For MIGRAINES, research shows that with gamma linolenic acid (GLA), a high percentage of patients enjoy a reduction in the severity, frequency, and duration of migraine attacks, while many have less nausea and vomiting. The essential omega-6 fatty acid GLA is converted into anti-inflammatory hormone-like substances called prostaglandins in the body that improve and regulate blood flow and platelet function. There is good evidence that inconsistent blood flow and platelets that clump more readily contribute to the over-constriction and dilation of blood vessels that cause migraine pain.

What causes migraines?

Migraines are a common chronic inflammatory neurological condition with inflammation around nerve cells and dysfunction of the endothelial cells that line blood vessels. Much evidence confirms the role of inflammation in the pathogenesis of migraines. The clinical and subclinical symptoms of migraine show that it is a neurovascular disorder following the production of pro-inflammatory factors around the nerves and in the blood vessels of the head.

Vascular instability and neurological dysfunction are both likely to play roles in causing migraines. Inflammation can trigger vasodilation–where blood vessels dilate and blood rushes in with a drop of pressure; or vasoconstriction–where blood vessels are narrowed, blood flow slows, and pressure inside arteries and veins increases. Sudden narrowing and then dilation of blood vessels is common with migraines.

Inflammation and oxidative damage can also injure neurons by increasing free radicals. An imbalance of neurotransmitters including GABA, serotonin, and acetylcholine affects blood flow. Likewise, hormones are linked with either vasodilation or vasoconstriction, and imbalances of cortisol, melatonin, testosterone, and estrogen can disturb brain blood flow and aggravate migraines.

What is Gamma Linolenic Acid?

GLA is an omega-6 fatty acid available in small amounts in specific plant oils, such as evening primrose oil, borage seed oil, and black currant seed oil. GLA has been used for centuries in homeopathic remedies and folk cures. Native Americans used it to reduce swelling, and by the time it made its way to Europe, it was in common use and eventually nicknamed the “king’s cure-all.”

Omega-6 fatty acids are considered essential fatty acids; those necessary for human health, but the body cannot make them. Omega-6 fatty acids as a group are very common in standard American diets, but GLA itself is relatively rare; we need supplemental GLA since our bodies cannot obtain adequate amounts from food. Although its precursor, linoleic acid, is found in nuts, seeds, and vegetable oils, its conversion in the body into GLA can be hampered by disorders like diabetes, the natural aging process, poor diet including excess saturated fats or sugar, or inadequate intake of vitamin C, magnesium, zinc, or B-complex vitamins.

The science behind GLA and migraines

Many factors contribute to headaches for both men and women, including family history and age. Women, however, often notice a relationship between headaches and fluctuating hormonal changes; also called menstrual-related migraines. GLA stabilizes hormone-related symptoms and calms inflammation. Women who suffer migraines and PMS are known to have low levels of GLA and are often unable to adequately convert linoleic acid to GLA. They would therefore have more inflammatory prostaglandins which worsen these symptoms. They may additionally have problems processing essential fats to generate enough of the ‘good’ prostaglandins which have a key role in reducing inflammation. For PMS and migraines due to hormone fluctuations and inflammation, GLA gives excellent relief of symptoms.

From GLA, the body forms prostaglandin E1 and thromboxane A1, both of which can reduce inflammation, inhibit the formation of pro-inflammatory leukotrienes, improve blood flow, and inhibit platelet clumping. Prostaglandin E1 also has a role in the regulation of healthy immune system function. As early as 1995, there was so much interest in the potential of GLA for medical use that the Health and Nutrition Division of the American Oil Chemists’ Society convened an international conference to examine the biological value of GLA. This meeting brought together world-renowned experts who explored in-depth the biochemistry, metabolism, nutritional, and clinical uses of GLA. This conference examined hundreds of studies and launched an equal number examining its mechanism of action and anti-inflammatory benefits and resulted in a book that summarized the studies to date.¹

In an important study of 168 patients over 6 months in an open-label uncontrolled trial using polyunsaturated fatty acids (PUFAs) like GLA, 86% of patients experienced a reduction in the severity, frequency, and duration of migraine attacks, 22% became migraine-free, while 90% of patients had reduced nausea and vomiting.²

Migraine headaches cause severe pain and can greatly diminish quality of life due to pain, missed work or school, difficulty driving, and reduced ability to concentrate. Migraines seem to occur as the result of functional disturbances of cranial circulation due to dilation of the scalp arteries, whereas prodromal, or preceding, symptoms such as flashes of light and paresthesias are probably due to intracerebral vasoconstriction. Early studies indicating that linoleic acid can improve blood pressure control reported that the deprivation of linoleic acid during a salt-loading study resulted in significantly elevated blood pressure. This led to speculation and more studies that omega-6 fatty acids exert an important regulatory effect on blood pressure. Diets rich in linoleic acid have been shown to reduce blood pressure, giving credence to their use for migraine pain due to vasoconstriction.³

“The migraine brain is vulnerable to change such as sleep and stress, and is therefore best kept stable,” says Peter Goadsby, M.D., Ph.D., who specializes in the treatment of headache disorders at UC San Francisco Medical Center. It has also been shown that gamma-linolenic acid, a metabolite of linoleic acid, helps lower stress-induced high blood pressure or hypertension.⁴ In a 1996 study published in The Journal of Human Hypertension, patients who received 1 gram of GLA daily for 8 weeks demonstrated up to 40% less increase in blood pressure during subsequent experimental stress tests, compared to the placebo group.⁵

Recent evidence suggests that migraines should be considered as a primary neurovascular disorder, while also stating that the causes or pathogenesis of migraines, which are the third most frequent disease worldwide, is complex and multifaceted. The leading triggers of the initial vasoconstriction seen in migraines entail both hereditary or acquired cerebrovascular or brain blood flow disorders. These can include local endothelial or smooth muscle dysfunction in blood vessel linings, arteriovenous malformations, autoimmune and inflammatory disorders that impact blood flow, along with cerebral micro-embolisms or tiny clots. The potential relationship between platelet biology and migraine was hypothesized more than 30 years ago, paving the way for a series of subsequent studies. However, the epidemiological trials that investigated the platelet count in patients with migraine failed to report significant associations, indicating that platelet function rather than count may influence migraine pain.

Another plausible link between platelet biology and migraine is represented by inflammation and we have discussed how GLA can calm inflammation.⁶

Conversely, several lines of evidence attest that serotonin metabolism is substantially impaired in migraine patients, thus triggering or enhancing vasoconstriction and hypersensitization of neurons. Although abnormalities of nitric oxide metabolism should be confirmed in larger studies, published data suggests that this compound may be effective in amplifying the reactive vasodilatation that specifically follows the initial reduction of cerebral blood flow.

 Studies show that a sufficient daily intake of between 400 to 1,000mg of GLA is needed for migraine relief and all the important anti-inflammatory benefits. In our clinic, we have seen high-dose GLA give excellent relief of migraine pain and associated symptoms while reducing the frequency of headaches.

Why we recommend a high concentrate of GLA

We find a super-high concentrate of GLA to be far more effective than evening primrose or black currant oil, requiring fewer capsules, and thus more economical. Evening primrose oil is less effective for migraines because it has only low amounts of GLA, so we sought out a product that would meet the proper dosage in a highly concentrated bioavailable format. Two capsules of a concentrate of GLA containing 240 to 250mg of GLA per capsule provide as much GLA as twelve capsules of 500mg evening primrose oil or six capsules of 500mg black currant oil.

We recommend our patients take between 240 to 960mg daily with any meals. For those with menstrual-related migraines, patients use GLA either for two weeks of the month for PMS or daily for other PMS-related discomfort.

Recommendation: 240 to 960mg GLA, Gamma Linolenic Acid daily (or for menstrual migraines for seven to fourteen days before and seven days after each period starts), or as directed by your healthcare provider. Changes can be seen after 1 to 3 months of use, and we recommend that patients with migraines continue GLA on an ongoing basis.

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