Bacteria in Your Patient's Mouth Could Be Causing Their Migraines

As many as 38 million Americans suffer from migraine headaches, and there’s new evidence that the bacteria in these people’s mouths may be a contributing factor to their headaches. A research team at the University of California San Diego School of Medicine has discovered that many people with migraines, which might be a significant number of your patients, have many more microbes in their mouths that can actually modify nitrates.

Nitrates trigger headaches for many people. These compounds are commonly found in drugs, like cardiac medications, and in a variety of foods including processed meats and green, leafy vegetables. The microbes in the mouth modify these nitrates into nitrites, which then circulate in the blood and, during circulation, can be converted into nitric oxide under a specific set of circumstances. Nitric oxide helps cardiovascular symptoms by reducing blood pressure and improving blood flow, but severe headaches are often reported as a side effect of this process.

The research team knew that certain foods were said to trigger migraines, and hypothesized that there was a link between the food, the microbiomes of the affected patients’ mouths, and the patients’ individual experiences with migraines.

Their study used data made available from the American Gut Project. The team was able to gene sequence bacteria collected from 172 oral samples. Bacteria for the study was also sequenced from 1,996 fecal samples provided by healthy study participants. All participants in the study were asked, prior to beginning, whether they suffered from migraines.

After sequencing the bacterial genes, the team noted that certain types of bacteria were found in different quantities in people who suffered from migraines and those that did not. In the fecal samples, the researchers found slightly more genes that encode nitrate, nitrite and nitric oxide-related enzymes present in people who developed migraines. Also, the same genes were more plentiful in people who suffer from migraines in the oral bacterial samples.

At this point, it is still unclear whether these oral bacteria are the actual cause of migraines, or if they are somehow the result of those types of headaches. They could be indirectly linked in a way not yet understood by scientists. The research team plans to next investigate more defined groups of patients which will be separated into distinct groups by the type of migraine each patient experiences. Then, it might be easier to determine how exactly oral microbes correlate to a patient’s experience with migraines.