How to Stop Headaches Using Science-Based Approaches

KEYPOINTS

• 01

  Knowing your headache type comes first, because the treatments differ

  Huberman groups headaches by where the pain comes from. Tension headaches start in the many muscles over the skull, neck and jaw. Migraine and cluster headaches start deep in the nervous system. Hormone-related headaches follow drops in estrogen and progesterone. Headaches can also follow traumatic brain injury. Hormonal, tension and migraine headaches together make up more than 70% of headaches.

• 02

  The meninges, blood vessels and inflammation create much of the pain

  Much of the ache comes from the meninges, the protective layers around the brain, and the blood vessels and nerves that supply them. Changes in vessel width (dilation or constriction) and inflammatory signals activate these pain fibers, which is why caffeine, omega-3s and curcumin can all affect headache.

• 03

  Migraine is a disorder of the nervous system, often with aura

  Prevalence estimates vary widely (roughly 6–17% of men and 17–43% of women, depending on the source), and migraine is more common in women. Aura can be a visual halo or simply a sense that something is about to happen. Imaging links aura to 'spreading depression,' a wave of reduced electrical activity in neurons that moves from the visual cortex at the back of the brain toward the front. Sensitivity to light (photophobia) often comes first and can trigger the headache.

• 04

  Cluster headaches come from the trigeminal nerve

  Cluster headaches are felt as excruciating pain behind the eye. They arise from the trigeminal nerve, which has three branches serving the eye, the jaw and lip, and the nose. The herpes simplex 1 virus behind cold sores, carried by up to 90% of people, also lives in this nerve.

• 05

  Low estrogen and progesterone drive hormonal headaches

  Estrogen doesn't cause these headaches. The drops in estrogen and progesterone at certain phases of the menstrual cycle and around menopause change vessel dilation and the inflammatory response. Steroid hormones act both by changing gene expression and by binding the surface of cells.

• 06

  Omega-3s at 1 g or more of EPA a day reduced headache in studies

  A 2018 study of 12,317 U.S. adults, adjusted for calorie intake, linked higher intake of long-chain omega-3s with a lower prevalence of severe headache or migraine. A meta-analysis of doses from 200 mg to 2,000 mg a day found significant cuts in headache frequency and intensity only at about 1 g a day or more. Huberman's suggested target is more than 1 g of EPA a day from fish, fish oil or both. A systematic review also found omega-3s reduced PMS symptoms, including headache pain.

• 07

  Cutting omega-6 linoleic acid while raising omega-3s worked even better

  In a controlled trial, a diet with more EPA and DHA plus less linoleic acid (omega-6) produced what the authors called a robust reduction in headaches compared with a typical-intake control diet. The authors could only partly explain the mechanism. Omega-3s are anti-inflammatory and are built into cell membranes.

• 08

  Caffeine can relieve a headache or worsen it, depending on timing

  Caffeine blocks adenosine receptors, which constricts blood vessels, but it also acts on the nitric oxide pathway, which dilates them. When adenosine is high, late in the day or after poor sleep, caffeine mainly constricts vessels and may help. When you're well rested it tends to dilate them. Withdrawal in daily users reliably causes headaches, and Huberman is skeptical of the advice to drink coffee at night and then sleep.