Demystifying Migraines: the gut connection, with Tanya Paynter

Episode Transcript

Ariel: Hello, everybody. And welcome back to another episode of the “Colon Health Podcast.” I’m your host, Ariel Bridges. And today, I’m here with Tanya Paynter. Tanya, how’s it going?

Dr. Paynter: Good. How are you, Ariel?

Ariel: I’m well, thank you so much. And thank you so much for being here. Can we just start off with you introducing yourself and sharing exactly what it is that you do with our listeners?

Dr. Paynter: Absolutely. My name is Dr. Tanya Paynter. I’m a naturopathic physician and I specialize in helping women with chronic migraines who are not well-controlled with medication to basically learn how to control their migraines.

Ariel: I always like to start off our podcast chatting with our guests about what their personal journey was and what led them to where they are today. And yours is very fascinating and one that I think some of our listeners may relate to. So, do you mind sharing what brought you to doing what you are doing and what led you to pursue this functional medicine work?

Dr. Paynter: Yeah. When I was in fourth grade, I remember just falling in love with the human body and how it worked. That was my first health class. And I knew from that moment on that I wanted to be a doctor. So, fast forward to time to apply to medical school and my mom heard this weird thing called naturopathic medicine. I was like, “What is that?” Where basically it’s kind of a functional approach to medicine.

So, it’s not just let’s make a diagnosis and then treat it, it’s let’s figure out what’s causing that diagnosis in the first place. And that really drew me. I really loved that digging and trying to understand more about how the body is working to create some of these disease symptoms. So, that’s the route that I chose to go. Now, as far as the migraine piece, that is kind of a personal history.

My migraine started when we ran into a car accident when I was 16. And they started as kind of occasional pretty intense headaches, and then they graduated to daily headaches, and then they graduated into severe migraine episodes. And from the time that I was probably 20 until the time that I was 32, 33, there wasn’t a day that went by that I didn’t have a headache to some degree or another.

So, I went through medical school and that was kind of always top of my mind, like what is causing these severe headaches? There has to be something else going on. And it was through just my education there that I started putting the pieces together and understanding that there was some other more foundational biochemical imbalances happening in my body, and once I started addressing those, my migraines started to go away and then my headache started to go away.

And, you know, I had more energy and more brain clarity, and I felt the rolling out of bed feeling like I was 80 when I was 25, I felt like I was a 25-year-old and I had energy, and it was amazing. So, when I started practicing medicine, I always had a soft spot in my heart for people who had these chronic headaches that they were dealing with all the time. And it is so common. I’d say probably greater than 70% of my patients that I saw had regular headaches, but I knew what to do with them.

And it was always very successful because, you know, doing this kind of foundational whole-body approach to a chronic problem like that can be very, very effective. So, then that led me down the path of specializing to these women who just have no support and no other road to turn to when they’ve tried all the medication options, they’ve tried all the conventional approaches and nothing is really controlling them well. So that led me to create my online program and to specialize in this to help women overcome those migraines. So that’s my story.

Ariel: Thank you so much for sharing. I was just going to say the feeling that you had to have felt when you finally found something that worked. I have so many friends that suffer from migraines and they’re so, so debilitating. And I can’t imagine how frustrating it must be to try all these things and not have anything work for you.

Dr. Paynter: Yeah. I don’t know what’s worse, the fact that you don’t have less pain or the fact that you had your hopes up that this was it and then just have them crash again. You know, it’s like that disappointment is almost worse and the fact that it didn’t work anymore, it’s really a huge problem. And there are so many…I mean, millions and millions of people, I think the last thing that I saw was 38 million people struggle with migraines across the country. Yeah. That’s just in the U.S. alone. A huge problem.

Ariel: That’s wild. A huge problem. So, we are obviously here on the “Colon Health Podcast,” and so, I am curious to hear you share some of the ways that migraines are connected to gut health. We always chat often about how we may not realize how all of these systems in our bodies are connected, and I feel like you are the perfect person to explain some of those connections.

Dr. Paynter: Yeah. And this is what I love. This is what naturopathic medicine is all about, is kind of understanding some of these connections to the extent that science knows about them, right? Like, there’s still so much about our gut that we just don’t even know. We know how it plays such a huge role in our immune function. It plays a huge role and actually as our second brain. I’m sure that you guys have probably, at some point, talked about that gut-brain access and the fact that our emotions and our thoughts and things, our cognitive function also, we found, that it’s linked to gut function.

So, there’s definitely a huge interplay going on there. And so, there’s a lot of really interesting research around how gut and gut health affect migraine, neurotransmitter balance, hormone regulation, all kinds of stuff. So, one of the first things that…we work on kind of eight major foundational areas when we work with our migraine clients and one of the very first one that we work on is gut health and diet because it is so key that without that in place, we can’t see any improvement anywhere else.

So, there’s kind of that leaky gut hypothesis, where… I loved how Dr. Donald Kirby, he’s the director of the Center for Human Nutrition at the Cleveland Clinic, he put it perfectly. Leaky gut syndrome isn’t a diagnosis taught in medical school. Instead, leaky gut really means you’ve got a diagnosis that still needs to be made. And I love that because so often it’s just, you know, we throw out these terms, but we don’t really know what does that mean?

Leaky gut can be caused by food sensitivities. It can be caused by gut bacteria imbalance. It can be caused by an undiagnosed infection like SIBO. So, we really want to encourage everybody, especially if they have a GI-related diagnosis as well, up to 54% of people with migraines are also diagnosed with IBS or some sort of other irritable bowel symptoms. That’s a pretty huge connection there.

And so, we wanna make sure that it’s not just an IBS, like that’s not a diagnosis, that’s just a name for a collection of symptoms. What is causing that IBS? So, we really want to encourage people to dive deeper into, all right, let’s look at small intestinal bacterial overgrowth. That’s being linked as a huge reason for IBS. And that’s an easy breath test that can be ordered through your doctor, through your GI doc, or even some primary care doctors are willing to order that. So that can tell us if there’s an actual infection going on in the small intestine that’s contributing to these symptoms.

It can be something like food sensitivities where there can be a non-allergic immune reaction to foods that we eat. For example, for me, I actually have a food sensitivity to dairy and to corn. My husband has one to apples and pears of all things. So, it can be something that is not an inflammatory food. Like, apples are super healthy, but for him, he can’t eat them. They cause him a bunch of problems. So, it’s really important to look at the specific individual person to understand a little bit more about their body and what their body is not responding well to. And it can be kind of hard to pick this out.

There are blood tests, a lot of people argue about how accurate some of those blood testing are. And when we’re talking about blood tests for sensitivities, we’re talking about IgG reactions. And so, that’s just kind of looking at how the immune system is potentially in a non-allergic way is reacting to various foods. And that can lead to inflammation in the gut which then kind of leads to this idea of leaky gut where the gut lining is just inflamed and that creates a whole host of problems systemically because of the connection that our gut has to our immune system and to our brain specifically.

There’s also some other very interesting research about how the gut is playing a role. So, for anybody suffering from migraine, especially women, they probably know that there is at least, to some degree, a component of hormones, something going on, right? I don’t think I’ve ever talked to somebody who has not had something going on with their hormones from a migraine standpoint. And so, interestingly, there are multiple studies that show that estrogen is regulated by gut bacteria and by some of the enzymes that our gut bacteria produce for us.

So, if there’s inflammation or the bacteria in our gut is not where it should be or if there’s an infection that’s disrupting that gut biome, then we’re looking at hormones are being directly affected as a result of this. So then that can set us up for all kinds of PCOS, endometriosis, or hormone-related anything. And then it also, there’s some research that’s showing that it’s actually affecting progesterone. So, leaky gut has been related to, or I should say inflammation, the gut has been related to lower progesterone levels.

So we also know that there’s lower progesterone levels, lower estrogen levels, and coming back to migraines, we know that drops in estrogen will trigger migraines. We know that chronically low progesterone, which is a neurosteroid, so it helps to reduce inflammation in the brain, that is also linked to migraines. So, we can see how the makeup of our gut bacteria and how the inflammation in our gut can actually directly impact our hormones.

So, there’s a lot of really good research showing how… And I didn’t even talk about diet, that’s kind of a whole other subject of how the inflammation caused by foods we eat, the chemicals that are either put in as additives, or dyes, or the pesticide being used on our food, including the glyphosate from Roundup used on wheat. They’re actually showing that maybe a lot of this gluten sensitivity issue that we’re kind of seeing is spreading across the country.

There’s so many people that can’t tolerate gluten anymore, and we’re actually starting to think maybe it’s not the gluten so much as the fact that all of these pesticides, the Roundup that’s being sprayed on it is actually what our body is reacting to. So, there’s a lot of that exposure that when we have that inflammation in our gut, then that gut barrier is compromised. And so, any of the toxins that we’re getting from our food and from the environment through our GI system, there’s not a good barrier there anymore.

So now we’re seeing that our body is absorbing those toxins and that’s encouraging an inflammatory and immune response against undigested food and everything else and then that kind of spreads systemically as well. So, there’s a huge link to our gut health and our migraine, and most people that I talk to aren’t really aware how huge of an impact our gut health really does play in our chronic conditions like migraines.

Ariel: I was just going to say you just shared so many things. I feel like I’m not surprised that a majority of people don’t understand the intricacy of all of these different kinds of connections and possibilities of how your gut health may be influencing your migraines. And one thing that you said that I really kind of honed in on was the fact that it’s so individual-specific. That example that you gave of your husband, I feel like, is the perfect example. It’s like, okay, apples are generally known as being healthy, but for him, he can’t eat apples. And then you also touched on things like how hormones play different. So, there’s things between different genders that may be at play here. So, I would love for you to just chat about what steps can someone take to improve their migraines and gut health, because I feel like it’s common or easy for someone to just Google, for example, what do I need to do, and be overwhelmed by all of the different paths or feel like there’s not something that’s actually working? So, how do they even go about trying to start this journey of feeling better?

Dr. Paynter: Yeah. That is an excellent question. There are three major steps to really kind of starting to work on that gut health piece. The very first is taking a look at diet. So, the first thing that we wanna encourage anyone, well, regardless of your health stuff, in general, we want to encourage people to eat whole foods anti-inflammatory diet just across the board. So, what does that look like? That looks like, you know, trying to go organic as much as possible.

There’s a list put out by the Environmental Working Group called the Dirty Dozen. And a lot of people have heard of it, a lot of people have not, but it’s basically, every year, they test the various produce, usually, fruits and vegetables, to see which ones are the top 12 most contaminated with pesticides that absolutely should be avoided. And those are the ones that you wanna go 100% organic with.

So, usually, potatoes, tomatoes, thin-skinned vegetables tend to be on the top of the list. So, going with organic produce as much as possible within the budget, obviously, and things like… A lot of people struggle with the gluten, as I talked about, so gluten and dairy are usually minimized in an anti-inflammatory diet. There are certain other inflammatory foods that are kind of high up on the list like corn being one of them, soy, dairy. Did I say that? So, trying to minimize those types of foods.

And then, of course, when we talk about whole foods, we’re steering away from everything that’s prepackaged. So all of our convenience foods, all of our frozen foods, all of our processed foods, our snacks, a lot of our snacky foods, we wanna try to steer more towards those whole foods snacks instead. And what I loved when I was in medical school, what we learned as far as whole food, if you can pick it or if it resembles what it looked like when it was growing or being made in or on the earth, then that’s considered a whole food. The farther away that you get from that whole food, the more processing our body has to do to utilize the nutrients. And a lot of the nutrients are stripped from the food, in general, just in the processing.

So, that’s the kind of a good rule of thumb. So, anything you can pick out of your garden, anything that a rancher has, you know, an animal, minimally processed, no hormones, no steroids, he’s out, the happy cow that’s grazing across the grass. So, any of those grass-fed free-range foods, cage-free animals, cage-free chickens, those kinds of things.

And then once we’ve looked at that, avoiding sugar, that’s a huge one for inflammation, sugar, alcohol, those kinds of things. And then we can hone that in…if we’re talking migraine-specific, we can kind of hone that in a little bit more to some of the foods that are more migraine triggers such as those high tyramine, high histamine. People can kind of take a look at some of those, what those look like.

So, that’s step one, is just really working on the diet, really making sure we’re getting high density, nutritious foods, trying to avoid fast foods, trying to avoid fried foods, all the things that our body just really wasn’t made to eat, the high sugar foods, high salt foods. We wanna go towards those more anti-inflammatories. And then we’re looking at step two, is really digging into… But there’s still GI symptoms, or… I feel a little bit better, but there’s still definitely something going on. Then we need to do a little more digging.

Is there an infection going on? Is there a yeast overgrowth? Is there a gut dysbiosis, which is when your good gut bacteria is out of balance? That can play a big role as well. It’s not actually an infection, but you just don’t have all of the good bacteria that we need to feel good and optimal. So really identifying…you know, I mentioned SIBO. So, identifying any of those potential underlying infections that could be at play that’s just keeping things inflamed and not working well.

And then, you know, kind of part B of that second step is working on improving. So, after you’ve treated any infection that you have found, most cases, I would say there’s not a…I’d say maybe 20% of people that we test actually have an infection of some sort. So, most people don’t have an infection, it’s just that imbalanced gut bacteria. So, then we wanna look at helping to support a healthy gut bacteria balance. So, that can be soil-based probiotics, what research is finding that soil-based probiotics are actually the bacteria that are making it through our gut intact to be able to repopulate and kind of change the environment in our gut.

So, a lot of the ND world, we’re kind of moving more towards that soil-based probiotics, and there’s a handful of them out there. And then looking at the kind of standard probiotics that are out there, the lactobacillus, those sort of bacteria. And those are also really great, but the studies are showing they’re beneficial while you take them. But as soon as you stop taking them, then the benefits are no longer there. So, it’s not actually changing anything, although you might definitely feel better when you’re taking them.

So just kind of a thought there because there’s a ton of probiotics. What option do I look for? If we’re gonna be working on actively changing the bacteria in our gut, you’re gonna wanna go with the soil-based. And then maybe you don’t wanna take supplements, maybe you wanna just do it by food. So, really helping to emphasize the high fiber diet, fermented foods are wonderful because they have naturally occurring bacteria. So those are gonna be really wonderful in helping to just naturally change your gut bacteria, using food as medicine.

And then step three, and this is probably one of the most important steps that is always missed, gut healing. We have to actively work on healing up the gut from the damage that has happened. So, certainly, by working on diet, reducing inflammation, helping to support the good bacteria, those will help with gut healing, but it will take a lot longer. We can actually work on speeding up that process with certain nutrients like glutamine. This will say kind of a little caveat, specifically in my clientele and people with migraines, high glutamine diet could be problematic.

So, I’m just gonna throw that out there. Glutamine turns into glutamate, glutamate is a big migraine trigger for some people. So being aware of that. But glutamine supplementation or high glutamine foods can be helpful in helping to heal the gut. And then there are some wonderful herbs, think of like the slimier things. So, aloe gel, there’s something called slippery elm, marshmallow root. Those all have some really wonderful healing properties that specifically help to soothe and reduce inflammation in the gut and help our gut lining to regenerate so that we can actually build back that barrier so that we no longer have those leaky gut issues going on.

And this is all done at the same time, right? We wanna work on dietary changes that should be hopefully long-term and working on the gut after we have those dietary changes put in place. But that third piece, working on that gut healing is so often forgotten about and is key in chronic illness across the board.

Ariel: Yeah. I feel like that final piece is something that’s not discussed often. So, I’m glad that you mentioned it. So, if we are taking these three steps, we’re doing everything together, how long will it take us to start experiencing relief? What’s a realistic expectation for seeing some sort of change?

Dr. Paynter: Yeah. It’s usually kind of this journey. I’ll speak specifically to the migraine population since that’s what I know best, but typically what we see just with some of the dietary changes alone, we can see almost immediate improvement. The very first thing in week one of my program, what we do is we work on getting rid of sugar. We start to understand how much of it we’re eating, what our sources are, where we’re getting it from, and how we can cut it out.

And even just with that, within the first week, I’ve seen people say, “I have gone my first week without a migraine in 20 years.” I’ve heard that very often. So, it can be almost immediate. However, there are a lot of people that have already tried all the dietary stuff and they haven’t seen any improvement there. So, then what I would say is if there is still some issues going on and they have not had any infections tested for, that step two needs to happen because once that’s identified, then we know that we’ve got something to work on there.

If there’s an active infection at play, that takes longer, right? Because, first, we have to work on effectively eradicating the infection, and then we have to work on the improvement in the gut healing itself. So that can take longer. Oftentimes I see anywhere from three to six months of working on treating the infection and then working on gut healing, that’s a bit of a longer process.

Ariel: So, you mentioned it just now and a couple of other times, and I wanna make sure we catch this. You have an excellent, it seems, program to help people out. How can people connect with you to be a part of this program?

Dr. Paynter: Sure. So, my program is called Migraine Mastery. You can find information about it at migrainemastery.org. Also, I have a YouTube channel called “Migraine Mastery – A Migraine Free Life.” And I talk about dietary stuff, histamine, tyramines, a lot of gut health things, hormonal. So, there’s a ton of resources there. And then I also have a Facebook group called “Migraine Mastery – A Migraine Free Life.” That’s a closed group to help support mainly women since I focus in on women health, and there’s just a wonderful bunch of women on there that’s a safe place to kind of ask about this stuff. And we do, you know, lives and Q&As occasionally and things like that.

Ariel: That’s amazing. We love a good community opportunity here on the “Colon Health Podcast.” So, as always, I’ll be sure to link all of these amazing resources down in the show notes below. So, if you’re listening, just scroll on down and make sure that you take advantage and you subscribe, request to join that Facebook group, sign up for the Migraine Mastery program if that makes sense for you. Tanya, we are just about out of time. Is there any other kind of final parting words or thoughts you wanna share with our listeners?

Dr. Paynter: Yeah. I would say a lot of times I share this information and then people are like, “Well, that’s fantastic, but what am I supposed to do with this? How do I get started?” And so, what I would say is if you haven’t ever looked at a functional medicine doctor or a naturopathic doctor to help you, they’re a wonderful piece of your medical team. So, I would encourage you to just Google local naturopathic doctors in my area or local functional medicine doctors. And they really… Like everything that I shared on here, that’s our bread and butter, right?

We do gut health, first and foremost, is the first thing that every ND will focus on. So, that’ll be a wonderful place for people to get started, even just going in and just setting up a game plan with a local provider so that you establish that care and then you have a plan to be able to implement for you specifically. And I think that can be a very helpful place to get started.

Ariel: I love that. On a nice, very clear, inspirational note. So, if you’re listening, you know exactly what you need to do next. Tanya, thank you so much for being here. I learned so much today.

Dr. Paynter: Thank you for having me. It’s been fun.

Ariel: And, everyone, as I always say at the end of the podcast, we all have colons. So, ask questions, do your research, and have a conversation. All right. We’ll see you next time on the “Colon Health Podcast.” Bye.