In this episode Dr. Meg Mill talks all about headaches and migraines and how to combat them. Like other functional medicine doctors, she is focused on finding the root cause of headaches to help get rid of them for good. She is offering a special eight week program in January to help you finally get the migraine relief you deserve and we also talk about migraines and nutrition.
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Cheryl McColgan: Hi, everyone. Welcome back to The Heal Nourish Grow Podcast. Today, I am joined by Dr. Meg Mill, and Iโm really excited to share her knowledge with you because she focuses a lot on headaches, which is something I know a lot of people in this audience struggle with. So, welcome, Dr. Mill. Can you just give us some of your background, how youโฆ Before you get to how you got into this work, you were originally, I believe, a pharmacist, so maybe you could kinda tell us about your progression of moving into functional medicine.
Dr. Meg Mill: Yes, absolutely, thank you so much for having me here. I spent almost 20 years actually practicing as a clinical pharmacist before I made my way into functional medicine, and I kind of have two tracks of how I ended up in this space, and one was a personal journey and the other one was just from experience with patients. So I justโฆ Over the years of working with people, weโre seeing people, I would say, survive rather than thrive, I would see people coming in with more and more medications and just really still not feeling their best. And although thereโs a really wonderful purpose for medications, itโs not the answer for everything. And when youโre not looking into some of the root causes, people were getting more and more sick while kind of piling up and getting side effects and other things from medications.
Dr. Meg Mill: And in the same vein, I actually had spent years with IBS and had been jumping around to different gastroenterologists and getting to them like, โOh, youโre fine, butโฆ โ And I did not feel fine by any means. And so I was looking for other answers and just found through that journey and my own personal experience, was able to find function medicine and heal myself and then go on to change career paths and go back and get certifications to practice. And I do seeโฆ Itโs amazing the difference you can see for people when youโre looking into the root cause, so many things can be fixed and healed that way.
Cheryl McColgan: Yeah, that is a real frustration in western medicine, and itโs certainly something that in theโฆ Iโm very involved in the keto low-carb space and biohacking stuff, and itโs certainly a conversation that we have quite often in the community about, why donโt we address the root cause more often? So as you moved away from pharmacy into functional medicine, can you describe a little bit the training there, how it differs maybe from our traditional medical track and how it more focuses on this root cause? What sort of things did you learn about in order to help people discover that?
Finding the Root Cause of Headaches and Migraines
Dr. Meg Mill: Yeah, so Iโm gonnaโฆ Iโll use in this example, headaches because weโre gonna kind of get into that, and I think itโs a great place to use an example of this kind of difference in the way we approach. So when someone comes in, generally in the conventional medicine space, and weโd say, letโs use the example of headaches, and youโre gonna come in, and a headache would be a symptom, so youโre getting aโฆ So in the conventional space, you would get medication, youโd be told to take Ibuprofen or Tylenol or even get a prescription to treat that symptom, so you wouldnโt experience the pain. And I had someone give me the analogy one time, which I like to use, of, if you took your car to a mechanic and you said โMy car is making a noise,โ and the mechanic gave you a pair of earmuffs, and then handed you back your keys, would you feel comfortable driving the car? [chuckle] And I liked it because I thought, โOh, thatโs a goodโฆ โ
Dr. Meg Mill: We can all relate to that and we wouldnโt be all safe going back in our car, but weโre accepting of just like, โOh here, take this for the pain and go on your way,โ and we find thatโs normal. So weโre going to then say, โOkay, a headache is a symptom, so what imbalances in your body are causing that symptom?โ So we look into all of the root causes, and even things like, weโll look at your nutrients and different food triggers, weโre gonna look at hormone levels, weโre gonna look at stress levels, weโre gonna look at gut imbalances, weโre gonna really dig into all the imbalances in the body that cause the symptom of headaches or of depression, or of autoimmunity or IBS, or all of these different things, and work from the imbalances going in your body so that the symptom goes away rather than putting the medication on to treat that symptom.
Cheryl McColgan: Right, and I would say based on my previous experience with different kinds of, whether itโs psychology or medicine or whatever, the interview process in more traditionalโฆ Well psychology is different, beause pretty much all you do is talk about theโฆ But in traditional medicine, the interview process is kind of missing because doctors typically now only have seven to 10 minutes to spend with a patient, so getting some of that history and background is quite difficult. So Iโm assuming in your practice, you probably have maybe a little bit more freedom to utilize that interview practice, but then are there also any types of testing that are different than traditional medicine that you utilize to get to that root cause?
Functional Medicine Approach to Headaches
Dr. Meg Mill: Yeah, so we have a whole different set of tests in functional medicine. So we would look into your food sensitivities. We have gut tests that look at your whole microbiome and we can see everything thatโs going on, so rather we can actually treat things that you have right there, like if you would have a parasite or if you have H. Pylori or things that maybe arenโt even being looked into, that can be at the root cause of some of these problems or intestinal variability, and then we have detailed hormone tests that we can check your imbalances. Because hormones are all about balance, so we wanna make sure we have that balance, we have no cortisol stress tests, and then we can even actually get into things like mold and environmental toxins and things that people may not even realized that theyโreโฆ I just did one yesterday that showed up with all of these chemicals that this person was carrying around with them that they werenโt even aware of. So if youโre not aware of it, you can never clear it because youโre not evenโฆ You donโt even know how you have it in there, so youโre not tryingโฆ So some of those when we dig deep and we canโฆ And itโs kind of like a detective, where do you need to go in orderโฆ The path leads you to some of the testing that you need to do too.
Cheryl McColgan: Well, now, based on your experience of working with multiple people over time, is there any sort of pattern that youโre seeing, or a couple of patterns that are maybe more prevalent than others, whether itโs some, like you mentioned, some environmental toxins or mold or food imbalances, or is it just kind of everything orโฆ But Iโm just wondering if thereโs one that sticks out in your mind.
Migraines and Gut Health
Dr. Meg Mill: I would say to prioritize the gut. So in functional medicine, sometimes we say all disease begins in the gut because that is how you have to absorb and digest and absorb your nutrients. So if you have a gut imbalance, then youโre notโฆ You could be eating the perfect diet, and if youโre not absorbing those nutrients, your body may not be getting the value that you intend for it to get from all the healthy choices and lifestyle choices that youโre making. If youโre not absorbing those nutrients, youโre not getting the full value. So that in relation to also gut imbalances can lead to underlying inflammation. And so sometimes people are living with that chronic low-grade inflammation all the time. So if youโre gonna start, thatโs a really good place to start. Itโs interconnected with so many other things in our body.
Cheryl McColgan: And having said that, are there any kind ofโฆ Of course, weโre trying to get to the root cause, and if itโs in the microbiome, eventually youโre gonna dig down to that. But are there certain kinds of symptoms that people might be experiencing due to these sorts of imbalances? So for example, Iโm sure headaches is probably one of them, but are there also other things that youโre seeing as far as symptoms that people might have?
Dr. Meg Mill: And I think this is really tricky. Itโs a good question because a lot of people are expecting to have gut symptoms, and if they donโt haveโฆ I do see a lot of people with bloating and reflux and things like that that are constant GI problems, but then I think a step further is sometimes people donโt associate that they could be having gut imbalances from other symptoms. For example, I just had someone who had been itching for years and he just had this chronic itching and he had been taking all these medicines and we couldnโt getโฆ He had in his journey for years and years, not been able to get rid of the itching, and here it was from a gut, we finally figured it out, and it was from a gut imbalance once he got to me, and now he doesnโt have to take that medication. So when youโre looking at eczema or itching or headaches or even just chronic fatigue and things, even sometimes like depression and anxiety, because a good amount of our serotonin is made in the gut, all of those can actually be stemmed from gut imbalances that youโre not necessarily directly associating with that problem.
Migraines, Food Allergies and Food Sensitivities
Dr. Meg Mill: So the other thing that is tricky is sometimes when weโre dealing with sensitivities versus allergies, an allergy is going to happen directly after you eat a food and youโre gonna have that response right away, but food sensitivities can be like four to 48 hours after youโve eaten that food. So something that you ate yesterday or even possibly like the day before that could still be affecting you a few days later, so itโs just a little bit harder to pinpoint. And I think thatโs why people struggle from not being able to identify exactly what foods are triggering them.
Cheryl McColgan: Yeah, I think that is very tricky. I think one thing that helps, when Iโm helping people, usually this is focused on weight loss or diet obviously, but keeping just a simple food log, and over time, it might take longer than if you got some testing, but over time, you might start to identify patterns like, โOh, I ate that one thing two days ago, and then I got a headache.โ I started noticing several years ago when I went lower carb and then keto, I would notice thatโฆ I finally identified that it was a certain alternative sweetener that I had been using that would give me headaches because I, knock on wood, very rarely get headaches. [chuckle] And so when thatโs already coming up, I was thinking, โWow, whatโs going on? There has to be something new here.โ So do youโฆ Outside of just keeping a simple food log, any other tips for people, how they can monitor things to start to, outside of testing, get a little bit of better handle so that when they come to you, they have a little bit more information to give?
Identifying Which Foods Cause Migraines and Headaches
Dr. Meg Mill: I actually do what youโre saying. I do think I tell people that if they have the symptom, then to write down everything they ate that day and the day before, and start to try to look for patterns. I mean, you can justโฆ We know that probably the biggest food sensitivities out there are gluten and dairy, so you could just do a trial period of lemonade and gluten and dairy. I think you need to give it at least four weeks though. I think thatโs where people will be like, โWell, I tried no gluten and it didnโt make a difference,โ and sometimes they didnโt try it long enough to actually get the body to calm down. So the half-life of a IgG antibody, and that would be the antibody weโre getting from that food sensitivity, is 23 days, so you need to give it up at least 23 days in order to get half of those antibodies down, and then every 23 days, another half goes down and down.
Dr. Meg Mill: So really, I generally recommend trying 90 days to really seeโฆ To get the antibodies cleared out and see if you notice a difference. So if thereโs a food that you feel like, โCould this be something?โ or โI just wanna start trying some things on my own,โ thatโs a way to go to try to just avoid some of those foods and cut them out of your diet for 90 days, and then add them back in and see if you can tell a difference. Once your body calms down, youโll often then be able to identify that difference.
Antibodies Have a Half Life, 90 Day Elimination Diet
Cheryl McColgan: And I just wanna thank you for that comment and highlight it because Iโve listened to many interviews like this in the past, and Iโve never heard someone explainโฆ I mean, itโs kind of common sense that you need to cut it out for a period of time, but Iโve never heard someone explain the half-life from the antibodies thing, so thatโs pretty amazing. And I think when people more understand why they really need to do this for a longer time, I think it makes it a little easier, because otherwise, giving up dairy for 90 days would definitely not be my favorite thing, but if I had a good reason why and I had some symptoms that were related, then I would definitely try. [chuckle] So now, weโve gone into some more of your background and how youโve been working with people and practicing with people lately. How did you come to sort of settle on headaches as being one of the things that you really specialize in and that youโre really focused on?
Dr. Meg Mill: Yeah, so actually it started that everyโฆ Everybody. Not exactly everyone but a lot, like so many women that were coming to me particularly, no matter what they were coming for me, were actually also, when I do, as you said, we do a very detailed intake form and we go through all of their health history, and when we were doing that, I started noticing that they wereโฆ Many people were having chronic headaches, and whether or not, as I said, that was their main chief complaint or whether that was just something that came up, so many of these people just had been having these chronic headaches, living with them, and I started to realize that this is something thatโs really not being discussed a lot. People just accept the fact that theyโre having this chronic pain and theyโre taking Advil or Tylenol or sometimes even prescription medications just to cover up the pain, but they just feel like this is a part of who they are, and theyโre being told that they justโฆ Itโs something that they have to just kind of cover up or suffer through.
Dr. Meg Mill: And so then once I was working with them, they would say, โOh my gosh, Iโve had headaches my whole life, or since I was a teen, and I donโt have headaches anymore.โ So it started to be the shift ofโฆ I just kept seeing the same pattern over and over again with, men too, but particularly women, that we would see these dramatic changes in their suffering. So I just thought Iโd like to bring more awareness to this because I think it is something that isnโt really discussed that people donโt have to take those medications, and that, in fact, those medications are contributing to other things, like if youโre taking Advil or Ibuprofen on a regular basis, then you are, we were talking about the importance of the microbiome, that youโre actually setting yourself up for a problem with your gut, or if youโre taking Tylenol all the time, that you have to be careful of your liver. And so youโre actually causing some other health issues by taking these medications when you donโt necessarily have to and can be pain-free without it.
Cheryl McColgan: And before we move on to the headache stuff, thereโs one point I wanted to clarify, because maybe not everybody is familiar with this. So when you mentioned about long-term Ibuprofen or Advil use and the microbiome, so I think what Iโve read about it, and Iโve never done a deep dive into this, but basically it can possibly damage your stomach lining, which over time could contribute to gut permeability, which lets things leak out in your bloodstream and causes any number of problems. So can you maybe give a more detailed explanation of how that affects your gut?
Leaky Gut, Migraines and Headaches
Dr. Meg Mill: Sure, yes. Yes, absolutely. So we get that, and the term that people are hearing a lot is leaky gut. So once youโre taking that medication for a long time, you can get this leaky gut syndrome, and then that actually can lead to further health problems which include autoimmunity, so people that are getting into that Hashimotoโs or rheumatoid arthritis or other autoimmune dynamics. And once we said that the gut health affects so many other aspects of your general health, so youโre just getting that disruption in your gut, and then that canโฆ Itโs a revolving door because that can actually then create more food sensitivities because once you get those little tears in the gut lining, thatโs when those, the IgG antibodies that I was talking about earlier, start comingโฆ Theyโre able to permeate through the foodโฆ Your food is able to permeate through that gut lining because of the tiny tears, and then those IgG antibodies are creating an immune response to foods that you eat very often. So sometimes you get in this cycle where the food that you eat regularly is the food that youโre creating this immune response to. So thatโs why we take it out of your diet to get those antibodies down in order to calm that immune response, and then usuallyโฆ And then we need to also heal that lining so you can get out of that cycle and tolerate things better.
Cheryl McColgan: Yeah, that makes sense. And thanks for that further explanation. Because I know sometimes people that are in this space, we just are like, โOh yeah, leaky gut, I know about that.โ [chuckle] But if somebodyโs hearing it for the first time, they might be thinkingโฆ And I remember years ago thinking, when I first would hear that term, I thought, โThat thatโs not even thing,โ because regular doctors would sayโฆ But now theyโre starting toโฆ Now that weโre learning more about the microbiome, most of this stuff is really proven out, and I think even now, more traditional doctors really accepted this sort of disease process thatโs harming the gut lining is actually happening and causing a lot of these kinds of issues. So Iโm glad you got to that point. So for the headache stuff, I guess, so you mentioned that you were seeing a pattern in the people that youโre working with, you werenโt specifically working on headaches at that point yet, but that they were having relief from symptoms from what you guys were working on. So can you talk a little bit more about sort of the protocols that you are using with your patients before we get to the more specifics of the headache, just protocols that youโre using with your patients, whether itโs dietary changes or lifestyle or whatever it is where you started to see those positive changes in sort of a more broader spectrum of their health?
Headaches and Hydration
Dr. Meg Mill: Sure, yes. So two things I think that people can start to do right away that are just simple, easy and free, are to drink more water to stay hydrated. We do wanna drink half of our body weight in water a day, and itโs really important for headaches and just general hydration that you actually sip your water throughout the day rather than chugging it at meals. Because when you drink, ifโฆ Sometimes weโre like, โOh, we drink our water.โ We grab that bottle because weโre thirsty, we chug it down and then we move on. But then youโre actually passingโฆ Can pass some of that water right through you where when you drink it slowly throughout the day and have sort of a glass that may be by your desk that you can sip on, youโre actually getting more cellular hydration. And then in addition to that, when we drink, have a large amount of water at meal time, then we also can change the consistency of the food, and that actually can affect the absorption of our food and the breakdown. So itโs just important to make sure youโre really drinking water, try to actually track it if you can to makeโฆ
Dr. Meg Mill: Because sometimes I think we think weโre drinking more than we are, and so we have that and just drink that slowly throughout the day. So thatโs kind of just an easy place to start, and then the next thing I think that you can do thatโs really fairly simple, is just really prioritizing sleep. We do know that migraines particularly, areโฆ There are studies showing that a lower REM sleep is a direct correlation to migraine, so sometimes I think people donโt even realize maybe how much theyโre sleeping. I had someone come in, she was like, โIโm getting good sleep,โ and then when we go into her sleep cycle, she thought she was sleeping about once a week, she was almost staying up all night to catch up on everything. And when youโre doing that once a week, even if youโre sleeping the other nights, itโs just getting your circadian rhythm off, it can getโฆ
Headaches, Migraines and Sleep
Dr. Meg Mill: Our melatonin needs to go up at night, so thereโs physiological purpose to sleep that we need for healing, and so just doing those things like keeping your room cool, dark and quiet, so that you have a comfortable space to sleep, turning off all electronics, even thinking about keeping your phone outside your room. [chuckle] I know thatโs a hard thing, but we are attached to those devices so that youโre not seeing the the blue light overnight, just having that maybe a quieting ritual at night. And then the other thing would be to avoid caffeine after 2:00 PM, we all metabolize caffeine differently, so sometimes even if youโre, evenโฆ People are thinking about coffee, but even eating a piece of chocolate after dinner can actuallyโฆ The foods have caffeine too, so you can stimulate your body in those ways that may disrupt that good sleep. So really just trying to focus on getting a good night sleep and prioritizing, thatโs another thing you can do lifestyle-wise right away.
Cheryl McColgan: Yeah. And thatโs, itโs so good for many things, because also with weight losses, again, it just happens to be a big part of my focus, but itโsโฆ Sleep is so underrated for so many things, and so much so that Iโll make sure that I put this in the show notes for people that are listening to this right now, is that I have a whole big article about sleep and it mentions all of those things that you said, plus a few more. And thereโs a couple of tools, that I found really to be helpful, and you might share this with your patients, but one of them being, almost 50-year-old myself, hot flashes, perimenopausal stuffโฆ Is that a cooling pad that you actually put on the bed so it maintains that cool temperature in the room no matter what your external environment happens to be.
Cheryl McColgan: And then a really good eye mask that really blocks out all those, in addition to blue blocking glasses, but even just in our room, for example, we have an air filter thatโs got some weird little light on, and then weโve got the house alarm thatโs got a light on, and all those things add up to sort of disrupt sleep over time, and so itโs like every little thing that you do, I think contributes to a better night sleep, soโฆ I love that tip. There is one thing that you mentioned, I just wanted not to totally belabor, but just quickly ask a question, is you mentioned hydration on the cellular level, so from a physiological level besides just getting enough water, is there anything else that affects the hydration of the cellular level?
Migraines and Electrolytes
Dr. Meg Mill: Well, we would just wanna make sure that weโre getting the right electrolytes to make sure because your electrolytes will affect how water is absorbed into the cells, so just making sureโฆ And there are actually even some people, especially if youโre not a big water drinker, that some people struggle just with even the taste, and so there are some electrolyte even packets that you can put in your water to enhance that too.
Cheryl McColgan: Yeah. And all of us in a low carb space are very focused on that. Because that is more of a problem, the lower carb that you go is the electrolyte balance, so thanks for that too. So letโs finally get into the headache stuff. [chuckle] This is pretty exciting because not only is it the focus of your work, but youโre also in January going to be offering a special group thing, I think, where youโre doing maybe some education and some education, I guess. So if you can maybe talk a little bit more first about your work with people and headaches and how you reallyโฆ After youโve noticed that this was happening, you started to focus on that and then about your program that youโre offering in January.
Dr. Meg Mill: Sure. Yes. So I think that one of the things thatโฆ Another aspect that we donโt realize with headaches is that food can cause your headaches, so there is that component ofโฆ Weโre talking about the triggers that are going on in your body and whatโs happening, and there are certain foods we know for sure that can trigger headaches, and then sometimes people with food sensitivities can also have that immune response thatโs triggering their headaches from them, so we work through a lot of different food. Some things that you can look at are tyramine, sulfites, some MSG, aspartame, or other triggers that we were in histamine-related foods. So we look at foods, we know that from the data that are foods that likely trigger headaches and we work on eliminating those from our diets, increasing the foods that have the nutrients that we want to be getting from the headache to support people that are commonly low when they have headaches and build up those nutrient levels and then clear out the food sensitivities.
Dr. Meg Mill: So weโre getting a more bound nutrition and not getting any aggravation of headaches from food. So thatโs one focus that we look at. We also know that stress can be a component of the headaches, and some people get in that chain of pain because whenever people have headaches, that actually is a stress on your body, so itโs again, so youโre getting the headache and the pain from the headache causes the stress, which increases the cortisol, which can make you more likely once your cortisol is elevated, you can have more stressโฆ Thatโs your stress hormones makes it more likely to get a headache, so we work on how to break that chain of pain with a stress response. And then we also will look at often hormone imbalances are another thing, many peopleโฆ You might hear women saying, โOkay, two days before my period, every month I get that headache.โ
Migraines and Hormones
Dr. Meg Mill: And so thatโs often at that time of the month, because the week before we get our period, our progesterone drops rapidly and our estrogen does too, but our progesterone often drops more rapidly than the estrogen, so you can end up with somewhat of an estrogen dominance, particularly right in that PMS window. So just really looking into hormones and peopleโs hormone balance and helping that, we also look at your environment, and if you have any environmental triggers, we know certain toxins such as lead and cadmium can be things that trigger headaches, but also environmental things in your house that can be causing that and triggering, so cleaning up your environment, then even possibly looking into things like mold and different things that you could be experiencing.
Dr. Meg Mill: So we just take it, we look at them, instead of all the things that you have going on in your life and balance each area, to help support you and get rid of the triggers for the headaches. And so thatโs why in January 24th, Iโm starting a group program called Headstrong Happiness Beyond Headaches, and taking people in that group to be able to reach more people through the same process that I useโฆ I call it My Eat Method, itโs enlighten, align, thrive. So we enlighten about all the things that can be triggering your headaches, then we align your body in the way we need to, and then set you up to thrive so that you donโt have the headache. So that will be a nine-week program that people will get a food sensitivity test actually as part of that, so they can identify what foods are unique to them that can be triggers, and then we go through that process and do education and group sessions on each one of those modules. Thereโs nine modules that we go through. Yes, and that you can get information about that at, itโs happinessbeyondheadaches.com.
Cheryl McColgan: Okay, great, and Iโll definitely have that in the show notes, but Iโm also interested because itโs such a good timing because quite often at the beginning of the year, people start to focus on creating new healthy habits, as you know, [chuckle] and I think that obviously, getting a life thatโs more pain-free should be at the top of everyoneโs list, so Iโm really happy that youโre offering that. To go back to, I think a lot of the things that you mentioned as far as triggers for headaches were pretty obvious, but since a lot of people that are listening to this show in particular are pretty focused on how they eat, can you maybeโฆ You mentioned, I think, did you say tyrosine or something with a T?
Dr. Meg Mill: Yeah.
Cheryl McColgan: You named a few things that Iโm not as familiar with, so maybe examples of what kind of foods might contain those might be useful for people or just foods that really commonly trigger headaches.
Migraines, Headaches, Histamines
Dr. Meg Mill: Yeah. So one of the things that people should look at are histamine foods, so that would be things like HGs, fermented food, shellfish, and often sometimes if youโre someone particularly that has regular congestion and headaches, you may be getting triggered from histamine, so you want toโฆ Actually you can even Google foods that are high in histamine, because itโs a pretty long list to read through, but some of those, like I said, the HGs, the fermented food, the shellfish, look through those foods and just try to cut back on histamine, it can be filling a bucket where you were getting hisโฆ So you want to look at foods that have histamine in them, and then there are certain foods that actually release your bodyโs trigger of histamine, because if youโre also someone who has allergies, you could be getting histamine reactions from your environment.
Dr. Meg Mill: And so once you get this level of histamine that builds up, that can actually be one of the triggers for headaches. And a little tip there thatโs tricky with that food in particular, is that you can get a build-up in histamine foods from leftovers too. So you actuallyโฆ If youโre someone who has a histamine sensitivity, you donโt want to eat leftovers after 24 hours, you donโt wanna be someone that like brings your food home itโs there for a few days, and then you pull it back out because histamines can actually grow in leftovers.
Cheryl McColgan: I had heard that one before, thatโs very interesting, and I sometimes wonder, you mentioned the congestion factor, which Iโฆ Like I mentioned, I donโt have headaches very often, but I do quite often have congestion and seasonal allergies, so Iโm wondering if I should maybe start looking at histamines a little bit more myself.
Dr. Meg Mill: Yes, I think itโs something that is affecting a lot of people that you might not even be realizing, and there is a genetic variant, if youโre someone whoโฆ Another test we do actually, is we test for genetic snips because everyone has different snips that to their genes that help them to process things differently, and if youโre someone who has a genetic snip for the DAO enzyme, itโs an enzyme where you may not be breaking down histamine as well as other people, so thatโs another piece of an investigation in the testing is we can seeโฆ Like if youโre someone who doesnโt have that, who has a snip that doesnโtโฆ DAO is an enzyme that helps break down that histamine. So you could be someone who just genetically has a higher level. And thereโs a supplement you can take actually to block that, so if you do something with histamine and you donโt break it down, well, you can take a supplement with your meal to help you through that.
Cheryl McColgan: Interesting. And I actually have one of those snip tests, Iโll have to look at my DAO status.
Dr. Meg Mill: Oh, yeah, look at it, yeah, look at your DAO. Yes, yeah. Thatโs something you should look at. Yeah, because especially if you have that congestion, these allergies, and see if you do, if thereโs any snip there that is inhibiting you from breaking down the histamine as well as you could be. And then the other thing I mentioned was tyramine-containing foods. So those would be aged or cured foods often, and we know that tyramine is produced in foods from the breakdown of the amino acid tyrosine, so certain amines, particular tyramine, are known to trigger migraines by triggering the release of hormones that constrict the blood vessels. So we wanna be careful, particularly in people with migraines, because those can also be a trigger.
Dr. Meg Mill: And then salicylates can be found in citrus foods, we also have nitrates, which are found in hot dogs, baconโฆ Some people have sensitivity to sulfites, which are generally found in wines and dry fruits, and then MSG usually is found in processed foods, boxed foods, can soups, so you wanna read that from the labels on your foods, often foods that are processed have that MSG in there, and then aspartame is from diet sodas. And then you also wanna be careful of any artificial coloring or dye you see in your food on the labels because that can trigger headaches for some. And then actually the last one is kind of controversial because itโs actually used to treat headaches, but caffeineโฆ Caffeine can cause rebound headache, so if you look at some of the medication that treat headaches, there is caffeine in there because it can actually help with the pain of a headache, but if youโre a heavy caffeine consumer, then you actually can then start to get headaches, rebound headaches from caffeine withdrawal. So that can actually be a cycle that some people can get into that can be fairly common, unfortunately.
Caffeine and Migraines
Cheryl McColgan: Yeah, thatโs interesting, I never thought aboutโฆ Obviously, caffeine is pretty dose-dependent, thereโs been a lot of over the years like, โCaffeine is good for you, caffeine is bad for you,โ much like eggs, much like many other things, [chuckle] but one of the most recent ones I saw was within the last month, and it was I think in New York Times headline something about, โFinally we know that caffeine is definitely good for youโฆ โ And Iโm thinking, โBut itโs still dose-dependent.โ You can really think of it as a cognitive aid, nootropic kind of thing. Itโs pretty well-known in the bio-hacking community, the enhancements it offers, but I think, again, that doesnโt meanโฆ Itโs like many things like, whatโs good, does it mean go more and more moreโฆ [chuckle]
Dr. Meg Mill: Yes, exactly, so Iโm not saying thatโฆ I totally agree with you. So Iโm not saying that that morning cup of coffee has to go, itโs more of that person who has that regular caffeine intake that is then going through withdrawal. And the other aspect, again, going back to genetics, is everybody metabolizes caffeine different, so we can geneticallyโฆ And thatโs why you could have a couple of coffee potentially at 8:00 PM and be fine, and maybe I canโt have a cup of coffee after 10:00 AM, or Iโm not able to fall asleep because we all have our own unique ability to process it, and so thereโs also that variability within each person.
Cheryl McColgan: Yeah, itโs funny, I actually looked that up one time because somebody didnโt believe me when I told them that I go cold turkeyโฆ First of all, for most of my adult years, Iโve only had one or two cups a day, but somebody didnโt believe me when I said if I go off caffeine, I never get headaches, I donโt, I donโt. But I looked it up and there actually is, itโs something with the genetic process, something in the way that your body processes it that some people, theyโre highly sensitive to it, if itโs like a true withdrawal symptom and then some peopleโฆ Itโs kind of like nothing, which is also, I think the same reason why it doesnโt make me feel any kind of certain way really. [chuckle] Thatโs probably why I can easily have one cup a day and not worry, I have it, I like the taste or whatever, but I donโt feel like it amps me up a whole lot, or anything like that.
Dr. Meg Mill: Yes.
Cheryl McColgan: All very interesting. So if people want to, first of all, you gave the website for your program, but if people want to stay in touch with you, look at your work, find you online, what are the best places they can do that, whether itโs social or your websites or LinkedIn, what are your favorite channels for all that?
Dr. Meg Mill: Yeah, sure. So I haveโฆ My website is just www.megmill.com, and I actually have a eight-step guide to get started eliminating your headache, so if you go to megmill.com/headache, you can download that guide, so thatโs a place if youโre interested in getting started, that is a free guide. And then Iโm also on Instagram, @drmegmill and on LinkedIn @DrMegMill. And I actually had started a Facebook group called the Headache Healing Club. And so if thatโs something where theโฆ Information I share on Instagram is general, more general overall functional medicine, but if you are interested, like I said, in headaches specifically, you could join that Headache Healing Club over on Facebook or look into the program at happinessbeyondheadaches.com.
Cheryl McColgan: Okay, awesome. And one final question for you before I let you go. After having switched the final functional medicine paradigm, thatโs easy to say, was there anything that you learned or in working with patients that youโve observed that has made you personally change either the way that you eat or certain things that you do in your life, whatโs been the biggest influence out of all this new learning and working with people in this way?
Relationship with Food
Dr. Meg Mill: Well, I think once you work with people and theyโre looking at lifestyle and food, you really look at your relationship with food, I think everyโฆ Iโve learned that everyone has a different relationship with food. And itโs very interesting because itโs so unique and some people use food for comfort and use food as their friend, and use food to fill the void, and so Iโve been in learning that in working with each individual, itโs made me more aware of how my relationship with foodโฆ There was one day I was so stressed and I grabbed a bag ofโฆ I had organic caramel popcorn or whatever that my kids had had, it wasnโt necessarily a bad food, but it wasnโt something I should be eating and I was just eating it quickly.
Dr. Meg Mill: And I was upset, and I had to step back and be like, โWoah! Youโre upset about something, like youโre using food.โ So I think itโs allโฆ Youโre talking about it all the time and working with people to use it in their life,โ and so usually I try to use food for nutrients, I try to think of food as information, and choose what I eat based on that, but weโre all human and we allโฆ [chuckle] But I think that has been interesting for me to really see that itโs very different for each person, and it needs to be incorporated in their lives in a way that works for them, but then also bringing that back like, โHow am I using it in my life too?โ
Cheryl McColgan: Yeah, no, it doesโฆ When you think about this stuff all the time, it definitely does bring a whole different way ofโฆ Not only a different way of eating, but a way of thinking about how you eat as well.
Dr. Meg Mill: Yes.
Cheryl McColgan: Well, thank you so much for your time today and for sharing all your wonderful knowledge. Again, Dr. Meg Mill, be sure to look for all her links in the show notes and that headache program, if youโre struggling with this and you wanna get in on it, contact her as soon as you hear this, and hopefully itโll still be open, if not, it sounds like itโs what your focus is now, so you might run it again in the future, but again, thank you.
Dr. Meg Mill: Yeah. Weโll just run itโฆ Iโm sorry, weโll run it again in the spring so yeahโฆ
Cheryl McColgan: Perfect. Thatโs even better. So if people miss it, you can still jump on board, get the free guide and check out our website. So thank you so much, Dr. Mill, it was great to meet you.Dr. Meg Mill: You too. Thank you so much.