The Role Dehydration Plays in Migraine

“Drink enough water,” they said. “It’s good for you,” they said. Turns out, in this case there’s actually something to everyone’s go-to health cliché!

Dehydration and migraine are often intertwined, with the lack of proper hydration potentially triggering more severe headaches, attacks, or heightened symptoms. But it’s not just a wives’ tale; scientific evidence supports it.

Introduction to Migraine

Migraine is a common headache disorder affecting more than 1 billion people worldwide. The chronic and often debilitating condition is more than your run-of-the-mill headache, usually characterized by specific symptoms such as sensory disturbances.

Symptoms of Migraine

Common symptoms of migraine include throbbing head pain (but not always!), nausea and vomiting, sensitivity to light or sound, aura or visual disturbances like blurred or zig-zagged vision, fatigue, and cognitive difficulties such as brain fog.

Triggers and Causes of Migraine

Various factors can trigger an attack, and attacks vary from person to person. Here are some of the most common ones: hormonal fluctuations, stress, dietary choices and habits (like skipping meals or eating tyramine-rich foods like aged cheeses), weather, irregular sleep patterns, sudden physical exertion, medication overuse, and genetics.

Understanding Dehydration

Dehydration, a condition resulting from insufficient fluid intake, has widespread effects on the body. It occurs when the amount of water leaving the body exceeds the amount being taken in. 

Dehydration can stem from various sources, including inadequate water consumption, excessive sweating, vomiting, diarrhea, or a combination of these factors. 

The Physiology of Dehydration

Fluid balance and electrolyte levels play a crucial role in preventing dehydration. Aside from fat cells, water, which makes up a significant portion of the human body, is involved in nearly every bodily function. Electrolytes, including sodium, potassium, and chloride, help regulate fluid balance, nerve conduction, and muscle function.

The process of dehydration unfolds as the body loses more fluids than it takes in, leading to an imbalance in electrolytes. As the body strives to maintain vital functions, it prioritizes the distribution of the remaining fluids, often redirecting them away from less critical areas. This redistribution contributes to increased heart rate, reduced blood volume, and compromised cellular function.

Recognizing Dehydration

Recognizing the warning signs of dehydration helps minimize its effects and prevent potential complications. Key symptoms include:

• Thirst: Being thirsty is the body’s initial signal of water imbalance. Not surprisingly, increasing your fluid intake is a proactive measure in preventing dehydration in the first place.
• Dry mouth and dry skin: Dehydration often manifests as dryness of the mouth and skin. Watch out for changes in the moisture levels of both.
• Dizziness and lightheadedness: Dehydration can lead to a drop in blood volume, affecting blood pressure and causing dizziness. Feeling lightheaded or experiencing unsteadiness may indicate the need for prompt rehydration.
• Dark urine: Monitoring urine color provides a visual indicator of hydration levels. Dark, concentrated urine suggests dehydration, while light, pale urine indicates adequate hydration.
• Fatigue: Dehydration can contribute to feelings of fatigue and lethargy. Recognizing a sudden onset of tiredness may prompt individuals to assess their fluid intake.

The Connection Between Dehydration and Migraine

Now that we’ve covered dehydration from a higher level, let’s explore the relationship between dehydration and migraine. What exactly happens in the body and brain, and how can you prevent it?

How Dehydration Affects the Brain

The impact of dehydration on the brain is… a lot. As the body experiences a loss in fluid levels, the brain, being highly sensitive to changes in hydration status, responds with a series of adaptive mechanisms. Here are some of the main ones:

• Cerebral blood flow reduction: Dehydration leads to a reduction in overall blood volume, which, in turn, diminishes blood flow to the brain. This compromise in blood supply can result in inadequate oxygen and nutrient delivery to crucial regions, contributing to altered brain function and potential headache development.
• Electrolyte imbalance and neural communication: Electrolyte imbalances, a hallmark dehydration trait, wreak havoc on neural communication. Sodium and potassium, essential electrolytes, play pivotal roles in nerve impulse transmission. Dehydration-induced shifts in these electrolyte levels can hinder the efficient transmission of signals within the brain.
• Brain tissue contraction: Dehydration reduces brain tissue volume, causing the brain to contract within the skull (ouch!). This change may exert pressure on pain-sensitive structures, potentially contributing to the development of headaches, including migraine.
• Neurotransmitter disruptions: Dehydration can disrupt the delicate balance of neurotransmitters, the chemical messengers that chit-chat between nerve cells. Changes in neurotransmitter levels, particularly serotonin and dopamine, may lead to migraine attacks as well.
• Increased inflammatory responses: Dehydration may contribute to increased inflammatory markers in the body, including the brain. You know what they say about inflammation? It’s not the best, especially since it can make pain receptors more sensitive. 

Scientific Evidence Linking Dehydration to Migraine

The connection between dehydration and migraine is proven. Studies that explore fluid deprivation, electrolyte imbalance, cerebral blood changes (which can be detected on an MRI), and neuroinflammation help illustrate the link. In fact, according to the American Migraine Foundation, one-third of people with migraine say dehydration is one of their biggest triggers. 

Preventing Dehydration to Manage Migraine

Now that we’ve covered the importance of hydration, let’s talk about practical application. 

Hydration Strategies

Adequate hydration involves more than just water intake. Here’s how you can take a more comprehensive approach and stay hydrated: 

• Optimal fluid intake: Hydration needs vary from person to person, and factors such as age, weight, and activity level influence these recommendations.
• The role of electrolytes: Electrolytes, including sodium, potassium, and magnesium, play a crucial role in maintaining fluid balance. Drinking sports drinks or consuming electrolyte-rich foods like watermelon and spinach can help.
• Hydration timing: Pre-hydration before exercise or exposure to heat helps ward off dehydration-triggered migraine attacks.
• Monitoring symptoms: Pay close attention to urine color or thirst level, which can help you make real-time adjustments to your fluid intake.

Lifestyle Changes to Prevent Migraine

Beyond hydration, lifestyle modifications such as stress management, adequate sleep, dietary modifications, regular exercise, and avoiding excessive caffeine intake can also contribute to migraine prevention. (Also, have we mentioned our love for reusable water bottles?)

When to Seek Medical Help

While mild dehydration and migraine are generally manageable with self-care strategies, there are instances where certain symptoms may signal a more severe condition, requiring immediate medical attention. Recognizing these red flags is crucial for preventing complications associated with dehydration and ensuring the safety and well-being of people experiencing migraine.

Red Flags in Dehydration and Migraine

Not sure if how you’re feeling warrants talking to your doctor? Here are some red flags to watch out for:

• Severe and prolonged headache: If a headache associated with dehydration becomes exceptionally severe or persists for an extended period, it may indicate a more serious condition. This is especially important if the headache differs from your usual migraine pattern.
• Uncontrolled vomiting: Continuous vomiting, especially when it becomes difficult to keep fluids down, can lead to severe dehydration.
• Confusion or altered mental state: Dehydration can affect cognitive function, leading to confusion or an altered mental state. If someone experiences disorientation, extreme lethargy, or an inability to concentrate, medical attention may be urgently needed.
• Signs of severe dehydration: Observable signs, such as sunken eyes, reduced skin elasticity, or very dark urine, indicate a critical fluid imbalance. 
• Rapid heart rate and breathing: Experiencing a significantly elevated heart rate or rapid breathing can indicate severe dehydration, leading to cardiovascular stress. If these symptoms are pronounced and persistent, urgent medical evaluation is necessary.
• Extreme fatigue or weakness: While fatigue is a common symptom of migraine and dehydration, extreme weakness or lethargy disproportionate to the usual symptoms may signal a more severe underlying issue.
• Fainting or loss of consciousness: Dehydration, if severe, can lead to a drop in blood pressure and potentially result in fainting or loss of consciousness. 
• Seizures: In rare cases, severe dehydration may lead to electrolyte imbalances that can trigger seizures. 
• Persistent high fever: Dehydration and a persistent high fever can pose significant health risks. If fever persists and is not responsive to standard fever-reducing measures, seeking medical attention is essential.
• Worsening symptoms despite home care: If symptoms associated with dehydration or a migraine attack continue to worsen despite diligent self-care efforts, it is crucial to consult with a health care professional as soon as you can. This may indicate an underlying issue that requires medical assessment and intervention.

Understanding dehydration goes beyond feeling parched. So, the next time someone tells you to “drink more water,” remember it might just be the key to keeping some of those migraine attacks at bay.