[00:00]
Can a simple cold switch your migraines on or off? Welcome to Migraine Heroes. For anyone
[00:06]
living with migraine and wondering why nothing has fully worked yet, I'm Diane Ducarme. In seven
[00:12]
years of working with people with migraine, I've learned that no two migraine stories are the same
[00:17]
and none of them are simple. But your migraine has its own patterns. Here we look at them from
[00:23]
different angles so you can start recognizing them for yourself. A quick note, this is educational.
[00:30]
For a diagnosis or medication, please keep working with your doctor. Now take a deep breath and let's
[00:36]
dive in. In this episode, you will learn why a cold can trigger migraine in one person and
[00:42]
seemingly switch it off in another. What changes in your immune system, nervous system, and daily
[00:48]
routine when you get sick, and which of those changes may matter for migraine. And how to
[00:53]
investigate your own strange migraine patterns instead of dismissing them, because sometimes
[00:58]
the smallest clue is the important one. So stay with me till the end because I'm going to talk
[01:04]
to you about Julia. Someone who normally had migraine every single day, yet when she caught
[01:10]
a cold, her migraines disappeared. And when we started investigating what she was doing differently
[01:15]
while she was sick, we found one small detail that added to the way we looked at her migraines.
[01:21]
So I have to confess, I'm a bit in my reddit phase at the moment. So when I take a topic,
[01:26]
I really enjoy reading the debates around that topic there, because people are not disagreeing,
[01:32]
but they are experiencing completely different things. And they are completely right. And I hope
[01:39]
you recognize yourself in some of what they describe. So let's indulge in a bit of curiosity
[01:44]
here. So on the topic of cold, one of them says, over the years, I've noticed that when I'm sick
[01:50]
with a cold, I never get a migraine. For example, I have a cold for the last four or five days,
[01:56]
and guess what? No migraine. Previously, I was getting around five or six migraine days per week.
[02:03]
So this is pretty significant. And they are right. It is very significant. Then someone replied,
[02:08]
I'm the opposite. I can't get a cold without a migraine, and oftentimes can't get a migraine
[02:14]
that lasts longer than a couple of days without turning it into a cold also. People are observing
[02:19]
different things in their own bodies. They're comparing notes, and they're spotting patterns.
[02:24]
And another person finished the conversation with, we're just permanent migraine detectives
[02:29]
with only dead leads. And that one is so true. But it also crushed my heart. And so I'm here
[02:35]
to give life to those leads, because they are really onto something, a piece of their migraine
[02:40]
puzzle. And to do that, again, I'm going to go east and west, because they complement each other
[02:45]
and reinforce one another. One is more rigorous, and one has passed the test of time and is more
[02:50]
intuitive. They fill in each other's gap. Now, to be clear, in my own experience, I've seen
[02:56]
both sides of this. I've seen people who almost always get a migraine when they have a cold,
[03:02]
which biologically actually makes quite a lot of sense. But I've also worked with people who had
[03:07]
migraine every single day, and then they caught a cold and suddenly had none. You have to imagine
[03:13]
me behind my computer, I'm on the dashboard, I'm following someone, and I see miles days,
[03:19]
strong migraine, strong migraine, strong migraine, terrible day, very strong migraine, very strong
[03:24]
migraine, strong migraine, and then sharpen free, sharpen free, sharpen free. I'm like,
[03:28]
what's happening in that pattern? What is happening here? And so the first time I saw that happen
[03:33]
was with Giulia, Giulia from Italy, and I actually picked up the phone because I wanted
[03:38]
to investigate it. I thought, okay, what's going on here? What has changed inside the body? And what
[03:45]
we both found was enlightening, and I will tell you what it was for her at the end of this podcast.
[03:50]
So today we're going to ask, what is your body doing during a cold that could make migraine
[03:55]
better in one person and worse in another? So let's start with the west. First, something I
[04:00]
want to say upfront. There is currently no established medical phenomenon showing that
[04:06]
catching a common cold protects people from migraine. So scientists have not identified
[04:10]
an antiviral immune response that would reliably switch off migraine, and deliberately stimulating
[04:17]
your immune system or trying to reproduce an infection would absolutely not be safe,
[04:21]
would not be a great and safe migraine strategy. But it does not make Giulia's experience
[04:26]
uninteresting. Quite the opposite. Because when you catch a cold, you're not just getting a
[04:31]
blocked nose. For a few days, your whole internal environment changes. Your immune system changes,
[04:37]
your nerve system changes, your sleep, your appetite, your metabolism, your circulation,
[04:43]
and your behavior changes too. So the question is not, can a cold cure migraine? But the more
[04:50]
interesting question is, what changes during a cold that might temporarily change migraine too?
[04:55]
And I think there are three places worth looking at. First, your migraine threshold may change. I
[05:02]
often find the idea of a migraine threshold more useful than thinking about one trigger at a time.
[05:06]
So imagine that your nervous system has a threshold. Below it, you cope. Above it,
[05:11]
you become more vulnerable to an attack. So poor sleep can push you upward. Hormonal changes can
[05:18]
hunger, dehydration, bright light, emotional stress, intense exercise, sensory overload.
[05:24]
They can all add to the load. But then you get sick. And suddenly, and you may not like this
[05:30]
explanation, but this is one of the explanations, the first one, you cancel your meetings, and you
[05:35]
stay home, and you sleep more, you turn lights down, you stop exercising intensely, you drink
[05:41]
more, you eat simpler food, you spend less time on screens, and maybe you stop drinking alcohol.
[05:47]
And perhaps most importantly, you finally give yourself permission to rest. So somebody who
[05:53]
normally lives very close to their migraine threshold may be sick and paradoxically removed
[05:58]
several of the things that usually push them over it. The virus may not be protecting them at all.
[06:05]
Their sick day behavior may be lowering their overall load. And that is something we actually
[06:10]
can learn from. But there's an important nuance here, okay, and I want to insist on that. If the
[06:14]
way you reduce migraine is by canceling everything, avoiding exercise, staying inside, cutting out
[06:20]
food, screens, social plans, and everything you enjoy, eventually your life becomes smaller.
[06:25]
And I see people with migraine doing this all the time, and oftentimes with limited success.
[06:30]
And it can work to some extent, but it's an enormous price to pay for fewer attacks.
[06:35]
My personal philosophy is that you should be able to live your life and still be yourself.
[06:39]
I know that it's much easier said than done, and sometimes temporary avoidance is absolutely
[06:44]
necessary, absolutely. But fundamentally, this is why our approach, my approach, is usually to add
[06:50]
before we remove. To build resilience, to support the body, and raise that threshold rather than
[06:55]
simply eliminating more and more of your life. It's a fine balance, and I hope that resonates.
[07:00]
It's probably a very foreign concept to you, but that's the whole concept I have personally
[07:05]
developed. So second possibility, your immune system changes the conversation with your brain.
[07:11]
When you catch a virus, your immune system is going to launch a coordinated response involving
[07:17]
chemical messengers called cytokines. You can think of cytokines as messages. Some tell the
[07:23]
body that an infection is present, some recruit immune cells, some affect temperature, appetite,
[07:29]
and sleep. And importantly, some communicate directly or indirectly with the brain. That is
[07:35]
part of why being sick makes you want to sleep, withdraw, slow down, and stop doing very much.
[07:41]
Researchers sometimes call this sick behavior. It's not simply the unfortunate side of an
[07:46]
infection. It is partly an organized biological response which is designed to change the body's
[07:51]
priorities. And this becomes relevant to migraine because migraine and the immune system are not
[07:57]
completely separate worlds. So migraine involves the trigeminal nervous system, the meninges,
[08:03]
pain processing networks, autonomic function, and neuropeptides such as CGRP, the calcitonin gene
[08:09]
related peptides. And CGRP is not just a migraine chemical. It also interacts with your immune
[08:16]
system. Think of it, right? Immune cells such as macrophage and mast cells sit close to trigeminal
[08:23]
nerve endings and blood vessels around the meninges. And there's increasing evidence of
[08:28]
very close communication between these nerve and immune systems. So rather than thinking
[08:32]
immune system over here, migraine system over there, it is probably more accurate to imagine
[08:38]
an ongoing conversation between the two. So could a particular immune state during an infection
[08:44]
temporarily change pain signaling in one person? It's possible. But this is where I want to be
[08:50]
careful. We cannot say the cytokine went up, therefore Julia's migraine disappeared. We do
[08:55]
not have that evidence. And this is, in her case, not what happened. What we can say is that infection
[09:01]
temporarily changes the chemical conversation between the immune system, nervous system,
[09:06]
and brain, and therefore is biologically plausible that migraine could change too.
[09:10]
So a third possibility is your autonomic nervous system may shift. This is the part of your nervous
[09:15]
system that regulates things that you do not consciously control, like your heart rate,
[09:19]
your digestion, your sweating, your pupil response, or things like your blood vessel tone, and much of
[09:25]
your stress response. And migraine is associated with changes in autonomic regulation. Although
[09:30]
the exact pattern differs between people, and being sick changes autonomic activity too. So
[09:36]
again, we cannot say that this explains Julia's five migraine-free days, but it gives us another
[09:42]
possible piece of the puzzle. Now let's flip the question. So why does a cold make migraine worse
[09:48]
for somebody else? And this is where the story becomes really important. Because plenty of people
[09:54]
will be listening and thinking, this is the complete opposite of what happens to me. A cold
[09:58]
gives me a terrible migraine. And that makes perfect biological sense too. A respiratory
[10:04]
infection can bring inflammation, poor sleep, can bring dehydration, reduced food intake,
[10:09]
fever, coughing, congestion, muscle pain, stress, and changes in caffeine consumption. And all of
[10:15]
those can push someone toward their migraine threshold, rather than away from it. Immune
[10:19]
activation can also increase pain sensitivity. So if your migraine system is already highly
[10:24]
sensitive, an infection may be exactly the additional stress that pushes you over the edge
[10:29]
into an attack. Now depending on your migraine patterns and the root causes of your migraine,
[10:36]
if your migraine manifests more as brain fog, congested sinuses, inner ear pain, the congestion
[10:44]
is likely going to add to it and make the migraine worse as well. It really depends. You know,
[10:49]
migraine is really one word. It's so many, so many different shapes of pain. And through the
[10:54]
testimonial podcast, you'll hear that the nature of people's pain is actually quite different.
[11:00]
And this is why two people can experience what appears to be the same cold and have completely
[11:05]
opposite migraine responses. One will say, my migraine disappeared. And the other says,
[11:10]
my migraine exploded. That does not necessarily mean one of them is imagining it. It may simply
[11:16]
mean their bodies are responding to that physiological shift in very different ways.
[11:21]
And there's one final layer of confusion. Now this is a really western way to think about it.
[11:26]
A cold can give you congestion and facial pressure, but migraine itself can also cause
[11:31]
blocks or runny nose, watery eyes and facial pressure. So sometimes what feels like a sinus
[11:36]
headache or part of a cold may actually be migraine. And the two can be surprisingly
[11:42]
difficult to separate based on symptoms alone. It's a bit of a chicken and egg.
[11:46]
The East doesn't see it like that because it talks about the system,
[11:49]
but the West separates both. And one thing I really want to say to you today is this,
[11:54]
it's okay to have your own explanation for what is happening in your body.
[11:58]
You can lean toward one of these hypotheses, or you may have another one entirely.
[12:03]
You live inside your body and you notice hundreds of small things. Some you can describe,
[12:08]
and some you would never even think to mention. That makes your intuition valuable.
[12:13]
The science here is still incomplete. It is trying to catch up, but it does not have all
[12:19]
the answers. And you cannot always wait for perfect science before making the small choices
[12:24]
that help you feel better. At the end of the day, you are the one living with the pain,
[12:28]
and you are the one living with the consequences of every decision.
[12:33]
So I want to call you back to your own leadership. Listen to good advice,
[12:37]
follow your doctor when something is serious or concerning. But when there is no clear
[12:41]
explanation and no perfect solution, trust yourself enough to notice what helps, what does not,
[12:47]
and what feels right for your body. So in traditional Chinese thought,
[12:52]
health is rarely understood as one isolated organ manually functioning.
[12:57]
So instead, the body is going to be viewed as, imagine, a bit of a dynamic landscape.
[13:02]
Something enters the landscape, the landscape responds, resource moves, priorities shift.
[13:08]
And one of the concepts traditionally used to describe respiratory illness is an invasion
[13:13]
of an external pathogenic influence, often described using ideas such as wind,
[13:18]
cold, or heat, depending upon the presentation. So to modern ears, that language can sound strange,
[13:24]
but forget the literal words for a moment and listen to the underlying philosophy.
[13:29]
When the environment changes, the organism reorganizes itself.
[13:34]
One other person on Reddit actually said something interesting. They said,
[13:39]
it's like my body can only handle one problem at a time. And Western immunology actually tells us
[13:45]
something surprisingly compatible with that broad principle. During infection, the organism really
[13:51]
does reorganize. Energy allocation changes, temperature may change, appetite changes,
[13:58]
sleep changes, immune activity changes, behavior changes, the brain changes its priorities.
[14:05]
And traditional Chinese medicine would say that when the body is dealing with an acute external
[14:10]
challenge, its resources and attention may temporarily be redirected differently.
[14:15]
So perhaps your everyday migraine state exists within a particular combination of tension,
[14:20]
stimulation, digestive demand, sleep disruption, and emotional load and nervous system vigilance.
[14:26]
Then illness arrives. Suddenly, life contracts. You stay in bed, you become quiet, you eat
[14:33]
differently, you stop pushing, the lights go down, the diary empties, the nervous system
[14:38]
receives a very different message, and your body has permission to do only one thing, recover.
[14:43]
And I wonder how many people living with chronic migraine experience true physiological rest
[14:48]
only when they are sick enough to justify it. That's a confronting thought, because perhaps
[14:54]
the lesson is not my body needs a virus. Perhaps the lesson is my body needed the conditions I
[14:59]
finally gave it when I had the virus. Not for everyone, but worth investigating.
[15:05]
And so traditional Chinese medicine also places an enormous importance on observing root causes,
[15:10]
patterns, rather than isolated symptoms. A very simple way to think about is my cold making my
[15:16]
migraine worse or better? Is this new condition aggravating my root cause, making it deeper
[15:23]
or making it lighter? And it's complex to explain, because in traditional Chinese medicine,
[15:28]
a cold can be induced by cold, but also by really hot temperature. I don't know if you've ever
[15:33]
experienced this, when it's like super summer hot and you get a runny nose. And so it's going to
[15:38]
depend on, again, the underlying root cause, and is the disease accentuating it or shifting it?
[15:46]
There is wisdom in that kind of attention when we separate it from the traditional diagnostic
[15:51]
system, because migraine is extraordinarily context dependent. The person who notices my
[15:56]
migraine disappears every time I develop a respiratory infection has noticed something
[16:00]
worth recording. And the person that notices a cold always causes three days of migraine
[16:05]
has also noticed something worth recording. None of these observations automatically tells us the
[16:10]
mechanism, but they give us the questions. And a good science begins with good question.
[16:16]
There's a Chinese idea that I particularly like in this context, rather than forcing the body
[16:20]
constantly. Sometimes we learn by observing which direction it is already trying to move.
[16:26]
Migraine Western treatment understandably focuses heavily on attack suppression, like be a pain
[16:32]
killer, stop the pain, block the pathway, prevent tomorrow's attack. And sometimes that is what is
[16:37]
needed, maybe for you. But another question can sit alongside it. What state does my body enter
[16:42]
when migraine becomes less likely? It is observation. And observation can sometimes
[16:47]
reveal the conditions under which the nervous system feels safest. Now back to Julia from
[16:52]
Italy, because there was one more clue. When she was sick, she was using a nasal decongestant spray.
[16:59]
And interestingly, most of these sprays work as a vasoconstrictors. They temporarily narrow
[17:05]
blood vessels in the lining of the nose, reducing swelling and congestion. And so during those same
[17:10]
days, her usually daily migraines also stopped. That does not mean that the spray was definitely
[17:15]
the reason, and it certainly does not mean she should start using it continuously. Many
[17:20]
decongestant sprays can cause rebound congestion and are only intended for short-term use. But for
[17:26]
Julia, it gave us another piece of information to explore. It suggested that changes in vascular
[17:31]
tone, congestion, and the anatomy around nose and head might be relevant to her particular migraine
[17:37]
pattern. And that is where a clue becomes useful. Rather than saying, great, take the spray forever,
[17:43]
you can ask, what else might support the same underlying pattern more safely and sustainably?
[17:49]
So the spray was not the answer, it was a clue. And sometimes a clue is enough to tell you where
[17:54]
to look next. Now back to you. Answer these in your head. When you're sick, does your migraine
[18:01]
get worse? Does it sometimes disappear? And when you finally stop pushing, less screen time,
[18:10]
more sleep, fewer demands, does your head feel different? You might say yes to one and no to
[18:17]
another, and that's normal. For one person, a cold adds inflammation, poor sleep, and dehydration.
[18:23]
And for someone else, being sick removes enough load that they move further away from their
[18:28]
migraine threshold. Observe and trust your instincts. That's all for today. I hope this
[18:35]
episode helped you notice some new things. If you'd like to keep exploring your patterns,
[18:41]
you can find us on migraineheroes.com. Your body has a story to tell. Let's keep listening.
[18:47]
I will be back with you soon.
