5 Diseases That Commonly Coexist With Migraine

Migraine is believed to coexist with (and perhaps be intricately linked to) a number of health conditions, such as fibromyalgia, mood disorders, gastrointestinal (GI) disease, insomnia, and heart disease.

Gaining knowledge about these conditions may provide clues into your migraine and overall health, and potentially even affect your treatment plans.  

Migraine comorbidities
Verywell / JR Bee 

1. Fibromyalgia

Fibromyalgia is a chronic pain condition that is characterized by widespread muscle pain, debilitating fatigue, memory loss, sleeping difficulties, and mood disorders, like anxiety and depression. Migraine headaches are common in those who suffer from fibromyalgia.

In fact, research suggests that up to 35 percent of migraineurs also have fibromyalgia.

Considering both fibromyalgia and migraine are disabling pain conditions on their own, the idea of them co-existing is worrisome. Each disorder may potentially feed into the other, creating a vicious cycle of pain—one that significantly affects a person's daily functioning and quality of life. 

While the common co-existence of these conditions still perplexes experts, many believe that the phenomenon called central sensitization may be the common thread here. With central sensitization, a person's nervous system remains in a state of high reactivity where the body's threshold for pain is low.

More precisely, central sensitization explains the symptom of allodynia, seen in both fibromyalgia and migraine headache attacks. With allodynia, a person experiences pain with non-painful stimuli, such as a light touch or bedsheet pressing against your skin.

Conclusion

If you suffer from migraines, it's reasonable to ask your healthcare provider to screen you for symptoms of fibromyalgia, especially if you are suffering from various overlapping symptoms like depression, anxiety, and sleeping difficulties. There may be a possibility that the treatment of your fibromyalgia may help thwart off your migraines. 

2. Mood Disorders

A bidirectional link exists between migraines and mood disorders, specifically depression and anxiety. This means that migraines may directly trigger a depressive or anxiety disorder and vice versa—depression or anxiety can increase a person's risk for developing migraines or cause more severe migraine attacks.

While the strong association between migraines and mood disturbances is complicated, experts believe the co-occurrence of these disorders may be due to shared biological pathways—ones that involve the imbalance of the brain chemicals (called neurotransmitters) serotonin and norepinephrine.

In addition to chemical imbalances, genes or hormone influences (especially estrogen in women) may play a role in the development of migraines and mood disorders.

Conclusion

It's important to talk with your healthcare provider if you are suffering from symptoms of depression and/or anxiety, in addition to your migraines. There are numerous therapy options that can target both migraines and mood disorders. Some of these therapies include engaging in an intervention like cognitive-behavioral therapy that targets relaxation and pain management training and/or taking a specific antidepressant, like Elavil (amitriptyline) or Effexor (venlafaxine).

3. Gastrointestinal Disease

Several gastrointestinal diseases have been linked to migraine, with irritable bowel syndrome (IBS) being the most notable one. IBS is a digestive disorder characterized by abdominal discomfort and bowel habit changes, like diarrhea and constipation

In linking migraines to IBS, experts suspect that several factors may be involved. Some of these factors include gut bacteria and the brain-gut axis, serotonin levels, your immune system, genetics, and a phenomenon called central sensitization.

In addition to IBS, migraine has been linked to other gastrointestinal diseases.

These include (although much less robustly):

Conclusion

The connection between your brain and gut is fascinating and an evolving area of research. If you do suffer from GI symptoms—diarrhea, constipation, heartburn, abdominal pain, to name a few—it's best to speak to your healthcare provider. Specific treatments, like elimination diets, or taking medication (such as an antidepressant) that target both conditions may benefit both your GI and migraine health.

Complementary therapies, like acupuncture, biofeedback, cognitive-behavioral therapy, and taking a probiotic, may also be considered.

4. Insomnia

Insomnia refers to difficulties falling asleep, staying asleep, or waking up too early in the morning and being unable to go back to sleep. As a result of these sleeping difficulties, various daytime symptoms arise like poor attention and concentration, fatigue and malaise, anxiety and irritability, and reduced motivation and energy. 

Many migraineurs suffer from insomnia and poor sleep, which can trigger more frequent and severe migraine attacks. Even more, insomnia may precipitate the transformation from episodic migraine to chronic migraine (when a person experiences migraines 15 days or more per month).

The good news is that strategies to combat insomnia, specifically cognitive-behavioral therapy for insomnia (CBTI) can improve your sleep and subsequently reduce migraine frequency. 

Conclusion

If you suffer from sleeping difficulties, consider seeing a sleep specialist, especially if your insomnia is chronic (occurring at least three days a week for three months). Also keep in mind that aside from insomnia, other sleep disorders such as restless leg syndrome and sleep bruxism have been linked to migraines. 

5. Cardiovascular Disease

According to a large Danish study, migraine is associated with a higher risk of cardiovascular disease, including stroke and heart attack. These associations were stronger in women than in men and in those with migraine aura than migraine without aura. 

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5 Types of Migraine Auras Visualized and Explained

Keep in mind, it's difficult to sort out the intricate connection between migraine and cardiovascular disease, especially considering there are numerous factors that may increase a person's chance for having a stroke or a heart attack such as smoking, the use of oral contraceptives, high blood pressure and cholesterol, and a family history of heart disease. 

Conclusion

While it's hard to tease out why people with migraines may be at a higher risk for developing cardiovascular disease, it's a potentially important relationship for you and your healthcare provider to consider.

Besides reviewing and addressing potential cardiovascular risk factors with your healthcare provider (which is best to do regardless of whether you suffer from migraines or not), how you prevent and treat your migraines needs to be considered. This is because the presence of cardiovascular disease limits the use of certain migraine medications.

A Word From Verywell

Sorting out the connections between your migraines and other health conditions is a challenging process. While some of them may be related, others may not be, and treating one ailment is not a guarantee of treating the other condition. Regardless, it's best to look at your overall health to determine if your individual health conditions may be interrelated.

Besides discussing these connections with your healthcare provider, focus on factors within your life you can control such as seeing your practitioner regularly, eating well-balanced, nutritious meals, exercising regularly, and managing your stress which will all contribute to better health.

Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  • Martin PR, Aiello R, Gilson K, Meadows G, Milgrom J, Reece J. Cognitive Behavior Therapy for Comorbid Migraine And/Or Tension-Type Headache and Major Depressive Disorder: An Exploratory Randomized Controlled Trial. Behaviour Research and Therapy. October 2015;73:8–18. doi:10.1016/j.brat.2015.07.005

  • Rains JC. Sleep and Migraine: Assessment and Treatment of Comorbid Sleep Disorders. Headache. 2018 Jul;58(7):1074-91. doi: 10.1111/head.13357

  • Tietjen GE. American Migraine Foundation. (n.d.). Allodynia: When Touch Hurts But Shouldn't. https://americanmigrainefoundation.org/resource-library/allodynia-when-touch-hurts-but-shouldnt/

  • Wei CB, Jia JP, Wang F, Zhou AH, Zuo XM, Chu CB. Overlap between Headache, Depression, and Anxiety in General Neurological Clinics: A Cross-sectional Study.Chin Med J (Eng). 2016 Jun 20;129(12):1394-99. doi:10.4103/0366-6999.183410

  • Whealy M, Nanda S, Vincent A, Mandrekar J, Cutret FM. Fibromyalgia in migraine: a retrospective cohort study. J Headache Pain. 2018; 19(1):61. doi:10.1186/s10194-018-0892-9

Colleen Doherty, MD

By Colleen Doherty, MD
 Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis.