Deeper into Migraine, Glucose and Insulin…

There’s a lot of talk about migraine and sugar levels.  At one time or another, it seems everyone suspects there’s a strong relationship.  So it really is surprising how little we talk about it, and how little research has come out to explain it.

One little study coming out of Austria published this month in the journal Cephalalgia is getting the conversation going again.  The study set out to investigate things like glucose, insulin, and something known as "nitric oxide stress" in migraineurs.

Now there’s a lot to explain here, so stay with me and I’ll try to give you a simple overview.

All three of these things – glucose, insulin, and nitric oxide, are interrelated.  It’s common for people with diabetes, for example, to have impaired nitric oxide (NO) pathways.  Too much or too little NO in your body can cause problems.

Now NO has an amazing influence on all kinds of things in your body.  It has to do with regulating blood flow in your blood vessels (through smooth muscle function).  It plays a role in inflammation.  Proper levels in your body may help prevent heart disease, influence how you feel pain, and even impact your memory.  You can already see how a migraineur may be interested in research related to nitric oxide.

Coffee Donut Glucose

But when there are problems with NO production or elimination, this can lead to too much insulin in the body (hyperinsulinemia).  Hyperinsulinemia may actually have no symptoms on its own, but it could lead to things like low blood sugar, and may lead to the development of insulin resistance and type 2 diabetes.  And this brings us back to questions of carbohydrates and glucose and the glycaemic index and all those things that have to do with blood sugar levels, diabetes and hypoglycemia.

Back to our study.  Using various parameters and tests on 48 migraineurs and 72 non-migraineurs, the researchers found that migraineurs were significantly more likely to have hyperinsulinaemia (hyperinsulinemia), and so showed signs of increased nitric oxide stress.

I hope you’ve followed me so far, and see the value of the study.  What we’re looking for is evidence that can be tested that migraine patients do have insulin related problems.  This gives us a glimpse into a web of related functions in the body – nitric oxide pathways, insulin production, glucose, and so on, and how these things may not be functioning properly in the person with migraine disease.

Not only is it a step into a new world of treatment, it’s also another confirmation of what we already knew – there is a relation between migraine and blood sugar levels.

Because of this, two things.  First, the way we eat and the way we exercise can make a difference in our symptoms, and this gives us a clue of how to think about it.  Second, just eating differently and exercising may not be enough for many of us.  The research needs to continue to see why the body is not functioning the way it should be.

Summary of the study:  Hyperinsulinaemia in migraineurs is associated with nitric oxide stress.
Another study currently in process related to nitric oxide stress and insulin

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27 comments… add one
  • Paula Kirsch Oct 4, 2009

    One thing I have noticed over the years (I have had migraines since age 9) is that I can eat things early in the day with no problem, but IF I eat the same things late in the day they will trigger a migraine. Wonder if this relates to the above?

    • Shalom Sep 8, 2010

      I’m the opposite. If I have a long fasting period (more than 10 hours) or if I’ve had a smallish dinner and I take something sweet in the morning I’m a goner in approximately 4-6 hours and the migraine will last for the next 48 to 72 hours.

    • Catmoon Oct 27, 2016

      Yes! If I eat yoghurt in the evening or eating after 9pm I’m sure to have a migraine the following morning these days. Pasta too I’ve noticed can feel unwell for 48 hours. ☹️

  • Megan Oct 4, 2009

    This is something that I have also noticed but my migraines do not occur until the next day when I wake up. Could there be a connection?

  • James Oct 5, 2009

    That’s interesting – I’m not sure how different times of the day would relate, but I’m sure it would. There could be other reasons as well why eating something later could have an impact – for example, a build-up of other triggers.

    Certainly many people have reported a significant “delayed reaction” when it comes to food triggers.

  • Aurora Oct 7, 2009

    The “smertesykepleier” literally pain nurse in English explained to me of the idea of strengthening my migraine threshold by not eating the triggers and attacking the attack early on; I understand now that it also works the same with my food allergies—some days I can tolerate eating prawns without taking antihistamine. Then one day, wham! I get thick lips and swollen ears. The bathtub is full, James. But one thing’s sure for me, the day after I have eaten hotdogs, I get an attack. I saw the pattern in my diary.

  • Linda Oct 21, 2009

    Hot dogs and all packaged lunch meat are a definite no-no for me. I’ve also noticed the sugar connection. I love my sweets. I can usually tollerate them early in the day, but I try hard not to eat anything after dinner. I do so much better if I go to bed on an empty stomach. When I’ve had food, especially something sweet before bed, I can feel the pressure behind my eyes when I wake up. Usually a cup of coffee shakes it out, but sometimes not, and I’m uncomfortable for the most of the morning.

    • Rhiannon Oct 10, 2017

      Processed meat often have sodium nitrate or potassium nitride in them…

  • Laurie Oct 23, 2009

    I notice that when I have a migraine, I usually crave high carb foods. If I eat pasta and have a soda the pain usually eases up.

  • Susan Oct 26, 2009

    I used to love pepperoni pizza, but would always get a killer migraine two days later. It took me awhile to notice the connection since it was that delayed, but once I did, I realized that it happened every time. Now I rarely eat pizza, and if I do, I definitely leave off the pepperoni. Certainly not worth the day (or more) in pain!

  • Leslee Oct 26, 2009

    My migraines with visual aura have been ocurring mostly midmorning when I am hungry. I have long suspected a drop in blood sugar as being the trigger.

  • James Jan 26, 2010

    Thanks for your examples. Yes, processed meats are generally a trigger – and probably not all that good for you anyway! 🙂

    One other challenge is that cravings are sometimes mistaken for triggers when they’re not. Of course, eating a food you crave may be a trigger, but sometimes the migraine attack causes you to crave something before the attack is in full swing.

    For many people, this may be the case with chocolate – not a trigger for you, but you tend to crave it early in the attack.

  • Tammy Feb 3, 2010

    I have suffered from migraines for ten years and currently take high doses of topamax to manage them and imitrex several times a week to manage the attack. I have always suffered with my headaches when I wake up at 4 – 5 in the morning. By then it’s too late for preventive medicine and usually have to take a shot. Recently, I was trying to lose a few lbs (from preganancy) and do some healthy detox and started fasting alternate days. I immediately noticed on the days that I didn’t eat dinner, I didn’t have a migraine. I was totally surprised because I had done always thought the opposite. So I tried to eat some small portions and healthy foods on the alternate days….didn’t work, I still got a headache…..not a migraine. Definitely different! Can’t remember the last time I just had a headache. Anyway, Over the past few weeks, I have stopped eating dinner and it has been amazing….I can’t tell you the difference. I don’t have diabetes but wonder if I do have some type of insulin problem. I do have hashimoto thyroiditis and take supplement for that. I’m 5’8″ and now weigh 125 lbs. Never been over weight just a heavy migraine sufferer trying to figure out how to find a cure! Thought someone else should try this because after ten years this is working for me. I’m going to try to start taking myself off of the topamax if this continues to work for me. I have also started taking a natural progesterone too.

    • Sara Oct 7, 2010

      Hi Tammy,

      My 19 year old daughter has had a low grade daily chronic migraine every day since February, 2010. She started on Topamax in July and gradually increased up to 125 mg over 2.5 months. Over the last month her headaches increased in intensity with earlier onset, and the headaches spike 45 minutes to one hour after eating, no matter what she eats and no matter how little she eats. I have read that Topamax increases sensitivity to insulin. Her neurologist does not believe she is having blood sugar issues, but it sure looks like it. I was wondering how you are doing off of the Topamax?

  • Shalom Sep 8, 2010

    Many years ago I read a book written by a medical professional with lots of great research and charts in it which really helped my migraine but I lent it to a friend and forgot the title. It talked about the relationship between gluten intolerance, glycemic index, insulin, blood sugar and migraine. The summary of it is don’t spike the blood sugar level too high and then go too low. This triggers migraines hours later.

    For instance, don’t drink on an empty stomach or drink too much alcohol if you’re going to go for hours later without eating, which is most likely the case if you got drunk.

    If you sleep a lot and the time between your first real meal and your last is more than 12 hours don’t take something sweet or high in glycemic index when you wake. Many cereals and processed foods (crackers, biscuits, white rice) contain a lot of sugar, including milk and juices. General rule : don’t take sweet things when you’re feeling VERY hungry. Try drinking a glass of warm water before.

    Don’t go without food for more than 6 hours unless you have moved to all low glycemic index food for some time and done detox to restore liver and pancreas function. When you do eat stay away from highly processed, deep-fried, sweetened food even though you’re most likely tempted to eat those types of food.

    Eat small regular meals. Make sure you have something healthy to standby for breakfast.

  • Cheryl Apr 30, 2012

    I also get migraines due to the heat, so I can’t do garden work or have to be very cautious not to get overheated and after some research found out that blood sugar drops when you are overheated. I notice that after I eat, if I get very sleepy, the next day I will have a migraine, even if it was just a salad and not a high carb meal. Very frustrating trying to figure it out.
    If I load up on magnesium at the start, I can reduce a 3 day migraine into 1. I have also noticed that my bowel movements have an offensive odor during the migraine, which leads me to think there is problem digesting something so it just sits there fermenting in my gut and hence causes me constipation. My first clue I’m going to get a migraine are muscle spasms or I’m constipated. I”ve just started keeping a food diary.

    • Melissa Apr 1, 2017

      Have you tried probiotics? I’ve read in many places that your gut is your 2nd brain.
      (I know this is an old post, so FWIW).

  • Garry May 12, 2012

    I usually get migraines every 1-2 weeks. I’ve tried vitamin D3 and Magnesium. They have taken the edge off much of my anxiety and depression associated with the migraines (my auras). I once tried a low carb diet for 3 weeks. No migraines. I now use Topamax. Migraines have gone for good. It must work because of how it affects the GABA levels. I am currently back on that low carb diet thanks to the topamax because all of my sugar cravings have gone too. Miracle drug.

  • Lynn Sep 3, 2013

    Yeah, there’s nothing like vigorous exercise that can give me a raging migraine and I have serious insulin resistance. They tell me to exercise. It’ll help improve the insulin resistance. Sure. Let me tell you something. It doesn’t. Fun fun fun…but I’m on Qsymia now and wow, I’m just eating the same low carb diet I’ve been eating for the past ten years and just wow. It’s only been 3 week and 6 lbs have fallen off. I’m even thinking about doing some vigorous exercise in the hopes I won’t get a migraine. 🙂

  • Nigel Ricketts Mar 31, 2014

    Just saw this thread. I started getting migraines after knee surgery about 10 years ago. Had a massive one the day after and were frequent ever since. 18 months ago I was diagnosed as a late onset Type 1 diabetic and put on insulin. Ever since, no migraines. It appears that for me injecting myself with insulin a few times a day has eliminated by migraines. I wonder if anyone has looked to treat migraine symptoms with an insulin injection?

  • brown sugar May 1, 2016

    I cut sugar and caffeine completely for 1 month. Used to have migraines once a week. None as of yet. My last headache was extremely mild and far from debilitating. Post exercise headaches are nonexistent after I quit the sugary drinks. Not sure about my Ha1c but my blood pressure went down so that’s another plus.

    I think both sugar and caffeine are suspicious causes. I recommend eating an apple or orange over the fruit juice of soda. Helped me out tremendously and I hope to continue this. I still eat carbs, just no added sugar.

  • marcus May 8, 2017

    The article refers to a scientific publication in the journal Cephalalgia. Unfortunately there is no link to the scientific article and neither does this article mention the names of the authors and/or the title of the article. Although this article is well written and informative the lack of referring to the source that brings evidence of what is stated here is a regretful omission. Maybe the author can be so good to reveal his reference?

  • Stefan May 31, 2017

    Interesting read. I have migraine with aura and speech impediments followed by severe 6-12 hours headaches.

    I have since the early 80’s and my teens “known” from experience there is a connection between sugar, blodsugar and my migraines. I tried to explain this to doctors through out the years but they have brushed me off, saying there is no such connection. I really didn’t care, because I knew.

    However, If I don’t eat enough and then exercise, I get migraines. I was an elite athlete from the age of 14 so this became pretty clear quite early. Also If I don’t eat, for lets say 5-6 hours, and then have one or 2 fruits or a marsbar or something high suger like that, I get a migraine, no mercy ever.

    If I don’t eat breakfast I’m likely to get a migraine just before lunch, not always, but maybe like a 30% risk.

    If I eat every third hour, like diabetic do, I never get migraines. I only get migraines when I’m sloppy with my food, so nowadays I get migraines like once a year, almost every time on weekends when I have slept in and got out of my “eat every three hour routine”.

    I also discovered that I can make a migraine attack shorter if I stuff myself with fat, high energy food when the aura appears (like peanuts, chips and olives). I have to be quick though, before the nausea sets in…

    The booze method (I learned about this method from my grandma, though she had promised my mother not to tell)
    The only way I know how to more or less stop an attack is to drink booze …fast, like half a litre of pure liquor in few minutes (whiskey or vodka or something like that. 🙂 But for practical reason that only work if your home, but it is sort of problem anyway since you might have to explain to people why you are pissed on a Wednesday evening, so I really don’t go down that road unless I know I will be alone and don’t expect any visitors or phone calls. This hardly ever happens since I have family. Also telling people you are drunk because you need to stop a migraine will only make them think you actually never have migraines, but in fact are a drunk, blaming hangovers on migraines, so I don’t recommend this method at all. We all know how much suspicion you get from employers, teachers and colleagues when you miss a a days work, a school day or exam because of migraine. People always doubt you, and adding to that doubt might be really damaging to career and social life… So this method is probably only usable if you live the “university life” and no one really raises their eyebrows on the fact that you are wasted in the middle of the week. I used this method as a student a few times, but stopped when I left the university…. 🙂

  • Wendy Oct 14, 2017

    Are you familiar with Dr. Kraft’s work on insulin? The ENT’s connected migraine’s, tinnitus, Meneirs with hyperinsulinemia years ago. As a lifelong sufferer of migraines (since 10 years of age) my migraines have stopped in their tracks with Intermittent Fasting, Ketogenic (keeping insulin low for longer periods of time). I think you will find this interview fascinating if you have not already studied this.

  • Vicky Jan 6, 2018

    Lots of good discussion here. I am a high exerciser and know there is a relationship with migraine but having been led down the popularist food allergy and intolerance path by the media and a nutritionit that I wasted money on, I am now thinking that my migraines are due to improper fueling. However if out for a whole days cycling for example the body struggles to eat enough food and a heavy dinner around 8 pm can often trigger a migraine. Fasting is not an option for an athlete! Any thoughts on this from anyone?

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