Blackmores Institute

<h3>Symptoms of migraine include:1</h3><ul><li>Unilateral throbbing headache</li><li>Aura (with/without)</li><li>Nausea</li><li>Vomiting</li><li>Photophobia</li><li>Phonophobia</li></ul>Migraines can further be classified as episodic or chronic where the individual experiences at least 15 migraines per month for three months.4<h3>Population data</h3>Specific populations at increased risk of migraine are:5Menstrual migraine<ul><li>Two subtypes including pure menstrual migraine (occurring on day 1 of cycle) and menstrual-related migraine (migraines occurring on day 1 AND any other day of the cycle) in two out of three cycles.5</li><li>Present in up to 8-13% of women</li></ul>Elderly<ul><li>Often association with a remission with progression of age, those who do continue to experience migraines often experience bilateral symptoms with autonomic symptoms such as flushing and tachycardia.6</li></ul><h3>Current treatment options</h3>Acute management of migraine involves the administration of non-steroidal anti-inflammatory medication, triptans and antiemetics based on the individuals' symptoms and comorbidities.4 While these medications can help many, they are not without side effects and may increase the risk of medication overuse headache.4These limitations to treatment emphasise the importance of migraine prevention. Advice on the management of migraines looks to lifestyle modifications for the prevention of migraines including counselling, relaxation techniques, sleep, posture improvement and dietary guidance.4<h3>The connection between zinc and migraines</h3>Utilising data from the US National Health and Nutrition Examination Survey (NHANES), a cross-sectional study by Liu et al. (2023) provided a secondary analysis of the relationship between dietary zinc intake and migraine.2As a trace element with anti-inflammatory and antioxidant properties, zinc has previously been investigated for its beneficial role in migraine management through supplementation - while the latest study focuses on dietary zinc and migraine management.2 Utilising a 24-hour dietary recall system, participant data from 11,088 people aged &gt;20 years of age and matching other key recruitment criteria was collected and analysed.2A correlation between higher dietary zinc levels and positive health measures including reduced hypertension, diabetes and metabolic syndrome levels alongside higher intakes of protein and carbohydrates and copper intakes, and subsequently lower serum C-reactive protein levels was found.2 Importantly, researchers found there was an increase in migraine frequency in the absence of the above positive health outcomes.2The study concluded that after adjusting for age, gender, marital status, race/ethnicity, education, BMI, smoking status, hypertension, diabetes, stroke, coronary heart disease, C-reactive protein, energy, protein, carbohydrate, and copper intake that low dietary intake of zinc was associated with an increase in migraine risk.2The promising results of this study emphasise the importance of dietary advice and provide practitioners with an opportunity to address potential zinc insufficiency with patients to prevent migraine occurrence, reducing the reliance on acute relief and potentially reducing the health burden of migraines. <h3>References:</h3><ol><li>Tu, S. et al. (2020) “The health and productivity burden of migraines in Australia,” Headache: The Journal of Head and Face Pain, 60(10), pp. 2291–2303. Available at: https://doi.org/10.1111/head.13969.</li><li>Liu, H. et al. (2023) “Dietary zinc intake and migraine in adults: A cross‐sectional analysis of the National Health and Nutrition Examination Survey 1999–2004,” Headache: 3. The Journal of Head and Face Pain, 63(1), pp. 127–135. rel="noopener noreferrer" Available at: https://doi.org/10.1111/head.14431.</li><li>Prevalence and cost of headache (2019) Headache Australia. Available at: https://headacheaustralia.org.au/what-is-headache/prevalence-and-cost-of-headache/#:~:text=4.9%20million%20people%20in%20Australia,in%20Australia%20is%20%2435.7%20billion. (Accessed: May 8, 2023).</li><li>The state of Migraine (no date) Australian Journal of General Practice. Available at: https://www1.racgp.org.au/ajgp/2021/december/the-state-of-migrain (Accessed: May 8, 2023).</li><li>Ashina M, Buse DC, Ashina H, Pozo-Rosich P, Peres MF, Lee MJ, Terwindt GM, Singh RH, Tassorelli C, Do TP, Mitsikostas DD. Migraine: integrated approaches to clinical management and emerging treatments. The Lancet. 2021 Apr 17;397(10283):1505-18.</li></ol>

Recognised by the World Health Organisation for the health burden that they are,1 migraines impact up to one billion people worldwide, with a considerably higher representation in women.2 A 2020 study found 8.5 million Australians regularly suffered from migraines, with 86% of these people of working age, with the prevalence increasing between 12-40 years of age.3 The pathogenesis of migraine continues to elude researchers, with many leaning on the role of neuroinflammation and oxidative stress in the presentation of migraine.2

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