If you suffer from migraines you are at a higher risk of having certain other medical problems, or comorbidities. They are not the result of having migraines, nor do those condition cause migraines. Most likely, they may have common underlying genetic, environmental, or behavioral factors. You should be aware of this link because treatment choice may be affected by the presence of these comorbidities.
Here is the list of conditions more common in migraines: anxiety, asthma, bipolar disorder, chronic pain, depression, fibromyalgia, reflux (GERD, or heartburn), irritable bowel syndrome (IBS), high cholesterol, hypertension, obesity, sleep apnea, TMJ syndrome. Having these coexisting diseases increases the risk of worsening (chronification) of migraines.
Migraine often coexists with another one or more painful conditions listed above – chronic pain (low back and other), fibromyalgia, irritable bowel syndrome, and TMJ. One plausible explanation is that chronic pain of one type leads to an increased sensitivity of brain cells. This increased sensitivity is well documented and is called wind-up phenomenon. Fortunately, many treatments can address several pain syndromes at once. These include antidepressant drugs (amitriptyline, duloxetine, and other), cognitive-behavioral therapy, exercise, and other.
One possible explanation for the coexistence of psychiatric disorders is that 40-60% of people with chronic pain have a history of physical, emotional, or sexual abuse and may suffer from posttraumatic stress disorder (PTSD). Another cause could be that they share serotonin and other neurochemical disturbances in the brain. Here too, antidepressants or certain epilepsy drugs may address both migraines and mood disorders.
Reflux (GERD) often seen in migraine sufferers could be the result of taking too many anti-inflammatory drugs such as ibuprofen, aspirin, and naproxen. Many patients will treat their heartburn with drugs such as omeprazole (Prilosec), which after prolonged use can cause multiple vitamin deficiencies, which in turn can worsen migraines and cause other symptoms.
Migraine has an inflammatory component and obesity is known to be pro-inflammatory, which could explain this connection. Diabetes drug, metformin could be a useful drug for patients who have difficulty losing weight with diet and exercise alone.
