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Migraines May Not Originate in the Head
A “magical probiotic mouthwash” may someday eradicate them, according to UC-San Diego researchers, whose research is leading them to a trigger in the microbiome.
Around one in seven people suffer from migraines. That’s 38 million in the US alone. Women are three times more likely to experience them than men. On average, most sufferers have one once per month. For some people the pain is so severe, it can be debilitating. Migraine sufferers are often put out of commission for hours, even days.
Although there are treatments and techniques to ease the pain, there is no cure. In fact, we don’t even know what causes them, although there have been a lot of theories. Hormone fluctuations, a brain chemistry imbalance, faulty genes, the brain stem interacting with the trigeminal nerve, electrical misfiring or restricted blood flow inside the brain, have all been prevailing theories at one time or another.
A new study offers compelling evidence that the head may not be the origin of these headaches, but rather the digestive tract. Certain bacterial species inhabiting the mouth and gut, if not at fault outright, are at least a trigger. These species break down nitrates, compounds found in certain foods, which are eventually converted into nitric oxide. This is the same compound goosed by Viagra, which in turn dilates the blood vessels downstairs in order to cause an erection. Headaches are also a common side effect of certain heart medications containing nitrates.
Though such dilation is good for the cardiovascular system, as it improves blood flow, it may cause too much blood pumping through the brain and scalp, causing a migraine to occur. We’ve known for a long time that foods containing nitrates such as red wine, processed meats, and certain vegetables can trigger migraines. Ever hear of a “hot dog headache"? High nitrate levels are the reason one occurs. The bacteria angle, however, is new.
Microbiota species in the lower intestine. (Image: Public Domain)
Investigators at the University of California-San Diego conducted the study, published in the journal mSystems. The senior author Antonio Gonzalez and programmer-analyst Rob Knight studied 1,996 stool samples and 172 oral samples collected from migraine sufferers. All the participants were a part of the American Gut Project.
This is the largest crowd-sourced research project ever conducted within the US. Thousands of people have given samples to be analyzed for the makeup of their microbiome or gut bacteria. A healthy human gut contains thousands of species, which when taken together number in the trillions. The exact makeup of each person’s microbiome is as unique as their fingerprint. But an imbalance in species, scientists are finding more and more, leads to certain disorders or illnesses.
The samples given to Gonzalez and Knight were genetically sequenced to discover what bacteria were present. This study proves association between nitrate-eating bacteria and migraines, but not causality. Further studies must discover whether these bacteria are the essential component or merely a trigger. For now, Gonzalez and Knight suggest migraine sufferers steer clear of all foods containing nitrates. They also speculate that someday a “magical probiotic mouthwash,” may become a viable treatment to overcome migraines.
To learn about another theory for the cause of migraines, click here:
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The team caught a glimpse of a process that takes 18,000,000,000,000,000,000,000 years.
- In Italy, a team of scientists is using a highly sophisticated detector to hunt for dark matter.
- The team observed an ultra-rare particle interaction that reveals the half-life of a xenon-124 atom to be 18 sextillion years.
- The half-life of a process is how long it takes for half of the radioactive nuclei present in a sample to decay.
Gender and sexual minority populations are experiencing rising anxiety and depression rates during the pandemic.
- Anxiety and depression rates are spiking in the LGBTQ+ community, and especially in individuals who hadn't struggled with those issues in the past.
- Overall, depression increased by an average PHQ-9 score of 1.21 and anxiety increased by an average GAD-7 score of 3.11.
- The researchers recommended that health care providers check in with LGBTQ+ patients about stress and screen for mood and anxiety disorders—even among those with no prior history of anxiety or depression.
Study findings<p>For the study, <a href="https://link.springer.com/article/10.1007/s11606-020-05970-4" target="_blank">published in the Journal of General Internal Medicine</a><em>, </em>Flentje and her team evaluated survey responses from nearly 2,300 individuals who identified as being in the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community. Most of the participants were white, while nearly 19 percent identified as a racial or ethnic minority. Multiple genders were represented with cisgender women (27.2 percent) and men (24.6 percent) making up a majority of the participants. Sixty-three percent had been assigned female at birth. For the most part, participants identified their sexual orientations as queer (40.3 percent), gay (36.5 percent), and bisexual (30.3 percent).</p><p>The JGIM study participants were recruited from the 18,000-participant <a href="https://pridestudy.org/" target="_blank">PRIDE Study</a> (Population Research in Identity and Disparities for Equality), which is the first large-scale, long-term national study focusing on American adults who identify as LGBTQ+. It conducts annual questionnaires to understand factors related to health and disease in this population. </p><p>Participants filled out an annual questionnaire (starting in June 2019) and a COVID-19 impact survey this past spring. Flentje noted that on an individual level, some people may not have experienced a big change in anxiety or depression levels, but for others there was. Overall, depression increased by a <a href="https://patient.info/doctor/patient-health-questionnaire-phq-9" target="_blank">PHQ-9 score</a> of 1.21, putting it at 8.31 on average. Anxiety went up by a <a href="https://www.mdcalc.com/gad-7-general-anxiety-disorder-7" target="_blank">GAD-7</a> score of 3.11 to an average of 8.89. Interestingly, the average PHQ-9 scores for those who screened positive for depression at the first 2019 survey decreased by 1.08. Those who screened negative for depression saw their PHQ-9 scores increase by 2.17 on average. As for anxiety, researchers detected no GAD-7 change among the study participants who screened positive for anxiety in the first survey, but did see an overall increase of 3.93 among those who had initially been evaluated as negative for the disorder. </p>
Risks among gender and sexual minorities<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="fc3fd1ae68b77bbbf58a6995638d6d65"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/EnUqDjCqg0A?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>The LGBTQ+ community is a vulnerable population to mental health concerns because of their fear of stigmatization and previous discriminatory experiences.</p> <p>Previous research by the Human Rights Campaign has found "that LGBTQ Americans are more likely than the <a href="https://medicalxpress.com/tags/general+population/" target="_blank">general population</a> to live in poverty and lack access to adequate medical care, paid <a href="https://medicalxpress.com/tags/medical+leave/" target="_blank">medical leave</a>, and basic necessities during the pandemic," said researcher Tari Hanneman, director of the health and aging program at the campaign.</p> <p>"Therefore, it is not surprising to see this increase in anxiety and depression among this population," Hanneman said in the release. "This study highlights the need for <a href="https://medicalxpress.com/tags/health+care+professionals/" target="_blank">health care professionals</a> to support, affirm and provide <a href="https://medicalxpress.com/tags/critical+care/" target="_blank">critical care</a> for the LGBTQ community to manage and maintain their mental health, as well as their physical health, during this pandemic."</p>
What should health care providers do?<p>The authors of the study recommend that health care providers check in with LGBTQ+ patients about stress and screen for mood and anxiety disorders in members of that community—even among those with no prior history of anxiety or depression.</p><p>As cases of COVID-19 continue to mount, the sustained social distancing, potential isolation, economic precariousness, and personal illness, grief, and loss are bound to have increased and varied impacts on mental health. Effective treatments may include individual therapy and medications as well as more large-scale coronavirus support programs like peer-led groups and mindfulness practices. </p><p>"It will be important to find out what happens over time and to identify who is most at risk, so we can be sure to roll out public health interventions to support the mental health of our communities in the best and most effective ways," said Flentje.</p>
What we know about black holes is both fascinating and scary.
- When it comes to black holes, science simultaneously knows so much and so little, which is why they are so fascinating. Focusing on what we do know, this group of astronomers, educators, and physicists share some of the most incredible facts about the powerful and mysterious objects.
- A black hole is so massive that light (and anything else it swallows) can't escape, says Bill Nye. You can't see a black hole, theoretical physicists Michio Kaku and Christophe Galfard explain, because it is too dark. What you can see, however, is the distortion of light around it caused by its extreme gravity.
- Explaining one unsettling concept from astrophysics called spaghettification, astronomer Michelle Thaller says that "If you got close to a black hole there would be tides over your body that small that would rip you apart into basically a strand of spaghetti that would fall down the black hole."