Oral + Gut Dysbiosis in Migraine: 2020-2025 Research

[Craigo]

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.

[Craigo]

Notebook LLM Audio Summary Podcast Generation (AI generated).

 

[Craigo]

Another review on this subject published a few days back..

A review on gut microbiota and migraine severity: a complex relationship

Noha M. Gamil, Rana M. Ghorab, Reham Z. Elsadawy, Nada M. Khadrawy, Mohamed Abdelhamid, Khalid A. Ismael, Omar A. Mohamed, Mohamed M. Ata, Habiba T. Jalal, Joumana E. Zeidan, Reem T. Rashed & Riham A. El-Shiekh 

Springer Nature Inflammopharmacology Published: 27 November 2025

The gut-brain axis plays a vital role in migraine pathophysiology. Studies highlight reciprocal interactions between the central nervous system and the gastrointestinal tract. Previous research suggests that factors such as gut microbiota profiles, inflammatory mediators, neuropeptides, serotonin pathways, stress hormones, and nutritional substances influence this interaction. The pathophysiology of migraine has been linked to changes in the gut-brain axis, which affects migraine severity and frequency. Additionally, dietary approaches, including the ketogenic diet, vitamin D supplementation, omega-3 intake, probiotics, and weight loss plans, have shown promising effects in reducing migraine symptoms by positively impacting the gut microbiota and the gut-brain axis. Understanding these connections could lead to novel therapeutic strategies for effectively managing migraines. It is worth noting that research highlights several innovative treatments for migraine, such as Zelirex and Cevimide, implantable devices like Cefaly and Revilion, and new effective routes of administration for Sumatriptan. Finally, patients’ perspectives and concerns were thoroughly discussed, with a focus on future directions in the migraine-gut axis research.