FAQ Episode 39: Is there a relationship between Migraine and Alzheimer's type dementia?

Frequently Asked Questions about Natural Migraine Relief for Women

Any disorder that repetitively stresses brain cells could promote age related cognitive decline later on. We know this to be true with head trauma or repetitive concussions, pesticide exposure, diabetes, smoking, drug or alcohol use, major depression, vitamin deficiencies, heavy metals exposure and hypertension. But what about having a history of migraine headaches? Is that a risk factor? And if so, what can be done to prevent it?

While migraines share risk factors and brain changes with the four major types of dementia in general, prior studies haven’t definitively proven that migraines cause dementia. A recent study from the Journal of Headache Pain study uncovers some interesting threads in this relationship. It reviewed seven longitudinal studies about migraine and brain aging, drawing from data gleaned from following 202,140 individuals.¹

The investigators looked at both 1) the development of dementia over time and 2) changes found in MRI studies of the brain in those individuals. They concluded that:

1. migraines with aura showed a higher risk of dementia than the migraines without aura.

2. a history of migraines may accelerate brain atrophy and the risk of dementia in the future.

3. migraines (especially those with an associated aura) were associated with damage and atrophy of the thalamus, a key information relay station in the brain that may be a common factor linking migraine and dementia. The thalamus also plays a critical role in cognitive functions such as memory recall, paying attention, planning and organizing, remembering details, and multitasking.

4. this risk was demonstratable for Alzheimer’s type dementia, but not for three other dementias: Lewy body disease, vascular dementia, or frontotemporal dementia.

5. the researchers concluded that: “migraine significantly increased the risk of Alzheimer’s type Dementia and accelerated the annual atrophy of the total cortical surface area and thalamic volume.”

None of these findings are particularly happy nor surprising.

How might migraines promote brain aging?

Injuries to brain tissue can lead to the pruning of the synaptic connections between one neuron and another as well as the loss of neurons. Over time this damage presents on MRI as atrophy, as was found in this study (point #3 above.)

Long lasting headaches like migraines provoke abnormal activity in the thalamus with the potential for long term damage. Because the thalamus is involved in pain processing and is consistently activated in response to painful stimuli it can experience a heightened degree of inflammation and hypoxia.

These factors can aggravate the:

• acute suffering associated with a migraine headache

• perpetuation of a vicious cycle with recurring headaches, and

• cumulative damage that can result in brain atrophy, and with time, the accentuation of cognitive decline.

Eventually this repetitive damage takes its toll on cognitive function, just like putting a lot of mileage on a car makes it age and eventually fall apart faster.

Because this thalamic atrophy is persistent instead of temporary, it suggests that the earlier the intervention, the better the outcome for both migraine and Alzheimer’s type dementia (AD.)

What can we do to reduce both migraines now and cognitive decline later?

Migraine and AD share some risk factors such as smoking, drinking, major depressive disorder, and hypertension, which suggests that managing those factors proactively may limit each and both of them. Quitting smoking or vaping is especially important if you have migraines with an aura.

There are several interventions which can lower the chronic inflammation associated with cognitive decline, migraines and in particular, migraine with aura. I’d like to finish this post with a discussion of one root cause factor for inflammation that you can address directly, even without assistance from your physician.

A neglected but crucial factor in Migraine and Alzheimer’s

An important risk factor in common for these two disorders is the elevation of blood protein called homocysteine. If you have any of the concerns we’ve addressed in this article, it should be a priority to get your homocysteine level checked and then to lower it, if it comes back with a level greater than 10-12 micromols/L.

An elevated homocysteine is a sign that you either:

• don’t get enough B vitamins, especially B6, B12 or folate, or more likely,

• don’t methylate (activate) these vitamins efficiently. This activation invloves adding a methyl chemical group to the vitamins Folate, B12 and B6 or

• have a high protein intake that is not compensated by an otherwise healthy methylated B capacity. This is possible with some high protein keto diets, especially if you have this genetic predisposition.

Approximately one in three of us have some genetic inability to methylate well, which means that there are hundreds of chemical reactions in the cell that can underperform when you are short on methylated B vitamins. For much more on the methylation story and related genetics, review FAQ Episode 3: Using genomic tests like 23andme to learn about your methylation genetics and their role in migraine.

An elevation in homocysteine levels can drive inflammation, arterial plaquing and down the road, the consequences of migraine activation, as well as, enabling cognitive decline.

One clue to the genetic inheritability of suboptimal methylation would be a family history marked by an early onset (age <60) of heart attack or strokes, or cognitive decline.

If you have not had your homocysteine checked, please do so. Any medical office can order this test, or you can get it done direct-to-consumer, with a lab like LifeExtension.com. Click here to see how to order a homocysteine test through them. It currently costs $54.

If the homocysteine level is higher than 10 mcmols/L, and certainly if more than 12 mcmols/L, consider:

• taking a combination of the methylated Bs daily for eight-12 weeks and then recheck the homocysteine level to assess response. Although its best to avoid extra-high protein meals in the 12 hours before the test, you don’t need to be fasting. One daily capsule of “Homocysteine Relief” by Life Extension is a cost-effective choice.

  Keep in mind that some labs still show a ‘normal level’ of up to 14. Unfortunately, using a cross-section of ‘average people’ to generate ‘normal ranges’ shows what is typical, rather than what is optimal. A level closer to six to eight mcmol/L would be desirable, especially if you have underlying factors like migraine, vascular disease or a family history for these, as previously discussed.

• if the follow-up homocysteine test shows that you need an additional boost in lowering your level, you may want to consider taking extra methyl groups to augment the methylation process. This can be provided by a 1000 mg/day dose of a nutrient called Trimethyglycine (TMG). NOW brand’s TMG 1000 mg/day is an example you can easily find locally or online.

  By the way, I want you to know that I do not have any financal ties to Life Extension, NOW or any other nutritional company I reference. Any mention of a name product is strictly based on my personal and professional clinical experience with its cost, quality and potential benefits. In most every case, there are several other similar products that are also reasonable choices.

• reducing the amount of red meat in your diet, particularly the amount of red meat per serving. Methionine is a primary amino acid in red meat, and homocysteine is a direct metabolite of methionine. If you like a steak, it might be reasonable to add an additional dose of the “homocysteine factors Bs” (i.e. methylfolate, methyl B12 and methyl B6, known as pyridoxyl-5-phosphate) after the meal.

• consider reviewing this information with blood relatives, especially those with migraines, or those who had either a heart attack or stroke, especially if they were under age 60 at the time. Because one’s methylation capacity is genetically coded via the MTHFR gene group, your relatives may also run high on their homocysteine level. You may be doing them a big favor if it turns out that they share this risk factor, and with this simple therapy could proactively reduce their risk for migraine, arterial plaquing and dementia.

I go into further detail on all of this, with additional specific management strategies in my Natural Migraine Relief course. Find these details, as well as, additional information on how:

-melatonin

-niacin

-B12

-CoQ10

-riboflavin

also help to augment cellular energy and heal inflammation to help you manage migraine and migraine with aura. These strategies also apply to managing brain aging co-factors.

Consider a $7/month subscription to get unlimited access to the Natural Migraine Relief course and the full subscriber experience.

1. Genetic evidence for the causal relationships between migraine, dementia, and longitudinal brain atrophy Lei Zhao et’ al’ The Journal of Headache and Pain volume 25, Article number: 93 (2024) https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-024-01801-7