hi there
welcome to the Healing Migraines Naturally podcast
I'm your host Doctor Leslie Caesar
and I'm a licensed naturopathic doctor
former chronic migraine sufferer
and I've dedicated my life to helping other women
with chronic migraines
rediscover a migraine free life
thank you for joining me on the podcast today
today
I wanna talk to you about a client of mine named faith
faith had chronic migraines for 25 years
yes 25 years
and she was particularly prone
to food related migraines which
oh my goodness it's its own kind of suffering right
because eating
is one of the foundational pleasures of life
and I don't mean just you know
the physical pleasure of eating something
that is appealing to you and tastes good to you
I mean psychologically socially
to be a human being is to enjoy eating
I mean think about this for a second
every culture on earth
uses food as the center of its holidays
family meals celebrations funerals
food is how we Mark the moments
that matter the most to us
and even more than that
it's how we take care of each other
when someone is grieving we bring food
when a baby is born we bring food
when we wanna say you know
you belong here you're part of us
we sit down and we share a meal
so this is not incidental to the human experience
it is the human experience
but for faith all of that was interrupted
going over to her mother in law's house was a
was a land mine okay
because her mother in law would have a hard time
sort of hiding her irritation
when faith couldn't eat the food that she had made
and I wanna you know I wanna be clear about something
because I think this is I think this is important
I don't think her mother in law
was getting upset because
you know she was a difficult person or she was selfish
or she didn't care about faith
or she didn't understand what faith was struggling with
with her chronic migraines
I think she was getting upset
because she's a human being
and she wants to break bread with her kin
and that's a completely legitimate human need
we can't and I would argue
that it's unreasonable to expect that we can
ask everyone around faith
to override their own human wiring
to accommodate food sensitivities
that are not actually food sensitivities
they're symptoms
your reactions to food are a symptom
they're not an inherent
inborn reaction to the food itself
I know it seems that way to you right now
but bear with me here I'm gonna walk you through this
hi there
I wanna jump in real quick and tell you about my client
Beth she was getting 15 to 20 migraines and headaches
per month and as you can imagine
this was impacting her work performance
and her confidence she also has two small children
and she was
starting to feel like she was a horrible mom
because she had nothing left for them
at the end of the day but she reached out
and she booked a free consult call with me
and after I asked her about her migraines
and her health history
I felt confident that I could help her
I help women uncover
the root drivers of their migraines
and follow a step by step plan to dramatically reduce
the frequency by up to 90%
without adding more medication
or taking a bunch of supplements
so we built her personal migraine map
followed the plan
and now she will get one to two migraines per year
which she uses ibuprofen to treat if she needs to
verses up to 15 to 20 per month
when we first started working together
that weren't responding well to any medication
she just reached out to tell me that
she got a promotion at work
she's on top of her career again
and has been able to come off all of her migraine
medication but most importantly
she's a confident mom again
and she's attending birthday parties at Jump Zone
with her kids and saying yes
instead of saying maybe later
I've worked with women like Beth
from all over the United States
who were told this is the best we can do
but they were still willing to dig deeper
so
if you are serious about changing your migraine story
go to Doctor Leslie Caesar dot com
slash apply or tap the link in the show notes
and on our free consult
we'll map out why your migraines keep coming back
and the first three steps you can take
over the next 30 days
I do cap new client spots each month
so if the calendar is full
the doors are closed for now
but if you're done
feeling helpless and ready to do the work to heal
pause this episode for 30 seconds
and book that console call now
something in your body is not working
the way that it should and the food is exposing that
okay and that distinction
that's a very important distinction
so getting back to faith here
you know
going on a girls trip
going out to a restaurant with her friends
what should have been a really fun occasion
became an embarrassing ordeal
how many of you have been there
you're looking at the menu
oh boy
what's in the sauce right
how how do they prepare this
asking the waiter the waiter doesn't know right
can you put this on the side every time
and then everybody at the table's waiting for you
while you're going through this whole thing
it's embarrassing and it's just
the constant embarrassment and anxiety and frustration
and apologizing
of being the only one whose body doesn't cooperate
and prevents you from ordering off the menu
faith carried that into every restaurant she went to
and then even at home you know
doing her home cooking I mean
she was spending a tremendous amount of time
and energy and planning
every time she sat down to eat right
it was you know
the culmination of so much effort and care
and worry and paranoia but even with all of that effort
she never quite knew how she was gonna feel afterwards
twenty five years of that okay
now
faith had been given a lot of advice
over these 25 years
and the one piece of advice that comes up constantly
in the migraine world
we have the the lists
we have the Facebook group forums dedicated to this
we even have apps on our phone now
that will help us track this
one of the most common recommendations
within the migraine community
is to avoid tyramine
tyramine is one of the biggest ones
so this is in aged cheeses
red wine cured meats
fermented foods soy sauce
tyramine you've been told
triggers migraines and you should avoid it
and most migraine sufferers do exactly that
that's what faith was trying to accomplish
in addition to trying to avoid other molecules in
in her food
so migraine sufferers what do they do
they eliminate they restrict
they build
an ever growing list of foods that they cannot eat
and and sometimes it helps a little for a while
but it never fully resolves anything
because the entire premise of this is wrong
so
this episode and what made me think about faith again
was actually inspired
by a post in my free Facebook group
Healing Migraines Naturally with Leslie
Caesar and D
someone posted in the group
has anyone else gotten migraines
after eating green beans
and several people responded yes
green beans are a problem for me too
but here's the detail that stopped me
the person who made the post followed up with
just to give context I'm sensitive to tyramine
I added green beans to my diet in the past 2 days
and got migraines on both days
it was strange as it
green beans has a low amount of tyramine
I guess I should limit the amount
so let's let's read that again right
she she already knew she said it herself
green beans have a low amount of tyramine
so
this is the insidious nature of this food sensitivity
paradigm within the migraine community
another commenter on the post agreed with the analysis
and said
anything that has to do with tyramine is a problem
for me green beans included
so this is the the nightmare that this food sensitivity
framing puts people in
you know
just to clarify green beans are not high in tyramine
okay so if you look at if you Google
you know high tyramine foods
green beans is not going to come up on those lists
they are on the approved list
and yet
here are women in the community who cannot eat them
who have connected their symptoms to a vegetable
acknowledge that the vegetable is low in tyramine
but concluded that the answer is more restriction
there's kind of a grudging acceptance
when someone says they can't drink red wine
okay there's alcohol in it
fine
there's more to it when it's aged cheese or cured meats
but when we have arrived at a vegetable
that isn't even high in tyramine
a vegetable that you might want in a casserole
at Thanksgiving
when we arrive to the conclusion that I ate this food
and then I got a migraine
so I should restrict the food
I should lower the amount even more
something has gone completely wrong with this premise
the list keeps growing your world keeps shrinking
and nobody is asking why
and this is exactly why faith suffered for 25 years
not because she wasn't trying
not because she wasn't paying attention
she was tracking her food
she was being extraordinarily conscientious
and diligent about this
she was doing precisely what she had been told to do
this is what the women in my Facebook group
have been told to do
by the American Headache Foundation right
worry about tyramine
and it sets people up to worry so much about tyramine
that even when
a food doesn't have very much tyramine in it
they're still worried about the tyramine in the food
you know there's no exit ramp for this
you follow the tyramine list faithfully
and when you still get migraines
the answer that this framework gives you is you must
have missed something right
restrict more the list gets longer and longer
the migraines keep coming
because this list was never the answer
it's not the way out of this problem
and here's what you know makes this even harder to take
because the National Headache Foundation
actively promotes a low tyramine diet
it gives a dedicated food resource
a food list full guidance
this is mainstream standard advice
and this is why today
I want to talk specifically about tyramine
what it actually is what's happening in your body
when you react to these foods that contain tyramine
and why the advice to avoid them
completely misses the point
so tyramine is not an amino acid
people sometimes confuse it with tyrosine
which is an amino acid and a very important one
tyrosine is the precursor to dopamine norepinephrine
your thyroid hormones it's a very useful amino acid
tyramine is what happens to tyrosine
when the bacteria in aged and fermented foods
gets to it first
through a process called decarboxylation
bacteria convert the tyrosine into tyramine
so by the time that food reaches you and you eat it
the beneficial molecule
has already been transformed
into something that your body
doesn't need and needs to dispose of
your body knows that it
we actually have a whole system to do this
so the first line of defense is your gut wall
specifically the intestinal mucosa
so there's an enzyme called m a O
and that is there in the intestinal wall in the mucosal
uh wall
to intercept tyramine and break it down
before it's absorbed into the bloodstream
so if you're familiar with how the enzyme d a O
handles histamine in the gut
this is very similar it's working on the same principle
so Mao for tyramine Dao for histamine
both are working at the point of entry
to neutralize a compound
before it gets into your bloodstream
so
if that m a O misses a few molecules
then
that is going to get absorbed into your bloodstream
so again this is a molecule that your body does not use
it needs to be detoxified and eliminated from the body
so what comes into your bloodstream
that hasn't been neutralized in your digestive track
now we've got the second line of defense
okay
so there's another round of the Mao enzyme in the liver
along with a detoxification pathway called CYP2D6
so those two enzymes
or pathways
handles whatever gets absorbed into your bloodstream
so it's a two stage clearance system okay
the gut wall first and then the liver second
so I wanna pause here for a moment
because I think that this is worth appreciating
one of the central themes of this podcast
is that your body is not defective
it's not broken it's not failing you
it doesn't hate you your body is trying to help you
and it has been from the very beginning
in ways that most of us don't even
think about right so
your digestive track
is not just a tube that absorbs food
it's a sophisticated intelligent barrier
designed to protect you from compounds
that have no business getting into your bloodstream
so I'm gonna use aluminum as an example
so aluminum is a very potent neurotoxin
and it's in the environment
it's in the soil it's in plants that grow in that soil
and then it's in animals that eat those plants
that grew in that soil that had aluminum in it
it's in fresh water sources
so you are exposed to aluminum pretty much constantly
and that's
that's if you don't use aluminum cooking pans
and you don't use aluminum foil for cooking
and yet your gut absorbs less than 1% of the aluminum
you ingest less than 1%
so your digestive tract is actively
purposefully limiting
how much of a known neurotoxin enters your body
because it was designed to do exactly that now
it's only going to be able to do that
if it's functioning properly okay
just like with the tyramine
so tyramine is another example of this design at work
here's a molecule that arrived in your food
but your body cannot use it
it has no function in the human body
and anything that enters the body with no function
has to be detoxified and eliminated
so our gut knows this the
Mao in your intestinal wall
is there specifically to intercept tyramine
and break it down before it ever gets absorbed
to do the work at the border
so to speak so the rest of your system doesn't have to
so this is not a bug this is a feature
it works beautifully
when it has what it needs to do the work
and that is the key phrase
when it has what it needs
and this goes back to what I call the three principles
so over many years of clinical practice
I've identified three
foundational things that the body needs
to restore itself to health
and to maintain its state of health
to stay in balance to stay in homeostasis
to function the way that it was designed to function
and when those things are in place
the body can do its job we feel good
our body doesn't generate symptoms
when those things start to break down
when they get blocked when they get depleted
when the load exceeds the capacity
you don't get just one problem
you get unfortunately
a downward spiral each piece that fails
makes the next failure more likely
what looks on the surface like a food sensitivity
a a migraine trigger
heck a total mystery
is almost always this spiral playing out in actually
a very predictable way
so when that system is working well
you can eat aged cheese and nothing happens
when it's not working well
the tyramine that doesn't get cleared
gets absorbed into the body
and is then a toxin
and that toxin load goes to the liver
and if the liver is already overloaded
with toxins and metabolic waste materials
more than it can handle
it can't handle the additional load
and it's that overload that produces the migraine
I like to say that a migraine is a hangover
without the alcohol
now a a alcohol induced hangover is your liver
failing to clear
the toxic byproduct of alcohol metabolism
and the headache and the nausea
and the light sensitivity
and the irritability that occurs
when someone has uh
alcohol induced hangover boy
it's so similar to a migraine
that's not a coincidence
because you've been temporarily
poisoned by your liver's inability to keep up
with the load generated by the alcohol
you chose to drink the night before
in this case
the tyramine migraine is the same mechanism
but the toxin molecule is different
but the symptoms that are generated are the same
and this is why I say that migraine
is a hangover without the alcohol
because a migraine
is
the expression of the overwhelming toxin overload
that the body is trying to clean up
at that moment
so the tyramine technically did not cause the migraine
the liver was already overwhelmed
the tyramine
was the last thing that was added to a system
that was already past its limit already struggling
this is why am I eating too much
tyramine is the wrong question
the right question is why can't my body clear it
so let me show you exactly why I can't
through each one of these three principles
so the first principle
the first thing that our body needs
is we have to get the nutrients that our cells need
to the cells
so this is not just like taking supplements
this is not just eating healthy
getting the nutrients all the way to the cells
where they actually do something
and I make this distinction deliberately
because I hear it constantly
I'm already taking supplements
I'm already eating well
how come I'm still getting migraines
and the answer almost always
is that there's a breakdown
somewhere between the food going in
and the nutrients getting to the cells
where they need to be
so the nutrients may even be in the bloodstream
but if they aren't reaching the cells
we're not
fulfilling what's required within this first principle
so there are three steps in this chain
and all three have to work
so the first step is being able to eat enough food okay
and a and a wide variety of food
because
different types of foods have different nutrient blends
right
it's not like every food that we eat has the exact same
nutrients in it right
so we wanna be able to eat a wide variety of food
so that we can collect over the course of a week
cause you know in one day
you're not gonna be able to eat even
that much variety of food
but over the course of a week
we've been able to eat enough variety of food
that we've been able to collect
and assimilate a wide variety of nutrients
so this sounds obvious
but consider what happens when someone
spends years on a tyramine restricted diet
or an elimination diet uh
you know worrying about an ever growing list of foods
they cannot eat I mean
I've had clients where when they come to me
they can only eat chicken
rice and broccoli okay
this happens to people this is the unfortunate
inevitable end point
when we start going down this food trigger road
so not only are they
not just losing the pleasure and connection of eating
they're narrowing their nutrient intake
the longer and the more restrictive the list
the fewer the nutrients are that are going to be eaten
that are going to be coming in to the digestive tract
so the very approach meant and endorsed by
like I say the National Headache Foundation
I mean every migraine advocacy group
encourages migraine sufferers to eliminate
so called migraine triggering foods
the very approach that's meant to help people
is systematically
depleting their body of what it needs to function
so this is not
like a side effect of the tyramine avoidance framework
it's a predictable consequence of it
the second piece of this first principle
the second step is your actual digestive function right
your digestive track
has to actually break the food down
and get the nutrients out of it
so here's something that I want
you to really consider when
when your digestive track is functioning properly
you should not be consciously aware of it okay
you should eat your food
and your body handles the rest quietly
in the background
you should not notice your digestive tract working okay
so you shouldn't have heartburn
you shouldn't have bloating by the end of the day
gas or cramping unpredictable loose stools
should have a daily ball movement
these things are so common
that millions of people have come to accept them as
normal as the inevitable consequence of eating a tomato
or having red sauce on pasta
or eating anything that isn't completely bland
this is not normal these are symptoms
they are
these are indicators
that your digestive tract is telling you
that something is not working properly
and faith had all of these okay
she had heartburn constipation
sometimes she'd have severe loose stools
and she had been on a proton pump inhibitor
Prilosec for years
a medication prescribed to suppress stomach acid
and manage
or suppress the heartburn that she was experiencing
she was still experiencing heartburn
while taking the Prilosec
and doing years and years of careful food avoidance
so despite all of the list
the restrictions
the questions that she asked every waiter
every time she went to a restaurant
despite all of this
her digestive track was still not working properly
and this matters tremendously for the tyramine story
because a compromised gut wall means that Mao enzyme
sitting in that wall
the enzyme designed
to intercept tyramine before it's absorbed
is also compromised
so her first line of defense was down
but there's another layer
hi there I want to jump in real quick
and tell you about my client Beth
she was getting 15 to 20 migraines and headaches
per month and as you can imagine
this was impacting her work performance
and her confidence she also has two small children
and she was
starting to feel like she was a horrible mom
because she had nothing left for them
at the end of the day but she reached out
and she booked a free consult call with me
and after I asked her about her migraines
and her health history
I felt confident that I could help her
I help women uncover
the root drivers of their migraines
and follow a step by step plan to dramatically reduce
the frequency by up to 90%
without adding more medication
or taking a bunch of supplements
so we built her personal migraine map
followed the plan
and now she will get one to two migraines per year
which she uses ibuprofen to treat if she needs to
verses up to 15 to 20 per month
when we first started working together
that weren't responding well to any medication
she just reached out to tell me that
she got a promotion at work
she's on top of her career again
and has been able to come off all of
her migraine medication but most importantly
she's a confident mom again
and she's attending birthday parties at Jump Zone
with her kids and saying yes
instead of saying maybe later
I've worked with women like Beth
from all over the United States
who were told this is the best we can do
but they were still willing to dig deeper
so
if you are serious about changing your migraine story
go to Doctor Leslie Caesar dot com slash apply
or tap the link in the show notes
and on our free consult
we'll map out why your migraines keep coming back
and the first three steps you can take
over the next 30 days
I do cap new client spots each month
so if the calendar is full
the doors are closed for now
but if you're done feeling helpless
and ready to do the work to heal
pause this episode for 30 seconds
and book that console call now
stomach acid is not optional
it's how protein gets broken down
it's how minerals get liberated from the food
and absorbed
it's how the whole nutrient extraction process begins
so when someone is on a proton pump inhibitor
suppressing that acid
they are not absorbing what they're eating
the food goes in but the nutrients don't come out
so the third step of this first principle
is the delivery of the nutrients to the cells
and this is something that nobody talks about
your blood is not just like this
simple transport system okay
it's not just this red stuff that your heart pumps
and things are randomly floating around in it until
you know they happen to bump into a cell okay
our blood is actually a very complex organ
we don't think about our blood as an organ
like our liver or our pancreas
but it is and it's just as complex
in addition to that most nutrients in the bloodstream
they're not just sort of like free floating around
randomly going places you know
where the heart happens to pump them
the nutrients any
really nearly everything in our blood
is bound to specific carrier molecules
carrier proteins
and without those carriers functioning properly
the nutrients are not going to reach their final
destination
so even then when the nutrient is delivered to the cell
it still has to get into the cell okay
and that process is governed by hormones
and other cellular signaling molecules
so for example
insulin drives glucose and amino acids into the cell
so without adequate insulin signaling
the nutrients
present in the blood are not going to enter the cell
optimally thyroid hormones
regulate the rate at which cells
actually use what they receive
chronically elevated cortisol
like the elevated cortisol that a
a woman who's been in pain and fear for years
like faith
can contribute to insulin resistance
progressively
blocking the cell's ability to take up these nutrients
even if they're sitting right there
so someone can be eating she can be supplementing
she can have the nutrients circulating in her blood
and her cells can still be starving
because the delivery system is broken at step 2
or step 3 or both
the second principle is clearing metabolic waste
material and toxins from the body
so every day the body produces waste material
hormones get used and need to be eliminated
compounds arrive from food that the body cannot use
like tyramine and must dispose of
cellular processes cellular metabolism
generates byproducts that have to be cleared
this is continuous 24 seven uh work
and if the body cannot keep up with it
the waste materials accumulate
and that accumulated load
doesn't make us feel good okay
so tyramine is a perfect example of this
it arrives in food as a is a waste material
is a byproduct from bacterial fermentation of the food
um and since this molecule we don't use it for anything
it has to be eliminated
has to be detoxified and eliminated
so under normal circumstances
the gut intercepts it the liver finishes the job
and it's eliminated from the body
but when the when the body's
waste clearing capacity has been compromised
when it's already overloaded
the tyramine builds up
and the liver can't handle the additional burden
coming in from the digestive tract
so we already talked about how
the digestive tract is the first line of defense
but once something makes it past that barrier
into the body the organ primarily responsible
for dealing with it is the liver
the liver is the main organ of detoxification
and this is where the body does the heavy work
of transforming waste
products and toxins into forms that can be safely
eliminated or excreted from the body
but when the liver is overburdened
when it's being asked to clear
more than the capacity that it has to process
things back up
and tyramine is one of the things that backs up
so I've talked in greater depth about
detoxification and other episodes
will link to those in the show notes
what I want to focus on today is something
even more specific
and that is the effect that certain hormones
have on the liver's detoxification capacity
and this m a O enzyme in particular
so what compromises that clearing capacity
just over and above this toxin overload
so in the context of tyramine
two hormonal pathways
are actually really important here
so the first one is estrogen so estrogen
suppresses
the enzyme that breaks this tyramine down
so when the estrogen itself
is not being properly cleared through the liver
it accumulates the estrogen accumulates
and that accumulated estrogen keeps the m a o
chronically suppressed so
I've talked about estrogen clearance in other episodes
too we will link to those in the show notes as well
but I hope if particularly
if you've been a regular listener to the podcast
you're starting to connect these very interesting dots
so now
the body is
failing to clear two waste products at the same time
the estrogen and the tyramine okay
so both are landing in the same overloaded liver
but the estrogen is actually shutting down the
Mao in the gut this is why
keeping that toxin bucket drained is so critical right
because as it backs up as everything backs up
one of those things is going to be estrogen
and we've got to get the estrogen out of our body
every month
the second hormone progesterone okay
so again progesterone inhibits
that CYP2D6 detoxification pathway in the liver okay
so when the progesterone we talk a lot about estrogen
progesterone has to be detoxified as well
you gotta get that out of your body every month too
but if you're not detoxifying your progesterone
that inhibits this detoxification pathway
it sort of slows it down
so the backup right
so I've got a compromised gut
so I can't neutralize the tyramine in my gut
so it's coming into my bloodstream
now
if I'm not getting my progesterone cleared every month
that's contributing to the backup
it's it's inhibiting the liver from detoxifying
the tyramine through the 2D6 pathway
hi there I wanna jump in real quick
and tell you about my client Beth
she was getting 15 to 20 migraines and headaches
per month and as you can imagine
this was impacting her work performance
and her confidence she also has two small children
and she was starting to feel like she
was a horrible mom
because she had nothing left for them
at the end of the day but she reached out
and she booked a free consult call with me
and after I asked her about her migraines
and her health history
I felt confident that I could help her
I help women uncover
the root drivers of their migraines
and follow a step by step plan to dramatically reduce
the frequency by up to 90%
without adding more medication
or taking a bunch of supplements
so we built her personal migraine map
followed the plan
and now she will get one to two migraines per year
which she uses ibuprofen to treat if she needs to
verses up to 15 to 20 per month
when we first started working together
that weren't responding well to any medication
she just reached out to tell me that
she got a promotion at work
she's on top of her career again
and has been able to come off all of her migraine
medication but most importantly
she's a confident mom again
and she's attending birthday parties at Jump Zone
with her kids and saying yes
instead of saying maybe later
I've worked with women like Beth
from all over the United States
who were told this is the best we can do
but they were still willing to dig deeper
so
if you are serious about changing your migraine story
go to Doctor Leslie Caesar dot com
slash apply or tap the link
in the show notes and on our free consult
we'll map out why your migraines keep coming back
and the first three steps you can take
over the next 30 days
I do cap new client spots each month
so if the calendar is full
the doors are closed for now
but if you're done
feeling helpless and ready to do the work to heal
pause this episode for 30 seconds
and book that console call now
so the luteal phase of the menstrual cycle
the second half after ovulation
this is where both
estrogen and progesterone are elevated
and so if we've got a build up at this point
and then our ovaries are making more of these
two hormones in the second half of our cycle
both clearance pathways
the Mao enzyme in the digestive tract
and the 2D6 detoxification pathway in the liver
are going to be blocked
so your body's capacity to neutralize or clear
or eliminate the tyramine
the second half of the menstrual cycle
it's going to be
it's going to get more backed up
so this is why
tracking your food triggers can be so maddening
for migraine suffers right
because
making sense of it on your own is nearly impossible
right so
you can have a woman in the first half of her cycle
when estrogen and progesterone are a little bit lower
maybe you know
she's still overloaded okay
she's she's still overloaded
but the production from the ovaries is a
little bit lower in that first half of the cycle
she eats something with tyramine in it
nothing happens because she had enough room
for that additional tyramine okay
so okay
I'm tracking my triggers this food is fine right
well
two weeks later after ovulation in the luteal phase
she eats the exact same food and boom
gets a migraine right
so she goes back but
you know I thought this food was fine
I just ate it two weeks ago
I had no problems right
I mean this happens all the time
when you're tracking food triggers right
one day you get a migraine
another time you don't get a migraine
it's maddening absolutely maddening
so um
you know what do
what do we do what did faith do
she blamed herself what am I missing
I'm not tracking properly right
it's a total nightmare
but what ends up happening
right is we develop a paranoia around the food right
particularly if I can't make sense of something
maybe I just cross it off the list
so we restrict even further
but it was it was never the food right
and so I want to be clear here too
it also really wasn't the menstrual cycle either
a liver that is functioning optimally
can keep up with the varying
hormonal load that accompanies a normal
menstrual cycle
estrogen rises and falls progesterone rises and falls
a liver that has what it needs to function optimally
processes these shifts
and clears what needs to be cleared
so the cycle itself
the menstrual cycle itself is not the problem right
because we women right
we have scapegoated our menstrual cycle
for so many things
but our body is designed to handle our menstrual cycle
okay so
I don't want to add the menstrual cycle
to your list of things
that you think are working against you
it really comes down to your liver's ability to clear
your sex hormones
so your menstrual cycle again
reveals the problem it's not the problem
it reveals the problem
when the liver's capacity is already compromised
already carrying more than it can handle
the additional hormonal shifts
are enough to push it past the limit
it's the same with the food right
it's the same thing with the tyramine or the histamine
or whatever molecule in the food
is going to hit the list
of the National Headache Foundation
if your liver if your
you know
if your digestive track is functioning properly
and can neutralize that molecule
before it even enters your bloodstream great
but your liver is the backup
and so if something makes it through
and your liver can handle it
you're not going to have food sensitivity
you're not going to have food related migraine triggers
so restoring
the liver's ability
to run these detoxification pathways
restoring your digestive function
so it's neutralizing these compounds
before it even gets into your body
that is what we wanna focus on now
I wanna talk about something that's
a little bit difficult to hear
particularly if you're taking medication
okay so again
I don't want you to change your medications
I don't want you to freak out about your medications
I know you don't want to take these medications
you're only taking them
because you're stuck between a rock and a hard place
but unfortunately many of the medications
that are commonly prescribed for migraine
that is preventative migraine preventative medications
are actually making this problem worse
so Ssris like Prozac Paxil
Wellbutrin
they're strong
inhibitors of that cyp2d6 detoxification pathway
that means that they actually slow that pathway down
beta blockers like metoprolol
another common migraine preventative medication
that has to be detoxified through that same 2D6 pathway
okay so if you're taking something like metoprolol
both the tyramine that's made it into your bloodstream
and that drug have to be cleared
detoxified through the same pathway
so now your liver has a choice
do I detoxify the metoprolol
or do I detoxify the tyramine
okay so you're going to get a backup in that situation
so for someone that's put on an SSRI for
you know the anxiety and the
you know
low mood that comes with living with chronic migraines
or be is being used as a preventative
or they're being put on a beta blocker
as a preventative
unfortunately
that can really contribute to the so called
tyramine sensitivity
no one is ever asking why the liver cannot
clear the tyramine in the first place
why the Mao in the gut
is not neutralizing it
before it ever enters the bloodstream
so I'm not saying this
because I think there's a cabal
of people that are trying to make you sick
I I don't think anyone is trying to make you sick
what I'm saying is this is what happens
when a treatment that is designed to manage a symptom
um is given
rather than understanding
the biochemistry and the physiology
everything that I've gone through is
in the biochemistry and the physiology textbooks
so when we are
using our medical system to give medications
to suppress symptoms instead of using
our knowledge of biochemistry and physiology
to actually identify hmm
what's going on here
this is the unfortunate result so that was a
a long explanation within that second principle
but I wanted to really connect those dots for you
so let's talk about the third principle
which is restoring our resilience and vitality
so if you've had migraines for any length of time
you already know that there's a threshold okay
there's a tipping point I call this the uh oh moment
right some days you can feel you're close to it
some days you feel like you've got a lot of room
and you're in the clear right
the migraine community has a name for this
the migraine threshold and migraine sufferers
talk all the time about managing the threshold
avoid this
limit this don't do too much don't eat that right
we gotta protect our threshold
I call this bubble wrapping ourselves right
we we try to bubble wrap ourselves
so that we don't tip ourselves into the
migraine threshold right
so living with migraines
the concept of living with migraines
is built around this concept
and here's the thing this is this is real right there
there's a tipping point we can feel it right
I like I say
I like to call it the uh oh moment where we go
uh oh I can feel it I can feel this brewing right
there's a very real tipping point
but nobody's asking the right question about this
the question is not
how do I avoid crossing the threshold
the question is what determines
how quickly you return to the other side of it
because stressors are not optional
they're not avoidable
the vast majority of them are not avoidable
we are continuously bombarded by stressors
by major physical stressors
like an illness or an injury
by very very subtle very minute
physical stressors
that most people never think of as stressors at all
by mental and emotional stressors
by the coworker that gets on your last nerve
the relationship that isn't working
the grief you're carrying
a change in barometric pressure
for instance
is a literal physical stressor on your body
this is why weather is a very real factor
with migraines it's it's not a mystery
these things are happening
and they are going to keep happening
the question is not how to eliminate them
the question is what counters them
what counters them is your own vitality
your body has an innate capacity to return
back to balance to homeostasis
back to health after being knocked out of it
when that capacity is strong
the stressors they knock you off center
they push you out of homeostasis
they sort of push you out of a state of health
but then you come right back
when that capacity is struggling
you stay off center longer
when it's chronically depleted
you can't get back at all
so
you've already seen this in your own migraine pattern
so think about it a two hour migraine
you cross the threshold
and something in your body pulled you back
you bounce back after two hours
a three day migraine
you cross the threshold and you struggle to return
a daily headache every morning you wake up
you're not crossing the threshold and bouncing back
you're stuck on the wrong side of it
so your migraines
actually give you a readout of your vitality
in two different ways the severity of the migraine
how far out of balance you fall
once you cross the threshold
and duration
how long your body stays out of homeostasis
before it can find its way back
when vitality is strong you cross the threshold
but you don't fall down too far and you recover quickly
when it's depleted
you cross the threshold and you fall hard
it's a severe migraine
and it takes days to climb back out
like think about the immune system right
you've been around a sick person and you caught a cold
you've also been around a sick person
and been completely fine same virus
same exposure different outcome
nobody tells you to avoid all sick people forever
and in fact you
you can't do that right
you're going to be exposed
the answer is a strong immune system
one that handles the exposure and clears it
vitality is that extended to all stressors
not just pathogens weather food
emotional stress
every stressor that your body encounters
and this connects directly back to tyramine
an uncleared toxin circulating in your bloodstream
is a physical stressor
it knocks the body out of homeostasis
and it's your vitality
that has to counter that stressor
and return you back to balance
and this is another reason why
two people can eat the same meal
and have a completely different outcome
it's not only about the efficiency
of their clearance pathways
it's about whether their vitality is strong
enough to counter the stressor
of that toxin load
and bring the body back into homeostasis
it's also a contributing factor as to why you can eat
the the cheese one day and you can't eat it the next
so
when someone with migraines is told to avoid tyramine
red wine aged cheeses
cured meats
what they're actually being told is limit the stressors
because your body can't handle them
bubble wrap yourself
make your world smaller and smaller
until the threshold feels manageable
but the threshold is not a fixed wall
the return force is what moves it
and the return force is what
the three principles are designed to restore
get the nutrients to the cells
clear the waste materials
and build back the body's capacity to return
back to center
so that the weather stops being a problem
the tyramine stops being a problem
and that coworker at work
hahaha
stops being as much of a problem too
and this means that faith can eat dinner
at her mother in law's table
without dreading the next day
tyramine sensitivity it's real
I get it
I know
you've eaten high tyramine foods and gotten a migraine
but it's not because of the tyramine
it's not a food tolerance
uh it's not a food intolerance
I wanna say that again tyramine sensitivity
it's real but it's not because of the tyramine
it's not because of the food
it's a downstream signal
it's your body telling you that something upstream
is not working
your nutrients are not getting to the cells
the liver is already overloaded
your gut is compromised and your vitality is low
or combination of all of the above
what's happening physiologically
is that uncleared tyramine becomes a toxin
and a liver is already carrying too much
and it can't handle the additional load
a tyramine restricted diet does not
fix any of this
it reduces a load on a system that isn't working
but that's not the same as fixing the system at best
it's a temporary reduction in suffering
but you know you're already overloaded
you can cut out tyramine completely
you're still gonna get migraines right
I know you've experienced that and at worst
this cuts you off from food
from connection
from pleasure from the table where your family gathers
even even your mother in law
right
and leaves the underlying problem completely untouched
so let me tell you what we did with faith
so first of all we did a thorough assessment
we mapped out all of her symptoms
not just the migraines but all of the symptoms
and what I just described in that first principle
that was Faith's picture exactly
digestion was broken at every level for years
while she eliminated more and more food
looking for an answer that wasn't there
so we started with her digestion
we got it working properly
we got her bowel movements normalized right
the heartburn went away
she was able to wean off of her PPI
and when everything started working
she actually started breaking her food down
much better nutrients
actually started getting into her bloodstream
they started reaching her cells
they started reaching her liver
your liver
needs nutrients to run these detoxification pathways
and then carefully very deliberately
with the right herbs and the right nutrients
we gave her liver a gentle little push
not too aggressive
not too much because if we do that too fast
it's a great way to get a migraine
trust me but just the right amount of
a little nudge to help it run a little bit faster
and it could do that
because it actually had what it needed
to run a little bit faster
and then we also did the mental and emotional work
because here's the truth about Faith's food anxiety
it was not her fault it was a completely predictable
completely understandable consequence
of 25 years of not knowing how she was gonna feel after
meals
but that kind of chronic
unpredictability rewires your nervous system
and it creates anticipatory food anxiety
and that fear that anxiety
that constant
low grade terror that every time she sat down to eat
had become its own burden
its own drain on her vitality
its own contribution to the problem
so we had to address that directly
not just as like a side quest
but as an actual clinical issue
so when Faith's body was ready
and knowing
when I have a client who's ready to reintroduce food
this is something that I've developed
it's it's a it's a ability to recognize um
that I've developed over years of clinical practice
working with women with migraines
when I see the signs that her body
is ready to reintroduce food
that's what we did
we began to slowly and carefully reintroduce foods
foods that she had not eaten in decades
and she did just fine
and now faith eats whatever she wants
because it was never the food
the food was not causing her migraines
it was her state of health
and when we corrected that
when we got her digestion working
when we supported her liver
when we addressed her nutrient deficiencies
and helped her body clear what it needed to clear
and we helped her heal from the anxiety that be
had become its own problem
the food stopped being a problem
because it never was the problem
this is the story that tyramine
sensitivity is actually telling
not you cannot eat these things
but your body needs support
in ways it has not been getting
and that is a story that has an answer
that is a story that has a happy ending
and the answer is not a list of foods to avoid
for the rest of your life
25 years of food anxiety
25 years of landmines and ordeals and embarrassment
and sitting at her mother in law's table
not knowing if she was going to be sick the next day
and it was never the food
thank you so much for joining me today on the podcast
I will see you next time
and her conclusion was not
maybe tyramine isn't the issue here
her conclusion was I guess I should limit the amount
right I guess I should restrict even more
