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How to Stop Headaches Using Science-Based Approaches

In this episode, I discuss the causes and treatments of different types of headaches, including tension headaches, migraines, sinus and cluster headaches, as well as menstrual and other hormone-based headaches.

Andrew Hubermanhost

Feb 6, 20232h 26mWatch on YouTube ↗

Summaries, chapters, transcripts, and FAQs on this page are made by uListen, not YouTube.

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Chapter summaries

Introduction: Scope, Hope, and Types of Headache
Huberman introduces the episode’s goal: to explain the biology of different headaches and present science-based tools to treat them. He highlights that everyone will experience headaches, many suffer debilitating forms, and that both pharmaceutical and surprisingly potent “natural” treatments exist when matched properly to headache type.
- •Headaches are ubiquitous and often debilitating, impacting work, sleep, social life, and exercise.
- •Major types: migraine, tension, cluster, sinus, hormonal, and post–traumatic.
- •Understanding underlying biology (muscle, vasculature, nerves, inflammation) makes treatment selection straightforward.
- •Natural treatments can match or surpass common drugs in efficacy, often with fewer side effects.
- •The episode will emphasize mechanism-based tools rather than vague “natural” remedies.
Sponsors and General Health Foundations
The episode pauses for sponsor messages and then moves into framing the podcast as an educational effort. Huberman begins laying the groundwork that foundational health behaviors underlie all headache interventions, whether drug-based or not.
- •Sponsor mentions: Thesis (nootropics), LMNT (electrolytes), Maui Nui (protein), Momentous (supplements), Athletic Greens, InsideTracker.
- •Huberman clarifies the podcast is separate from Stanford roles and is zero-cost to consumers.
- •He repeatedly returns later to sleep, light, nutrition, exercise, and social connection as bedrock for headache recovery and prevention.
Core Biology: Tissues and Mechanisms That Generate Headache Pain
Huberman defines the main tissue sources of headache pain: musculature, meninges and vasculature, neural pathways (especially trigeminal), and inflammatory signaling. He explains how tight anatomical packing in the skull and nociceptors in surrounding tissues create the sensation of “pressure” and pain during vasodilation or inflammation.
- •Muscular sources: scalp, jaw, neck muscles can over-contract and cause tension headaches.
- •Meninges (including dura) and associated blood vessels can cause pain when vessels dilate in a tight intracranial space.
- •The brain itself lacks pain receptors; pain comes from surrounding tissues and vasculature.
- •Trigeminal nerve pathways can generate deep, unilateral cluster-type pain behind the eye.
- •Inflammation is a broad, non-specific signal that often spreads beyond a local problem, activating pain in muscles, meninges, and nerves.
- •All experienced pain is ultimately neural, carried by sensory neurons (nociceptors).
Neurons 101: Motor, Sensory, and Modulatory Pathways in Pain
To frame treatment options, Huberman describes three key neuron types: motor (move muscles), sensory (detect stimuli, including pain), and modulatory (gate and contextualize responses). He shows how interventions can target different points: relaxing muscles, blocking sensory input, or modulating perception and reflex responses.
- •Motor neurons control muscle contraction (limbs, facial muscles, eyelids, heart via related mechanisms).
- •Sensory neurons detect touch, temperature, pain, light, sound, internal pressure, and fullness.
- •Modulatory neurons decide whether sensory input triggers motor output or conscious perception.
- •Headache treatments can: relax overactive muscles, reduce pain signaling, or change how pain is processed.
- •Many drugs and behavioral tools work at different levels of this motor–sensory–modulatory triad.
Tension Headaches: Muscular Origins and Lifestyle Links
Huberman defines tension-type headaches as often headband-like, involving forehead, temples, jaw, neck, and upper back. They arise mainly from muscular tension, often driven by stress, poor sleep, and lifestyle factors, sometimes exacerbated by mild infection.
- •Typical pattern: halo/band of pain above eyes and around head; can localize to one side via neck-muscle asymmetry.
- •Common triggers: chronic psychological stress, sleep deprivation, overwork, caffeine misuse, low-grade infections.
- •Jaw clenching and neck tightness frequently accompany these headaches.
- •He references a separate “master stress” episode for tools to reduce chronic stress as an upstream intervention.
Migraine Headaches: Recurrence, Aura, Hormones, and Photophobia
Huberman characterizes migraines as recurring attacks often preceded by aura and accompanied by photophobia and vasodilation. Women experience migraines at much higher rates than men, independent of menstrual hormones, and pregnancy tends to be protective. He explains why aspirin and other vasodilators can worsen migraines and why caffeine can cut both ways.
- •Migraines are recurring, debilitating, and disproportionately affect women (3–4x higher prevalence).
- •Aura is an anticipatory sensation—visual or otherwise—that something is about to happen, reflecting deep neural changes.
- •Vasodilation of cranial vessels and photophobia (light sensitivity) are hallmark features.
- •Photophobia is exacerbated by sleep deprivation and systemic infections.
- •Aspirin and some NSAIDs can worsen vasodilatory migraines by further promoting blood flow.
- •Caffeine can either relieve or worsen migraines depending on timing and individual response due to its dual vasoactive effects.
Cluster Headaches: Trigeminal Nerve and Extreme Unilateral Pain
Huberman describes cluster headaches as excruciating, unilateral headaches felt deep behind one eye or in face regions served by the trigeminal nerve. He links them to neural inflammation and autonomic symptoms like tearing, nasal discharge, droopy eyelid, and pinpoint pupil, and notes their circadian and sex-specific patterns.
- •Pain is deep, inside-out, typically behind one eye and on one side of the face (ophthalmic branch of trigeminal).
- •Associated symptoms: tearing, nasal discharge, droopy eyelid, small non-dilating pupil.
- •Can occur in “clusters,” sometimes waking sufferers from sleep; men experience nocturnal cluster headaches more often.
- •Origins likely include trigeminal inflammation and circadian clock involvement.
- •Standard vascular or muscular treatments are often ineffective; neural-specific strategies are required.
Hormonal Headaches: Estrogen, Progesterone, and the Menstrual Cycle
Huberman details how menstrual-cycle hormone dynamics create windows of vulnerability to headaches, especially early in the cycle when both estrogen and progesterone are low. He briefly reviews follicular and luteal phases to explain why day 1–5 (menstruation onset) is a headache hotspot.
- •Estrogen rises in follicular phase, peaks before ovulation, then drops; progesterone rises in luteal phase, then plummets if no pregnancy.
- •Days 1–4/5 of menstrual bleeding: both estrogen and progesterone are at their lowest.
- •Low estrogen and progesterone alter vasodilation, vasoconstriction, and inflammatory signaling, promoting headaches.
- •Hormonal headaches are not due to high estrogen as commonly believed, but rather to this dual low-hormone state.
- •Similar mechanisms are relevant in perimenopause and menopause due to chronically lower sex hormones.
Head Hits and Traumatic Brain Injury: Headache Mechanisms
Huberman distinguishes concussion and TBI-related headaches from sports-only narratives, emphasizing that most TBIs come from accidents and work. He outlines how swelling, disrupted CSF flow, and meningeal congestion create persistent headaches and cognitive/mood issues that often appear hours to weeks after injury.
- •Most TBIs are from car, bike, playground, and workplace accidents, not just football or boxing.
- •Swelling in brain/neck and meningeal tissues can clog CSF and blood flow, causing pressure and headaches.
- •The skull has limited space; even minor swelling can alter intracranial dynamics.
- •Current sideline evaluations are poor at detecting long-term TBI effects.
- •Sleep, circadian alignment, nutrition, and exercise are crucial for recovery but often neglected by necessity (work, life).
Lifestyle Pillars: Sleep, Light, Exercise, Nutrition, Social Connection
Before presenting more targeted interventions, Huberman emphasizes that no pill can replace sleep, sunlight, movement, adequate nutrition, and healthy relationships. These pillars regulate immune function, inflammation, vascular tone, pain thresholds, and brain repair, making them central to headache prevention and recovery.
- •Deep, regular sleep enhances glymphatic clearance, hormonal balance, and pain control.
- •Morning and daytime sunlight plus low light at night align circadian clocks, reducing photophobia and improving resilience.
- •Exercise, quality protein, and nutrient-dense diets support tissue repair and immune regulation.
- •Positive social connection modulates stress systems that feed into headache risk.
- •All targeted tools (drugs, supplements, procedures) work far better on top of these foundations.
Creatine as a High-Impact Tool for Post–TBI Headache and Fatigue
Huberman reviews a human pilot trial where high-dose creatine monohydrate after TBI drastically reduced headache, dizziness, and fatigue. He explains how creatine supports neuronal ATP production and calcium handling, arguing it is one of the more promising over-the-counter interventions for TBI-related symptoms.
- •Dose: ~0.4 g/kg/day creatine monohydrate (≈20–40 g/day) for 6 months.
- •Results: headache prevalence dropped from ~90% to ~10–12%; dizziness and fatigue also decreased significantly.
- •Mechanism: creatine stores in brain (especially forebrain) support energy metabolism and help correct post-TBI calcium/ATP dysregulation.
- •Creatine is inexpensive, widely available, and generally safe, but high-dose use should be coordinated with a physician.
- •Data are strongest for TBI-related headaches, but the findings invite cautious exploration for chronic headaches more generally.
Omega‑3 vs Omega‑6: Dietary Levers to Reduce Migraine and Tension Headaches
Huberman summarizes large population studies and randomized trials showing that raising omega‑3 intake and lowering omega‑6 linoleic acid sharply reduces headache prevalence and severity. He explains how EPA-rich omega‑3s exert analgesic and anti-inflammatory effects and why dose matters.
- •High omega‑3, low omega‑6 diets outperform low omega‑6 alone for pain reduction.
- •EPA/DHA from fatty fish or supplements integrate into cell membranes and reduce pro-inflammatory mediators (e.g., prostaglandins, CGRP).
- •Meta-analyses across 200–2000 mg/day show benefits become robust at ≥1 g/day of EPA specifically.
- •These strategies help tension and migraine headaches and reduce PMS-related headache severity.
- •Seed oils aren’t inherently “evil,” but typical modern diets skew heavily toward omega‑6 and excessive total oil calories.
Photophobia and Aura: Neural Basis and Red-Light Strategy
Huberman explains aura as a back-to-front wave of neuronal “spreading depression,” and photophobia as an overactivation of melanopsin ganglion cells that feed into thalamic pain circuits. He proposes a practical red-light protocol to stay functional during photophobia and potentially avert full migraines.
- •Aura reflects a wave of reduced neuronal excitability moving from visual cortex forward, producing visual and somatic “halos” and anticipation.
- •Photophobia is driven by intrinsically photosensitive retinal ganglion cells (blue–green light sensitive) projecting to lateral posterior thalamus and meningeal nociceptors.
- •Bright blue/green or broad-spectrum light intensifies headache via increased intracranial pain signaling.
- •Shift to dim red/orange indoor lighting at onset of aura/photophobia to avoid activating these pathways.
- •Inexpensive red bulbs suffice and also help keep evening cortisol and sleep architecture intact.
Tension Headache Treatments: NSAIDs, Botox, Peppermint/Menthol Oils, and Acupuncture
Huberman reviews common and advanced treatments for tension headaches, including NSAIDs and Botox, and then presents compelling data on peppermint/menthol and eucalyptus oils as well as acupuncture. He notes that some “alternative” approaches outperform NSAIDs without their side effects and now have clear mechanistic explanations.
- •NSAIDs (ibuprofen, acetaminophen, aspirin) can help but cause tolerance, liver/GI issues, blunt exercise adaptations, and alter body temperature.
- •Botox (botulinum neurotoxin) injected into overactive head/jaw/neck muscles blocks acetylcholine release, relaxing muscles for weeks to months.
- •Studies inducing headache with pressure, heat, and cuffs show peppermint/menthol and eucalyptus oils on temples/forehead significantly reduce pain and EMG-measured muscle tension.
- •These oils act on TRP channels, promoting “cooling” sensations and suppressing heat/pain pathways.
- •Acupuncture, once viewed as opaque, now has mechanistic support: needle placement activates specific sensory pathways, reduces inflammatory cytokines, and relaxes target muscles.
- •Both oils and acupuncture often match or exceed NSAIDs for tension and some migraine headaches with fewer systemic risks.
Herbal and Nutraceutical Tools for Migraine: Curcumin and More
Drawing from a 2020 systematic review, Huberman surveys herbal treatments for migraines, highlighting curcumin as particularly promising. He cautions on dosing and interactions but points out that, in combination with omega‑3s, curcumin can meaningfully decrease migraine frequency and intensity.
- •A wide range of herbs and oils (lavender, chamomile, coriander, Damask rose, etc.) show varying degrees of benefit.
- •Curcumin (turmeric extract) is strongly anti-inflammatory and inhibits nitric oxide and CGRP-related vasodilation.
- •Trials using ~80 mg/day curcumin (often with ~2.5 g/day omega‑3) over weeks reduce migraine days and severity.
- •Curcumin is generally safe even at high doses in trials but can reduce DHT and affect libido/hormones in some individuals.
- •Curcumin also interacts with cytochrome P450 and coagulation pathways, so caution is essential for those on anticoagulants or multiple medications.
Caffeine’s Double-Edged Role and Extreme Spice-Induced Thunderclap Headache
Huberman unpacks caffeine’s paradoxical ability to both relieve and worsen headaches via adenosine-blocking vasoconstriction and nitric-oxide-related vasodilation. He then closes with a cautionary tale about ultra-spicy peppers triggering thunderclap headaches and even stroke-like brain damage.
- •Caffeine blocks adenosine (a vasodilator), causing vasoconstriction that can relieve some headaches, especially withdrawal headaches.
- •Caffeine also engages NO pathways that dilate vessels; net effect depends on time of day, sleep debt, and individual biology.
- •People typically show a stable pattern: caffeine either reliably helps or reliably worsens their headaches.
- •Ultra-hot peppers (e.g., Carolina Reaper) can induce thunderclap headaches via extreme cerebrovascular constriction and inflammatory responses.
- •In rare cases, such challenges have caused brain damage akin to stroke; tolerance for everyday spice is not the same as tolerating extreme pepper contests.
Summary, Positioning of “Natural” vs Pharmaceutical Tools, and Closing
Huberman recaps the main headache types, mechanisms, and toolkit of interventions, emphasizing that many non-prescription tools are mechanistically grounded and can sit alongside conventional drugs. He reiterates the primacy of lifestyle foundations and points listeners to podcast resources, newsletters, and supplement partners.
- •Reiterates types: tension, migraine, cluster, hormonal, post‑TBI, and their main tissue/neuronal mechanisms.
- •Summarizes key tools: creatine, omega‑3s, curcumin, peppermint/menthol/eucalyptus oils, acupuncture, red light, judicious caffeine.
- •Stresses these are not necessarily replacements for prescription drugs; they can be combined thoughtfully under medical guidance.
- •Re-emphasizes that lifestyle pillars determine the ceiling for any intervention’s success.
- •Directs listeners to Huberman Lab website for sleep, stress, light, and supplementation toolkits and the free Neural Network newsletter.

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