What is a Headache?

Headaches. Yuck!

Although they are often not cause for major concern, no one likes having them.

They can be a real annoyance, impacting quality of life and productivity.

It’s estimated that 96% of the population have had the unpleasant experience of having a headache. Appropriately named, pain in your head or face is the most common symptom. They are often described as pressure that’s throbbing, constant, sharp, or dull in the head or face.

In this post and video, I’ll review more about headaches.

Topics include:

• Classifications of headaches (primary and secondary)
• Common types of headaches (tension, migraine, and cluster)
• Causes of headaches
• When headaches are serious and require prompt medical attention (the “SNOOP” acronym)
• Functional and naturopathic medicine tests to consider if the cause of headaches is not clear

Do you have headaches?

They can be clues to various body imbalances. Rather than simply resorting to pain killers to cover up your discomfort, this information can help you to determine some potential causes and prevent further symptoms down the line.

So, read on.

More About Headaches

Thankfully, 96% of headaches are benign and not a medical emergency. People aged 25-40 years old experience pain in the head or face the most. As one ages, prevalence decreases.

Females tend to suffer with headaches more than males. In a study from governmental data in the United States, 20% of women and 10% of men reported severe headaches or migraines over the course of three months.

There are several classification systems of headaches. They are often divided into primary (no identifiable cause) and secondary (an underlying medical condition). The International Classification of Headache Disorders (ICHD-III) groups headaches as follows:

• primary headaches (tension, migraine, and cluster)
• secondary headaches (potentially life-threatening, including traumatic brain injury and vascular disorders)
• cranial neuropathies (e.g., trigeminal neuralgia)

Overall, there are more than 150 types of headaches. Primary headaches are the most common. The main subtypes of primary headaches include tension, migraines, cluster, and New Daily Persistent Headaches (NIPH).

The location, duration, and quality of pain can be hints to the kind of headache.

In the next part, we’ll review in more detail several of the most experienced headaches.

Common Types of Primary Headaches

Tension Headaches

Tension headaches tend to come and go and usually have no other symptoms except discomfort in the head. These are the most frequent type.

Migraine Headaches

Migraines generally occur at regular intervals, such as once a month or once a week. They can have a duration from 4 hours to 3 days. This type of pain in the head is often described as pounding and throbbing.

Migraines are often divided into three phases with different and individualized symptoms:

The prodrome phase consists of “warning signs” prior to the migraine onset. Symptoms can include changes in mood, energy, appetite, thirst, and urination. They can last a few hours to days.

The aura phase is when “strange sensations” occur just before or at the start of the headache. About 1 in 3 or 4 people experience the changes in vision, skin sensations, and language issues of an aura. These symptoms can persist for five minutes to an hour.

The attack phase is the actual headache. Common symptoms, along with the pain in the head and/or face, include sensitivity to light, noise, or smells; nausea or vomiting; loss of appetite; dizziness; and digestive disturbances. These issues are usually worsened with movement.

Cluster Headaches

Cluster headaches are the most severe type. They are appropriately named because they appear in clusters of one to three times a day and can last 2 weeks to 3 months. The duration of each headache can be 15 minutes to 3 hours long.

According to WebMD:

You could have intense burning or piercing pain behind or around one eye. It can be throbbing or constant. The pain can be so bad that most people with cluster headaches can’t sit still and will often pace during an attack. On the side of the pain, the eyelid droops, the eye reddens, pupil gets smaller, or the eye makes tears. The nostril on that side runs or stuffs up.

Secondary Headaches

Secondary headaches can be linked to an underlying condition. The ones that are most common include:

• Dehydration headaches
• Sinus headaches
• Medication-induced headaches
• Post-traumatic headaches

Less common types of secondary headaches include exercise headaches and Hemicrania Continua (chronic headaches that almost always affect the same side of head or face).

Common Causes and Triggers of Headaches

The exact cause(s) of headaches will vary based on the individual. Some of the most common triggers of primary headaches include: (R, R)

• Lifestyle factors: lack of sleep, alcohol and nicotine use, caffeine withdrawal, and lack or excessive physical activity
• Missing meals (low blood sugar)
• Gut disturbances from food or dietary triggers
• Environmental toxins, including mold exposure
• Muscle tension and poor posture
• Chemical exposures
• Stress
• Hormonal shifts
• Environmental stimuli (light, temperature, weather, etc.)
• Nutrient deficiencies

Some less well-known triggers can also be assessed if remedying the above aspects do not alleviate head pain. These include:

• Heat illness
• Acute Mountain Sickness (AMS)
• Mast cell activation syndrome
• Intestinal permeability: This is due to the gut-brain link. Toxins, aggravating foods, or infectious agents can cause damage to the gut lining and the gut becomes “leaky.” As a result, systemic inflammation that aggravates the nervous system and brain can ensue.
• Allergies: food or environmental
• Mitochondrial dysfunction (compromised cellular energy and metabolism)

Common causes of secondary headaches, that aren’t dangerous, are related to the types and can be identified. These include:

• Dehydration
• Sinus issues
• Medications

When Headaches are Serious

More often than not, headaches are not a sign of a serious issue. However, it’s important to know when to seek medical attention.

Sudden onset, being “the worst headache” ever, co-occurrence with a fever or new symptoms, and/or head pain experienced after a head injury or accident all require an immediate medical workup.

SNOOP is an acronym used to remember red flags that signal a headache may have dangerous underlying conditions.

• S: Systemic illness (e.g., fever, history of immune deficiencies)
• N: Neurologic signs or symptoms (e.g., confusion, weakness in a body limb, seizures, eyes bugging out)
• O: Onset is new or sudden (especially if over 50 years old)
• O: Other associated features (e.g., head trauma, drugs or toxins, headache awakens from sleep, worse with coughing or exertion)
• P: Previous headache history with progression or change in characteristics

The causes of emergency conditions for secondary headaches include:

• Traumatic brain injury
• Extremely high blood pressure
• Bleeding in the brain and stroke
• Meningitis and infections in the brain
• Carbon monoxide poisoning or toxin exposure

Naturopathic and Functional Medicine Tests for Headaches

Usually, once a serious issue is ruled out, a good history and knowledge of common triggers can point a practitioner to the cause of someone’s headaches. However, if the underlying condition is not known, naturopathic and functional medicine doctors may pursue lab testing. Abnormal levels could be the signals for contributing factors to headaches.

A lot can be found with just the basics:

A comprehensive metabolic panel assesses electrolyte balance (and hydration), protein status, acid-base balance, glucose (blood sugar) levels, and liver and kidney function.

A complete blood count with differential measures the amount and size of red blood cells and the quantity of white blood cells and types. Numbers can indicate if there is an infection, inflammation, and/or anemias (linked to nutrient deficiencies, chronic diseases, or bleeding).

After these tests are run, additional functional labs may be considered based on a person’s presentation. These include:

Hormonal panels: Using blood, saliva, or urine metabolites, practitioners can measure sex hormones, thyroid hormones, lipids, and cortisol (the “stress hormone”). These levels can help to determine if hormone imbalances are triggering headaches. This based on the fact that the brain has receptors for hormones and hormones themselves modulate neurotransmitters.

Comprehensive stool tests: These can offer a complete look at gut health by assessing for pathogens, digestion function, nutrient absorption, inflammation, intestinal permeability, and immune function (including celiac markers). Gut health has a direct link to the brain, as mentioned above.

Environmental tests: There are mycotoxin urine markers that can be run if mold is suspected, though these should be correlated with home-based tests and symptoms. There are also various labs that can assess for the presence of toxins and heavy metals in the blood and urine. These all impact the brain and its function.

Summary on Headache Types, Causes, and Naturopathic and Medicine Tests for Head Pain

Getting to the root cause of headaches is important. Most often, the headache is not serious and triggers such as stress, hormones, or gut imbalances are contributing to the pain.

If the clues are not obvious, or the headaches are complex, digging into labs with a practitioner can help. This can ensure that all the various aspects contributing to head discomfort are being attended to.

As with any symptom, headaches can provide clues to something being off in your body. Addressing an issue straight away can prevent a bigger problem in the future.

This is in alignment with the naturopathic philosophy of prevention as the best medicine.

In the next post, I’ll review some naturopathic and functional medicine approaches to soothe an aching head.

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References

1. https://www.ncbi.nlm.nih.gov/books/NBK554510/
2. https://my.clevelandclinic.org/health/diseases/9639-headaches
3. https://pubmed.ncbi.nlm.nih.gov/29527677/
4. https://www.rupahealth.com/post/integrative-medicine-treatment-for-headaches
5. https://www.webmd.com/migraines-headaches/migraines-headaches-basics
6. https://www.webmd.com/migraines-headaches/guide/migraine-phases:
7. https://americanmigrainefoundation.org/resource-library/migraine-prodrome-symptoms-prevention/
8. https://pubmed.ncbi.nlm.nih.gov/8294194/
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088284/
10. https://pubmed.ncbi.nlm.nih.gov/29571016/
11. https://www.clinicaltherapeutics.com/article/S0149-2918(18)30229-7/pdf
12. https://www.webmd.com/a-to-z-guides/comprehensive-metabolic-panel
13. https://www.verywellhealth.com/what-is-a-comprehensive-metabolic-panel-2860812
14. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=complete_blood_count_w_differential
15. https://pubmed.ncbi.nlm.nih.gov/33210961/
16. https://pubmed.ncbi.nlm.nih.gov/19854819/
17. https://www.ninds.nih.gov/health-information/disorders/neurotoxicity/doi/10.1161/JAHA.122.026493#d1e1004