How can epigenetics be incorporated into the treatment and research of

migraines and neurology?

Mylie Lanier

Senior Project Advisor: Sara Price

Abstract:

Migraine is viewed as one of the most debilitating health disorders. The surprising lack of
awareness associated with migraine makes it challenging to effectively treat patients. While
western medicine may work for some chronic migraine sufferers, a large percentage of patients
do not respond to the medications. These medications are borrowed from other disciplines to
treat migraine patients. A revolutionary field of science, called epigenetics has evolved, and
experts have discovered that it is the missing piece to chronic migraine. Epigenetics studies how
your behaviors and environment can cause changes that affect the way your genes work. It's
crucial for traditional medical experts, neurologists, and their patients to understand epigenetics
connection to migraines. This field needs to be incorporated into the treatment of migraines and
neurology. It will be the primary indication of what each sufferer’s triggers are, what blockages
are happening within their genetic code, what can be added to a patient's regimen, and then fix
the misspellings in their genes. In the end, this will decrease the frequency, severity, and duration
of migraines or make them cease altogether. This research paper draws primarily on the
incorporation of epigenetics into western medicine. It explores the question of “how can
epigenetics be incorporated into the treatment and research of migraines and neurology?” This
research draws fundamentally on the basics of migraines and their history, going into depth about
the definition, the symptoms, what's occurring in the brain, the effects, side effects, and
excruciating pain they cause. Then, the paper will go into depth about how conventional western
medicine is treating this condition and the shift in treatment in the last 3 years. After, it will
discuss what epigenetics are, the Xr program that has been developed, and the method of
HOMING to treat chronic conditions. Lastly, it discusses the author's personal struggles with
migraines. The conclusion indicates that by educating experts and the public, publishing
methods, and creating clinical trials to continue to develop the foundation and validity of this
field, it can then be incorporated into the treatment of migraines.
12th Grade Humanities
Animas High School
8 March 2021
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Part 1: Introduction

The brain is a complex organ of nerves communicating with trillions of synapses, each

specialized area responsible for voluntary and involuntary movements; all operating collectively

in order to help you function, and understand the world. This intricate puzzle works to keep you

alive and is always forming new pathways, but missing or out-of-place puzzle pieces can cause

debilitating brain disorders. Chronic migraine is a large piece out of place for many people and

affects “12% of the population – including children.” (“Raising”). Migraine is an underdiagnosed

and under-discussed topic. Conventional western medicine doesn’t utilize new alternative

options to treat chronic conditions. However, epigenetics is the revolutionary study of gene

expression, and how environmentally induced factors attribute to this condition.

All medications have their limitations. Prescription analgesics designed to reduce pain are

addictive, while triptan medications have their own constraints. There are headaches and

migraines of every kind being researched and new treatments are being developed, but there’s

another side to the puzzle of migraines. Hormonal imbalance, food allergies and sensitivities,

nutrient deficiency, genes, and neurotransmitters, all of the possible reasons, can now be

identified by the revolutionary field of epigenetics. By incorporating the study of epigenetics

and alternative programs into the treatment and research of migraine and neurology, it can

greatly decrease the severity of migraines and find the root cause at the cellular level. Further

advancements for migraine treatments are proving to be incredibly successful for patients.
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Part 2: Historical Context/Background:

Migraines have been debilitating people for centuries. In 1200 BC it was named after a

professor of Egyptology who researched neuralgia, which is the shooting head pains caused by

inflation of the nerves, suggesting that the pain originated in the meninges and vasculature of the

head. Also, formulating a connection between the stomach and the brain due to the vomiting that

seemed to be related to migraines.” (Foxhall). The word migraine is derived from the Latin word

“hemicrania, meaning “half” (Hemi) “skull” (crania).” However, it was said there were even

earlier medical documents from around 1550 BC with mention of the same pain. (Lance). Even

ancient men documented migraine symptoms. They believed spirits were the cause of headaches

and disorders such as madness and epilepsy. All of this history demonstrates just how long this

cruel condition has been debilitating people. The history of this condition opened the door to

migraine research, exemplifying how many are affected by migraines, and broadening/improving

the base of the field. “In 1948, Harold G.Wolff published The Headache and Other Head Pain

Journal, which would become undoubtedly the most influential study of migraine in the 20th

century.” (Foxhall). Allowing experts to base new discoveries on what was thought to be

happening in the brain during a migraine, which was later discovered to be very different

neurological activity.

Over the last century, migraines were eventually classified as, “ a neurological condition

that can cause multiple symptoms. It's frequently characterized by intense, debilitating

headaches. Symptoms may include nausea, vomiting, difficulty speaking, numbness or tingling,

and sensitivity to light and sound.” (“Migraine”). The effects of this debilitating condition can
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deviate between sufferers, occurring in different forms. The different forms include cluster

headaches, “these attacks occur in groups, or “clusters.” During a cluster cycle, brief,

excruciatingly severe headache attacks recur between 1-8 times per day.” (“Understanding”).

Chronic migraines with aura (WA), “physiological warning sign that occurs in your vision or

additional senses, alerting the sufferer to migraine, occurring during and after

onset.”(“Understanding”). Migraine without aura (WOA), “occurs in 85 percent of all who

experience migraines. Sufferers experience each feature of the migraine attack, with no visually

related symptoms.”(Madell). Abdominal migraines, “characterized by stomach pain, nausea, and

vomiting and pain within the GI track.” (“Abdominal”). Lastly, ocular migraines, “characterized

by temporary vision loss or even temporary blindness in one eye.” (Swanson). Every form is

treated differently and includes excruciating symptoms that cause impairment and disruption of

everyday life. There is still much that is unknown for each form of migraine and no regimens

categorically to treat them, creating more complexities for sufferers.

Primary Focus: Chronic Migraine

The Effects/Symptoms:

“Chronic migraine is understood to be the most debilitating disorder in the world, it

affects women more than men, and over 60% of all individuals that meet the criteria for chronic

migraine started getting headaches before the age of 12.” (Koehler). There are stages during a

migraine, which range from severe to extreme. The first stage is what's known as a prodrome. A

prodrome occurs even before the onset of a migraine/aura. The prodrome is an early warning

sign of a migraine attack. This state can last several days making the person feel an

overwhelming sense of self-awareness in the body, extreme sensitivity to everyday things, such
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as light, sound, noise, food, and smells. It makes the sufferers feel dazed, confused, and out of

sorts. It is the body’s way of preparing for what is to come.(“Migraine”).

Once a prodrome occurs the onset of a migraine could happen within minutes or days, it

is dependent on each patient. When the migraine does occur, severe symptoms set in, including

throbbing pain ranging from moderate to severe; the pain is usually centered on one side of the

head. It can be paired with pain on the temples, eye area, and back of the head. Migraines cause

nausea, lightheadedness, sensitivity to light, sound, smell, and touch, making it very difficult to

move, speak, and process. Sufferers are confined to dark, quiet spaces to rest until the episode

has passed. There are a plethora of different triggers associated with chronic migraine, all

causing the severe symptoms.. Some of the triggers include: lack of sleep, changes in food or

sensitivity to specific foods, not enough water, a drop in magnesium levels, abnormal calcium

channels on the surface of the neuron, mitochondrial changes, or other genetic abnormalities.

One of the largest factors associated with migraine is a woman’s menstrual cycles and fluctuation

in hormones. (“The Truth”).

In the most extreme cases, migraines can take the victim out of commission entirely and

last up to 3 days. A chronic state can make these symptoms reoccur and continue for long

periods of time, depending on the migraine’s duration. Chronic patients are classified as

experiencing 15 or more days of migraines per month for more than three months, which

significantly affects the sufferer’s emotional and physical state. Even after the migraine has run

its course, there is also a period of time following the attack called a postdrome. A postdrome is

known as the after effects of a migraine, and can linger for a few hours or up to a day after the

migraine has run its course. “Migraine sufferers don’t always experience the postdrome, but

experts believe that they happen up to 80% of the time. Postdrome effects include the feeling of
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being dizzy, confused, weak, moody, and drained.” (Nazario). In these extreme cases,

researchers have found that the brain will start to reform itself in order to cope with the constant

and chronic pain the sufferer is going through. The brain will begin to shrink the size of each

hemisphere and rewire each pathway to decrease the severity. It is imperative that experts can

find the root cause of the patient’s migraines, in order to prevent the brain’s reformation and

decrease the chances of any future medical conditions, such as, the risk of stroke, which is higher

in women and people that suffer from migraines (WA). (Koehler). “There are also other extreme

cases that can affect sufferers later in life, such as increased risk of cardiovascular disease,

especially for women with aura. There is double the risk of having seizures for migraine

sufferers, and many more medical diseases that are connected to migraine are still being

researched.” (Elgendy et al.) These alarming extreme cases demonstrate the urgency of

medications and treatments needed specifically for migraines, and the importance of early

detection and treatment for this impairing condition.

What Is Occurring In Your Brain?

There were many premises about what was happening in the brain when a migraine

occurs, but scientists came to the conclusion that “migraines are caused by the contraction and

dilation of blood vessels on the surface of the brain, which creates the throbbing pain that

migraine sufferers experience. Scientists believed that they were explicitly a vascular disorder,

but they now understand that the changes happening within the brain when a migraine occurs is

due to complex neuro pathways in the brain.” (Koehler). Which ascertains that this condition is

largely genetically based. There is still much that is uncertain pertaining to the research and

symptoms associated with migraines, but in the last three years, scientists have come closer to
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putting the pieces of the puzzle together.

“When a migraine occurs, the nerve cells within the brainstem are activated, releasing

calcitonin gene-related peptides (CGRP), a protein that causes intense inflammation in

the coverings of the brain (meninges). This activation is due to a variety of different

triggers, as listed above. After activation, neurons in the brain send a signal along the

trigeminal nerve, which is a pathway that begins at the brain stem and then travels along

the face and blood vessels to the brain. The vessel begins to expand or dilate in reaction

to the trigger. This reaction then creates activity in the brain called, ‘spreading cortical

depression.” (Koehler).

Then, after the chemicals are released, the spread of CGRP advances slowly, traveling

from the back to the front of the brain. The wave passes over the brain, it causes the blood

vessels to constrict, limiting the flow of oxygen. The constriction of the blood vessels or

“cortical depression” is the cause of the visual auras, which makes it difficult to speak, causes

shaking, bright spots, zigzagged vision, light flash/vision loss, and numbness in the face and

body. (Koehler).

“The brain can also respond to this activation by releasing neuropeptides, which include

serotonin, noradrenalin, prostaglandins, and several others. Neuropeptides are the small proteins

produced by neurons that can help influence synaptic transmission. After they are released, they

travel on the outer layer of the brain, the meninges - and cause inflammation of blood vessels and

increase the blood flow of the brain, which also cause the symptoms and effects of the migraine

such as the throbbing pain migraine sufferers experience.” (Koehler). This evidence

demonstrates the complexity of activity that occurs in the brain during a migraine, and further

supports the notion that this condition is extremely paralyzing and tortuous.
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Medications:

There are several classifications of migraine medications, they range from

over-the-counter analgesic, to prescription medications. But, many of these drugs are not

specifically designed for migraines and are taken from other disciplines of medicine. Migraine

sufferers can be identified as needing “acute treatment, which is intended to reverse attacks once

they have begun, to limit disability, and to reduce pain and the associated symptoms of migraine.

Or, needing preventive treatments which are used to reduce the severity and frequency of

expected attacks in those with a significant headache burden.” (Miller). The list of drugs that act

as preventative and acute treatment is long, including, “Ergotamines: were the first class of drugs

used to try and relieve migraines. They cause blood vessels around your brain to contract and can

relieve a migraine within a few minutes. Generally, they are taken at the first sign of headache

symptoms, and some have the option to take additional doses every 30 minutes if the headache

continues.” (Gbemudu). “Triptans: are a newer class of drug that increases serotonin levels in

your brain, reducing inflammation and constricting blood vessels; which can stop a migraine.”

(Gbemudu). “Pain killers: some over-the-counter (OTC) and many are available in prescription

strength.” (Gbemudu). “Anti Nausea Drugs: these drugs reduce nausea and vomiting that can

accompany severe migraines. They’re usually taken along with a painkiller, ” (Gbemudu).

In more severe preventative cases, stronger medications such as, “Botox: (Botulinum

toxin type A) injections in your forehead or neck muscles for the treatment. Generally, they’re

repeated every three months and can be costly.” (Gbemudu). There’s also, “ Antidepressants:

affecting levels of various brain chemicals, including serotonin. They can reduce inflammation
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and constrict blood vessels, which can help alleviate migraines.” (Gbemudu). Lastly,

“Beta-Blockers: prescribed for high blood pressure, decrease the effects of stress hormones on

your heart and blood vessels, and can help reduce both the frequency and intensity of migraines.”

(Gbemudu) . Each medication on this list comes in individual forms and their effectiveness

differs for each person.

However, in some cases, those medications are not at all effective for the patient. In the

instances that the medication doesn't work for migraine sufferers, there is little that can be done

to relieve pain and decrease the length of the migraine. In some cases, ice packs placed on the

head, drinking water, and sleep can give slight relief. Each medication listed is given for other

diagnoses that have been found as a side effect that can help with migraines and associated

symptoms. For example, “Depakote” is commonly given to people with seizures, but it has been

found to help migraines because it can help prevent cortical spreading depression, dampening

neurologic activity and interrupt pathways in the brain.” (Doherty). These drugs, although

occasionally proven to be effective, come with severe side effects, such as liver toxicity, and

tapered medications, which makes it difficult for the patient to quit when they are ineffective.

There weren't medications developed specifically for migraines and to treat patients, due to each

form of migraines complexity and the exponential amount of questions and unknowns associated

with migraines. This condition still has many unknown factors and is constantly making it

difficult for experts to determine what is the best form of treatment for patients. Any regimen

prescribed is not specifically for treating migraines. These happened upon medications, were

found to decrease the severity of migraines for some sufferers, and have now become the normal

and standard that experts utilize to treat this condition. Demonstrating the lack of resources and
 Mylie 9

awareness for how debilitating and complex this disorder is, and the need for medications, new

practices, and understanding within this field.

Part 3: Research and Analysis:

Until,

The Shift in Western Medicine/Apprehension:

In the last 3 years, western medicine has been turning towards new procedures and forms

of treatment. Specifically, the newest medication developed to treat migraines is called CGRP,

calcitonin gene-related peptides are a chemical that is released in your brain when a migraine

occurs. Scientists characterized the medicine based on how the medication blocks receptor sites

in the brain, preventing a migraine from happening. It took 30 years to develop this medication

and scratch the surface of what was happening in the brain during a migraine. Every single

treatment prior to CGRP that was used to treat this condition has been borrowed from other

disciplines, and with the advent of CGRP medications, this is the very first time a

disease-specific treatment for migraine has been found.

“CGRP is a receptor that has been partially responsible for turning on the cascade of

events that lead to migraine and the associated symptoms. CGRP is located in the

stomach, skin, head, and is found in all of the areas which experience pain when a

migraine occurs. When it turns on, it releases other chemicals such as, serotonin and

nitric oxide in the vessels, and that is what leads to a migraine.”(Koehler)

Here's what makes it distinct and different from any of the other drugs used to treat

migraines. This once a month injection blocks receptor sites of the CGRP and when these sites

are blocked and activated, the less that the patient will have CGRPs in their body. This

medication causes “downregulation” so migraine events do not occur while decreasing the pain

throughout this process. There are no cognitive or severe physical side effects with this

medication, but the problem being that this medication is not approved for patients 18 and under.

(Koehler). The procedure at western medical facilities, such as Children's Hospital has always

been, “patients are always started on preventive medications and class A medications such as

amitriptyline. After no success, a new procedure has been put into place in the last 3 years to

ensure the patient is off the medication after 8 weeks and the drugs need to be changed. After 2-3

of the preventive medications have failed and depending on how severe the headaches are, they

are then tried on monoclonals or enrolled in a clinical trial. The very last resort for patients is

botox and then in rare cases, CGRP medications are given.” (Koehler).

However, in the instances when the patient does not respond to medications and needs

alternative resources, “ but several government insurances will not cover the new more intense

meditations for anyone under 18. Also, due to the recency of this medication and the complexity

to obtain them, it is difficult to prescribe. Patients have no alternative options and hit a roadblock

when seeking different treatments, making it much more challenging for the patients; making

them feel as though they are running out of options. But, western medicine is trying to shift its

focus to providing new ways of looking at migraine and alternative more holistic views to this

condition.
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Holistic View:

The shift in new medications provided a need for alternatives to be incorporated into

treatment regimens. The newest treatment regimen is based around, “getting patients to engage

in cognitive behavioral therapy, discussion with a clinical psychologist, participating in

community outreach/education programs, focusing on pain management in conjunction with

stress reduction techniques, medication management, and structured/tiered treatment modality

with no larger time restraints on medication shifts. There are also many new devices and ways of

thinking that conventional western facilities and medical treatments are incorporating into their

regimens, such as using vagus nerve stimulator (VNS) devices, and biofeedback with patients.

The problems with the new devices that have come to market, is that the insurance companies

won't cover them and they’re costly” (Koehler). Although trying to shift focus and incorporating

new ways of treatment for patients, there continues to be a theme of hesitation to new treatments

and the future. Western medicine has made small progressive steps that are helping to change the

old ways and focus on new treatments, but experts and facilities are still not incorporating the

key pieces that can change the field of migraines and neurology, understanding this condition

from a cellular level through epigenetics.

Genes:

When treating chronic conditions, experts need to understand each individual patient.

That is not performed by imposing conventional drugs on patients, it’s performed by recognizing

that each patient is different and should be treated accordingly. By understanding alternative

methods, each patient’s genetic code, and examining the complex genetic map that makes each
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person unique. “Genes are the instruction manual for your body. Within every cell, there is a

chemical called DNA, and genes are short sections of DNA. (Buchanan et al).

Your genes act as instructors, which tell your cells the various molecules and proteins to make.

Proteins have numerous different functions in order to help your body remain healthy, and each

gene in your body carries a code that determines your factors and features, such as eye color and

height. There are several different variations of genes that pertain to each feature you have.

“However, mutations can occur with your genes (variants) which carry different instructions than

the original gene. For example, genes give cells different instructions for making a protein, so the

protein works differently.” (Rozakis). Very few variants affect proteins within the body, and are

in charge of important functions, however, in some instances, you can inherit genes, and

mutations can occur which are mal contributors for some of your features and cause medical

conditions/illnesses, such as, chronic migraines. Scientists have identified over 10,000 genetic

conditions.” (Rozakis).

Understanding the Code:

DNA is a molecule that contains biological instructions that make each species unique,

“it is made up of millions of small chemicals called “bases.” “There are four specific bases, type

A, C, T and G, and each section of DNA has variations of sequences of A’s, C’s, T’s and

G’s.”(Mullis 2). “Your genes are so tiny you have around 20,000 of them inside every cell in

your body! Human genes vary in size from a few hundred bases to over a million bases.” (Mullis

4). The entire sequence of genes in your body is called your genome. Understanding these letter

sequences and utilizing the field of epigenetics to look at patients’ misspellings, is the future of

treating chronic illnesses, such as migraines.

What is Epigenetics:

Epigenetics is a revolutionary field that will expand the parameters of science, neurology,

and medicine. It will change the way we look and treat chronic conditions. The history of

epigenetics is linked with the study of evolution and development, but during the past 50 years,

“epigenetics became closely associated with DNA methylation. Furthering, the meaning of the

term “epigenetics” has itself undergone an evolution that parallels our dramatically increased

knowledge of the molecular mechanisms underlying regulation of gene expression.”

(Felsenfeld). The definition of epigenetics is “the study of changes in organisms caused by

modification of gene expression rather than alteration of the genetic code itself.” (“Epigenetics”).

“While your genetics change and alter the proteins in your body, epigenetics affect your gene

expression, which refers to “how often or when proteins are created from the instructions within

your genes.” (“Epigenetics”). “Epigenetics alters the effects of gene expression to turn “on '' and

“off '' specific genes.”(Rozakis). Your environment and behavior greatly impact your genetics.

For example, exercise and diet create epigenetic changes and make it easy to identify where your

reaction to environmental factors and behavior originates. Your genes and genetic code are

always being rewritten, due to epigenetics and these changes start right when you are born.

“Each of your cells has the same genes, but they look and act differently. As you grow and

develop, epigenetics helps determine which function a cell will have, for example, whether it

will become a heart cell, nerve cell, or skin cell.” (“Epigenetics”). Not every epigenetic change

that occurs in your genes is permanent. These changes can be linked or removed, it depends on

your changes in environment and behaviors. Epigenetics can also change your health, by

weakening or strengthening your immune system. (Rozakis). By utilizing epigenetics and

examining your environmental factors, experts can determine the root cause of chronic illnesses.
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There are 3 types of epigenetics that are utilized. There is methylation genetics, “which

refers to the addition of chemicals to a DNA group. It is typically added to specific sections

within the DNA. By blocking the proteins attached to the DNA in order to “read” the gene’s

code.” (Kent). “These chemical groups that attach to your genes can also be removed in a

process called “dymethylation.” (Kent). Methylation reception is to turn genes “off” however the

reversal of this process “dymethylation” turns genes “on” (Kent).

Next, there is histone modification: “DNA wraps around proteins called histones. DNA

wrapped tightly around histones cannot be accessed by proteins that “read” the gene.”

(“Epigenetics”). When genes wrap around the histone they are turned “off” and when this gene

wraps around, they are turned on. (Kent). Each chemical group can be added and removed from

histone to change whether the gene is on or off. (Kent).

The last type of epigenetics is Non-coding RNA, “your DNA is used as instructions for

making coding and Non-coding RNA. RNA is “ribonucleic acid. Many different kinds are now

known. RNA is physically different from DNA: DNA contains two intercoiled strands, but RNA

only contains one single strand. RNA also contains different bases from DNA.” (“RNA”).

“When coding you use RNA to make proteins, and non-coding RNA is gene control expression

by attaching to coding RNA and specific proteins, which break down the coding in RNA.

Non-coding helps regulate gene expression by attaching to coding RNA and certain proteins.

Non-coding RNA may use proteins to modify histones, turning the genes “on” and “off”. (Kent).
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The Xr Program:

The Xr program is a revolutionary treatment plan developed by Dr. Rozakis which

incorporates the science of epigenetics into treatments for people suffering from chronic

migraines. “Dr. George Rozakis, M.D, a biomedical engineer, Board-certified Ophthalmologist,

and LASIK eye surgeon,”( Rozakis), developed an interest in advanced wellness (epigenetics)

and creating an alternative treatment for migraine sufferers. He partnered together with “Dr.

Brian Bakke, who has a Ph.D in biochemistry and organic chemistry. They created an advanced

program (Xr) that “utilizes the revolutionary field of epigenetics to determine the root cause of

why specific patients get migraines.” (Rozakis). The Xr program greatly decreases the frequency,

severity, and duration of migraines, along with the associated symptoms by looking closely at

each patients’ “hormones, oxidative stress, methylation, inflammation, nutrigenomics, and gene

expression, (HOMING)” (Rozakis). Because of the genetic tests, hormone testing, biochemistry

testing, proprietary nutritional genius test for food sensitivities, and history review, they are able

to find the root cause within your genetic code. This helps determine how that is affecting your

health at the cellular level, and how to fix it. (Rozakis).

The Tests

Nutritional Genius Test:

The Nutritional Genius test was developed by Dr. Rozakis and Bakke to combine DNA

results with food sensitivity testing, “by doing a finger prick test to determine if you have

antibodies to various foods which can cause inflammation in your body.” (Rozakis). By color

coordinating and highlighting specific foods on a chart, they can effectively label and
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demonstrate where blockages in the body are occurring. For example, if the chart has genes that

are highlighted in greens, there is no inflammation, yellow there's a minor reaction, reds there's

extreme inflammation, gray represents your biochemistry. “They can analyze methylation,

hormones, and biochemistry to see where these blockages and misspelling are happening in your

genetic code. “We have done over 3,000 of these tests and have found that patients either have

moderate inflammation from foods, or extreme amounts of inflammation.” (Rozakis). Apart from

determining the patient’s food sensitivities, the Nutritional Genius test also analyzes hormone

levels and the effects they have on migraine, which is another major piece of the puzzle. The

hormones they examine are Cholesterol: “helps build cell membranes and is used to make

hormones, like estrogen and testosterone, and vitamin D.” (Watson). Pregnenolone: “is a steroid

hormone that plays a key role in the production of other steroid hormones, including

progesterone, DHEA, and estrogen.”(Kelly). DHEA: “is converted into hormones such as

testosterone and estradiol. DHEA is produced from cholesterol by the outer layer of the adrenal

glands. It is also produced in small amounts by the ovary and testes. DHEA is an important

source of estrogen for women.” (Puneet). Estrogen: “is a hormone that plays various roles in the

body. In females, it helps develop and maintain both the reproductive system and female

characteristics, such as breasts and pubic hair.” (Bradford). Progesterone: “is one of the

hormones in our bodies that stimulates and regulates various functions. Progesterone plays a role

in maintaining pregnancy. The hormone is produced in the ovaries”. (Goldstein). Thyroid: “the

thyroid gland is part of the endocrine system and produces thyroid hormones, which are

important for metabolic health.” (Khatri). Testosterone: “is the key male sex hormone that

regulates fertility, muscle mass, fat distribution, and red blood cell production.” (Murrell).

Hormones have a direct effect on what genes are turned “on” and turned “off.” They also
 Mylie 17

influence age, and can be deficient or imbalanced, having great effects on health.” (Rozakis).

The symptoms that can arise with hormonal imbalance include, “ heavy menstrual cycle, thyroid

endometriosis, autoimmune disease, skin aging, wrinkling, concentration issues, heart disease

and many more.” Each of these hormones are derivatives of cholesterol and the keys to why

patients are getting migraines, and what can be done to fix them.

Methylation Test:

By conducting a blood methylation test, they can further examine and be sure which

roadblocks will be happening within your body, and look closely at your biochemistry.

Biochemistry is the branch of science that explores the chemical processes within and related to

living organisms. It is a laboratory-based science that brings together biology and chemistry. By

using chemical knowledge and techniques, biochemists can understand and solve biological

problems. (“Biochemistry”). “Many people have abnormalities in their methylation and

biochemistry testing, and that is a good thing because it can be treated.” (Rozakis). By analyzing

your biochemistry and processes within the body, Rozakis can then determine what biological

relationship triggers, food, and surroundings have on the patient. Then, use epigenetics to

determine what factors are causing migraines.

Genetic Tests:

An additional test was created in order to analyze your genetic code. By conducting a

cheek swab, they can identify if certain genes that are associated with migraine have

misspellings in their code. If these specific genes are found, or mutations occur, proper
 Mylie 18

substitutes or eliminations will be added to the patient’s everyday life, such as, supplements,

dietary modifications or environmental changes. The genes which are tested for and have the

most correlation with migraine are, MAOA(R297R) (Rozakis). “This gene provides instructions

for making an enzyme called monoamine oxidase and breaking down molecules called

monoamines.” (Feldman). If these mutations occur then limited tyramine breakdown support will

be provided. This tells the scientists that the patient should stay away from foods with

tyramine.(Rozakis). Another gene that is tested for is, VDR(Taq)( Rozakis). “This gene provides

instructions for making the protein vitamin D receptor (VDR), which allows the body to respond

to vitamin D.” (Feldman). If these mutations occur then vitamin D support will be provided.

(Rozakis). Next, MTHFR(C677T, A1298C) (Rozakis). “This gene is responsible for the

breakdown of a vitamin called folic acid. The breakdown of folic acid creates folate. This

enzyme plays a role in processing amino acids, the building blocks of proteins.” (Feldman). If

these mutations occur, methyl folate support will be provided. (Rozakis). Another gene that is

tested for is CBS(C699T) (Rozakis). “This gene provides instructions for making an enzyme

called cystathionine beta-synthase. This enzyme acts in a chemical pathway and is responsible

for using vitamin B6 to convert building blocks of proteins.” (Feldman). If these mutations

occur, sulfur and sulfate sensitivity will be provided. This tells the scientist that the patient

should stay away from foods that contain sulfur/sulfite. (Rozakis). Next is the MTRR gene

(A66G)( Rozakis). “This gene provides instructions for making an enzyme called methionine

synthase reductase, which helps process amino acids.”(Feldman). If these mutations occur,

methyl B12 support will be provided. (Rozakis).

When a misspelling occurs, the chemical or instruction of which that gene produces will

not be correct and create the inappropriate instructions, and this will show up in your

biochemistry.”

Other genes that are tested for are, COMT (V158M) (Rozakis). “This gene provides

instructions for making an enzyme called catechol-O-methyltransferase.”(Feldman). If these

mutations occur, methyl transfer enzyme support will be provided. (Rozakis). Another is,

BHMT(G716A) (Rozakis). “This gene is an enzyme that converts homocysteine into

methionine.”(Feldman). If these mutations occur, TMG beneficial support will be provided.

(Rozakis). Lastly, DAO (G4586T/C47T) (Rozakis). “This gene is an enzyme that helps break

down excess histamine in your body, thus easing uncomfortable symptoms, such as nasal

congestion, itchy skin, headaches, and sneezing.” (Feldman). If these mutations occur, histamine

sensitivity support will be provided. This tells the scientist that the patient should stay away from

foods that contain high levels of histamine. Each of those types of foods can cause severe

inflammation and then migraines.

Both of these tests become complicated, so they devised a way to connect the

food-sensitivity data with genetic data into one report. (Rozakis). “Many people have genetic

errors, they may have one or two genetic errors per gene.” (Rozakis). “The genes that are largely

tested for are contributing factors to methylation and the turning “on” and “off” of specific

genes.” (Rozakis). The diagrams and charts created with results from these tests offer a

complicated path and description of what is happening within your genetic code, and what

blockages are making your migraines occur, worsen and happen more frequently. The Xr

program discovers these abnormalities while the patient is suffering from migraines or before the
 Mylie 20

disease occurs. Then, Dr. Rozakis and Dr. Bakke create a care plan for each patient to treat the

condition, or prevent it from occurring in the future.

My Story:

I experienced my first migraine at 8 years old. I couldn't see, got nauseous and developed

a horrible headache. My face went numb and it traveled down my arm and hand, then down my

leg. I vomited and couldn’t tolerate having the light on. My first experience with a migraine was

terrifying and unforgettable. I didn’t get another one for 3 years, but it was worse, and the start of

a pattern of debilitating, and often chronic migraines that changed my otherwise active and

carefree life. Attending school, participating in sports and activities, and maintaining friendships

became difficult. Over the next 3 years, I was a frequent patient at Children’s Hospital in Denver,

and much time was devoted to managing my condition and figuring out how to live a normal life.

My diagnosis was clarified as chronic migraine disease and I was considered to be in the top

10% of their most difficult cases. Each medication I tried proved to be ineffective and other

treatments such as botox that would work temporarily, only proved to be effective for a limited

amount of time until the puzzle piece shifted out of place again. My parents were advised I’d

likely be homebound and should work on acceptance and chronic pain management. Then, we

found a science-based approach, an epigenetics program for migraines, which uncovered the

underlying conditions responsible. Testing included my methylation cycle, biochemistry, specific

genetic and hormonal testing, and food sensitivities tied to genetic information. My blood

histamine levels were extremely elevated and they determined my body was unable to process

folate, also concluding I had chemical sensitivity, histamine intolerance, and polymorphisms in

my MTHFR and other genes that lead to chronic migraine. I went from experiencing 24
 Mylie 21

debilitating migraines a month to 1 to 3 much milder ones. Changes required a restrictive diet,

exercise, being aware of chemical sensitivities, specific supplements and a disciplined lifestyle.

Understanding my biochemistry, I rediscovered life, allowing me to enjoy it with a greater sense

of purpose and gratitude. This revolutionary field is not another medical mystery, this field offers

freedom and an innovative way of relieving the pain and failure from debilitating conditions.

Being able to overcome migraines is a testament to resilience and offers hope to others who

experience something that feels so out of their control.

SO WHY?

Why can't the integration of epigenetics be incorporated into the treatment of migraines,

neurology and associated research? If there are clinical trials being done for medications and

devices, with new holistic alternatives being incorporated into this field, then a clinical trial and

the integration of epigenetics to treat chronic conditions is possible, and could revolutionize

management of migraines and western medicine.

Part 4: Conclusion

Chronic migraine has been impairing and debilitating sufferers for centuries. Although

we have made progress in getting closer to understanding this disorder, our level of expertise in

this topic and methods of treatment are still lacking. Experts and neurologists want to provide the

best treatment possible for patients and the incredible new developments that have taken place in

the last 3 years have proven to be effective for many. However, the percentage of patients that

medications are ineffective for is 8%. These patients start to experiment with alternative

medicine and methods to find relief and the missing piece to their puzzling condition to help
 Mylie 22

them live a normal healthy life. Continuing to try different drugs, management techniques and

the process of searching is exhausting, time-consuming, confusing, and expensive.

However, the revolutionary field of epigenetics is the missing piece to the complex

puzzle we have been trying to solve. Epigenetics won't just help treat patients with chronic

migraines, but it will help treat other chronic illnesses such as macular degeneration, IBS, and

chronic fatigue. By creating clinical trials in western medicine, which has the resources to

research this important topic and develop a foundation of validity with evidence that this

treatment works, more experts will incorporate it into their methods and research for migraines

and neurology. Publishing this can be the basis for all future chronic migraine treatments,

enabling experts to find the root cause of a patient’s migraines by utilizing programs such as: the

Xr Program; the Mayo Clinic’s epigenetics migraine research program, and Eurofins epigenetics

program. Each of these practices are combining (HOMING) methodologies to analyze a patient's

hormones, oxidative stress, methylation, inflammation, nutrigenomics, and gene expression to

fix the blockages in the pathways. Epigenetics won't only help migraine sufferers, but many

other chronic medical conditions as well. This revolutionary program could change the way

neurologists and migraine experts treat and understand migraines. Patients will continue to

deteriorate and not get well if they continue to mask their symptoms with various drugs not

specifically created to treat migraines. This condition needs to be approached and managed from

each patient’s underlying factors in order to resolve the root cause. Epigenetics will make each

unique sufferer’s puzzle pieces fit perfectly together again.

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