How labs can lend insight into migraine
I’m often asked by clients and those interested in coaching with me what kinds of lab tests for migraine are most valuable to help determine the root causes of their migraine pattern.
In my coaching practice, I primarily focus on the Hair Tissue Mineral Analysis (HTMA) test and thorough description of symptoms and history taken during the intake process to develop a plan for them. In most cases, this is sufficient information. However, there are additional tests and assessments that can give even more insight. These labs and tests can help to paint a more complete and clear picture of the unique cause of an individual’s migraine pattern.
While I do not personally order all of these tests, they may be tests you can order through your doctor or independently – or you may already have had these tests done. It’s best to discuss the value of certain tests in person, but in the meantime, here’s a rundown of some of the most insightful tests.
Clinical tests
- Any previous HTMA tests that other practitioners have performed.
- Serum Copper, Zinc, and Ceruloplasmin – While blood tests represent a short window of time and blood is just a transport medium, this blood test is valuable because with it, the amount of free copper in your blood can be calculated. This test gives a sense for how well your liver and adrenals are functioning to make ceruloplasmin, the enzyme that gets copper into the cells. Low ceruloplasmin production will lead to more free copper and more migraine symptoms even in those with low copper. The best times to get this test are a day after ovulation and on a day of your period if you’re female. It’s great to have two tests within a given month to compare.
- Thryoid tests – The thyroid is intimately connected to migraine and also plays a direct role in other issues common in migraineurs, like pressure in the ears or hearing loss. Migraine can result from both hyper and hyp-thyroid.
- Beta-glucuronidase (beta-GUR) – When certain “unfriendly” intestinal bacteria are present in the gut, they make an enzyme called beta-glucuronidase, which re-activates estrogen in your gut. That’s a problem because re-activated estrogen then re-enters your body and causes excess estrogen. Beta-glucuronidase also slows down the glucuronidation pathway and liver detoxification. This test helps to understand to what extent gut flora imbalances are playing a role in migraine and liver function.
- Steatocrit or acid steatocrit – This is a bile flow marker test. Because bile flow plays such an important role in fat metabolism, hormone regulation, and the body’s ability to detoxify, this test can be valuable. It’s also reflective of the functioning of the liver and pancreas.
- 17 Hydroxyprogesterone – There are genetic factors that can play a role in how well hydroxyprogesterone converts 21 hydroxylase to cortisol. When this enzyme pathway is not not working efficiently progesterone can build up which affects aldosterone levels and the ability of the body to retain sodium and copper. This can lead to salt wasting and progesterone dominance. This enzyme converts 21 hydroxylase to cortisol. It’s a useful test for understanding why someone may be chronically low in sodium or copper.
- Kryptopyrrole test –This test is valuable because some people with a pyrrole disorder waste very large amounts of zinc and have much higher requirements for zinc than others. Since zinc depletes copper so powerfully, I tend to be very very modest with zinc supplementation, but some people (ie, those with pyrrole disorder) do need more – in some cases, much much more.
- Urinalysis. Depending on the results of an HTMA, a urinalysis can sometimes be helpful to confirm cellular loss of certain minerals like potassium or zinc if they are showing up as a spike on the HTMA.
Tests you can do at home on your own
- Saliva pH for Stomach Acid– Test your saliva using pH test strips before and after a meal. A normal salivary pH is around 6.4 before a meal. Then have breakfast, wait an hour and retest. If the pH is higher, around 8.0 then it is safe to assume a normal pH of the stomach, as the pH rises after a meal. If the pH does not go at least one point higher one hour after a meal than it was prior to the meal, then you may have an impaired HCl production in the stomach. A Heidelberg Test is another test (clincial test) that can give a more accurate reading of your HCL status.
- Blood pressure reading – Most migraineurs have low blood pressure but it’s useful to know how low -or, if your blood pressure is not low, this can also give important clues for a mineral balancing plan since electrolytes play such an important role in blood pressure. Owning a blood pressure cuff can be valuable because you can see very clearly that your migraines are likely to crop up when blood pressure gets below a certain level and be alleviated when they rise higher. Watching blood pressure changes is a good way to track your healing.
- Hydrogen sulfide gas – Only needed for those with SIBO symptoms. Bismuth has been shown to reduce hydrogen sulfide gas in a few studies. It’s typical for people with an excess amount of hydrogen sulfide gas to have their stools turn black when they take bismuth. This can also be used as a simple diagnostic tool to determine whether hydrogen sulfide is playing a role in your symptoms.
Between testing and paying close attention to symptoms, the mystery of migraine can be unravelled and solved!
