Could that phantom smell mean a migraine is on its way?

Migraine attacks are often thought of as just severe headaches (grrrr! don’t get me started on THAT myth), because for those of us who suffer from them, we know they can be much more than that.

One of the lesser-known (and I think fascinating) aspects of migraine is that the disorder has the potential to induce smell or olfactory hallucinations. In other words, we can perceive smells that aren't actually there. I call them “phantom smells”! This usually happens in the “aura” phase of migraine just before the pain attack hits.

Understanding olfactory hallucinations or phantom smells in migraine

Imagine suddenly smelling the fragrance of flowers blooming in your room, only to realise there are no flowers around. This is what olfactory hallucinations associated with migraines can be like. These hallucinations involve perceiving various smells, often unpleasant, ranging from burning odours to chemical scents, without any external source. I often smell cigarette smoke when I’m certain that there is nobody nearby who is smoking.

Research indicates that olfactory hallucinations during migraine attacks are likely linked to cortical spreading depression (CSD), a wave of abnormal neuronal activity that moves across the brain. This wave is believed to disrupt sensory processing areas, including those responsible for smell perception, leading to the sensation of odours that aren't actually present. (It can also lead to visual or aural hallucinations such as flashing lights.)

(I should mention that phantom smells may also indicate other health problems, so getting it checked out by a GP might be a good idea.)

Triggers and associations

Olfactory hallucinations in migraine can be triggered by various factors, including stress, hormonal changes, food intolerances, inflammatory foods, environmental stimuli (like strong odours), and even changes in weather.

Interestingly, studies have shown that our gender may influence whether we are likely to experience olfactory hallucinations with migraine, with women being more likely to experience the symptom. (This could be due to hormonal fluctuations that occur throughout the menstrual cycle and influence migraine, as well as the overall higher prevalence of migraine in women compared to men.)

Naturopathic approaches to managing migraine

As a naturopath, I take a holistic approach to health, addressing the underlying drivers of migraine attacks and olfactory hallucinations rather than just masking the symptoms. Incorporating strategies such as stress management techniques, dietary modifications, gut healing, herbal supplements, and Emotional Release Technique® (ERT) are ways I work with my clients to build overall health resilience and reduce the frequency and severity of migraine.

For example, magnesium supplementation has shown promise in migraine management due to its role in neurotransmitter regulation and muscle relaxation. BUT – you need to be using the right form of magnesium and of course the right dose. Similarly, CoQ10, and riboflavin (vitamin B2) have been studied for their potential to reduce migraine frequency and intensity – but again, these need to be correct for you. I also like to use custom-blended herbal medicines that support the nervous system, hormone balance and gut health.

Plus fixing the diet, healing the gut and adding in the correct supplementation can make a difference.

Reach out for a free no-obligation chat if you are curious to see if naturopathic support could benefit you.

References:

Schulte LH, May A. The migraine generator revisited: continuous scanning of the migraine cycle over 30 days and three spontaneous attacks. Brain. 2016;139(Pt 7):1987-1993.

Brennan KC. The Olfactory System as a Portal of Entry to the Brain. In: Dalkara T, Moskowitz MA, editors. Migraine and Other Headaches. Humana Press; 2006. p. 1-11.

Baldo P, Doretti A, Valentini MC, et al. Migraine with aura and olfactory hallucinations: imaging the visual cortical network. Neurol Sci. 2016;37(11):1805-1807.

Sun-Edelstein C, Mauskop A. Foods and supplements in the management of migraine headaches. Clin J Pain. 2009;25(5):446-452.