Science-Based Approaches to Stop Headaches | Huberman Lab 

Dr. Andrew Huberman, Ph.D. is a Professor of Neurobiology and Ophthalmology at Stanford University School of Medicine. His lab focuses on neural regeneration, neuroplasticity, and brain states such as stress, focus, fear, and optimal performance.

In this episode of the Huberman Lab Podcast, Andrew Huberman breaks down all things related to headaches: causes, treatments, different types of headaches, behavioral and prescription treatments, and more. Host: Andrew Huberman (@hubermanlab)

There are different types of headaches, arising from different tissues of the head and neck To get relief, you need to know which tissue is involved in that specific headache

Tension headaches are felt around the top part of the head (like a headband) which is constriction from the muscles of the skull

Headaches can also come from the meninges which are the tissues that line the space between the brain and the skull When blood vessels or arteries are dilated, there’s pressure between the brain and the tissues that causes headaches The brain itself doesn’t have pain receptors

The tissues surrounding the brain are close by and compact and the presence of nociceptors (pain receptors), any change to the size of the vascular portals causes headaches

Cluster headaches feel like they come from deep within the head because they originate from nerves – this pain is usually felt behind the eye on one side

Inflammation causes headaches when tissues around the head and neck release molecules (cytokines) that signal to the body something is going on (could be a toxin, localized, systemic, etc.)

Sinuses allow the passage of fluids through the skull for nourishment – but sinuses can become clogged and cause sinus headaches

“All experience of pain is neural in origin.” – Dr. Andrew Huberman The three types of neurons are (1) motor neurons (control contraction of muscles), (2) sensory neurons (respond to events in the environment or within the body), (3) modulatory neurons (adjust the relationship between motor and sensory to determine whether we need to respond) Knowing the types of neurons helps us identify how we want to target headache pain – we can adjust the relationship between the neurons for relief through medication and behavioral approaches

Tension headache: usually starts off as a halo or headband above the eyes and can include jaw or neck muscles, even extending into the upper back Usually induced by psychological stress and lack of sleep

Migraine headaches: recurring headaches; females suffer 3x higher than males but there is no relationship to menstruation Pregnancy is protective against migraines (for an unknown reason) Can be extremely debilitating Aura is a prominent feature, the experience of something is about to happen either visually or auditorily (not déjà vu) The exact origins of the aura aren’t clear but are thought to be the result of reduced excitability of neuronal activity Photophobia originates from neurons in the eye that connect to the eye and respond to short wavelength light and blue light Other symptoms of migraine headaches: dilation of vessels, photophobia

Treatment of migraines: (1) focus on constriction of blood vessels in the brain area; (2) prevent/alleviate photophobia Taking an aspirin is the worst possible choice – it’s an anti-inflammatory so even more blood will flow and cause pain

Drinking coffee or getting caffeine may help (or hurt) headache treatment (more below), but again, you need to know what type of headache you have

Cluster headaches : feel like they originate from deep within the head and are felt on one side more than the other Symptoms: unilateral, deep, excruciating pain, long-lasting, can sudden onset during sleep, droopy eyelid, myosis, nasal discharge Men get cluster headaches more than women Like migraines, these headaches will not be relieved with aspirin

Hormonal headaches (women) come from changes in gene expression and are most likely to take place when estrogen and progesterone are lowest in women in the first week of the menstrual cycle Progesterone and estrogen have an impact on the vasodilation system

Headaches from hits to the head and traumatic brain injury(TBI) – come with swelling of the brain region which constricts the flow of fluids Most of the effects of a hit to the head don’t take place immediately after the hit, they show up days, weeks, months, or years after (full episode on TBI coming) More than 90% of TBIs are a consequence of bicycle, playground, car accident, and construction accidents – not sports

Raise baseline of health to reduce risk of headaches (and assist with TBI recovery): sleep, sunlight at the right time of day, avoiding bright light at night, nutrition, exercise, healthy social connection

Tension headaches are associated with muscular pain from muscles of the skull, jaw, and neck

Creatine monohydrate for TBI (in dosage higher than used for muscle performance) Mechanism: nerve cells rely on calcium to generate action potential; creatine can be stored in brain tissue and improves cognition Dramatically decreases the frequency of headache after TBI and promises for reduction of headache, dizziness, and fatigue from other origins

Diets high in omega-3 (1g EPA per day) from supplements or through foods and low in omega-6 can be beneficial in reducing pain from headache Even if you just increase omega-3 without changing omega-6, you will experience a reduction in the severity of pain from a headache People who ingest more linoleic acid from omega-6 do experience more inflammation, vasodilation, and headaches Reduction in pain is particularly noticeable in hormone-related headaches during menstruation

Offsetting photophobia from migraine headaches: Avoid activation of cells that would trigger photophobia in the first place – if you feel a migraine coming on, shift to use dim orange or red light and avoid blue light If you can offset early signs, you may be able to reduce probably of headaches entirely

The most common treatment of tension headaches is NSAIDs but tolerance develops quickly and may offset benefits Botox is an advanced modern treatment of Botox when injected into muscles

Some oils outperform over-the-counter NSAIDs for the treatment of headaches without the side effects

Peppermint oil (with or without eucalyptus oil) when applied to the temple and forehead reduced pain form headaches, increased cognitive performance through headaches, and relaxed muscles Mechanism: peppermint selectively activates certain sensory neurons and inhibits others

Acupuncture has been used successfully to treat headaches and pain by reducing inflammation through the activation of certain sensory neurons and deactivation of certain motor neuron pathways

Caffeine is both a vasodilator and vasoconstrictor Caffeine as vasoconstrictor:it blocks adenosine (vasodilator) so when we drink caffeine, we’re effectively vasoconstricting – headaches caused by vasodilation can be alleviated with caffeine Caffeine as a vasodilator: caffeine can impinge on the nitric oxide pathway that causes dilation of blood vessels If you are well rested or it’s early in the day, you will not experience the vasoconstriction effects of caffeine because adenosine is low or not present – caffeine will induce vasodilation If you have not slept well or it’s late in the day, caffeine will have more of a vasoconstriction effect

Try non-traditional treatments in lieu of or in conjunction with other treatments

Curcumin is known to have potent anti-inflammatory effects alone and in conjunction with omega-3 and reduces the frequency and intensity of headaches Be mindful of dose! Curcumin is an inhibitor of dihydrotestosterone – stick to 25-80mg per day

Some spicy foods can induce headaches, be aware of your tolerance and stay away from Carolina reaper (it can cause hyper-constriction in the vasculature of the brain and brain damage which may be permanent)

Prevention of traumatic headache, dizziness, and fatigue with creatine administration. A pilot study ( Acta Paediatrica ) Long-chain omega-3 fatty acids and headache in the U.S. population( Prostaglandins, Leukotrienes & Essential Fatty Acids )

Dietary alteration of n-3 and n-6 fatty acids for headache reduction in adults with migraine: randomized controlled trial ( BMJ ) Effect of omega-3 fatty acids on premenstrual syndrome: A systematic review and meta-analysis ( Obstetrics & Gynaecology )

Effect of Peppermint and Eucalyptus Oil Preparations on Neurophysiological and Experimental Algesimetric Headache Parameters ( Cephalalgia ) Herbal treatments for migraine: A systematic review of randomised-controlled studies ( Phytotherapy Research )