“This indicates a large unmet need to diagnose and treat migraine in GWI and CFS”
Could chronic fatigue syndrome be a form of migraine? That might not be so wacky an idea as it sounds. About ten years ago Puri and Chaudhuri suggested chronic fatigue syndrome was similar to migraine. In the last two years not only have Baraniuk’s studies indicated high rates of migraine are present in ME/CFS but other studies have found that many people with migraine meet the criteria for ME/CFS.
Are similar central nervous system problems contributing to both migraine and chronic fatigue syndrome?
Finding similar incidences of migraine in Gulf War Syndrome and ME/CFS in their latest study, Baraniuk and Rayhan smushed the two together and then added fibromyalgia to the mix as they proposed GWI, ME/CFS, FM, and migraine are kind of like kissing cousins.
“Similar patterns of gray and white matter abnormalities and altered brain energetics in GWI, CFS, FM, and migraine suggest that common central mechanisms may contribute to the type of headaches and cognitive impairments perceived as ‘brain fog’. “
Let’s check out more of the migraine/ME/CFS connection.
The ME/CFS Migraine Connection
Besides symptoms and high rates of comorbidity, the relapsing-remitting nature of both disorders, the problems with barometric pressure changes, some similar triggers (including exercise for some), similar central nervous system abnormalities, etc. make a possible connection between migraine and ME/CFS/FM an intriguing one.
Consider that about three times as many women as men get migraines. Consider that both migraines and ME/CFS symptoms are often substantially reduced during pregnancy. Consider that central nervous system hyperactivity plays a role in both conditions, that both feature blood vessel problems and inflammation is a key factor in both.
Consider that stress often plays a key role in triggering both migraines and symptoms in ME/CFS. Consider that during migraines and relapses in ME/CFS exertion and exposure to stimuli often must be curtailed dramatically. Whether in the midst of an ME/CFS crash or migraine attack hypersensitivity to lights, sounds and odors is common.
Let’s see what their studies found.
The Studies
Migraine in gulf war illness and Chronic Fatigue Syndrome: prevalence, potential mechanisms, and evaluation Front Physiol. 2013 Jul 24;4:181. doi: 10.3389/fphys.2013.00181. Rayhan RU, Ravindran MK, Baraniuk JN.
Baraniuk and Rayhan did ‘structured headache evaluations’ and tested for the evidence of widespread ‘hyperalgesia’ (increased sensitivity to pain) in 50 Gulf War Illness (GWI), 39 ME/CFS, and 45 controls in the 2013 study. The presence of hyperalgesia was tested by applying pressure to different areas of the body. A person was classified as having a migraine if they had had five or more episodes lasting 4-72 hours that included at least two of the following:
- Unilateral headache (headache on one side of the head)
- Pulsatile quality
- Moderate-severe pain severity
- Aggravation of the headache by doing usual activities
A representation of a scotoma or zigzaggy line sometimes occurring in auras in migraines.
In addition, sensitivity to light or sound or nausea (with or without vomiting) was required.
(Many forms of migraine exist; abdominal migraines involve nausea but do not cause head pain; cluster headaches typically cause eye pain, eye-watering, and a stuffy nose. Aura’s can involve vision problems (zigzag lines, flashing lights, blind spots, eye pain, blurred vision), pins and needles sensations in an arm or leg, speech problems, and weakness. Aura’s typically precede headaches in about 20% of migraines and are not always followed by a headache. Other migraine symptoms can include increased sweating and urination, face swelling, and fatigue.)
The Results
High rates of migraine occurred in both ME/CFS and GWI groups. Migraines were present in 64% of GWI and an astonishing 82% of ME/CFS patients vs. 13% of the healthy controls. Fully two-thirds of the ME/CFS and GWI patients experienced auras (flickering lights, rotating discs, photosensitivity, loss of vision) with their migraines. That people experiencing auras also tended to experience more pain suggested that when things go wrong they really go wrong. Almost 70% of ME/CFS migraine sufferers also had tension headaches.
Most people with ME/CFS had migraines and many migraine sufferers meet the criteria for ME/CFS
Low rates of tension headaches without migraine in ME/CFS (8%) patients and GWI patients (20%) suggested the two types of headaches usually occurred together. ME/CFS patients with just tension headaches had lower pain scores overall.
Except for lower rates of migraine with aura, the 2011 ME/CFS study found similar results.
As if migraine wasn’t enough, systemic hyperalgesia (increased and widespread pain sensitivity) was present in 62% of GWI and 70% of ME/CFS patients. With that kind of result, it wasn’t too surprising to find that over half of ME/CFS (56%) and 38% of the GWI participants meet the criteria for fibromyalgia.
That both ME/CFS and GWI patients with migraines had significantly lower systemic and sinus pain thresholds suggested to these Georgetown researchers that they were suffering from a ‘central sensitization’ disorder that increased their pain levels system-wide.
Systems Biology Approach Requested
Rayhan and Baraniuk called for a ‘fresh, systems biology’ approach in ME/CFS, GWI, FM, and migraine that integrated all the systems involved in filtering and assessing sensory data from the body. This would include systems such as the insular cortex where misinterpreted sensory data would perceived as a ‘serious illness’, and inflammation or other triggered glutamate releases that resulted in increased pain signals (hypersensitivity).
They proposed that dysregulated sensory inputs to the brainstem could cause many problems including high levels of pain, fear (PTSD), and reduced executive functioning (decision-making and planning, aka brain fog). They suggested, interestingly, that ion channelopathies–which we haven’t heard about for a while–that trigger widespread neurotransmitter release (e.g., glutamate?), may be present. Basant and Puri proposed that a neurological channelopathy was present in ME/CFS about 10 years ago.
Migraine Model Proposed for Chronic Fatigue Syndrome
“It is tempting to speculate that the parallel findings of GWI, CFS and migraine indicate a shared underlying pathophysiological mechanism” Rayhan and Baraniuk, 2013
Noting that 67% of migraine sufferers meet the criteria for ME/CFS, they suggested that the cortical spreading depression (CSD) known to occur in migraine may provide a model for the central sensitization at work in ME/CFS and GWI.
Several processes can cause CSD but the most relevant for ME/CFS involve a) a wave of ischemia (caused by low blood levels) or (b) a wave of blood vessel vasodilation (opened blood vessels) followed by a wave of vasoconstriction (narrowed of the blood vessels) across areas of the brain. A similar process was proposed by ME/CFS researchers about 10 years ago.
Brain blood flow problems appear to play a role in both migraine and chronic fatigue syndrome
CSD depression typically leaves in its wake hypoxia (low blood oxygen levels) and an emphasis, not surprisingly, on anaerobic metabolism with a corresponding increase in lactate levels (which we do see in ME/CFS). CSD is usually a time-limited event, but Baraniuk and Rayhan propose that it’s become chronic in ME/CFS and contributes to the anxiety, fear, fatigue, pain, allodynia and cognitive problems in ME/CFS and similar disorders.
Some alternate hypotheses (Unitary hypothesis, periaqueductal gray matter hypothesis (PAG), neurolimbic hypothesis), all very complex, are proposed.
Maizels’ neurolimbic migraine model actually includes fibromyalgia. Maizels proposes dysfunctional brain networks originating in the brainstem and reaching out to the limbic system (amygdala, insula, anterior cingulate cortex, prefrontal cortex, hypothalamus) produce migraine and fibromyalgia. Brain imaging studies indicated interesting patterns of increased and decreased activity occur in these networks in migraine (and ME/CFS/FM).
Clearly taken by Maizels’ brain network focus, the study authors proposed that future research should focus on network connections, brain blood flows, and integrity of the white matter in the brain. (Baraniuk’s most recent GWI paper focused on the over-activation of the fatigue and pain-producing network in the brain.)
Treatment
CFS patients “were often unaware of migraine with aura headaches and the potential to use beneficial migraine treatments.” Ravindran and Baraniuk 2011
In the 2011 study, only forty percent of migraine sufferers had been diagnosed, and only a third were being treated with drugs. That thirteen out of the fourteen ME/CFS patients with migraines reportedly responded well to sumatriptan (Imitrex) suggested many people with ME/CFS may be missing out on a valuable treatment option.
Anti-migraine treatments may be beneficial for CFS-related symptoms even in subjects who do not have migraines. Ravindran and Baraniuk 2011
Ravindran and Baraniuk weren’t just talking about migraines, though, when they discussed treatments. Given the similar central nervous system processes they believe are behind ME/CFS, migraine, GWI, and FM, they proposed anti-migraine drugs could be helpful in ME/CFS patients without migraines.
Triptans and Sumatriptan
Triptans include sumatriptan (Imitrex, Imigran, Cinie, Illument, Migriptan), rizatriptan (Maxalt), naratriptan (Amerge, Naramig), zolmitriptan (Zomig), eletriptan (Relpax), almotriptan (Axert, Almogran), frovatriptan (Frova, Migard, Frovamig), and avitriptan (BMS-180,048).
Sumatriptan is a well-known anti-migraine drug that reduces inflammation in arteries and veins in the brain by enhancing 5-HT (serotonin) production. Increased 5-HT production causes over-dilated veins to constrict. Sumatriptan also decreases the activity of nerves called the trigeminal nerves that are associated with cluster headaches.
Interestingly, some research suggests triptans may be affecting the periphery (the body) more than the brain. Triptans’ difficulty in passing the blood-brain barrier has led researchers elsewhere to figure how they’re doing what they’re doing. Studies suggest triptans reduce pain-producing peptides such as substance P in the periphery.
Migraine – Another Difficult To Treat Disorder
Acknowledging the frustration physicians face with “difficult to treat and understand” ME/CFS/GWI and migraine patients, Baraniuk and Rayhan quote Maizel’s description of the presentation of a typical patient:
“..a middle-aged woman with chronic migraine and medication overuse, as well as fibromyalgia. In addition, there is anxiety and depression, fatigue and insomnia, and the familiar exhaustive list of psychotropics and antiepileptic drugs tried and failed”
Baraniuk and Rayhan propose that Maizels’ neurolimbic model which incorporates dysfunctional serotonergic pathways and central sensitization (i.e., overheated neural networks) is a good place to approach treating these disorders, and they referred to a table produced by Maizels.
Besides the triptans, both Baraniuk and Maizel’s approach to ME/CFS/FM and migraine emphasized stress reduction
Maizel’s approach is similar to others taken in the field that attempt to tone down central nervous system activity. Other than the use of triptan drugs, his approach relies mostly on behavioral practices to reduce the activation of the neural networks producing central sensitization, arousal, etc.
Maizel proposes that physicians examine issues such as personality styles, stressful lifestyles, and psychiatric comorbidity that can have a profound negative effect on one’s quality of life. Noting that depression and anxiety increase the risk of migraines, Maizel educates patients about the role the limbic system plays in regulating mood, emotion, perceptions, and stress. He includes the following recommendations for physicians:
- Treat any mood disorders that are present.
- Use CBT, carefully prescribed activity, acupuncture, tai chi, and other means to retrain the brain and reduce the stress that triggers migraines/relapses and pain.
- Explore triptan drugs, and topiramate. and other migraine therapies in ME/CFS, GWI, and FM.
Check out Migraines and Chronic Fatigue Syndrome and Fibromyalgia for more on the commonalities between these diseases and treatment options for migraines.
Do You Have Migraines and Not Know It?
- Check out a slideshow on migraines
- Check out two self-tests for migraines here and here.
Well, I find this very interesting, as I have had migraines pre-dating my “CFS” and “FM” diagnoses, but how this explains the preponderance of EBV, HHV6, CMV, RnaseL, etc., is beyond my understanding.
This is the kind of Bull Shit study that is draining money out of ME/CFS research. So I came home, fell asleep and woke up with acute exhaustion, but no headache. Two hundred people plus in Incline Village “caught” a migraine headache? I have had now a chronic daily headache that started a month after I got sick, hasn’t stopped for 7 years, and doesn’t respond to triptans- guess I can’t have ME/CFS?
What about all the other outbreaks- infectious Migranious Maximus. Get serious!
I must know 30 people with migraines that don’t have CFS.
Greg
I think you’re looking at this a little differently than I am…:)
For me it’s that ME/CFS is ‘migraine’ but that similar problems may underlie both; in particular, blood vessel problems in the brain. I’m not surprised Baraniuk looked at migraine; his earlier proteome study suggested blood vessel problems and perhaps amyloid fragments in the blood (that were puncturing the blood vessels) played a role in ME/CFS.
We’re casting a wide, wide net here; the suggestion, I think is… inflammation and blood vessel issues are causing migraine in some, CFS in others and CFS and migraine in others. With the low cerebral blood flow issues, the lactates and the white matters that seems viable to me.
The most intriguing thing for me with this study was the idea that ME/CFS patients are kind of in a continual migraine-like state…instead of popping in and out of migraines like most people with migraines do. Note that over 50% of people with migraines meet the criteria for ME/CFS; that means there are alot of people with migraine who don’t pop in out of migraines; they’re sick all the time and then they relapse – and get migraine. How they get diagnosed (migraine or ME/CFS) may depend on which doctor they saw first.
For sure there are no answers, here – although if you are getting migraines – that’s a good thing to know since medications can be very helpful –
The small veins are constricted. This is due to the autonomic nervous system problems 🙂
I would wonder where the statistic is that 50% of people that suffer from migraines meet the criteria for CFS? It’s estimated that 30 million people in America suffer from migraines, so we’re to believe a study found 15 million people?
A recent study also clearly identified a very high percentage of an abnormal blood vessel anatomy in Migraine sufferers that also experience aura, I saw no mention of this in the study.
My point is people with ME/CFS get migraines, people get Migraines, science requires some semblance of Koch’s postulates to establish cause and effect.
Greg
The criteria of CFS/ME and the disease itself may not match, so theoretically a mild CFS/ME might be very common.
Same time as Cort Johnson published his thougths about a connection we discussed the aura/visual disturbance in FM and CFS/ME in a Norwegian group. We then discussed the similarities and a possible connection between the disease. Diseases that are closely connected might appear wery different, as an example I find a close connection between: CFS/ME, FM, Alzheimer, Crohns, mononucleosis, Arthritis, migraine, Lyme and several others. They all are connected to infections, basically the same infection and they might all be genetic predisposed. When I read about the underlying cause and theories about this in one of the diseases, the others show up in an amount that is hard to explain as a coincidence. I end up feeling way beond the doctors at the hospitals, and when trying to discuss the issues with them they have seldom read about this. The connections are still easilly found on PubMed and elsewhere.
For example the connection between CFS/ME and EBV(Epstein Barr virus) are well known, but the same defect caused by EBV appear to be nessesary to develop chronic Lyme after a tick-bite (and other Borrelia routes of transmission).
Cort that is really something! Thank you.
I have every year or so ophthalmic migraines, and I have at times thought of their onset as being analogous to the onset of a crash , at least in the manner crashes occur in my case: they begin rather quickly after that critical X amount of effort (half an hour); when I have crossed that line, I know it will happen, I can’t stop it, in 30 minutes the Damocles’ sword will fall. With my migraines, I have my aura thing, those black crystals which start to blur my peripheral vision, and I know that, in 30 minutes, I’m doomed, the hellish headache will happen.
I really like how in your own very tempting way you make us consider all the many similarities, one of the most obvious of which, I guess, being the intolerance to light and sound.
I have some powerful pills for my migraines and they work like magic, when nothing else will. I once thought: what if, what if… they had an effect on brain fog!! (one of the symptoms I hate most in crashes – the brain fog’s intensification which nullifies my mental life).
I tried the very minute the thought came to me. No chance. No effect at all. Brain fog wins…
Thanks for yet another surprising and stimulating read.
Oh well :). It’s an interesting theory…
Glad I don’t have to worry about migraines. I did experience the zig zags on and off for a couple of days but thankfully that was it.
Thanks
Thanks for another interesting report Cort. I rarely have what I would consider to be typical migraine headaches but do experience ocular migraines about once a week since coming down with ME/CFS. They generally start in the peripheral vision of one eye and then move all the way across until both eyes are affected with what looks like liquid mercury. They only last about 20-30 minutes but I can’t see clearly enough to do anything requiring clear vision during that period. There doesn’t seem to be anything I can point to that triggers them although occasionally I notice that a new medication will cause them to be more frequent so I stop the medication and the frequency returns to about once a week. They rarely end up causing nausea or pain. The opthomologist said to come into the office while I’m having one but, not only can I not see clearly enough to drive, by the time I got to the office it would already be gone!
I rarely get headaches and never a migraine. Wasted money for a study that involves cfs/me. I do feel for people who have migraines and studies should be done to help those people, just not cfs/me money.
Actually my guess is that, as with much of Baraniuk’s work, this was done using Gulf War Syndrome funding. Both he and Nancy Klimas have been good at getting ME/CFS patients into GWS studies.
Five years after becoming ill with CFS I was finally diagnosed with Migraine, I had not experienced any prior to CFS. They became increasingly frequent and debilitating until my physician put me on daily doses of Verapamil as a migraine preventative. It took a few months of steadily increasing dosages but it began to reduce the frequency from 4 or 5 severe migraines a week to now about 3 a month and those have become mostly auras without a lot of pain afterwards.
CFS and all its other lovely symptoms are still present 32 years after getting sick, but I’m VERY thankful that I finally found a physician who listened to me enough to realize that part of the symptoms I was experiencing might also be migraine – a neurologist never even mentioned it as a possibility – but my rural internal med doctor spotted them easily.
I’ve always thought that a LOT of people with CFS were also suffering migraine but many have not even wanted to listen to the suggestion.
CFS and migraines. 2013. Sigh.
Can we get more vague? Really…
Not to discount CFS patients who get migraines. Not, but this kind of research is not moving the ball forward in terms of establishing biomarkers, and hard data. Migraines are common to many diseases.
I’m with Gregory G Cutler DVM on this one.
Best,
Questus
This was a very simple and must have been a very cheaply done study. It simply required filling out questionnaires and doing physician visits, and then doing statistical analyses in order to determine who did and who did not have migraines. No blood tests, no scans….
What almost assuredly happened here is that this is a part of a larger study which did include testing. Baraniuk has done a series of studies involving ME/CFS and GWI patients and Baraniuk turned into a paper. Studies like this usually a pump out a series of papers and this was just one of them.
Migraines may be common to other disorders but are they found in 80% of those disorders? ( !’d hardly call that ‘vague’. by the way)..If that’s actually true (it seems high to me, to be honest) it’s a pretty striking finding and high comorbidities like that do mean something. If this study helps underscore the blood vessel/blood flow problems in ME/CFS I think its probably well worth whatever small amount of funding it cost.
I agree Cort…no stone can be left unturned. Sometimes corrolations like puzzle pieces will fit….. Ive had cfs etc what seems like forever. Ive always had severe fatigue..dizziness..brain fog.headaches..etc etc. …..but yesterday was the first time I ever had an ocular migraine…with blurry vision and flashing lights. And today I am more exhausted…out of it…..and a little depressed…slowed down….and feeling wierder than I ever have. Im all for checking out every corner of possibilities.
Thanks Anne – now an occular migraine! I had several brief sessions of zig-zag lines which thankfully did not continue. I hope you fare the same and, if not, you can find something that will help 🙂
I am 50 years old. I have had CFS for 30 years and FM and migraines for 10 years. I often feel I am “in a constant state of migraine”- that a headache could come on at any time if I lay down for too long, use my arms too much, or irritate my shoulder and upper back muscles. While the fatigue from my CFS has improved over the years, my migraines have become almost equally debilitating. For me, there seems to be an important connection.
I always try to keep in mind that what we have, probably isn’t caused by only one thing. This (and other possibilities) could be a piece of the puzzle that may point to part of/or the cause. If this is something found, more than not, in those with CFS/ME/FMS/Dysautonomia and there are blood flow issues; What does this indicate? What causes the dysfunction with this? Since there is a blood flow issue and vascular dysfunction with migraines and this is one of many other possible presentations. Let’s get to the core of the problem. If this is caused by inflammation, faulty veins or valves, autoimmune dysfunction, dysfunction of the ability of the veins to expand and contract (and if so, why?). Then there is the issues with the autonomic nervous system (definite problem with dysautonomia) —which is the bodies automatic part of the nervous system —the part we have no thought control over. The electrical controls of our body —what makes us run and function. This affects every single function of every part of our body. If this is malfunctioning we get some unpredictable problems that are hard to predict and correct.
There is also another type of migraine that was not spoken of —a silent migraine that can have all sorts of physical manifestations yet not give the person the “pain in the head” that a regular type migraine gives. Things that would make a person feel unwell and not really be able to say what was wrong or why. (I have this type of migraine more than the sort that cause the head pains. I have them both.) This is the sort that might would have similar symptoms to CFS. The kind that is hard for a doc to DX. (When I first found out I was having silent migraines, I was in another state and started having silver stars floating and completely clouded my vision and then started having double vision. I thought I was having retina detachment in both eyes at the same time. Scared me terribly. Was in a store and they called an eye doc for me and he told me to come immediately there. My husband got me there within about 30 minutes and by then that aura had started to get better. He determined after a very good exam that it was a silent migraine. That was the start of my migraines. And over the years, I started having the ones with pain some of the time.) Here’s a WebMD article on silent migraines. See how much may apply.
http://www.webmd.com/migraines-headaches/what-are-silent-migraines
Cort, is the messenger. I think he is doing a really good job of presenting the information. He is trying to present possibilities. There is always something that we can learn from whatever we read, whether or not we think it may apply to us. Thanks Cort!
Issie
I stumbled across this after looking to see if anyone was researching a link between the two disorders. Here is my story.
At the age of 63 I have only recently been diagnosed and begun treatment for what I now know is “silent” migraine – that is, migraine that occurs primarily without a headache.
Migraine is a neuroinflammatory disease and I have apparently had these symptoms my whole life without understanding what they were. Many people mischaracterize migraine as a headache, but there are many other symptoms associated with it and there are many people out there like me who do not realize their symptoms might be migraine related because, like me, they do not (or only rarely) get the headache part, and when they do get a headache it is not exceedingly painful.
I would sometimes have headache but it was never debilitatingly severe so I chalked those up to tension or sinus issues because I also have bad allergies. Nope, all of that was migraine.
I have also had ME/CFS-type symptoms since I was in my 20s, so that’s about 40 years of impact from those symptoms. I’ve been researching and trying different treatments throughout that entire period with limited success.
I finally was diagnosed with migraine early this year, after I did develop a weeks-long headache with strong light sensitivity and other migraine symptoms. I got some abortive migraine treatments; within an hour of taking those, not only was my headache gone but my brain fog had cleared and I felt remarkably well.
With my recent diagnosis I’ve started some new preventive migraine treatments, and the results are promising so far. Probably the most important things I’ve taken are propranolol and riboflavin as preventives.
For the first time in 40 years I’m waking up most days without brainfog or inflammation in my hands and face. I’m able to function better – it is early days still but I’m hopeful at this point that treating the migraine is going to reduce what I believed were ME/CFS symptoms, as well.
I am not trying to suggest that treating your ME as migraine is going to fix every problem or help every person, but I would not so readily dismiss the possibility that these disorders are linked, or two sides of a similar metabolic process gone haywire. Many people like me have “silent migraine” and do not know it because of the absence of headache. It’s definitely worth additional research and consideration in my view.
Wishing everyone here a healthy future!
Thought I would follow up here since it’s been quite a few years since this article was published and I’d expect more research has happened since then. This is an interesting and far more recent review in a neuroscience journal that talks a lot about the non-headache components in migraine. Worth a look.
https://www.frontiersin.org/articles/10.3389/fnhum.2021.646692/full
Thank you for this interesting article, Cort. I have had CFS/ME for over 20 years and see Dr. Lerner. A year ago I was dx. with Hemiplegic Migraines. The same things that trigger my CFS/ME trigger my stroke symptoms. I have also started having angioneurotic edema. Besides my anti-virals for my EBV and CMV, all three of my specialist put me on the same medication to lesson the severity and duration of my relapses. Obviously, to me, they must be inter-related some way if they are all prescribing the same medication for different purposes. But it has a band-aid affect. As soon as these issues are corrected, something else, more serious shows up and still puts me in a “have to be on couch rest” state. Viruses down to normal, POTS under control, but can’t seem to get a handle on the angio-neurotic edema. Keep the great updates on research coming. Someday we may have all the pieces. Thanks for all you do for us.
I had migraines in my high-stress life prior to coming down with CFS. I suspect that the common link is that they’re all PTSD symptoms. I’m pretty sure that’s what I’m really dealing with. Cheers, Graham
Thanks for the interesting article Cort. While I’ve had migraines since the age of 7, they had largely disappeared (even in my very fast paced adult life) until I developed POTS and ME/CFS 4 years ago; then they came back with a vengeance. Don’t think they are one and the same, but it’s interesting to see the similarities between the two.
I’ve had Chronic Fatigue Syndrome for 24 years with daily pain and fatigue that’s better or worse at times. I lost my career and most of my social life because I was too sick to function well enough to continue. My migraine-type vascular head pain is in the blood vessels in my temples. The blood vessels swell up and the pain radiates through the side of my face and head, but the pain center is in specific blood vessels in each temple.
Lately, the head pain has been worse than usual. No meds have helped to stop it. Through the years I’ve been to many doctors of all types and I read research groups and forums daily.
Just a week ago, for the first time, I read that Ginger Root can stop migraines. I had a friend buy some fresh ginger root at the store. I sliced about 5 little pieces of the ginger and boiled it in two cups of water and let it steep about ten minutes. I drank a cup of the ‘tea’ and chewed and swallowed a couple of the sliced pieces. Sure enough, within about 10 minutes, my head pain was gone.
Anytime the pain started again during the day, I chewed and swallowed a couple more slices of the boiled ginger. Each time the pain stopped. I’ve been doing this for a week now and the ginger continues to work against the pain. You can Google ‘ginger for migraines’ and read more about it. I hope it helps others as well.
Congratulations Sandra! I’ve been taking herbs and supplements for the first time in years recently. I’m surprised how potent particularly some herbs are. I’ll put ginger down on the list of migraine treatments and refer to your comment. Thanks for passing the info on.
I find that adding turmeric to ginger is a great combo to help with pain. Even though they are in the same food family – the combo seems to work better than either by themselves. (Some people find that turmeric is helpful for POTS and MCAS. But, there are some that it will make worse. Subsets —it’s tricky.)
Issie
I’m always on the look out for research which shows there are similarities between migraine and M.E. Not because I believe they are the same thing but it’s possible that there are some shared pathologies and research in one area may help another.
I have a personal interest because I started getting migraines in my 40s which were hormonal migraines. These went from episodic to chronic over a 10 year period, so I now get migraines all the time which vary in intensity from low grade to severe. Hand in hand with my migraines worsening, my stamina levels & cognitive impairment worsened to such an extent that I began to wonder if it was more than just chronic migraines + menopause? I do fit any CFS/ME diagnostic criteria you care to mention, except I don’t have acute onset.
I suspect there are many differentiating factors however between M.E. and migraine e.g. cardiac irregularities, PEM, muscle pain etc. I also feel I can instinctively tell when my symptoms are worsening because of a migraine brewing and when it is more an M.E. type thing.
So I appreciate for some this research has no relevance to them whatsoever but for those of us who do have chronic or episodic migraine any pieces in the puzzle are useful. I do get pretty pissed off though when researchers make a link between symptoms and stress and decide CBT and relaxation techniques are the answer. If only *sigh*
Thanks Cort for pointing out this research. I think it’s a good idea to cast the net wide to help try and get all these jigsaw pieces in place.
I’m always on the look out for research which shows there are similarities between migraine and M.E. Not because I believe they are the same thing but it’s possible that there are some shared pathologies and research in one area may help another.
I have a personal interest because I started getting migraines in my 40s which were hormonal migraines. These went from episodic to chronic over a 10 year period, so I now get migraines all the time which vary in intensity from low grade to severe. Hand in hand with my migraines worsening, my stamina levels & cognitive impairment worsened to such an extent that I began to wonder if it was more than just chronic migraines + menopause? I do fit any CFS/ME diagnostic criteria you care to mention, except I don’t have acute onset.
I suspect there are many differentiating factors however between M.E. and migraine e.g. cardiac irregularities, PEM, muscle pain etc. I also feel I can instinctively tell when my symptoms are worsening because of a migraine brewing and when it is more an M.E. type thing.
So I appreciate for some this research has no relevance to them whatsoever but for those of us who do have chronic or episodic migraine any pieces in the puzzle are useful. I do get pretty pissed off though when researchers make a link between symptoms and stress and decide CBT and relaxation techniques are the answer. If only *sigh*
Thanks Cort for pointing out this research. I think it’s a good idea to cast the net wide to help try and get all these jigsaw pieces in place.
I certainly think it is possible that there is a genetic link between CFS and migraine. My mother was a life long sufferer of migraines. If treated early, within first half day or first few hours of migraine she re-couped avoiding three days of misery in bed. She never showed any signs though of having CFS, however. I have never had a migraine and cannot remember ever having a headache either. I have met many more people who suffer from migraines than who suffer from CFS. Outside of my family, I had met only 2 people with CFS prior to developing my own CFS. I cannot count how many people I know who also suffer from migraines (yes the bad 3 day kind), it is exponentially much greater. Prior to mid-life I did experience episodes of excruciating pain, nausea at the beginning of a menstrual period. This experience seemed very much like a migraine in terms of pain, nausea and dysfunction -but more intense, not in the head and the duration of pain much shorter (2-3 hrs). In the beginning I took the same pain medication as my mother to resolve it. Like my mother, if I did not have anything on hand to resolve it, I had to go to the hospital because the symptoms were so severe. I have a set of twin sisters, both with CFS. One of these twins has both allergies and migraines, the other has neither. Both twin sisters had problems with their menstrual cycles, later developing fibroids and endometreosis (I developed neither). Once again many people have problems with their reproductive systems but do not have CFS. The twins had early onset CFS symptoms and mine developed much later. I don’t think anyone can generalize about the relationship between CFS and migraines. I have tried sumatriptan migraine medication just to see if they would help resolve CFS symptoms and they did not. I am looking forward to the day that CFS is understood through the most advanced hard research such as DNA, Epigentic like research or whatever research comes next along these lines, as such research is quickly evolving.. It’s complicated. A big thanks to those who are doing the research and to Cort who lets us know about everything going on in the quest to understand ME/CFS.
Cort,
Thank you for a great article. I think I have “METABOLIC MIGRAINES” of my body that is mostly localized to the trunk of my body. I meet the two out of three migraine criteria and have fought pain un-successfully for 10 years now. The migraine angle fits perfectly with my experience. Keep the articles coming!
Thank You
I started suffering from migraines when I came down with ME. It took me a while to realise what was happening because I’d never suffered from them before. These migraines seem to be triggered by a combination of noise and a sudden change in atmospheric pressure. They begin with me becoming more and more sensitive to noise along with a stiff neck and cognitive problems . The only thing to do is to go to bed in a dark quiet room and wait. You could also say that these migraines are a flare up of my ME symptoms.
I find this extremely interesting. I’ve been sick for many years. I experienced many episodes of wavy lines in peripheral vision – first one eye, the the other, then both at the same time. They always seemed to come in bunches during a week or so and would resolve when I took a nap or rested. It starts with something that looks like a flashbulb in my eye, then the wavy lines, first in black and white, then progressed to color (nice, huh?) although when both eyes were hit at the same time I was blinded. There was never any pain involved. After years of this, off and on, I was diagnosed by an opthamologist with ocular migraines. He had seen many patients with CFS and Lyme and said it was somewhat common, in his experience. He offered no help, just “get through it”. I actually had them wake me from a deep sleep, open my eyes and there it was.
A few years ago I saw a NEURO opthamologist as I had another few episodes that caused me to be blinded. He agreed that it was ocular migraine and said he had other patients over the years with it and for some reason decided to try low dose aspirin (through his research, why I have no idea) and told me to take aspirin every day to see what happens. It worked. I haven’t had one in over a year and never fail to take my daily aspirin. I take two low dose aspirin. At my last visit he asked if I had any over the year and when I said no, he said “I knew it”…….for some reason the aspirin has helped everyone. He said he was going to write a paper on it.
Interesting and so far, an simple “fix” for that one symptom. Now for the other horrendous symptoms???? No, aspirin isn’t the answer………..wish it was.
At least that one terrible symptom is gone after all these years. Keeping fingers crossed.
Hope this is of some help to others.
Had migraines since 16, I’m 58. Two years ago had a viral infection that had me bedridden for two days. A month later I was diagnosed with EBV four times higher than the acceptable level. That was the kick off to my Fibro and CFS symptoms.
Classic ME/CFS onset, perhaps set up by the same issues that contributed to your migraines. Very interesting.. Thanks for sharing.
Thanks Cort
I think I’m inclined to agree with Izzie more.
I’m inclined to things held in common, rather than it being migraine. More women also have auto-immune disorders than men. I have dry eye and volunteered for a study of eye drops. The university ophthalmologist doing the local data gathering for this international study surprised me by telling me that dry eye is an inflammatory disorder, rather than insufficient tear production. So there are a variety of inflammatory processes going on. Then there’s the possible viral cause-contribution. I think all these different processes, and perhaps more, cause changes in the neuro system, but can cause similar symptoms, simply because the same structures and/or neuro-chemicals are all affected. Eg serotonin levels effect pain and mood but those levels can be influenced by a variety of things
This is a pretty convincing arguement about a possible connection, but association and causation are not the same. Still it warrants further investigation and consideration. Thanks.
I occasionally get migraine with aura, peripheral vision, loss of sense in left hand, usually followed by headache, and I have to go to bed and sleep it off. One time I was away from home when the loss of sense in left hand started, and the normally irreversible process made me pump the pedals hard on my bike, to get home before the crash. But lo and behold, the attack disappeared! I have since heard that vigorous exercise can sometimes stave off an attack. Another time the symptoms began, I started exercising hard, but it didn’t really work that time…
The attacks are farther between now, but I also do a lot of “right things”, like sleep in absolute dark in an electrosmog-free environment, take supplements like vitamin a, b, c, d, e, eat turmeric, ginger and garlic, exercise regularly (the “7 minute workout”), drink plenty of water with a pinch of salt, eat LCHF to reduce the amount of fast carbs, take some Apple cider vinegar once in a while etc. And it all seems to add up.
I worked in the cardiac cath lab and then as a vascular ultrasound technologist for 31 years and we found that a transcranial doppler could establish whether or not micro-bubbles injected into the arm would find their way through a hole in the heart (called a Patent Foramen Ovale or PFO). This condition is thought to exist in as many as 20% of people where the hole, which is open for circulatory reasons prior to birth, fails to close in that many people after birth. It is often the reason for strokes in younger people who have no other reasons to have had one and these people are much more likely to have migraines as well.
The comparative study we did at our institution found that many cardiac echocardiograms missed it and it was easily found by the TCD or transcranial doppler study. I think these issues could also be included in a large study to sort out the possiblility of it having any connection to CFS/ME. Viral causes could still be included and a PFO could allow for infections of the brain by having a compromised Blood Brain Barrier.
I have had migraines since around the age of 15 and fibromyalgia by my late teens or early 20’s and then CFS in mid 30’s. I’d love to have the TCD to see if I show a PFO, but the studies on closure of a PFO are mixed as to whether they are effective or lessen strokes, though it seems it has been mostly successful at minimizing or even ending migraines. Closure of a PFO requires either a procedure by catheterization and some doctors even prefer to do open heart surgery. Neither of which is likely to appeal to people with CFS/ME since even simple procedures can leave us feeling worse, and much worse having the open heart surgery. Still, a study of these possibilities could illuminate a problem that could exist that has gone undiscovered all this time.
This is so fascinating for me to read. For years I had chronic fatigue/fibro that I managed poorly with medication and a lot of luck in that as an academic I was able to adjust my schedule to my relapses. During my pregnancy all my symptoms went away completely, but after I stopped breastfeeding, I began getting increasingly bad migraines until at one point I had a migraine that lasted almost 3 months and didn’t respond to repeated steroids. For 3 years now I get almost daily migraines – usually 3-4 a week. Very few medications have been useful and exercise has been the most helpful thing for me. However, in the past two years, the fatigue/fibro has returned. When that flares up, the migraines go away; when the migraines return, the fibro comes back. I find it completely bewildering. The rheumatologist I finally met with suggests that the migraines are part of the fibro, and to be fair, often the body aches are best described as a migraine in my body, but still I haven’t really read anything connecting the two until this. So interesting to come across this! Thank you.
Wow! That’s amazing – one pops up the other disappears and vice versa….
I hope somebody can figure this out. If you get any further insights please let me know.
Good luck 🙂
I am 70 yrs old and have had CF IDS for over thirty yrs. I am convinced that all these illnesses are connected to a stress-response system that is stuck on the “on” position. My headaches, although infrequent, are in the middle frontal area (amygdala?). I find leaning forward and rolling my head back and forth brings blood in that area (tested at the Cleveland Clinic yrs ago and have mild OI).
The onset to my illness came when I was under lots of stress (two young children, teaching with a evening part-time job). Rush to the hospital one night, 37 yrs ago, and have never really recovered.
There is genetic link, I believe, to this illness. My sister has FM and so does my younger daughter. I believe we are wired genetically and with the a series of stressors the stress-response system is in disarray.
I certainly agree about the stress response link. Thankfully genetic studies of families are underway. If there’s any way you can get to Stanford I hope you will see if you could get into that one there. It would be great to get your family in one. (I will have an update soon). One is also underway in Salt Lake City.
Given your head rolling issue have you checked out craniocervical instability or other spinal issues?
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Interesting stuff, appears to tie in with Marco’s neuroinflammation series, as well as my own thoughts on a synergistic neuro-glial etiopathogenesis and associated symptomatological expression not universally including chronic widespread pain/hyperalgesia/allodynia in ME/CFS (unlike FM) yet certainly including at least one potential vestige of central pain anomalies in every case (conforming to contemporary diagnostics) such as (myalgia?~ if not comprehensively explained by mito/lactic/O+NS/HSP type issues), post-exertional hyperalgesia, and migraine
As a person with migraine (and a form of it that causes dizziness in addition to severe headaches), who also experiences constant fatigue and widespread muscle and joint aches and pains (that fluctuate in severity), a link between ME/CFS/FM/Migraine would not come as a surprise to me at all.
It could be that these are all different manifestations of some underlying functional disorder.
One thing is for sure – better treatments/approaches are desperately needed for those with ME/CFS and/or FM and/or migraine.
Thanks BD some interesting research is coming out showing high rates of migraine in POTS and autonomic neuropathy with alot of comorbidity with CFS in those. The connections are getting stronger…
This is extremely interesting to me as I have suffered migraine with aura for 4 decades…I get the blinding zig-zag lights type which I is always frighting. I used to get a terrible headache on one side, but as the years have passed I hardly get anything for a headache, but I do get a debilitating fatigue before, during and after with a big dose of depression. The whole process takes about 2 or 3 days.
I have always been sort of low-energy, even in my youth, but the last 10 years or so, could accurately be described as CFS (I wake up at dawn and am pretty much a fizzle by early afternoon.)
I still work full-time, but it is truly like rolling rocks up a hill, and most of my life is a mind over matter event…using the very limited energy I have to get the bare-bones essentials done.
I am despite it all a physically & mentally strong person. I have tried for years to crack this nut and figure out what is causing this constellation of problems, particularly the migraine. No one seems to really know, but I have noticed some connections…the migraine does seem related to the fatique, and something in the circulatory system. And even though I am physically active I have always had poor circulation, blood flow to the hand & feet which get icy cold, easy bruising, broken capillaries in the lower legs and feet. So, if there is a vascular abnormality in the brain, wouldn’t that also effect the rest of the body? Oh, I also get bouts of vertigo.
Just an aside, both my daughter and grand daughter have migraine with aura.
I sincerely hope with all the misery caused by migraine to so many people & all the bright researchers working to understand it’s causes, very soon a real CURE will be found…
The overlap between the fatigue and other symptoms that often follow, from what I’ve heard, migraine for days sometimes and ME/CFS is fascinating. Hopefully we will eventually get some answers.