While there are various types of migraines, some women experience these painful headaches when their levels of progesterone drop during their cycle, just before menstruation. To mitigate symptoms, some doctors may recommend a method of birth control for their patients who have what are called “menstrual migraines”: The Depo-Provera shot.
The Depo-Provera shot is essentially synthetic progesterone. Progesterone is an immunosuppressive steroid hormone – it’s what rises dramatically during pregnancy in order to prevent the immune system from attacking the growing, unborn child.
However, like most causes of chronic or recurring pain, the root cause of most migraines, menstrual or not, is a combination of neurotoxicity plus nutrient deficiency, leading to cellular damage and inflammation.
These two root causes can lead to just about any chronic condition depending on the type of toxic substances you’re exposed to and where they are deposited in the body, the nutrients you’re missing, your genetic and inherited vulnerabilities, any physical obstructions in the body, and more. It can lead to greater risk of pathogenic infections, hormonal imbalances, unstable blood sugar levels, etc. Migraine symptoms, like other symptoms displayed by the body, are evidence that the immune system is activating to attempt to detoxify and correct the issue.
Progesterone slows or stops the immune system from attempting this, via suppression. Unfortunately taking progesterone (or other steroid hormones) without correcting the underlying issue of toxicity and deficiency can make the root of the problem much worse in the long run due to the fact that immune suppression accelerates the bioaccumulation of toxicity.
According to research on the root causes of migraine, there is emphasis on the phenomenon of excitotoxicity and the destruction or damage of neurons in the brain. Excitotoxicity occurs when there are toxic, oxidative stressors present, an imbalance in minerals/electrolytes, and additional nutritional deficiencies, leading to over-excitation of nerve cells and ultimately, cell rupture. However, the inflammation and pain is not triggered until the immune system activates in order to repair or replace these cells.
For menstrual (hormonal) migraines, toxic substances like cadmium can trigger an increase of estrogen in the body, while also disrupting synthesis of progesterone. It’s possible that although hormonal imbalance in and of itself leads to additional negative effects, this may be an adaptive response of the body to toxic exposures.
As stated previously, progesterone is immunosuppressive, but in contrast, estrogen up-regulates detoxification via increasing glutathione production in the liver. Estrogen and phytoestrogens (estrogenic compounds from plants), increase the expression of antioxidant enzymes in the body, and are protective against glutamate-mediated excitotoxicity and nerve cell death in the brain.
A rise in estrogen improves protection and detoxification against harmful substances, while a drop in progesterone allows the immune system to engage more effectively in this endeavor.
Therefore, the solution to this problem is not to increase progesterone nor try to starve the body of beneficial phytoestrogens (which makes it more difficult for the body to correct the root cause of the imbalance), but to help the body eliminate the toxicity that has been deposited in the brain and provide enough nourishment for the body to repair nerve cells.
What I would do to remedy this issue:
Improve antioxidant intake. Eat more fresh fruits. If possible, I would get a juicer and start juicing (leafy greens, cucumber, apples, oranges, carrots, ginger, lemon, etc.) for potent nutrition, regularly or even daily in the mornings, especially for the folate, vitamin C content, and other antioxidants, bioflavonoids, carotenoids, etc. Many studies have demonstrated that the health of our cells is dependent on the presence of antioxidants to counteract reactive oxygen species (ROS) which cause oxidative stress and damage.
Increase magnesium rich foods and water. Our water sources are typically deficient in magnesium, including even most bottled spring waters. Fiji, Evian, & Gerolsteiner are a few I’ve found that have sufficient magnesium content. Coconut water also has higher levels of magnesium.
Have a supplement on hand like magnesium threonate. This is the best form for the neurological system but some may get headaches with it. You may want to try magnesium malate or glycinate if so.
However, food and water sources are most effective for absorbing and replenishing magnesium levels, If you take vitamin D supplements it’s more likely that you are deficient in magnesium (activation of D requires magnesium). Side note: Blood levels of magnesium are not a reliable measure of the magnesium content in tissues.
Include a methylated B complex plus additional B1 (thiamine). Taking a B complex that contains all of the B’s may be helpful to mitigate deficiencies, at least short term. It is always best to obtain nutrients through food first and foremost, but supplementation (especially via whole food supplements) can help accelerate getting nutrients to depleted cells.
- B1 (thiamin/thiamine)
- B2 (riboflavin)
- B3 (niacin)
- B5 (pantothenic acid)
- B6 (pyridoxine)
- B7 (biotin)
- B9 (methylfolate, not folic acid)
- B12 (methylcobalamin)
Since B complex supplements often contain very high levels of each vitamin you may only need to supplement every other day for a time.
Additional B1 (thiamine) daily to help correct severe deficiency may help tremendously. Some studies have recommended 100mg thiamine per day or twice daily, for chronic conditions.
Thiamine is critical for brain health and has been found to help with severe headache disorders and recovery from neurological damage. Thiamine forms complexes with heavy metals like lead and cadmium to improve excretion of these toxic elements, and through excess exposure to heavy metals, many can become severely thiamine deficient as a result.
Unfortunately, no natural sources or foods exist which can replenish the amount you may need if this is the case. Deficiency in B1 can lead to cell death and severe deficiency causes neurological damage (among other conditions, such as hyperglycemia).
Like magnesium levels, B1 deficiency in tissues is not detected on blood tests. Sufficient magnesium levels are important for thiamine utilization. Benfotiamine (a supplemental form of thiamine) is better absorbed but does not have the lead-chelating capability that thiamine hydrochloride does.
Address potential iodine deficiency. Menstrual migraines are a sign of other endocrine conditions and if a hormonal imbalance is suspected, it may be wise to address potential iodine deficiency.
Those who have migraines often have undiagnosed, subclinical hypothyroidism. Iodine is important for proper thyroid and ovarian function. Chronic illness affecting the thyroid and ovaries (e.g. Hashimoto’s and PCOS) is a very common set of comorbidities for women!
Eating seaweed or taking a seaweed supplement is best. A nascent iodine supplement is another option. In general, Americans don’t get enough iodine in their diets and the RDA (recommended daily amount) is actually quite low compared to the intake via the typical diet of individuals living in Japan where there is a much lower risk of iodine-related chronic illnesses and cancers.
Start low and slow with increasing iodine because it is detoxifying. I would take breaks from supplementation once in a while if choosing to supplement rather than consume seaweed.
Consider chiropractic care. Obstructions and pinches, especially in the cervical spine, can negatively impact nerve impulses and proper drainage of lymphatic fluid from the head to lymph nodes in the neck and beyond. Shifts in barometric pressure during seasonal changes can further restrict lymphatic drainage of the sinuses in the head, leading to headache pain or migraines.
In addition to relieving any misalignment of the spine, staying hydrated is important. Lymphatic massage may help as well.
Incorporate bentonite / montmorillonite clay. Using clay a bath or in supplement form may help bind and remove heavy metals like cadmium and lead. Animal studies have found that using clay can reduce the levels of several toxic metals in organs and tissues.
Include the following types of foods in your diet to obtain more B vitamins, magnesium, antioxidants, vitamin C, and more:
Leafy greens, almonds, peanuts, sunflower seeds, walnuts, cashews, hemp hearts, pumpkin seeds, avocados, quinoa, and antioxidant-rich berries (blueberries, strawberries, blackberries, etc.).
Side note: While dark chocolate is high in antioxidants, it also typically contains significant levels of cadmium and lead.
The association between cadmium, lead and mercury blood levels and reproductive hormones among healthy, premenopausal women https://academic.oup.com/humrep/article/26/10/2887/610233?login=true
Effect and mechanism of cadmium on the progesterone synthesis of ovaries https://pubmed.ncbi.nlm.nih.gov/17719163/
Estrogen protects primary cortical neurons from glutamate toxicity https://www.sciencedirect.com/science/article/abs/pii/0304394096127609
Estrogen May Protect Against Cognitive Effects of Lead Exposure https://www.endocrinologyadvisor.com/home/topics/androgen-and-reproductive-disorders/estrogen-may-protect-against-cognitive-effects-of-lead-exposure/
Protective effect of 17beta-estradiol on oxidative stress and liver dysfunction in aged male rats https://pubmed.ncbi.nlm.nih.gov/18309775/
Cadmium, iron, lead overload in patients with migraine, deficient in magnesium, copper, and zinc: https://www.jpma.org.pk/PdfDownload/7394
An investigation of oxidant/antioxidant balance in patients with migraine: a case-control study https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-019-1555-4
B1, B6, B12 for menstrual related migraines: https://www.sid.ir/FileServer/JE/df50010520200302.pdf
Chronic Migraine Responding to Intravenous Thiamine: A Report of Two Cases https://pubmed.ncbi.nlm.nih.gov/27197607/
Nutrients to Improve Mitochondrial Function to Reduce Brain Energy Deficit and Oxidative Stress in Migraine https://www.mdpi.com/2072-6643/13/12/4433
Subclinical hypothyroidism is associated with migraine: A case-control study https://journals.sagepub.com/doi/full/10.1177/0333102418769917
Iodine and chronic illness: https://youtu.be/seymLq1ofXA
Inflammation and excitotoxicity: role in migraine pathogenesis https://pubmed.ncbi.nlm.nih.gov/16688611/
Inhibition of Mg2+ Extrusion Attenuates Glutamate Excitotoxicity in Cultured Rat Hippocampal Neurons https://www.mdpi.com/2072-6643/12/9/2768
Lead and Excitotoxicity https://link.springer.com/referenceworkentry/10.1007%2F978-1-4614-5836-4_142
Cell Damage Mechanisms in Thiamine Deficiency: Focus on Oxidative Stress, Excitotoxicity and Inflammation https://academic.oup.com/alcalc/article/44/2/141/185731?login=true
Effects of thiamin and methionine administration in preventing cadmium-induced biochemical alterations and metal concentration in male rats https://pubmed.ncbi.nlm.nih.gov/9760416/
A randomized controlled trial of chiropractic spinal manipulative therapy for migraine https://www.sciencedirect.com/science/article/abs/pii/S0161475400900733https://www.sciencedirect.com/science/article/abs/pii/S0161475400900733
Bentonite Clay as a Natural Remedy: A Brief Review https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC5632318/
Cadmium and lead in cocoa powder and chocolate products in the US Market https://pubmed.ncbi.nlm.nih.gov/29310543/