Headache Pain? Inflammation – and fat – could be to blame What is the connection between migraine headaches, inflammation, and body fat? - By: gregffatma

I’m a neurologist, which means that I diagnose and treat disorders of the brain, spinal cord, nerves and sometimes muscles. Since the brain is the body part that recognizes pain, much of my practice involves treatment of painful conditions, such as headaches.

Inflammation is the body’s attempt to remove harmful stimuli and initiate healing. Inflammation is an extremely important process because without it, our bodies could not fight infection, and our wounds would not heal. For example, if my immune system could not cause inflammation in my foot, my foot sprain would never heal, and I would be stuck using crutches for the rest of my life!

However, too much inflammation is harmful. Inappropriate inflammation is a major contributing factor to many “Western” diseases, such as heart attacks, strokes and also to headaches.

Migraines

Migraine is a specific type of headache that afflicts 12% of all Americans. Its hallmarks are a moderate to severe throbbing pain on one side of the head that is worse with physical activity, lasts for hours to days, and is associated with nausea, vomiting, or light and noise sensitivity.

Medications often used for migraines include NSAIDS, or “non-steroidal anti-inflammatory drugs,” and corticosteroids.

Estrogen has many effects, one of which is suppression of the immune system. Women are more likely to have migraines around the time of menstruation, when their estrogen levels are low, and are less likely to have migraines when they are pregnant, when their estrogen levels are high.

An important change that takes place during a migraine is called “neurogenic inflammation,” which is the swelling of the blood vessels of the brain, possibly with leakage of bloodstream proteins into brain tissue. Many successful migraine treatments work by counteracting this blood vessel swelling, including caffeine, a group of medications called the triptans, and another group of medications called ergots.

Cytokines are small proteins that most cells in the body produce to communicate with other nearby cells. One cytokine that triggers blood vessel swelling in neurogenic inflammation is called CGRP (calcitonin G-related peptide). CGRP also stimulates the production and release of more inflammatory cytokines with names such as TNFá (tumor necrosis factor-alpha), IL-1â (interleukin 1-beta), and IL-6 (interleukin-6) from special white blood cells called lymphocytes. While the names of all these cytokines can seem a little technical, just remember that they’re all small proteins that allow communication between nearby cells.

Scientists gave TNFá to volunteers, who subsequently developed headaches. In another study, an anti-inflammatory cytokine called IL-10 (interleukin-10) decreased pain levels in volunteers. Studies have shown increased levels of the proteins TNFá, IL-1â, and IL-6 in the blood draining away from the head in the first few hours after a migraine attack.

A potential new class of migraine medications works by preventing CGRP from signaling the blood vessels to dilate. These “CGRP receptor antagonists” are still in development.

While neurogenic inflammation is a localized process of the brain’s blood vessels, migraine might also involve systemic inflammation, or inflammation of the rest of the body. Two studies found that migraine sufferers had elevated levels of many inflammatory molecules in their blood both during headaches (TNFá, IL-1â, and IL-10), and perhaps more importantly, even in between headaches (TNF-á and IL-1).

Headaches, inflammation, well-being and fat

Simply put, headaches make us feel lousy. Migraine sufferers especially tend to feel tired and achy. Inflammation relates to these feelings. When scientists studied the blood of volunteers who felt tired, irritable, achy, feverish and who couldn’t concentrate, they found that a particular group of white blood cells called mononucleocytes produced more IL-1 and IL-6 in these afflicted volunteers than in other volunteers who felt good.

If you have migraines, your fat may have something to do with your headaches, possibly because your fat cells secrete an anti-inflammatory protein (cytokine) called adiponectin. Interestingly, the less body fat you have, the more adiponectin your fat cells produce. In other words, thin people have high adiponectin levels, and overweight people have low adiponectin levels. Adiponectin protects against diabetes, high cholesterol and atherosclerosis (hardening of the arteries).

Two important types of dietary fat are the omega-3 fatty acids and omega-6 fatty acids. In general, omega-6 fatty acids promote inflammation, and omega-3 fatty acids oppose inflammation. While your body does need some omega-6 fatty acids, the typical Western diet contains up to 30 times too much. Therefore, decreasing dietary fat intake is normally expected to reduce the amount of inflammatory omega-6 fatty acids.

Does this mean that people can cure their headaches by losing body fat? We don’t know for sure, but we do know that obese people with headaches are more likely to find their headaches worsening. If you have headaches, you may want to ask your doctor if decreasing your fat intake or altering the types of fat you consume is worthwhile.

About the Author

By Dr. Joshua A. Tobin Joshua A. Tobin, M.D., is a board-certified neurologist at 21st Century Neurology in Phoenix, AZ. He especially enjoys caring for patients with headaches, fibromyalgia and sleep disorders Improve your Health and Increase your Wealth

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