In this episode of HeadWise™, host Lindsay Weitzel, PhD, talks with Vincent Martin, MD—director of the Headache and Facial Pain Center at the University of Cincinnati—about a foundational and evolving question in headache medicine: Is migraine a systemic disease?

Dr. Martin explains why migraine is not always a single neurological disorder and how emerging genetic and population-based research is revealing that only about half of migraine risk is inherited. He discusses how certain environmental factors—including head trauma, respiratory and immune-related conditions, and even gastrointestinal disorders—may contribute to developing migraine disease or increasing migraine frequency over time.

They explore:

• Why migraine may be neurologic, vascular, or influenced by other systemic conditions

• What Mendelian randomization studies reveal about diseases that may actually cause migraine

• How depression, asthma, autoimmune disease, IBS, and celiac disease intersect with migraine

• Why people sometimes develop migraine later in life after injury or physiological change

• The difference between what causes migraine disease versus what triggers an attack

• How whole-person clinical evaluation may change migraine diagnosis and management

This conversation offers clarity on a topic many people have sensed but lacked language for—why migraine often feels like more than “just head pain”—and presents a science-based understanding of how the brain, immune system, vascular function, and other organ systems interact in migraine disease.