What is the relationship between migraine and osteoporosis?

Today we talk about the surprising link between migraine and osteoporosis: we will explain the connection between these two pathologies, the factors that trigger them and the treatment options through supplements.

Migraine and osteoporosis are two medical conditions that have traditionally been unrelated, however, recent research suggests that there may be an intriguing link between them.
Read on to find out more.

Starting from the beginning: what is migraine?

Migraine is a severe, recurring headache that can be accompanied by a variety of symptoms, including severe pain, nausea, vomiting, and sensitivity to light and sound.
These headaches are often one-sided and throbbing in nature.
This type of headache is of primary origin, often disabling and directly affects more than one billion people worldwide.
Despite its widespread prevalence, migraine remains underdiagnosed and poorly treated.
According to the scientific journal The Lancet, which has published a study of the Global Burden of Disease Study, migraine is the second most prevalent neurological disorder worldwide and is responsible for more disabilities than all other neurological disorders combined. https://doi.org/10.1016/S1474-4422(18)30322-3

While the exact cause of migraine is not yet fully understood, several points have been identified that could act as triggers: #

• Hormonal changes: Fluctuations in estrogen levels, such as those that occur during menstruation, pregnancy, or menopause, can trigger migraines in susceptible individuals.
• Environmental factors: Bright lights, loud noises, strong odors, and certain weather conditions can act as triggers and have been described as the most common. https://doi.org/10.1111/j.1526-4610.2009.01443.x
  • Emotional and physical factors: Stress, anxiety, fatigue, lack of sleep, and excessive physical exertion have been associated with migraine attacks.
• Dietary triggers: Certain foods and beverages, such as aged cheeses, chocolate, caffeine, alcohol, and artificial sweeteners, are known to trigger migraines in some people.
• Genetic predisposition: Migraine tends to run in families, suggesting a genetic component to the condition.

Let’s look at the standings

According to the International Classification of Headache Disorders, (ICHD-3) migraine is classified into three main types:

• Migraine without aura: This migraine is characterized by recurrent headache attacks that last from 4 to 72 hours.
  Typical features of an attack include unilateral location, pulsatile type, moderate or severe pain intensity, and worsened by routine activity.
  However, bilateral pain is not uncommon; Population-based data indicate that approximately 40% of people with migraine report bilateral pain during attacks.

The most frequent associated symptoms are photophobia, phonophobia, nausea and vomiting.
Prior to the onset of pain, prodromal symptoms may include depressed mood, yawning, fatigue, and cravings for specific foods.
After resolution of the headache, postdromic symptoms can last up to 48 hours and usually include tiredness, difficulty concentrating, and neck stiffness.

• Migraine with aura: About one-third of people with migraine experience aura, either with each attack or with a few attacks.
  Auras are defined as transient focal neurological symptoms that usually precede, although sometimes accompany the headache phase in a migraine attack. In more than 90% of affected individuals, the aura manifests visually, classically as fortification specters because its pattern resembles the walls of a medieval fort.
  Sensory symptoms occur in approximately 31% of affected individuals and are usually experienced as predominantly unilateral paresthesia (tingling and/or numbness) gradually spreading to the face or arm. https://doi.org/10.1016/0895-4356(91)90147-2

Less common aura symptoms include aphasic speech disorders, brainstem symptoms (such as dysarthria and vertigo), motor weakness (in hemiplegic migraine), and retinal symptoms (e.g., repeated monocular visual disturbances).
The symptoms of the aura may be similar to those of transient ischemic attacks, but they can be differentiated on the basis that the symptoms of the aura often spread gradually – over about 5 minutes – and occur in succession, whereas the symptoms of an ischemic attack have a sudden and simultaneous onset. https://doi.org/10.1177/033310241773820

• Chronic migraine: Chronic migraine is defined as more than 15 days of headache over the course of a month, for more than 3 months and meeting the ICHD-3 criteria for migraine on more than 8 days per month.
  Chronic migraine is not a static entity, and reversion to episodic migraine is not unusual.
  Similarly, a retransformation to chronic migraine can occur later. https://doi.org/10.1186/s10194-017-0787-1

What about osteoporosis?

Osteoporosis is defined as a specified systemic skeletal disease with a combination of poor bone quality and/or low bone mineral density.
As a result, bone strength decreases and the risk of fractures increases.
DOI: 10.1001/jama.285.6.785

It is most commonly associated with aging, particularly in women after menopause.
As individuals age, their bone mass decreases and the rate of bone loss exceeds the rate of osteogenesis, resulting in weakened bones.
While age is a significant risk factor for osteoporosis, other factors include:

• Gender: Women, especially after menopause, are at a higher risk of developing osteoporosis compared to men.

• Hormonal imbalances: Low levels of estrogen in women and testosterone in men can contribute to bone loss.

• Lifestyle factors: A sedentary lifestyle, smoking, excessive alcohol consumption, and a diet low in calcium and vitamin D can increase the risk of osteoporosis.

• Medical conditions and medications: Certain medical conditions (e.g., rheumatoid arthritis) and medications (e.g., corticosteroids) can accelerate bone loss.

The Link Between Migraine and Osteoporosis

While the exact mechanisms linking migraine and osteoporosis are not yet fully understood, several studies have shown an association between the two conditions.
One hypothesis suggests that the chronic pain experienced by migraine sufferers may lead to reduced physical activity and increased sedentary behavior, thereby contributing to decreased bone density.

Another possibility is that shared genetic or hormonal factors may influence both conditions.
Further research is needed to elucidate these connections.

On the other hand, magnesium and vitamin D levels are known to be vital for proper bone function, while they can regulate the frequency of migraines by shaping nociceptive processes in neurons positive for the unmyelinated calcitonin gene-related peptide (CGRP), a process also influenced by ovarian hormones.
Inflammatory mediators such as certain interleukins and tumor necrosis factor-α contribute to endothelial dysfunction and pain pathways in migraine and exert a significant influence on bone turnover that induces osteoporosis.

In addition, inflammatory mediators play a role in activating the trigeminovascular system, which in turn releases pro-inflammatory substances, particularly CGRP.
Elevated levels of CGRP have also been found in subjects with osteoporosis and may indirectly regulate osteoclast activity.
In addition, both diseases include high prevalence rates of migraine and osteoporosis in patients with inflammatory bowel disease, possibly due to multiple factors, such as gut microbiota profile, stress hormones, nutrients, and neuropeptides that affect different gut bacterial strains.
Finally, migraine causes social withdrawal with the consequent reduction of motor activity, and less exposure to light due to a photophobic reaction. https://doi.org/10.3988/jcn.2022.18.6.720

The exact mechanisms underlying the relationship between migraine and osteoporosis are likely elusive.
However, several lines of evidence in the literature suggest that osteoporosis and migraine have a shared pathophysiology.
First, bone density is significantly associated with magnesium, an essential micronutrient with a wide range of metabolic, structural, and regulatory functions.
In humans, magnesium deficiency contributes to osteoporosis.
In addition, an association between serum magnesium and bone density has been identified in pre- and postmenopausal women.
Magnesium deficiency also has a strong association with migraine attacks.
DOI: 10.1016/0022-510x(95)00196-1

Gallai et al.
It showed that people suffering from migraines had lower levels of magnesium in plasma and saliva between attacks compared to controls without migraines.
DOI: 10.1111/j.1526-4610.1992.hed3203132.x

Therefore, osteoporosis and migraine are associated with hypomagnesemia, suggesting an interaction between osteoporosis and migraine.

Alternative treatment with supplements

While conventional treatment for migraines and osteoporosis often involves medication, there is growing interest in alternative approaches.
One such approach is the use of supplements to support both conditions simultaneously.
Here are some supplements that may be beneficial:

• Vitamin D: Adequate levels of vitamin D are crucial for bone health.
This vitamin promotes calcium absorption and helps maintain bone density.
It may also play a role in reducing the frequency and severity of migraines.

• Magnesium: This mineral has been shown to potentially relieve migraines and may also help improve bone mineral density.

• Omega-3 fatty acids: Found in fish oil and certain nuts and seeds, omega-3 fatty acids have anti-inflammatory properties that can reduce the frequency and intensity of migraines and support bone health.

• Coenzyme Q10 (CoQ10): This antioxidant has shown promise in reducing the frequency and severity of migraines.
It can also have a positive impact on bone health.

Our contribution

In this section, we would like to suggest two products, one of them from our own Salengei laboratory and the other that is part of our star products that, in addition to making up for the aforementioned shortcomings, will provide benefits at a systemic level.

The first preparation is Active Procollagen Plus, which incorporates hydrolyzed fish collagen, hyaluronic acid, various vitamins with regenerative capacity, minerals and amino acids.

Thanks to its formula, it contributes to the normal formation of collagen and connective tissue, to the normal functioning of bones and cartilage, and to the maintenance of bones in normal conditions.
In addition, through vitamin C, it stimulates the generation of collagen.

By clicking on the product link, you will be able to read all the components, the product certifications and more information for a better understanding.

On the other hand, DAOSIN solves the problem of hyperhistamine due to diaminooxidase (DAO) deficiency.
It is well known that DAO deficiency overloads our system with biogenic amines, which produce headaches and other disorders that affect well-being.

In addition, you can click here to read a little more about this interesting topic that we have developed in depth in a previous post.

Conclusion

While the link between migraines and osteoporosis requires more research, it’s clear that there’s a connection worth exploring.
By understanding migraine triggers, recognizing the age-related risk of osteoporosis, and considering alternative treatment options such as supplements, we can take steps to manage both conditions effectively.

As always, it is crucial to consult with a healthcare professional before making any changes to treatment plans or starting new supplements.