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Hormone irregularities linked to chronic migraine

November 23, 2001

Hormonal irregularities may explain why migraine becomes chronic, shows research in the Journal of Neurology Neurosurgery and Psychiatry. Around 3 per cent of the population are chronic migraineurs, suffering pounding headaches for around 15 days a month.

Hourly blood samples were taken from 17 chronic migraine sufferers, three of whom were men. Their average age was 31. These were compared with hourly samples taken from nine healthy people of similar age.

In total, 13 blood samples were taken from both patients and volunteers between 7 at night and 7 in the morning. The levels of four different hormones, all controlled by an area of the brain called the hypothalamus, were assessed. This regulates basic functions, such as body temperature, hunger, and thirst. The analysed hormones included melatonin, involved in sleep regulation, and cortisol, produced when the body is under stress.

The results revealed hormonal abnormalities among the migraineurs which were not seen in the healthy volunteers. In almost half of the migraine sufferers peak melatonin levels were delayed; and in those with insomnia, commonly found in chronic migraineurs, peak melatonin levels were significantly lower than in the healthy volunteers.

The timing and amount of melatonin production are an integral part of the body's circadian rhythm, and this hormone is also an important free radical scavenger, protecting neurological processes. But it is unclear whether melatonin irregularities are a cause or consequence of chronic migraine, say the authors.

Levels of cortisol, the stress hormone, were also significantly higher in the migraineurs, while prolactin levels were lower. Prolactin counterbalances a neurotransmitter called dopamine, the suppression of which has been used successfully to treat headache. Prolactin release is also inhibited by a potent chemical involved in pain and inflammatory diseases, such as multiple sclerosis, meningitis, and psoriasis.

The authors conclude that hormones produced by the hypothalamus may have a key role in chronic migraine.

British Medical Journal (BMJ)

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