I've had migraines for 30 years.
And every single time one comes on — before the pain even peaks, before I've reached for medication — I feel it in my gut first. A low-grade nausea. A restlessness in my stomach that doesn't quite match normal nausea. Something that feels almost like my digestive system is bracing for impact.
I used to think that was just an annoyance layered on top of the real problem. A side effect. One more way migraines are miserable.
I was wrong.
That gut signal isn't separate from the migraine. It's part of the same neurological event. And understanding that connection might be one of the most important things you can learn about managing your brain health long-term.
Your Brain Has a Second Address
Most people know the brain as the thing in your skull. But neuroscientists have a name for another brain you carry everywhere: the enteric nervous system — a network of roughly 500 million neurons lining your digestive tract from esophagus to colon.
That's more neurons than your spinal cord.
The enteric nervous system operates largely on its own. It regulates digestion, secretes hormones, coordinates gut motility, and communicates constantly with your brain via the vagus nerve — a superhighway of nerve fibers running directly between your gut and your brainstem.
This is the gut-brain axis. And it's bidirectional. Your brain influences your gut (stress giving you a stomachache is a real neurological phenomenon, not just metaphor). And your gut influences your brain in ways researchers are only beginning to fully map.
Why Migraines Hit Your Stomach
When a migraine attack begins, the protein at the center of modern migraine science — CGRP (calcitonin gene-related peptide) — gets released in abnormally high amounts. CGRP is primarily known for dilating blood vessels around the brain and triggering the pain cascade.
What most people don't know: CGRP receptors exist throughout your digestive tract too.
When CGRP floods your system during an attack, it doesn't stay neatly confined to your head. It activates receptors in the gut, slows gastric emptying (which is why oral medications often absorb poorly at peak migraine), and triggers the nausea that's become so synonymous with attacks that we've almost stopped questioning it.
The nausea isn't incidental. It's mechanically linked to the same molecular event driving your head pain.
There's more. Research increasingly shows that migraine patients have measurably different gut microbiomes than non-migraine patients — with lower populations of certain beneficial bacteria strains and higher prevalence of intestinal permeability markers. Migraine and irritable bowel syndrome (IBS) are comorbid at rates far above chance. That's not a coincidence either. It's the same underlying gut-brain dysregulation expressing itself in two different locations.
Serotonin: The Plot Twist
Here's the fact that stops most people when I share it: approximately 90% of your body's serotonin is produced in your gut — not your brain.
Serotonin is deeply implicated in migraine pathophysiology. The drop in serotonin levels during the prodrome phase (the hours before pain hits) is one of the most well-documented early events in a migraine attack. The fact that triptans — the gold-standard acute migraine medications for decades — work as serotonin receptor agonists is not unrelated.
But if most serotonin is gut-produced, and gut microbiome health directly influences serotonin synthesis, then gut health isn't a peripheral concern for migraine patients. It sits near the center of the equation.
What the Supplement Stack Is Already Doing for This
At Wellday, we built our supplement stack specifically around what the American Headache Society and peer-reviewed migraine research endorses for prevention. But when you look at the mechanisms — not just the migraine outcomes, but the biochemistry — the gut-brain connection is woven throughout.
Omega-3 EPA (1,800mg EPA/day) The EPA in fish oil is one of the most studied nutritional compounds for gut microbiome health. EPA and DHA directly shift microbiome composition toward anti-inflammatory species, strengthen the intestinal barrier (reducing the "leaky gut" permeability that's been associated with migraine), and suppress the systemic inflammation that drives both gut dysfunction and neurological sensitization. This is the supplement in our stack with the strongest direct gut-brain mechanism — and it's also one of the best-studied cardiovascular supplements on the market, with well-established triglyceride-lowering effects at therapeutic doses.
Magnesium Glycinate (400mg/day) Magnesium deficiency is among the most common nutritional findings in migraine patients. But magnesium is also critical for gut motility and the health of the intestinal microbiome. The glycinate form crosses the blood-brain barrier efficiently — which is why we chose it over oxide or citrate — but it also supports serotonin synthesis at the enzymatic level. You can draw a direct line from this supplement to the gut-serotonin pathway.
Riboflavin / B2 (400mg/day) Riboflavin's migraine mechanism is mitochondrial — it supports the energy production in brain cells that migraine patients often show deficits in. But the gut connection is real: B2 is partially produced by gut microbiota, and it plays a key role in maintaining the gut lining. A healthy gut microbiome and adequate B2 are mutually reinforcing.
CoQ10 (300mg/day) Mitochondrial support is CoQ10's primary job. And while the migraine connection is well established at the neurological level, mitochondrial health is foundational to gut epithelial cells as well — the cells that form the barrier between your gut contents and your bloodstream. Those cells turn over rapidly and have extremely high energy demands. CoQ10 supports them the same way it supports neurons.
What This Might Mean for How We Treat Migraines
Right now, Wellday is a CGRP-focused telehealth platform. That's the clinical core, and the evidence base for CGRP therapy is the strongest in migraine medicine. We're not walking away from that.
But what I believe — and what the research is starting to support — is that migraine patients who address the gut-brain connection alongside their clinical treatment are going to see better long-term outcomes than those who treat the head in isolation.
That means:
- Paying attention to dietary triggers not just as anecdote, but as microbiome signals
- Supporting the gut environment with evidence-backed interventions (our supplement stack is a start)
- Recognizing that gut symptoms — nausea, motility changes, IBS-like episodes — aren't a separate problem to manage separately, but part of the same system
We're actively exploring what a more comprehensive gut-brain health offering looks like as Wellday grows. The science is there. The patient experience — mine included — points to it. It's a matter of building it right.
The Thing I Wish Someone Had Told Me 30 Years Ago
When you feel that gut sensation before a migraine peaks, your body isn't malfunctioning in two ways at once. It's giving you a signal from a connected system that's under stress.
That's actually useful information. And it points toward a version of migraine care that treats the whole system — brain, gut, and the nerve highway connecting them — rather than just chasing symptoms at the head.
We built Wellday because migraine patients deserve better than the care most of them have received. This is part of that story.
Jeff Glasco is the founder of Wellday Health and has lived with chronic migraines for 30 years. Wellday provides CGRP-based preventive migraine care via telehealth — no specialist waitlist, no dismissal, just treatment that works.
This article is for informational purposes only and does not constitute medical advice. If you're experiencing migraines, consult a qualified healthcare provider.