How Does a Piece of Bread Cause a Migraine?

November 27, 2019

Migraine is the third most prevalent illness in the world and causes suffering for tens of millions of people. In fact, nearly 1 in 4 U.S. household includes someone with migraines.

Migraine is not just a headache but also includes a collection of associated symptoms that can be debilitating. These include nausea, vomiting, light sensitivity and dizziness. Often people struggle to determine what triggers their migraines. It can be environmental, hormonal, genetic, secondary to an underlying illness, or triggered by certain foods, such as cheese, red wine or chocolate. One food that has received a lot of attention in recent years is gluten – a protein found in wheat, rye and barley.

As a registered dietitian and board-certified neurologist who specializes in headache management, I often will have my patients try a gluten-free diet.

Celiac disease vs. gluten sensitivity

When someone suffers from celiac disease – a digestive disorder caused by an autoimmune response to gluten – there is a clear link between migraine headaches and gluten. Gluten triggers immune cells to release antibodies to attack substances the body sees as foreign.

When someone without celiac disease eats gluten, it goes into the gastrointestinal tract where food is broken down and the nutrients are absorbed. In the case of celiac disease, that person’s immune system sees the gluten as a foreign substance (like a virus or bacteria that shouldn’t be there) and attacks it with a specific antibody – called transglutaminase (TG) 2 serum autoantibodies – to destroy the gluten.

The problem is the person’s own healthy tissues gets destroyed in the process. In other words, when people who are sensitive to gluten consume it, the immune system sees this protein as an invader and creates antibodies to capture and destroy the protein. If the protein is sitting in the GI tract or has been absorbed by other organs, the antibodies go looking for it and attack whatever tissue is harboring the gluten protein.

This triggers an inflammatory reaction that puts the body in high alert that injures various healthy organs. Organs then release molecules that cause blood vessels to become leaky and release water, electrolytes and protein into the tissues and cause swelling.

This is an inflammatory response that affects the whole body, not just the brain. In addition to headaches, it can cause broader symptoms including gastrointestinal problems, fatigue and learning difficulties, just to name a few.

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