Allergies and headaches

Allergies and Migraine

A recent large study has confirmed findings of previous studies that migraine headaches are more common in people who suffer from allergic rhinitis, and that immunotherapy can decrease the frequency of headache in those patients. Data from the Migraine, Allergy and Rhinitis Study (MARS) was analyzed. Allergy patients with headache received formal headache diagnoses, and received allergy testing with either skin tests, or blood tests of IgE antibodies. Of the 536 allergy patients in the study (60% women), 32.5% had migraine.

The most common allergens found were weeds, trees, grasses, and indoor insects. Patients were divided into those with high atopy and low atopy. (People who have allergies suffer from atopy, the genetic predisposition to develop IgE antibodies to allergens.) The average was 3.39 migraine days per month, and each attack lasted an average of 1.5 days.

What the study found was that the number of people with migraine was not altered by treatment with immunotherapy, but that the frequency and disability from migraine was reduced, but only in migraine sufferers under age 45. The study showed a predicted 52% reduction in the frequency of migraine headache and a 45% reduction of the number of days with migraine-related disability in migraineurs ≤45 years of age that received immunotherapy. The study also found that in the younger group, 45 or younger, low degrees of allergic sensitization were corrlated with migraines that were less frequent and less disabling, and that migraines were more frequent in those with high degrees of allergic sensitization.

Allergies and chronic headache

Allergies are comorbid with chronic daily headache, which means that they occur more commonly in those with chronic headache. This is true of both chronic migraine, and of new daily persistent headache. (New daily persistent headache is a chronic headache that starts off right from the very beginning as a daily or near-daily headache.) It is not yet clear whether controlling allergies can reverse chronic headaches.

References:

1. Ku M, Silverman B, Prifti N, et al. Prevalence of migraine headaches in patients with allergic rhinitis. Annals of Allergy, Asthma & Immunology. 2006;97(2):226-230.
2. Mortimer MJ, Kay J, Gawkrodger DJ, Jaron A, Barker DC. The prevalence of headache and migraine in atopic children: An epidemiological study in general practice. Headache. 1993;33:427–431.
3. Martin VT, Taylor F, Gebhardt B, et al. Allergy and immunotherapy: are they related to migraine headache? Headache. 2011;51(1):8-20.
4. Eross E, Dodick D, Eross M. The Sinus, Allergy and Migraine Study (SAMS). Headache. 2007;47(2):213-224.

by Christina Peterson, M.D.

updated June 20, 2011