From the Guidelines
Autoimmune disorders and migraines are related, with shared inflammatory pathways potentially triggering migraine attacks in individuals with autoimmune conditions. The relationship between autoimmune disorders and migraines is complex, with various autoimmune conditions, such as thyroid disease, celiac disease, and autoimmune gastritis, increasing the risk of developing migraines 1. A comprehensive treatment approach is recommended for individuals suffering from both conditions, including first-line migraine treatments like triptans and preventive medications, as well as immunosuppressants and biologics for autoimmune management.
Key Considerations
- The connection between autoimmune disorders and migraines involves shared inflammatory mechanisms and immune system dysregulation, with inflammation potentially triggering migraine attacks in those with autoimmune disorders 1.
- Treatment should be coordinated between neurologists and rheumatologists or immunologists for optimal management of both conditions.
- Anti-inflammatory diets, regular sleep patterns, stress management techniques, and moderate exercise can help manage both conditions.
- Keeping detailed symptom journals can identify triggers and treatment effectiveness.
Treatment Options
- First-line migraine treatments include triptans like sumatriptan (50-100mg as needed) for acute attacks and preventive medications such as topiramate (starting at 25mg daily, increasing to 100mg daily), propranolol (40-160mg daily), or amitriptyline (10-50mg at bedtime) 1.
- For autoimmune management, treatment depends on the specific condition but often includes immunosuppressants like methotrexate, biologics, or corticosteroids.
- Anti-inflammatory diets may benefit both conditions by reducing foods that trigger inflammation (processed foods, refined sugars) while increasing anti-inflammatory options (fatty fish, olive oil, fruits, vegetables).
Recent Evidence
- A 2022 study found that adult atopic dermatitis is associated with food allergy, asthma, and allergic rhinitis, highlighting the importance of considering comorbidities in individuals with autoimmune disorders 1.
- A 2021 review emphasized the need for a comprehensive approach to diagnose and manage migraine, including patient-centric care and education, as well as best practices for acute and preventive treatment 1.
From the Research
Relationship Between Autoimmune Disorders and Migraines
- There is evidence to suggest a relationship between autoimmune disorders and migraines, with studies indicating that patients with systemic autoimmune diseases are more likely to experience migraines 2.
- Systemic lupus erythematosus, antiphospholipid syndrome, Sjogren's syndrome, and other diffuse connective tissue diseases have been linked to an increased prevalence of migraines, particularly migraines with aura 2.
- Endothelial dysfunction is a common alteration among autoimmune diseases and headache types, which may help explain the link between these disorders and migraines 2.
- Large propensity cohort population-based studies have suggested that systemic autoimmune diseases are more frequent in patients suffering from migraines 2.
Prevalence of Migraines
- Migraines are a common and debilitating condition, affecting approximately 12% of the population, with a significant impact on quality of life and productivity 3, 4, 5, 6.
- The prevalence of migraines is higher in women, and various studies have reported an association between migraines and systemic autoimmune diseases, which are also more common in women 2.
Treatment of Migraines
- Treatment options for migraines include analgesics, nonsteroidal anti-inflammatory drugs, triptans, and calcitonin gene-related peptide receptor antagonists, among others 3, 4, 5, 6.
- Preventive treatments, such as calcitonin gene-related peptide monoclonal antibodies, have been shown to improve quality of life and reduce disability in patients with migraines 6.