of the migraine through our core migraine rehabilitation program. We do this by restoring normal function within the trigeminovascular pathway that is shown to result in migraine pathology. This will ideally result in less sensitivity to allergens that are aggravating your migraine headache. We also know that oxygen levels and respiration are involved in migraines and therefore appropriate posture, spinal and rib function treated by a Chiropractor or Physical Therapist can be helpful to increase oxygen levels and desensitize the trigeminovascular pathway (see http://www.portchiro.com/blog/article/2020/4/30/migraines-proper-breathing-ph-oxygen-delivery/ for more information). Allergens can affect our lungs and gas exchange and should be considered as a potential contributor to increasing migraines in individuals. 

Histamine is a chemical we produce in our body when exposed to allergens and it's connected with Migraines. Histamine is synthesized and stored in Mast cells and Basal cells (1). In addition to that, exposure to allergins trigger your immune system to release certain chemicals. They can fuel inflammation throughout your body, all of which can set you up for a migraine. If you're prone to migraine headaches, your symptoms may be more severe during allergy season. Some people can also have "nonallergic" triggers like perfume, the smell of gasoline, cigarette smoke, and weather changes (2). 

If allergies trigger your migraine, you may have

  • Pain in your sinuses (behind your cheekbones and forehead)
  • Facial pain
  • "Sinus headache"
  • A throbbing or "stabbing" headache that's often one-sided
  • Nausea

Headache after infusion of histamine was thoroughly described and it was shown that histamine induced headache in a dose-dependent manner but that there was great variability between subjects (1)

Numerous studies have found that migraine is more common in those with hay fever and asthma. One study found that migraine occurred in 34% of persons with hay fever (allergic rhinitis) as compared to 4% of those without this disoder. Asthma is 1.2-1.6 times more prevalent in those with migraine than in those without it (5-8). 

There are numerous ways that these disorders could increase the frequency of migraine attacks. First, increased inflammation caused by these disorders might increase migraine. Second, nasal congestion caused by hay fever could directly activate the trigeminal nerve in the nose and trigger migraine. Also, it might cause snoring that could lead to sleep apnea that could precipitate headaches. Third, use of asthma medications such as albuterol might trigger attacks of migraine. Fourth, both hay fever and asthma activate nerves in the parasympathetic nervous system. It is possible that activation of these nerves increases migraine frequency (4). 

As discussed previously, referral to an allergist-immunologist may be helpful for you, as well as the appropriate treatment by a Chiropractic Neurologist to address other underlying sources of migraine that may be causing an increase in hypersensitivity along the trigeminovascular pathway. Migraine is defined as a disorder of sensory processing and results in abnormal activity within brain structures that relay sensory (pain) information to the cortex (3). Treatment as such by a Chiropractic Neurologist to manage your migraines can be life changing, as is for many of our patients at our clinic, Portland Chiropractic Neurology, which is located in Portland, Maine. We are accepting new patients at this time for those that are interested in receiving migraine care. You can read more about migraine care on our website at http://www.portchiro.com/our-care/condition/migraines/64/. Please let us know if you have any questions - you can call us at 207-699-5600, or email at drmacarthur@portchiro.com. 

 

References:

(1) Worm et al. Histamine and Migraine revisted: mechanisms and possible drug targets. The Journal of Headache and Pain volume 20, Article number: 30 (2019)

(2) https://www.webmd.com/migraines-headaches/migraine-triggers-allergies 

(3) Goadsby et al. Pathophysiology of Migraine: A Disorder of Sensory Processing. Physiol Rev 97: 553-622, 2017

(4) https://americanmigrainefoundation.org/resource-library/migraine-hay-fever-asthma-allergies/ 

(5) Davey G, Sedgwick P, Maier W, Visick G, Strachan DP and Anderson HR. Association between migraine and asthma: matched case-control study. Br J Gen Pract. 2002; 52: 723-7.

(6) Fernandez-de-Las-Penas C, Hernandez-Barrera V, Carrasco-Garrido P, et al. Population-based study of migraine in Spanish adults: relation to socio-demographic factors, lifestyle and co-morbidity with other conditions. J Headache Pain. 2010; 11: 97-104.

(7) Lateef T, Swanson S, Cui L, Nelson K, Nakamura E and Merikangas K. Headaches and sleep problems among adults in the United States: findings from the National Comorbidity Survey-Replication study. Cephalalgia. 2011; 31: 648-53.

(8) Aamodt AH, Stovner LJ, Langhammer A, Hagen K and Zwart JA. Is headache related to asthma, hay fever, and chronic bronchitis? The Head-HUNT Study. Headache. 2007; 47: 204-12.