Gut-brain axis: RCT shows gut-friendly probiotic improves migraine symptoms
The trial, conducted by Dr. S. R. Jahromi and colleagues, from Tehran University of Medical Sciences, in Iran, found that migraine frequency and intensity could be significantly decreased with probiotics, providing a significant development in understanding the role live bacteria and the gut play in the management of migraines.
The double-blind, randomised, placebo-controlled study, published in leading headache journal 'Cephalagia', is the first successful trial of its kind to show a beneficial role of probiotics in alleviating the frequency, severity and duration of migraine attacks.
In the study, 50 patients suffering with chronic migraines (CM) and 50 suffering with episodic migraines (EM) received either a placebo, or the probiotic Bio-Kult Advanced which contains 14 strains, including Bacillus subtilis, Bifidobacterium, Lactobacillus, Lactococcuslactis and Streptococcus thermophilus.
After taking 4 billion CFU per day, for a 8-10 week period, migraine attacks in the probiotic group had significantly decreased compared to the placebo group; 40% in the EM group and 45% in the CM group.
Migraine intensity was also significantly improved in the probiotic groups compared to placebo; 29% in the EM and 31% in CM.
Migraine research comes to a head
The gut-brain axis is a hot topic right now. It’s fairly well established that the gut can impact our psychological health and influence our susceptibility to stress and anxiety with research showing the microbiome may hold the key to neuropsychological disorders. Previous research has also shown that the oral microbiome could influence the likelihood of suffering from migraines.
The association between migraines and gastrointestinal disorders may be explained by numerous mechanisms; one of which may be increased intestinal permeability, which allows leakage of bacterial compounds (endotoxins) into the bloodstream, thus triggering inflammation and possible migraine attacks.
Dr Katy Munro, headache specialist at the National Migraine Centre, believes these findings are a significant development in understanding the role live bacteria and the gut play in the management of migraine headaches.
“There is certainly a link between migraine and the functioning of the gut, as many sufferers tell us at the National Migraine Centre about their digestive symptoms,” says Dr Munro.
“It is an interesting new approach to look at better gut health by the use of probiotics. This small study suggests further research is necessary and we look forward to seeing the results of a larger scale trial.”
Bringing hope to millions
Professor Glenn Gibson, professor of food microbiology at the University of Reading, and leading gut health expert adds: “This study shows how alteration of the microbiome through a safe and efficacious probiotic mixture can positively help migraine suffers.
“This brings such hope to the millions of sufferers in the UK. Knowing that our gut microbiome can be changed with such interventions is a major area of research with massive clinical implications. I especially liked the mechanistic science that underpinned the research done here.”
Dr Ashton Harper, Medical Director at ADM Protexin Healthcare adds: “This ground-breaking trial is the first of its kind to show that an oral live bacterial product is capable of improving multiple aspects of migraine headaches.
"These results support exciting research developments in the microbiome-gut-brain axis - the bidirectional communication between the gut and brain - which have identified the fascinating potential of our gut bacteria to influence neurological health and disease.
"The single most meaningful result of this current study was the substantial reduction in frequency of migraine attacks for those taking the probiotic.
"Although this area of probiotic research is relatively novel, and further confirmatory studies are required, it does hold promise for improving multiple symptoms in one of the world’s most disabling illnesses”.
Dr Fayyaz Ahmed from the department of neurology, Hull and East Yorkshire Hospitals NHS Trust, adds that any research that could potentially help a migraine sufferer is always welcome, adding: “This research opens new doors for further research into the link between Nervous System disorder and Gastrointestinal structures”
Published online ahead of print, doi: 10.1177/0333102418820102
“The effects of a multispecies probiotic supplement on inflammatory markers and episodic and chronic migraine characteristics: A randomised double-blind controlled trial”
Authors: Martami. F. et al