What is migraine?
Migraine is one of the most common neurological disorders. According to a study by the Robert Koch Institute, approximately 15 percent of women and 6 percent of men in Germany meet the full diagnostic criteria for migraine (1).
Typical symptoms include recurring, often one-sided, throbbing headaches that may worsen with physical activity. Nausea, vomiting, and sensitivity to light, sound, and smells are also common. A migraine attack can last up to 72 hours and significantly impair quality of life.
Approximately one-third of those affected also experience what is known as an aura. This involves temporary neurological symptoms such as flashes of light, flickering vision, visual field defects, tingling sensations, or speech disturbances.
What happens in the brain during a migraine?
In people with migraine, certain networks of nerve cells in the brain are particularly sensitive to internal and external stimuli. An important role is played by the trigeminovascular system, which connects nerve fibres and blood vessels in the meninges.
During a migraine attack, signalling molecules such as CGRP (Calcitonin Gene-Related Peptide) are released. These influence pain transmission, dilate blood vessels, and are involved in so-called neurogenic inflammatory processes.
The brain's energy metabolism is also a focus of research. Studies suggest that the energy supply to nerve cells and the function of mitochondria, our cellular powerhouses, may be altered in people with migraine (2).
Migraine causes: Which factors play a role?
Migraine generally develops through a complex interaction of various unfavorable lifestyle and environmental factors that affect the body over an extended period and may initiate different mechanisms of damage. Certain genetic factors also increase the risk of developing migraine. Recurring migraine attacks should always be medically evaluated.
The following sections present important causes from the perspective of functional medicine and also discuss common triggers that frequently precede an attack in people with migraine.
Lack of sleep and insufficient recovery
Insufficient or irregular sleep can both directly trigger migraine attacks and contribute to the long-term development of the condition.
Important regenerative processes take place in the brain during sleep. These include the activity of the so-called glymphatic system, which is involved in removing metabolic waste products from the brain. Impaired glymphatic function increases the risk of disorders of the nervous system.
Getting sufficient, restorative sleep is therefore one of the most important preventive and therapeutic measures for migraine. Regular bedtimes and wake-up times are particularly important, ideally even on weekends. A dark, cool bedroom, avoiding heavy meals before bedtime, and a relaxing evening routine without screens can help improve sleep quality.
Acute and chronic stress
Acute psychological or physical stress can trigger migraine attacks. Symptoms may occur immediately or with a delay, for example, on weekends when tension subsides.
Short-term stress is initially a natural and important adaptive response of the body. However, in people with migraine, it can act as a trigger for an attack. It becomes particularly problematic when stress persists over time and adequate recovery periods are lacking. Chronic stress can increase susceptibility to migraine attacks through various physiological mechanisms.
Common causes of ongoing stress include work overload, family conflicts, and financial worries. These may be accompanied by physical stressors such as chronic infections, exposure to harmful substances, or overtraining. Often, several of these factors affect the body simultaneously.
Chronic stress influences numerous physiological processes: Sleep quality and gut health may deteriorate, potentially impairing the absorption of micronutrients in the intestine. At the same time, hormonal regulation and energy metabolism may be disrupted, while inflammatory signalling pathways may become increasingly activated. These processes, in turn, can affect the function and resilience of the nervous system.
Targeted stress management should therefore address two levels: In the short term, breathing exercises, yoga, meditation, or other intentional recovery breaks can help calm the nervous system. In the long term, it is important to identify chronic stressors and gradually reduce them.
Chronic inflammatory processes
Inflammatory processes play an important role in the development of migraine pain. In addition to local neurogenic inflammatory reactions, researchers are investigating whether chronic, low-grade inflammation throughout the body may also influence susceptibility to migraine.
Such inflammatory processes are associated with unfavourable dietary habits, lack of sleep, chronic stress, exposure to environmental pollutants, and nutrient deficiencies. From the perspective of functional medicine, chronic, low-grade inflammation is considered a contributing factor in the development of nearly all chronic diseases.
Gut health
A healthy gut is not only important for digestion and the absorption of macro- and micronutrients, which are also required for proper nervous system function, but also plays a central role in immune regulation and metabolic health. Changes in the gut microbiome and disturbances of the intestinal barrier can promote inflammatory processes in the body.
Through the so-called gut-brain axis, the gut and brain are in constant communication via neural pathways, immune signalling molecules, and microbial metabolites. Studies show that the composition of the gut microbiome in people with migraine differs in some respects from that of healthy control subjects (3). Whether these changes play a causal role in the development of migraine is still being investigated.
Important measures to support gut health include good eating habits, such as chewing thoroughly and eating in a relaxed environment, as well as choosing a diet rich in vegetables, fiber, protein, and healthy fats, prioritizing whole foods and avoiding highly processed convenience foods.
Energy metabolism and blood sugar
The brain has a high and continuous energy demand. Prolonged fasting, skipping meals, or major fluctuations in energy intake can trigger migraine attacks in susceptible individuals.
To maintain a consistent energy supply, a diet that promotes stable blood sugar levels is recommended, with regular meals containing sufficient protein, fibre, and complex carbohydrates. Sugary foods and products made from refined white flour should be avoided, as they can cause pronounced blood sugar fluctuations.
Micronutrient supply
The body requires micronutrients such as minerals, trace elements, and vitamins for all cellular functions. Inadequate nutrient intake can impair metabolic processes that are relevant, for example, to the normal functioning of the nervous system. Magnesium, vitamin B2 and other B vitamins, as well as coenzyme Q10, are among the nutrients and substances important for healthy nervous system function.
Before taking supplements, individual micronutrient status should be assessed through laboratory testing. This allows existing deficiencies to be corrected in a targeted manner.
Hormonal fluctuations in women
The fact that women are affected by migraine significantly more often than men is partly related to hormonal influences.
Changes in estrogen levels, in particular, can promote migraine attacks. Many women therefore report more severe symptoms shortly before or during menstruation. During perimenopause, when hormone levels fluctuate increasingly, migraine patterns may also change.
After menopause, symptoms improve in some women, while in others they persist. The relationships are highly individual. Bioidentical hormone therapy may be a possible treatment option. This should, of course, only be undertaken under professional medical supervision.
Histamine and food intolerances
Histamine is a natural signaling molecule that influences vascular regulation and pain processing, among other functions. Researchers are also investigating a possible connection between histamine, mast cell activity, and the migraine-related signalling molecule CGRP (4).
Some individuals react to histamine-rich foods such as red wine, aged cheese, salami, or fermented products. Other food intolerances may also play a role. Keeping a food diary can help identify actual connections. However, avoiding healthy foods that act as individual migraine triggers should only be considered a short-term intervention rather than a treatment. Instead, the goal is to address the underlying cause of the symptoms, such as impaired gut health and immune regulation, and restore long-term tolerance.
Exposure to harmful substances and external stimuli
Harmful substances from the environment, cosmetics, household products, or food promote inflammation and oxidative stress in the body and represent a relevant source of chronic stress in modern life. Observational studies have shown a direct association with migraine, for example, in relation to exposure to air pollutants such as particulate matter and nitrogen dioxide (5). Of course, it is impossible to avoid harmful substances entirely, but conscious purchasing decisions can significantly reduce everyday exposure.
Many people with migraine are also particularly sensitive to external stimuli. Potential triggers include weather changes, flickering lights, noise, strong smells, and prolonged screen time. A migraine diary can help identify individual triggers and avoid them more effectively.
Dehydration and electrolytes
Insufficient fluid intake can cause headaches and, in susceptible individuals, may also promote migraine attacks. Fluid requirements increase particularly in hot weather, during physical activity, or with heavy sweating. Regular hydration and an adequate supply of electrolytes are therefore important preventive measures.
Suitable Allvital products at a glance
The following dietary supplements may play a role in the holistic treatment of migraine, as they can, for example, contribute to healthy nervous system function or energy metabolism, regulate inflammatory responses, or support gut health:
· Magnesium Plus: Combines magnesium citrate with vitamin B6. Both nutrients contribute to the normal functioning of the nervous system and energy metabolism. Magnesium also supports electrolyte balance, normal muscle function, and many other metabolic processes.
· Vitamin B Complex: Contains all eight B vitamins, including vitamins B2, B6, and B12. Vitamin B2 contributes to normal energy metabolism, while vitamins B6 and B12 support the normal functioning of the nervous system.
· Coenzyme Q10: Provides 50 mg of coenzyme Q10 per capsule, combined with alpha-lipoic acid, resveratrol, OPC, and curcumin. Coenzyme Q10 occurs naturally in mitochondria and plays an important role in mitochondrial energy production.
· DHA plus EPA: Contains the long-chain omega-3 fatty acids DHA and EPA derived from high-quality microalgae oil. DHA contributes to the maintenance of normal brain function and is an important component of nerve cell membranes.
· Vitamin D3 + K2: Combines vitamin D3 and vitamin K2 in a convenient liquid drop formulation. Vitamin D contributes to normal immune system and muscle function and helps maintain healthy bones. It is also involved in magnesium metabolism.
· ProBio 14: Combines 14 selected bacterial cultures with the prebiotic fibres inulin and fructooligosaccharides and was developed as a synbiotic to support healthy gut flora.
· Gut-Brain Complex: Contains L-glutamine, sodium propionate, choline, cat's claw, and lapacho, among other ingredients. Sodium propionate serves as an energy source for intestinal epithelial cells. The formulation was specifically developed to support the gut-brain axis.
Sources
1. Robert Koch Institut. Migräne und Spannungskopfschmerz in Deutschland. Prävalenz und Erkrankungsschwere im Rahmen der Krankheitslast-Studie BURDEN 2020 - Journal of Health Monitoring S6/2020.
2. Gross EC, Lisicki M, Fischer D, Sándor PS, Schoenen J. The metabolic face of migraine - from pathophysiology to treatment. Nat Rev Neurol. 2019;15(11):627-643.
3. Mugo CW, Church E, Horniblow RD, et al. Unravelling the gut-brain connection: a systematic review of migraine and the gut microbiome. J Headache Pain. 2025;26(1):125. Published 2025 May 21.
4. de Mora F, Messlinger K. Is calcitonin gene-related peptide (CGRP) the missing link in food histamine-induced migraine? A review of functional gut-to-trigeminovascular system connections. Drug Discov Today. 2024;29(4):103941.
5. Portt AE, Orchard C, Chen H, Ge E, Lay C, Smith PM. Migraine and air pollution: A systematic review. Headache. 2023;63(9):1203-1219.
