Gut-Brain Axis, Part III: Mental Health

By: Brooklyn A. Bradley, BS; Medically edited by Dr. Deena Kuruvilla, MD

Mental health is an important factor in your overall well-being and quality of life. One area of research in the field of mental health is the gut-brain axis (GBA), which sheds light on how gut health impacts mood and mental health, particularly in individuals living with migraine. Today’s blog post will be our third installment in the Gut-Brain Axis series [1, 2], and we will dive deeper into this complex relationship and its implications for mental well-being.

First, let’s recap on what the GBA is, and why it is of recent interest in the field of migraine research. The GBA is the communication between the central nervous system (CNS) and the enteric nervous system (ENS) [1, 2, 3]. The CNS includes the brain and spinal cord, which controls everything from thinking to feeling [4]. On the other hand, the ENS is mainly responsible for your gut, controlling functions from digestion to immune defense [5]. The gut-brain connection is important to study especially in the field of migraine research, as migraine can be complicated by GI conditions such as functional dyspepsia and cyclic vomiting syndrome (CVS) [6].

Individuals with migraine may experience a range of mood and mental health symptoms that can have an impact on their quality of life, such as anxiety, depression, and brain fog [7]. The unpredictability of symptoms during a migraine attack and overall discomfort experienced during them can lead to heightened anxiety levels [8]. Other factors that can contribute to increased anxiety include the anticipation of future attacks (when they will happen, the degree of severity, whether other symptoms will be present, etc.) and overall stress of managing the condition. There has also been a connection observed between migraine and depression in clinical and community samples [9]. Migraine can have an impact on daily activities, relationships, and quality of life, which can contribute to feelings of sadness. Lastly, individuals may experience “brain fog,” as a result of migraine, which includes problems with concentration, memory, and processing information. These cognitive difficulties can not only impair daily functioning and quality of life, but also worsen mood symptoms [10].

Emerging research suggests that the gut microbiota play a major role in producing neurotransmitters such as serotonin [1, 2, 11]. Serotonin regulates many activities in the body, including behavior, mood, memory, and gastrointestinal balance [12]. The role of serotonin in the gastrointestinal system is specifically to increase gastric emptying, gut motility, intestinal secretion, and colonic tone (has a role in colonic transit). Decreased or ineffective serotonin activity has been hypothesized as having a role in the development of depression, anxiety, and other psychological disorders [12]. In terms of gut microbiota, in a study from 2023, researchers looked into whether the types of bacteria in the guts of people with episodic or chronic migraine were different from those in people without migraine [13]. They discovered that there was a noticeable difference in the types of bacteria between the groups [13].

There are different ways to boost serotonin in the body, including natural and pharmacological approaches. According to a 2022 study interested in neurotransmitter regulation and food intake, consumption of food such as kiwi, oranges, bacon, walnuts, and turkey aid in boosting serotonin levels [14]. Fruits, vegetables, and seeds are referred to as chief sources of serotonin [14]. There are also dietary supplements that may increase serotonin levels. Tryptophan, abbreviated Trp, is an essential plant-derived amino acid and is important for the production of serotonin in the body [15]. Past research has suggested that Trp supplements could increase brain serotonin [16]. A 2019 study researching the connection between dietary tryptophan intake and migraine found that in subjects who had a median intake of 0.84-1.06 g of tryptophan per day had reduced odds of developing migraine by about 54-60%, relative to those who only consumed less than or equal to 0.56 g/day [17]. From a medication perspective, serotonin receptor agonists may be used in the treatment of migraine [12]. 5-hydroxytryptamine (5-HT) receptor agonists, also known as triptans, are considered a first-line acute therapy for patients who experience moderate-to-severe migraine attacks [18]. Some examples of 5-HT receptor agonists include zolmitriptan, rizatriptan, and sumatriptan [18].

So, how can we address this intricate connection between the gut and the brain? Optimizing gut health may offer therapeutic benefits for individuals with migraine. For example, you can consume a balanced diet rich in fiber, fruits, vegetables, and probiotic foods to promote a healthy gut microbiota [19]. In addition, stress can be managed through relaxation techniques, reducing stress overall, and mindfulness. It is important to seek support and connect with others. Having a support system (whether it is through talking with friends, scheduled therapy sessions, or support groups) can make a positive impact on migraine management and maintaining mental health.

In conclusion, the GBA has been hypothesized to play a role in shaping mood symptoms and mental health in individuals with migraine. Further research into this GBA connection is needed in order to develop novel therapeutic approaches for migraine management and prevention. Remember to be kind to yourself, set aside time for self-care, and reach out for support when you need it.

 

References:

  1. Bradley BA, Kuruvilla D (2023) Gut Brain Axis and Migraine. In: Westport Headache Institute. https://www.westportheadache.com/gut-brain-axis-and-migraine/. Accessed 8 May 2024
  2. Bradley BA, Kuruvilla D (2023) Gut-Brain Axis, Part II – Nausea. In: Westport Headache Institute. https://www.westportheadache.com/gut-brain-axis-part-ii-nausea/. Accessed 8 May 2024
  3. Carabotti M, Scirocco A, Maselli MA, Severi C (2015) The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Ann Gastroenterol 28:203–209
  4. Thau L, Reddy V, Singh P (2023) Anatomy, Central Nervous System. In: StatPearls. StatPearls Publishing, Treasure Island (FL)
  5. Fleming MA, Ehsan L, Moore SR, Levin DE (2020) The Enteric Nervous System and Its Emerging Role as a Therapeutic Target. Gastroenterol Res Pract 2020:8024171. https://doi.org/10.1155/2020/8024171
  6. Aurora SK, Shrewsbury SB, Ray S, et al (2021) A link between gastrointestinal disorders and migraine: Insights into the gut–brain connection. Headache: The Journal of Head and Face Pain 61:576–589. https://doi.org/10.1111/head.14099
  7. Al Ghadeer HA, AlSalman SA, Albaqshi FM, et al Quality of Life and Disability Among Migraine Patients: A Single-Center Study in AlAhsa, Saudi Arabia. Cureus 13:e19210. https://doi.org/10.7759/cureus.19210
  8. Kumar R, Asif S, Bali A, et al (2022) The Development and Impact of Anxiety With Migraines: A Narrative Review. Cureus 14:e26419. https://doi.org/10.7759/cureus.26419
  9. Breslau N, Lipton RB, Stewart WF, et al (2003) Comorbidity of migraine and depression: investigating potential etiology and prognosis. Neurology 60:1308–1312. https://doi.org/10.1212/01.wnl.0000058907.41080.54
  10. Gil-Gouveia R, Oliveira AG, Martins IP (2015) Cognitive dysfunction during migraine attacks: a study on migraine without aura. Cephalalgia 35:662–674. https://doi.org/10.1177/0333102414553823
  11. Cámara-Lemarroy CR, Rodriguez-Gutierrez R, Monreal-Robles R, Marfil-Rivera A (2016) Gastrointestinal disorders associated with migraine: A comprehensive review. World J Gastroenterol 22:8149–8160. https://doi.org/10.3748/wjg.v22.i36.8149
  12. Bamalan OA, Moore MJ, Al Khalili Y (2024) Physiology, Serotonin. In: StatPearls. StatPearls Publishing, Treasure Island (FL)
  13. Yong D, Lee H, Min H-G, et al (2023) Altered gut microbiota in individuals with episodic and chronic migraine. Sci Rep 13:626. https://doi.org/10.1038/s41598-023-27586-4
  14. Gasmi A, Nasreen A, Menzel A, et al (2022) Neurotransmitters Regulation and Food Intake: The Role of Dietary Sources in Neurotransmission. Molecules 28:210. https://doi.org/10.3390/molecules28010210
  15. Friedman M (2018) Analysis, Nutrition, and Health Benefits of Tryptophan. Int J Tryptophan Res 11:1178646918802282. https://doi.org/10.1177/1178646918802282
  16. Richard DM, Dawes MA, Mathias CW, et al (2009) L-Tryptophan: Basic Metabolic Functions, Behavioral Research and Therapeutic Indications. Int J Tryptophan Res 2:45–60
  17. Razeghi Jahromi S, Togha M, Ghorbani Z, et al (2019) The association between dietary tryptophan intake and migraine. Neurol Sci 40:2349–2355. https://doi.org/10.1007/s10072-019-03984-3
  18. Negro A, Koverech A, Martelletti P (2018) Serotonin receptor agonists in the acute treatment of migraine: a review on their therapeutic potential. J Pain Res 11:515–526. https://doi.org/10.2147/JPR.S132833
  19.  Ferraris C, Elli M, Tagliabue A (2020) Gut Microbiota for Health: How Can Diet Maintain A Healthy Gut Microbiota? Nutrients 12:3596. https://doi.org/10.3390/nu12113596
Published On: June 6th, 2024