The Link Between Gluten and Migraine

More and more, scientists have been studying the link between migraine and gastrointestinal (GI) disorders, including gluten-related disorders like celiac disease and non-celiac gluten sensitivity (NCGS). So far, they've found an association between multiple GI disorders and migraine, but how the two may affect each other is still unclear.

Celiac Disease and Gluten Sensitivity

Celiac disease and non-celiac gluten sensitivity are both common disorders. It's estimated that NCGS affects 0.6 percent to 6 percent of the general world population, while celiac affects an estimated 1.4 percent. Though NCGS is believed to be more prevalent, there isn't currently enough information to really know how many people have non-celiac gluten sensitivity.

Both celiac disease and gluten sensitivity involve a reaction to gluten, a protein in wheat, barley, and rye, though the mechanisms involved in NCGS aren't yet understood. In celiac disease, gluten triggers an autoimmune response that causes your immune system to attack, resulting in damage to your small intestine.

The Link Between Gluten and Headaches

People with celiac disease and NCGS appear to have headaches and migraines at a much higher rate than the general population. And conversely, if you have migraines, you're more likely to have celiac disease or NCGS.

A 2018 meta-analysis and review of multiple studies on this phenomenon, published in the journal Nutrients, found that the mean prevalence of headaches in celiacs was 26 percent, significantly higher than in the control groups without celiac disease. The review also noted that headache, usually migraine, was often reported as the first symptom of celiac disease.

There's less research on NCGS and headaches, but a 2018 narrative review of available studies on the topic in World Journal of Gastroenterology reported that around 25 percent of people with gluten sensitivity had chronic headaches and that migraine especially is very common in this population.

Similarities Between Celiac Disease and Migraine

Some of the similar features of both celiac disease and migraine include:

• A higher prevalence in females: More women get migraines and severe headaches than men; the prevalence is nearly 21 percent in women and not quite 10 percent in men. Celiac disease, too, affects more women than men, occurring in an estimated 0.6 percent of women and 0.4 percent of men.
• A potential genetic component: Like celiac, migraines also seem to run in families.
• Relief during pregnancy: Some women experience fewer migraines during pregnancy, just as some women with celiac see a reduction in symptoms while they're pregnant.
• Overlapping symptoms: The conditions have a number of symptoms in common like fatigue, diarrhea, constipation, nausea, bloating, head pain, and brain fog, which includes difficulty concentrating and paying attention, poor short-term memory, and slowed thinking.
• An association with depression and anxiety: Having migraines increases your chance of developing depression, while depression, in turn, increases your risk of developing migraines. The same is true with anxiety and migraine. Depression and anxiety have both been linked to celiac disease and gluten sensitivity as well.

The Role of a Gluten-Free Diet

Studies have found that for some people with celiac disease, a gluten-free diet can help to reduce the number and severity of migraines or even eliminate them completely, which is good news since this diet is the only option available to treat celiac.

The aforementioned Nutrients review found that, depending on the study, headache frequency was significantly reduced in 51.6 percent to 100 percent of adults with celiac disease who followed a gluten-free diet, and up to 75 percent of adults had complete relief from their headaches. In children on the gluten-free diet, the number of headaches was significantly reduced in 69.2 percent to 100 percent of subjects, and up to 71 percent found complete headache relief.

It's unclear how long it took participants to feel better since there were a variety of studies included in the review, but in general, many people start to feel better after a few days on a gluten-free diet. Symptoms like bloating, gas, and nausea often clear up within a few weeks. However, it can take months or even years for your gut to completely heal.

As for gluten sensitivity, part of the diagnostic process involves going on the gluten-free diet to see if it helps your symptoms, including migraine. If your symptoms improve by 30 percent or more as measured by a diagnostic questionnaire that you periodically fill out, you'll most likely be diagnosed with NCGS as long as everything else has been ruled out.

Experts believe that it's entirely possible that gluten sensitivity is temporary, so a gluten-free diet may only be necessary for a period of time if you don't have celiac disease.

In fact, one proposed treatment option is to eliminate gluten for a specific period of time—say, six months—and then reintroduce it gradually via low-gluten foods. Then, in the long-term, the gluten-free diet can be used as needed to treat any symptoms that reoccur.

It's still not clear why eliminating gluten might help migraines, but it's probably due to a variety of factors, including inflammation caused by ingesting gluten (inflammation is believed to play a large role in migraine).

Getting Tested

Despite the potential connection between migraine, celiac disease, and NCGS, most healthcare providers don't advocate testing for celiac disease in migraineurs unless you also suffer from celiac symptoms or a close relative has already been diagnosed with the disease.

Some celiacs who get migraines have found that they need to adhere very strictly to their diets in order to get their migraines under control. In fact, cheating on the gluten-free diet can bring on a very painful attack.

In addition, it can take some time on the diet to get your migraines to die down completely. You'll likely see an improvement in headache severity and frequency right away, but it can take a year or two to see the frequency become less and less.

When Diet Doesn't Help

If you don't cheat on the gluten-free diet and you still have frequent migraine attacks, it's entirely possible that you're still getting trace amounts of gluten in your gluten-free foods. To counter this, it might be helpful to talk to a dietician for advice. Eating fresh, unprocessed, whole foods may make a difference as well.

If these measures don't work, you may be someone whose migraines don't improve even on a gluten-free diet. If that's the case, speak with your healthcare provider about trying a preventive migraine medication that can help reduce the frequency and severity of your migraines. You may need to try more than one drug before you find the best option for you.

A Word From Verywell

If you suspect you have celiac disease or gluten sensitivity, it's important that you don't diagnose yourself. It doesn't hurt to try eliminating gluten on your own for a week or two just to see if your symptoms improve, but be sure to go see your healthcare provider afterward. For one thing, your symptoms may be due to something else entirely. For example, NCGS and irritable bowel syndrome (IBS) have many symptoms in common.

A gluten-free diet is also a serious lifestyle change that experts only recommend for people who really need to be on it. Getting your healthcare provider involved will ensure that you're meeting all of your nutritional needs and that you're on the right track regarding your health.