Migraine strongly runs in families. Many genes have been linked to migraine, mostly ones that affect how nerve cells signal, how blood vessels behave and how cells make energy ¹. Having these genes is not a sentence, though. They seem to set a threshold, and the rest of life determines how often that threshold is crossed.

Genes and nutrition interact

Some genetic differences affect how the body processes B vitamins such as folate, B6 and B12. These can raise homocysteine, a compound linked to migraine, and may help explain why some people respond to B-vitamin and folate support ^2,3.

The energy hypothesis

The migraine brain appears to use energy differently. Several lines of research point to reduced mitochondrial energy production and increased oxidative stress, which may make the brain more vulnerable when demands rise or fuel drops ^4,5. This is one reason steady blood sugar, sleep, and nutrients like riboflavin (B2), magnesium and CoQ10 are studied in migraine ⁶.

What this means for you

You cannot change your genes, but you can lower the load on a sensitive system. That is the central idea behind Dr. Harcourt’s framework: address the factors you can change, across nutrition, hormones, the musculoskeletal system and the nervous system. See The Mastering Migraine framework.

Research cited on this page

1. Goadsby PJ, Holland PR, Martins-Oliveira M, et al. Pathophysiology of Migraine: A Disorder of Sensory Processing. Physiol Rev. 2017;97(2):553-622. PubMed 28179394 · DOI
2. De Marchis ML, Guadagni F, Silvestris E, et al. Genetic bases of the nutritional approach to migraine. Crit Rev Food Sci Nutr. 2019;59(14):2308-2320. PubMed 29517920 · DOI
3. Menon S, Nasir B, Avgan N, et al. The effect of 1 mg folic acid supplementation on clinical outcomes in female migraine with aura patients. J Headache Pain. 2016;17(1):60. PubMed 27339806 · DOI
4. Hassan SA, Farooque U, Choudhry AS, et al. Therapeutic Implications of Altered Energy Metabolism in Migraine: A State-of-the-Art Review. Cureus. 2020;12(6):e8571. PubMed 32670707 · DOI
5. Geng D, Liu H, Wang H, et al. Association between Oxidative Balance Score and Severe Headache or Migraine among American Adults A Cross-Section Study. Curr Neurovasc Res. 2024;21(2):139-147. PubMed 38323611 · DOI
6. Holland S, Silberstein SD, Freitag F, et al. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012;78(17):1346-53. PubMed 22529203 · DOI