Why Are We Seeing So Many More Migraines?
I keep seeing more and more clients come to me with migraines, and it has become a much bigger piece of what I do than I ever expected.
Some have lived with them for decades. Others developed them seemingly out of nowhere. Some experience aura, others don't. Some can pinpoint obvious triggers, while for many they appear completely random.
Yet the more I read, the more convinced I am that migraines are far more interesting - and far more complex - than we have traditionally given them credit for.
More than a bad headache
Migraine is one of the most common neurological disorders in the world and one of the leading causes of disability globally. But describing it as "just a headache" completely misses the point.
A migraine can involve nausea, vomiting, sensitivity to light, sound and smell, visual disturbances, cognitive changes, fatigue, mood shifts and, for around one-third of sufferers, aura symptoms before the pain even begins. For many people, it affects work, relationships, confidence and the ability to make plans with any certainty.
Migraine is a whole-brain event
Researchers increasingly describe it as a heterogeneous neurological syndrome rather than a single disease. In other words, there isn't one migraine pathway, one migraine trigger, or one migraine solution.
An evolutionary trade-off?
One question that fascinates researchers is why migraine remains so common throughout human history. If it were entirely disadvantageous, why would the genes associated with it persist so strongly?
Some scientists have proposed that migraine may represent an evolutionary trade-off. The same individuals who are highly sensitive to light, sound, smells, weather changes and subtle shifts in their environment may once have offered advantages to their communities through heightened awareness and vigilance. While we cannot prove that migraine sufferers made better "night watchmen" for early human groups, the broader idea - that increased sensory attunement comes with both benefits and costs - is increasingly discussed in evolutionary medicine.
The very traits that make certain brains exceptionally perceptive may also make them more vulnerable to overload.
The energy story: where the research is heading
Perhaps the most exciting area of migraine research today centres around energy metabolism.
Our brains are incredibly expensive organs to run. Although they represent only a small proportion of our body weight, they consume enormous amounts of energy and have very limited capacity to store it. Unlike muscle or liver tissue, the brain depends on a constant supply of fuel.
That energy is packaged in the form of ATP (adenosine triphosphate) the body's fundamental energy currency. Every thought, every movement, every heartbeat and every repair process relies upon ATP production.
And the brain is particularly demanding.
Dr Elena Gross and others have highlighted evidence suggesting that people with migraines may experience reduced ATP availability between attacks, with some studies demonstrating approximately 16% lower brain ATP levels compared with healthy controls.
If the brain's energy requirements exceed the energy available, problems begin to emerge.
This has led researchers to investigate whether migraine might, at least in part, be a disorder of impaired energy metabolism, mitochondrial dysfunction and oxidative stress.
Mitochondria matter
Mitochondria are often called the powerhouses of the cell because they generate the vast majority of our ATP.
When mitochondrial function is compromised - whether through nutrient deficiencies, inflammation, oxidative stress, environmental toxins, poor sleep, chronic stress, or genetics - energy production becomes less efficient. The brain, with its enormous demands, may be one of the first organs to notice.
This framework suddenly helps explain why so many seemingly unrelated migraine triggers exist.
Stress increases oxidative stress and consumes metabolic resources.
Skipping meals reduces available fuel.
Poor sleep alters hormonal rhythms and mitochondrial function.
Alcohol increases oxidative stress and interferes with glucose production.
Hormonal fluctuations, particularly falling oestrogen levels, may reduce protection against oxidative damage.
Even weather changes can alter oxygen availability and place additional demands on energy production.
Perhaps these are not dozens of independent triggers....
Perhaps they are different ways of challenging an already energy-hungry brain.
Precision medicine, not one-size-fits-all
The future of migraine treatment is almost certainly going to be more personalised.
Researchers increasingly recognise that migraine is a syndrome with multiple underlying drivers. Genetics, hormones, nutrient status, metabolic health, inflammation, sleep quality and environmental exposures all interact in different ways for different people.
For one person, stabilising blood sugar may be transformative.
For another, addressing iron deficiency changes everything.
For someone else, histamine intolerance, hormonal shifts, or chronic stress may be the dominant factor.
One client eliminated gluten and it changed her life.
The goal is no longer simply to ask, "What treats migraine?"
The better question is: "What is driving this person's migraines?"
What can we actually do about it today and at home?
While there is no universal answer, there are several evidence-informed strategies that consistently emerge from both the research and clinical practice.
1. Stabilise energy availability
If migraine is partly an energy problem, maintaining a reliable supply of fuel becomes incredibly important. You'll be used to me saying all this by now.
That means:
Eating regular meals.
Avoiding long periods of fasting if they are a trigger.
Prioritising adequate protein intake.
Reducing reliance on ultra-processed foods.
Supporting healthy blood sugar regulation.
For some individuals, lower-carbohydrate or ketogenic approaches may offer benefits by increasing ketone availability as an alternative fuel source for the brain. Ketones appear to provide a particularly efficient form of energy when glucose metabolism is impaired. But this is not for everyone.
2. Prioritise the basics
One of my favourite frameworks is the SEEDS approach:
Sleep. Exercise. Eat. Diary. Stress management.
Not because it is revolutionary, but because it addresses the foundations upon which resilient brain function depends.
Consistency often matters more than perfection.
3. Investigate nutrient status
Several nutrients have been studied for their role in migraine prevention and management, particularly those involved in mitochondrial energy production and nervous system function.
These include:
Magnesium
Riboflavin (Vitamin B2)
CoQ10
Omega-3 fatty acids
Vitamin D
Iron
Zinc
Vitamin B12
Folate and Vitamin B6, particularly where homocysteine or MTHFR variants are relevant.
Magnesium, riboflavin and CoQ10 are especially interesting because of their direct involvement in ATP production and mitochondrial health.
The goal, however, is not to take everything.
The goal is to identify what is missing. And why. We can do this through blood tests, organic acid tests, and overlay them both with nutrigenomics.
4. Track patterns
Migraine diaries remain one of the most powerful tools available.
Food.
Sleep.
Hormonal changes.
Stress.
Weather.
Exercise.
Patterns emerge that memory alone cannot capture.
5. Reduce the overall load
The modern world places enormous demands on our brains.
Prioritising sleep, managing chronic stress, spending time outdoors, eating anti-inflammatory foods, supporting metabolic health and creating periods of genuine recovery all contribute to reducing the total burden on the system.
Sometimes the answer isn't adding more.
It's removing what the brain has been struggling to compensate for.
The more I work with people experiencing migraines, the less I see them as isolated events and the more I see them as the product of a complex interaction between genetics, environment, metabolism, nutrition and lifestyle.
We still have much to learn.
But the direction of the research is encouraging.
We're moving away from one-size-fits-all solutions and towards understanding the individual sitting in front of us. We're paying greater attention to ATP production, mitochondrial health, oxidative stress and metabolic resilience. And we're recognising that nutrition and lifestyle are not alternatives to good medicine - they are often fundamental components of it.
The brain is our most energy-demanding organ.
Looking after that energy may be one of the most important things we can do.
If you would like to discover more about working with me in Nutritional Therapy, then book a free 20-minute Health Conversation where we can talk through your current health and your health goals, and I can tell you how I would work with you. There's never any pressure to book a programme and I ask that you go away and think about it, not book on the spot. It has to be right for both of us.
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"Working with Gemma was life changing. She was able to pin point why I was feeling the way I was feeling and helped me manage all the issues with nutrition. I was able feel so much better and actually get out of bed without feeling fatigued. She planned every session considering everything I said to her and always dealing with the main problem. She listened and gave me a encouragement in every session. Gemma explained everything and I learned so much to build healthier habits. This was the best investment into myself and I could not have done this without Gemma's guidance."
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