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Migraine
Migraine is a brain that is highly sensitive to change. We look upstream at energy, inflammation, hormones, blood sugar, and brainstem regulation.
What you may be noticing
A throbbing pain on one side. Light and sound feel like assaults. Nausea, a need to lie in the dark, and a lost day, sometimes several. Before it arrives you may see shimmering lines, feel yawny, or crave sugar. After it leaves, you feel hungover.
Why it is rarely one thing
Migraine is not just a bad headache, and it is not an isolated brain problem. It is a neurological event in which the brainstem and trigeminal nerve become hyperexcitable and release inflammatory signals such as CGRP around blood vessels. The migraine brain is often an energy-hungry brain. When demand outruns supply, it sounds the alarm.
Triggers are not the cause. They are the final straw. A migraine tends to arrive when several loads stack at once: a short night, a skipped meal, a hormonal shift, bright light, fragrance, and a stressful week. Underneath, I often find a gut-brain-hormone story: antibiotics that changed the microbiome, a birth control transition, histamine load, or mold exposure. The work is to lower the loads and to raise the threshold itself.
Patterns we look for
- Mitochondrial energy production, supported by magnesium, riboflavin, and CoQ10.
- Blood sugar dips and skipped meals.
- Hormonal shifts, especially the estrogen drop before menstruation.
- Histamine excess and mast cell activation.
- Gut microbiome disruption and gut-brain inflammation.
- Brainstem and trigeminal sensitization, and cortical spreading depression behind aura.
- Upper neck tension feeding into the trigeminocervical nucleus.
- Sleep disruption and circadian light exposure.
- Environmental exposures: mold, fragrance, and sulfites.
- Visual and vestibular processing, which often make light and motion triggers worse.
How I evaluate it
A comprehensive functional neurological exam examines eye movements, pupil responses, vestibular function, the upper cervical spine, and sensitivity to light. This shows where your threshold is lowest.
Functional labs may include magnesium, ferritin, B vitamins, fasting insulin, a thyroid panel, hormone patterns across the cycle, inflammatory markers, and histamine markers. NeuroQuant volumetric MRI is used only when history, such as a past head injury, suggests structural change.
Seek emergency care for the worst headache of your life, a sudden thunderclap headache, headache with weakness, confusion, fever with stiff neck, or vision loss.
How we address it
Your nervous system is stabilized before it is stimulated, so the plan follows a sequence:
- Quiet the brainstem and the senses: a slow sigh with a long exhale, low humming, a gentle supine neck press, and visual grounding in soft light.
- Lower the trigger load: steady meals, sleep, hydration, histamine, light, and fragrance.
- Restore the upper neck with slow, pain-free chin tucks, turns, and nods, and integrate eye movement and vestibular input with a short daily morning routine. Visual drills pause during an active aura.
- Build focus and cognitive endurance only once those layers hold.
- Address the roots: mitochondrial nutrients, hormone metabolism, gut repair, and environmental burden.
Progress happens by readiness, never by the calendar alone. Consistency, not perfection, raises the threshold of your brain, and a brain with a higher threshold meets life with less pain.
Book your Comprehensive Functional Medicine Eval/Neurological Exam today to discover what the contributing root causes are that are underlying your health concerns.