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How to Stop Headaches Using Science-Based Approaches

Episode 110 Feb 6, 2023 2h 21m 24 insights
In this episode, I discuss the causes and treatments of different types of headaches, including tension headaches, migraines, sinus and cluster headaches, as well as menstrual and other hormone-based headaches. I describe how to distinguish between the different headache types and how to select the right treatment, including prescription-based and non-prescription-based treatments, behavioral and nutrition-based approaches. I also explain the evidence and mechanisms supporting the use of omega-3 fatty acids, high dose creatine, peppermint oil, turmeric, acupuncture and more. Additionally, I touch on traumatic brain injury, the causes of photophobia, aura, and the link between spicy foods and thunderclap headaches. By the end of this episode, listeners and viewers will have a comprehensive understanding of headaches, their types and the best way to prevent and stop them. For the full show notes, visit hubermanlab.com.
Actionable Insights

1. Establish Foundational Health Habits

Prioritize regular, sufficient deep sleep, morning and evening sunlight exposure, limiting artificial light at night, proper nutrition, exercise, and healthy social connections. These are critical for maintaining and raising baselines of health, reducing headache frequency, and improving recovery from conditions like TBI.

2. Identify Headache Type for Treatment

Understand the specific type of headache you are experiencing (e.g., tension, migraine, cluster, hormonal, TBI-related). This understanding is crucial for selecting the most effective treatments and avoiding those that could worsen your condition.

3. Balance Omega-3 & Omega-6 Intake

Increase your intake of omega-3 fatty acids (aim for >1g EPA/day, potentially 2-3g EPA/day for mood) and simultaneously reduce linoleic acid (omega-6 fatty acid) intake. This dietary adjustment, achievable through food or supplements like fish oil, has anti-inflammatory and pain-relieving effects, reducing the severity of tension-type headaches, migraines, and PMS-related headaches.

4. Creatine for TBI Headaches

For headaches, dizziness, and fatigue following a traumatic brain injury (TBI), consider supplementing with creatine monohydrate at 0.4g/kg body weight/day for six months. This regimen can significantly decrease headache frequency (by 90% or more) by improving brain tissue energy stores.

5. Red Light for Photophobia & Migraine

When experiencing photophobia or the onset of a migraine, switch to using dim orange or red light bulbs instead of bright blue/green light. Bright short-wavelength light triggers pain sensing and intracranial pressure via specific eye neurons, whereas red light avoids this activation, potentially preventing headache and allowing continued activity.

6. Topical Oils for Headache Relief

Apply peppermint and eucalyptus oil preparations (containing menthol) to the temples and forehead for tension-type and migraine headaches. These oils can significantly reduce pain intensity, increase pain tolerance, relax muscles, and improve cognitive performance during headaches by activating cooling sensory pathways.

7. Curcumin for Migraine & Headache

Consider supplementing with curcumin (approximately 80mg/day, or 25-50mg for sensitive individuals) for migraine and other headaches, ideally in conjunction with 2.5g/day of omega-3 fatty acids. Curcumin’s potent anti-inflammatory properties and ability to inhibit nitric oxide can reduce intracranial pressure and headache frequency/intensity.

8. Acupuncture for Headache & Pain

Explore acupuncture as a treatment for tension-type and migraine headaches, as well as other forms of pain. Acupuncture works by activating sensory neurons, deactivating sensory-motor pathways, modulating pain, relaxing muscles, and reducing inflammation.

9. Combat Stress & Sleep Deprivation

Actively manage chronic psychological stress and ensure you are getting proper sleep. These are identified as common underlying causes of tension-type headaches.

10. Optimize Hydration with Electrolytes

Drink an electrolyte solution like Element (one packet in 16-32 oz water) first thing in the morning and during physical exercise. This ensures adequate hydration and electrolyte balance, which is critical for optimal brain and body function and prevents diminished cognitive and physical performance from dehydration.

11. Relax Muscles for Tension Headaches

For tension headaches, which are primarily muscular in origin, consider using muscle relaxers or relaxants. These treatments aim to turn off hyper-contracted muscles in the head, jaw, and neck.

12. Constrict Vessels for Migraine Relief

Focus on treatments that can constrict blood vessels in the brain area when dealing with migraines. Migraines are characterized by excessive vasodilation, so constriction can help alleviate the associated pressure and pain.

13. Prevent Photophobia to Offset Migraine

Actively adjust your sensitivity to light to prevent photophobia, especially during the early stages of a migraine. By doing so, you can potentially short-circuit the onset and subsequent pathology of the migraine, significantly reducing the ache.

14. Understand Hormonal Headache Triggers

Recognize that hormonal headaches are most likely to occur when estrogen and progesterone levels are lowest, typically during the first 4-5 days of the menstrual cycle. Understanding this pattern allows for more targeted prevention and treatment strategies.

15. Caffeine for Headaches (Context-Dependent)

If you are a regular caffeine consumer experiencing a withdrawal headache, drinking caffeine can provide relief. Caffeine may also cause vasoconstriction and offer relief for headaches late in the day or after poor sleep, but its effects are bimodal and depend on individual response and time of day.

16. Avoid Aspirin for Migraines

Do not take aspirin or similar anti-inflammatory drugs for migraines. Aspirin promotes vasodilation, which can exacerbate the hyperdilation of blood vessels that is a prominent feature of migraines, making the pain worse.

17. Limit Evening Caffeine Intake

Avoid consuming caffeine within 10 to 12 hours before bedtime. Even if you can fall asleep, caffeine disrupts the essential architecture of sleep.

18. Botox for Severe Tension Headaches

For individuals suffering severely from tension-type headaches caused by hyper-contracted muscles, consider Botox injections. This treatment relaxes specific muscles, providing long-lasting relief for weeks or months.

19. Seek Medical Help for Cluster Headaches

If you experience unilateral, deep headaches behind the eye, especially with sudden onset during sleep, consult a physician immediately. These symptoms are consistent with cluster headaches, which are neural in origin and require specific medical intervention, as standard anti-inflammatories are ineffective.

20. Consult Ophthalmologist for Eye Infection

If you suspect a herpes infection of the eye, seek immediate consultation with an ophthalmologist. Herpes of the eye can be dangerous and requires professional medical attention.

21. Caution with High Curcumin Doses

Do not take excessively high dosages of curcumin (e.g., 8 grams/day) without medical supervision. High doses can inhibit dihydrotestosterone (DHT) synthesis, potentially leading to undesirable hormonal effects like reduced libido.

22. Curcumin & Anticoagulants Caution

If you are taking anticoagulant medications to prevent blood clotting, exercise extreme caution and consult your doctor before using curcumin. Curcumin can inhibit pathways related to blood coagulation, posing a risk when combined with these drugs.

23. NSAIDs & Exercise Benefits

Be aware that non-steroidal anti-inflammatory drugs (NSAIDs) can diminish some of the adaptive benefits of exercise. Much of the body’s beneficial adaptation to exercise stems from acute inflammation, which NSAIDs suppress.

24. Avoid Extremely Spicy Peppers

Do not consume extremely spicy peppers, such as the Carolina Reaper, especially if you are not accustomed to very spicy foods. Such peppers can cause severe vasoconstriction in the brain, leading to thunderclap headaches and potentially permanent brain damage or stroke.