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Hormones and How They Affect Migraines

Hormones serve a variety of functions in the body and are involved in numerous metabolic processes. They can also influence the occurrence of migraine attacks. Learn about the key hormones and their impact on migraines here.

Reading time: 15 minutes

Last updated: March 4, 2024

What you will learn in this article

Insulin: Blood Sugar and Migraines

When we consume large amounts of simple carbohydrates, such as sugar, our blood sugar levels typically rise sharply. However, sugar cannot remain in the bloodstream indefinitely—it must be transported into the body’s cells, where it is needed for energy production. To facilitate this process, the pancreas releases the hormone insulin, which acts like a key that allows sugar to enter the cells. As insulin is released, blood sugar levels decrease again.

Recent studies indicate that large fluctuations in blood sugar levels may contribute to the development of migraines, a phenomenon sometimes referred to as “blood sugar migraines.” This can occur through various mechanisms. Rapid spikes in blood sugar can lead to sudden drops, which may cause low blood sugar levels (hypoglycemia). Hypoglycemia can, in turn, result in an energy deficit in the brain, potentially triggering migraine attacks. Additionally, low blood sugar levels stimulate the release of calcitonin gene-related peptide (CGRP), a neurotransmitter that has been found in pain-sensitive areas of the brain and is known to play a role in migraine development.

On the other hand, high blood sugar and insulin levels can promote inflammation in the body, which also increases the likelihood of migraine attacks.

To help prevent migraines, it is important to keep blood sugar levels as low and stable as possible. This reduces the need for insulin release and helps counteract insulin resistance.

Cortisol: The Stress Hormone Elevates Blood Sugar

To understand why the stress hormone cortisol is important in relation to migraines, let’s take a brief look at human evolution: Our ancestors had to be able to defend themselves or flee quickly whenever they faced danger. This is why our nervous system has two opposing components: the sympathetic and parasympathetic nervous systems. They are not active at the same time and have opposite effects. When the sympathetic nervous system is activated, the body responds according to the “fight or flight” principle.

This heightened state of alertness leads to the release of stress hormones, including cortisol. As a result, blood pressure and heart rate increase, breathing becomes faster and shallower, and skeletal muscles receive more blood flow. All of this serves to enhance awareness and readiness for action.

However, the release of cortisol has another significant effect: the body mobilizes its energy reserves. This means that stored glucose is consumed, leading to a rise in blood sugar levels. Additionally, stress and the associated high cortisol levels impair insulin function, further contributing to elevated blood sugar levels and a potential energy deficit in the cells.

In modern times, constant stress—whether due to work or other pressures—can keep the sympathetic nervous system permanently active. This condition is known as “sympathetic overdrive.” Prolonged activation of the sympathetic nervous system can lead to chronic stress, which exhausts the body. Chronic stress is associated with numerous health risks, including an increased likelihood of cardiovascular disease, type 2 diabetes, certain cancers, and neurodegenerative disorders such as Alzheimer’s.

Studies also show that stress can increase the frequency and severity of migraine attacks. Additionally, highly stressful life events can raise the risk of transitioning from episodic to chronic migraines. Some studies have observed that migraine sufferers often have high cortisol levels, while others have found no significant differences in cortisol levels.

Stress management techniques—including mindfulness, meditation, yoga, regular physical activity, and sufficient sleep—can help lower stress levels, which in turn has a positive impact on blood sugar regulation. Meditation has also been shown to reduce headaches and improve the quality of life for migraine sufferers. For more information on the link between stress and migraines, check out our blog article “Migraines Caused by Stress.”

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Estrogen: Women Are More Prone to Migraines

Migraines occur 2 to 3 times more frequently in women than in men. Women of childbearing age, from puberty to menopause, are particularly affected. One explanation for this is estrogen levels. Estrogen, the female sex hormone, influences pain perception and nerve signal transmission in the body through complex metabolic pathways and may therefore play a role in triggering migraine attacks.

Menstrual migraines, which occur at the beginning of the period, can also be explained by the drop in estrogen levels at that time. You can find more details on this topic in our blog article “Menstrual Headaches.” Additionally, there may be a connection between the occurrence of migraine attacks and the use of oral contraceptives.

Estrogen levels also fluctuate during pregnancy, and many pregnant women experience a significant reduction in migraine attacks. In fact, around 60–80% of pregnant women see an improvement in their migraines during pregnancy. For more detailed information, check out our blog article “Headaches Before Birth.”

Furthermore, estrogen influences serotonin levels in the brain. When estrogen levels are high, serotonin levels also increase. You can read more about the link between migraines and serotonin later in this article.

Dopamine: Reduced During Migraine Attacks

Dopamine is often referred to as the “happiness hormone” because its release triggers feelings of euphoria, energy, and motivation. In the brain, it serves as a crucial signaling molecule—also known as a neurotransmitter—that facilitates the transmission of nerve impulses. Additionally, dopamine plays a role in pain perception.

Studies have shown that people with migraines often exhibit low dopamine levels during an attack and that fluctuations in dopamine may contribute to the onset of migraines. This aligns with observations that migraine sufferers are more likely to have conditions associated with low dopamine levels, such as Parkinson’s disease. A reduced dopamine level during an attack can lead to increased sensitivity to external stimuli, such as light or smells. It can also alter how pain is perceived on the skin.

Other studies suggest that migraine sufferers are particularly sensitive to dopamine itself or dopamine-like substances. Research conducted in the United States, the United Kingdom, and Italy involved administering low doses of apomorphine, a dopamine-like substance, to migraine patients. Participants reported increased yawning and more frequent migraine symptoms, such as fatigue, nausea, and vomiting. These symptoms can serve as early warning signs of an impending migraine attack. Furthermore, there is ongoing discussion about a possible link between migraines and mutations in dopamine-related genes.

This raises the question of how we might influence dopamine levels—and potentially the frequency of migraine attacks. There are several approaches: both physical activity and mindfulness practices, such as meditation and yoga, have been shown to increase dopamine release. Sunlight exposure not only boosts vitamin D levels but also increases dopamine production.

Diet also plays a role in migraine management. The body produces dopamine from the amino acids phenylalanine and tyrosine. These amino acids are the building blocks of proteins and are found in many foods, including shellfish, fish, soy products and other legumes, meat, nuts, and avocados. Additionally, a significant portion of dopamine is produced in the gut, making gut health an important factor. A well-balanced gut microbiome, supported by sufficient fiber intake and probiotic foods, can help maintain dopamine levels.

However, it remains unclear whether lifestyle modifications that influence dopamine levels can definitively impact the frequency of migraine attacks. Further research is needed to establish a clear connection.

Serotonin: Low Levels in Migraine Sufferers

Serotonin can also have a positive effect on mood, promoting calmness, harmony, and a sense of well-being. For this reason, it is often referred to as the “feel-good hormone.” It helps suppress feelings of fear and aggression and plays a crucial role in regulating the sensation of satiety.

Additionally, serotonin causes blood vessels to constrict, which can reduce pain signals. Scientific studies have shown that migraine sufferers often have low serotonin levels. A deficiency in serotonin may lead to the dilation of blood vessels, making pain receptors more sensitive to pain stimuli. Some migraine patients also report that their migraine attacks subside after vomiting. This could, at least in part, be explained by serotonin levels, as vomiting increases serotonin through complex metabolic pathways.

Serotonin levels fluctuate in tandem with the female menstrual cycle. Specifically, when estrogen levels are high, serotonin levels are also elevated. At the beginning of menstruation, estrogen levels drop, and serotonin levels decrease as well. This decline in both estrogen and serotonin can contribute to the development of menstrual migraines (commonly referred to as “period headaches”). Understanding these mechanisms also explains why triptans, medications specifically used to treat migraines, can help prevent menstrual migraines. Triptans are serotonin receptor agonists, meaning they act similarly to serotonin itself and can help prevent migraine attacks.

So how can serotonin levels be increased or balanced during menstruation? As with dopamine, diet plays a significant role. Serotonin is produced in the body from the amino acid tryptophan, which is found in various foods, including nuts, legumes, fish, and whole grains. A large portion of serotonin is synthesized in the gut with the help of beneficial gut bacteria. These health-promoting bacteria, in turn, require fiber to thrive, and probiotic foods can also support their growth. Therefore, maintaining an adequate intake of these nutrients is essential for serotonin production and balance.

Conclusion

The occurrence of migraines is influenced by various hormones. Insulin, for example, regulates the uptake of sugar from the blood into the cells, thereby lowering blood sugar levels. Significant fluctuations in blood sugar have been linked to the onset of migraines. This makes it all the more important to keep blood sugar levels both low and stable to help prevent migraine attacks. With the migraine app Ebby, you can determine which foods and food combinations are best suited to maintain your individual blood sugar stability, helping to reduce migraines.

The stress hormone cortisol affects many metabolic processes, including blood sugar regulation. When stress levels—and consequently cortisol levels—are persistently high, blood sugar levels also rise. Some studies indicate that stress can increase both the frequency and intensity of migraine attacks.

The female sex hormone estrogen is suspected to play a role in migraine development. Women are generally more affected by migraines than men, and a drop in estrogen levels at the beginning of menstruation can trigger so-called menstrual migraines. However, migraine attacks often improve during pregnancy.

Dopamine is often referred to as the “happiness hormone,” but it also plays a role in pain perception. Studies have shown that migraine sufferers often have low dopamine levels, which may increase sensitivity to external stimuli and pain perception. Dopamine is synthesized in the body from the amino acids phenylalanine and tyrosine, which are found in various foods. Ensuring an adequate intake of these nutrients can help support dopamine regulation.

Serotonin, also known as the “feel-good hormone,” is often found to be low in some migraine patients. Low serotonin levels may contribute to blood vessel dilation and make pain receptors more sensitive to pain stimuli. Like dopamine, serotonin can be produced in the body, requiring the amino acid tryptophan, which is found in foods such as nuts and fish.

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About the Author
Picture of Jasmin Ostermann
Jasmin Ostermann

Jasmin is studying for a Master's degree in Nutritional Medicine and has been working as a student trainee at Perfood since December 2021. Through her studies, she has experienced the great impact nutrition can have on people's health and quality of life and that some diseases can even be cured through nutrition. Driven by this, she would like to share her knowledge with you.