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In lieu of a recent article I wrote exploring the literature that may support dysbiosis in cluster headache (check general board), a number of parallels were cautiously drawn from emerging migraine literature, which I thought worth sharing in one place here on the migraine board. These recent studies explore the emerging role of dysbiosis as a causative factor in migraine pathogenesis, exploring potential links via the gut-brain axis, microbial imbalance and therapeutic interventions like probiotics or faecal microbiota transplantation (FMT). 

Whilst I don’t suffer from migraine myself, having read this body of work, if I did I think it would be a fair and reasonable question to be asking: “Do I have dysbiosis, and if so, what can I do about it?” None of the papers below explore the role of optimised nutrition in detail, nor do they touch on two of my favourite patient-led protocols that are known to reshape the gastrointestinal environment and microbiome - high-dose vitamin D and psilocybin - but the door remains open for those avenues to be investigated (and hopefully discussed here).

Happy reading – welcome your comment and you’ll find a NotebookLM audio summary generation below if you’d rather listen to a podcast rather than read studies. I have offered the links to the articles and a short generated summary snippet - any of the articles are behind a paywall and you’d like me to shoot you off a copy please reach out via DM.

 

Gut microbiota dysbiosis enhances migraine-like pain via TNFα upregulation

Published January 2020

https://doi.org/10.1007/s12035-019-01721-7 

Yuanyuan Tang, Sufang Liu, Hui Shu, Lora Yanagisawa, Feng Tao

Key finding: Antibiotic-induced dysbiosis and germ-free status markedly worsen nitroglycerin-triggered migraine-like pain in mice through TNFα-mediated trigeminal sensitisation; probiotics reverse the effect.

 

The association between migraine and gut microbiota: a systematic review

Published April 2023

https://doi.org/10.1007/s13760-025-02779-y 

Alon Gorenshtein, Kamel Shihada, Liron Leibovitch, Tom Liba, Avner Goren

Key finding: Consistent reduction in anti-inflammatory genera (especially Faecalibacterium) and increased Veillonella in migraineurs; overall picture of dysbiosis and reduced diversity.

 

A causal effect of gut microbiota in the development of migraine

Published July 2023

https://doi.org/10.1186/s10194-023-01609-x 

Qiang He, Wenjing Wang, Yang Xiong, Chuanyuan Tao, Lu Ma, Junpeng Ma, Chao You, and The International Headache Genetics Consortium

Key finding: Mendelian randomisation evidence of causal links from multiple bacterial taxa (including Bifidobacteriaceae) to migraine, migraine with aura, and migraine without aura.

 

Making migraine easier to stomach: the role of the gut–brain–immune axis in headache disorders

Published 2023

https://doi.org/10.1111/ene.15934 

Marissa Sgro, Jason Ray, Emma Foster, Richelle Mychasiuk

Key finding: Narrative review emphasising that a diverse, healthy microbiome is required for optimal brain health and that dietary manipulation is a logical therapeutic lever.

 

Migraine as a Disease Associated with Dysbiosis and Possible Therapy with Fecal Microbiota Transplantation

Published 14 August 2023

https://doi.org/10.3390/microorganisms11082083 

Ágnes Kappéter, Dávid Sipos, Adorján Varga, Szabolcs Vigvári, Bernadett Halda-Kiss, Zoltán Péterfi

Key finding: Explicitly proposes fecal microbiota transplantation as a future therapeutic option for migraine on the basis of restored serotonin signalling and reduced neuroinflammation.

 

Linking Migraine to Gut Dysbiosis and Chronic Non-Communicable Diseases

Published 11 October 2023

https://doi.org/10.3390/nu15204327 

Manuela Di Lauro, Cristina Guerriero, Kevin Cornali, Maria Albanese, Micaela Costacurta, Nicola Biagio Mercuri, Nicola Di Daniele, Annalisa Noce

Key finding: Places gut dysbiosis at the centre of a bidirectional relationship between migraine and cardiometabolic disorders; advocates nutritional and lifestyle approaches to restore eubiosis.

 

Lipopolysaccharide, VE-cadherin, HMGB1, and HIF-1α levels are elevated in the systemic circulation in chronic migraine patients with medication overuse headache: evidence of leaky gut and inflammation

Published 2024

https://doi.org/10.1186/s10194-024-01730-5 

Doga Vuralli, Merve Ceren Akgor, Hale Gok Dagidir, Ozlem Gulbahar, Meltem Yalinay, Hayrunnisa Bolay

Key finding: First human evidence of raised circulating LPS and leaky-gut markers in chronic migraine + medication-overuse headache, directly implicating intestinal hyperpermeability.

 

The Brain, the Eating Plate, and the Gut Microbiome: Partners in Migraine Pathogenesis

Published 11 July 2024

https://doi.org/10.3390/nu16142222 

Parisa Gazerani, Laura Papetti, Turgay Dalkara, Calli Leighann Cook, Caitlin Webster, Jinbing Bai

Key finding: Strong call for personalised dietary and pre/probiotic interventions; highlights bidirectional influence between diet, microbiome, and migraine susceptibility.

 

Oral and Gut Dysbiosis in Migraine: Oral Microbial Signatures as Biomarkers of Migraine

Published 2025

https://doi.org/10.1212/NXI.0000000000200437 

Soomi Cho, Yeonjae Jung, Hyun-Seok Oh, Jungyon Yum, Seungwon Song, JaeWook Jeong, Woo-Seok Ha, Kyung Min Kim, Won-Joo Kim, Min Kyung Chu

Key finding: Oral dysbiosis is even more pronounced than gut dysbiosis in migraine; specific oral microbial clusters predict migraine status with high accuracy and correlate with headache frequency.

 

Unravelling the gut–brain connection: a systematic review of migraine and the gut microbiome

Published 3 April 2025

https://doi.org/10.1186/s10194-025-02039-7 

Caroline W Mugo, Ella Church, Richard D Horniblow, Susan P Mollan, Hannah Botfield, Lisa J Hill, Alexandra J Sinclair, Olivia Grech

Key finding: Synbiotic and combined probiotic–synbiotic regimens consistently reduce attack frequency, severity, duration, and analgesic consumption in randomised trials.

 

Gut microbiota, probiotics, and migraine: a clinical review and meta-analysis

Published 12 September 2025

https://doi.org/10.22514/jofph.2025.043

Olga Grodzka, Izabela Domitrz

Key finding: Meta-analysis of RCTs confirms probiotics significantly lower migraine frequency; effect on severity approaches significance despite limited trials.

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