Why do I keep getting migraines: Brehan Crawford, L.Ac., explaining liver yang rising into the head

Why Do I Keep Getting Migraines?

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    If you keep getting migraines and your doctor cannot tell you why, it is usually because everyone is looking at the head. The pounding pain is the symptom, not the cause. In Chinese medicine we follow it back to the liver. When the liver is worn down, its force surges to the head. We call it liver yang rising.

    The short answer

    Constant migraines are a sign that something underneath keeps pushing force and blood up into your head. In Chinese medicine the liver keeps emotions, blood flow and signaling gases moving smoothly upward. Screens overstimulate it, stress depletes it, plastics obstruct it, viruses destroy it and poor sleep weakens it. Then that yang surges into the head. Cold on the head and warm water on the feet draw it back down. Lasting relief comes from settling the rising yang and addressing each cause in the right order.

    The short version, on video.

    Why do I keep getting migraines?

    Because the pain in your head is where the problem shows up, not where it starts. That is why you constantly have migraines and why your doctor cannot figure it out.

    Look at what sets attacks off. In a study of 1,207 patients at a headache center in Atlanta, 75.9 percent reported triggers. The most common was stress, named by 79.7 percent. Sleep disturbance was named by 49.8 percent and lights by 38.1 percent.[1] None of those live in the head. They act on the whole system, and the head is where the system gives way.

    That is the shift I teach inside Gut Brain Synchrony, and it is the foundation of how I approach chronic pain.

    What causes migraines in Chinese medicine?

    Most often, the liver. In Chinese medicine your liver is not just the organ that filters your blood and makes bile. It is the system that keeps your emotions, your blood flow and your signaling gases moving smoothly, especially up to your head and your eyes.

    The classical texts describe the liver as the organ of free flow. It stores the blood, it opens into the eyes, and its channel travels up through the throat and behind the eyes to the top of the head. When it is worn down, what should flow evenly starts to surge.

    The signaling gases

    Modern research has found real gases at the center of migraine. Nitric oxide is a small gas molecule that regulates blood flow and the diameter of the arteries inside and outside the skull, and it is involved in how nerves carry pain. Nitroglycerin, a drug that releases nitric oxide, causes a headache in healthy volunteers and a delayed attack that meets the criteria for migraine in people who get migraines. Blocking the enzyme that makes nitric oxide treated attacks of migraine without aura.[2]

    Nitric oxide is not alone. A 2025 review describes three gases the body makes as messengers, nitric oxide, carbon monoxide and hydrogen sulfide, and shows how each one shapes vascular tone, pain transmission and inflammation in migraine.[3] These are the gases the liver has to keep moving in the right direction.

    What wears the liver down

    When your liver is constantly overstimulated by screens, depleted by stress, obstructed by plastics, destroyed by viruses and weakened by poor sleep, it loses its ability to direct these gases correctly, and they surge upward to the head.

    01 Overstimulated by screens. The liver opens into the eyes, and the eyes are what screens use. Among 491 college students in Kerala, India, 37.5 percent screened positive for probable migraine, and more than six hours of screen time a day was one of the factors independently linked to it.[4] In 1,046 university students in Chennai, the odds of headache rose with screen time and were 6.53 times higher in those on screens more than ten hours a day.[5]
    02 Depleted by stress. The liver is the organ most bound up with emotion in Chinese medicine, and stress drains it. In the Kerala students, higher perceived stress was independently linked to migraine.[4] A diary study at Montefiore Headache Center went further: when stress dropped from one evening to the next, the odds of a migraine starting over the following 6 to 18 hours rose 1.5 to 1.9 times.[6] The stress spends the reserve, and the attack comes as you come down from it.
    03 Obstructed by plastics. Bisphenol A (BPA), a chemical in many plastics, acts on the liver. A 2025 meta-analysis of 34 studies found that exposure to BPA was associated with 1.42 times the odds of steatotic (fatty) liver disease.[7] In a rat model of migraine, BPA exposure made migraine-like behavior worse, including aversion to light and sound.[8]
    04 Destroyed by viruses. Viral illness can leave the system that regulates the head badly damaged. In a case series of seven people with a history of migraine, most had more frequent and more intense migraines shortly after a COVID-19 infection, and six of them found their usual medication worked less well afterward.[9]
    05 Weakened by poor sleep. Classically, the blood returns to the liver when you lie down at night, and that is when it restores. Researchers at Harvard followed 98 adults with episodic migraine for six weeks with sleep diaries and wrist monitors. After nights of low sleep efficiency, the odds of a headache the following day were 39 percent higher.[10]

    What is liver yang rising?

    Liver yang rising is the Chinese medicine name for what happens when the liver can no longer hold its force down and it surges up to the head. Think of yang as the force that keeps your body awake, warm and moving. The trouble starts when it piles up at the top.

    When all that yang rises into the head, the blood vessels and nerves in the temple and the eye area become overpowered, throbbing and hypersensitive. That is the migraine you feel: the pulse in your temple, the pressure behind one eye, the light you cannot stand.

    What happens in the temples and eyes

    The blood vessels around the head are wired by the trigeminal nerve, the same nerve that carries sensation from the temple, forehead and eye. In 1990 Peter Goadsby and colleagues drew blood from the jugular vein, which drains the head and face, during migraine attacks. Calcitonin gene-related peptide (CGRP), a powerful vessel-widening messenger released by these nerves, was substantially raised in the blood leaving the head, but not in blood from the arm.[11] The surge is local to the head.

    A 2026 study of 174 people with migraine and 153 without measured those messengers across the migraine cycle. CGRP and nitric oxide were significantly higher in migraine, especially during attacks.[12] That is a modern description of yang rising.

    It is not only a Chinese pattern

    Practitioners see this pattern well beyond China. At a Chinese medicine hospital in Bad Kötzting, Germany, the records of 159 migraine patients were analyzed, and hyperactivity of liver yang was one of the two most common patterns. Most of those patients were mental workers.[13]

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    What does a liver yang rising tongue look like?

    You can see it in your tongue: the sides and the tip turn crimson red. In Chinese tongue diagnosis the sides of the tongue reflect the liver and gallbladder, and the tip reflects the heart and the upper body. When yang is rising, the heat collects in exactly those places. Check it in daylight, before you eat or brush.

    How do you treat liver yang rising at home?

    One of the most effective home remedies for migraine is putting cold packs on the head and soaking your feet in warm water to draw yang back down.

    Both halves have research behind them. A meta-analysis of six studies of cold for migraine, among them gel headbands, gel caps and cold wraps, found that cold lowered pain scores 30 minutes after it was applied.[14] And in a trial in Bengaluru, India, 40 people with chronic migraine were randomized to their usual medication alone, or medication plus a hot arm and foot bath at 103 to 110°F with ice massage to the head, 20 minutes a day for 45 days. Headaches became less frequent and less intense in both groups, more so with the hydrotherapy, and in that group heart rate came down and vagal tone, the calming side of the nervous system, went up.[15]

    01 Cool the head. Put a cold pack on your head, across the temples and forehead where the throbbing sits.
    02 Warm the feet. At the same time, soak your feet in warm water deep enough to cover the ankles. Keep it warm as it cools.
    03 Stay with it. Give it 20 minutes or more.
    04 Check your tongue. If the sides and tip are crimson, rising liver yang is part of your picture, and the causes above are where to look.
    05 Start early. The same routine works best before the pain peaks. I explain how to catch that window in how to stop a migraine before it starts.

    How do you settle rising liver yang for good?

    To finally calm migraines, you need to settle that rising liver yang. The cold pack and the foot soak bring it down for one attack. Settling it means repairing the liver's ability to direct what rises.

    Chinese medicine has treated this pattern directly for a long time, and it is studied in clinical trials. In one, 110 people with migraine diagnosed as liver yang hyperactivity were randomized to electroacupuncture at the Four Gates, Hegu and Taichong on the hands and feet, or to the preventive drug flunarizine, for four weeks. Pain scores and migraine days fell in both groups and were lower with acupuncture, after treatment and at one, three and six months.[16] Notice where those points are: on the hands and feet, far from the head. The treatment draws the yang down and out, the same principle as the foot soak.

    Most people have more than one cause of this. Screens, stress, plastics, a virus and poor sleep stack on each other, and addressing them in the right order is what helps people find permanent remission. That order is different for each person.

    Liver yang rising and migraines, answered

    What are the symptoms of liver yang rising?

    The classic picture is a throbbing, one-sided headache at the temple or behind the eye, often with dizziness, ringing in the ears, a flushed face, irritability and dry or sore eyes. The tongue is red on the sides and tip, and the pulse feels taut, like a wire.

    Can liver problems cause migraines?

    In Chinese medicine the liver is the most common root of a recurring migraine, as this whole post explains. Modern studies are starting to find the link too. In 90 people with migraine examined by ultrasound, those who also had fatty liver disease had auras more often, and had both longer attacks and a longer history of migraine, than those without it.[17]

    What is the difference between liver yang rising and liver fire?

    Both send force to the head, but they start in different places. Liver fire is an excess of heat: red eyes, a bitter taste, thirst, constipation and a deep red tongue all over. Liver yang rising usually sits on top of something that has run low underneath, so you see a red head above and tired, weak legs and lower back below. The first calls for clearing heat. The second calls for anchoring the yang and rebuilding what is beneath it, which is why the foot soak suits it so well.

    Your head is where the migraine lands. The cause is almost always somewhere else, and it can be found.

    — Brehan Crawford, L.Ac.

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    References

    1. Kelman L. The triggers or precipitants of the acute migraine attack. Cephalalgia. 2007;27(5):394-402. doi:10.1111/j.1468-2982.2007.01303.x
    2. Olesen J. Nitric oxide-related drug targets in headache. Neurotherapeutics. 2010;7(2):183-190. doi:10.1016/j.nurt.2010.03.006
    3. Badaeva A, Maiolino L, Danilov A, et al. Neurogasobiology of migraine: carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation. Open Med (Wars). 2025;20(1):20251201. doi:10.1515/med-2025-1201
    4. Panneer S, Nandi T, Kamisetti ST, et al. Prevalence and determinants of migraine among college students in Ernakulam, Kerala, India: a cross-sectional study. Cureus. 2026;18(2):e103352. doi:10.7759/cureus.103352
    5. Kumari S, Maran YM, Krishnan KA, et al. Digital eye strain among Indian university students in the post-COVID era: a cross-sectional study. Front Public Health. 2026;14:1829471. doi:10.3389/fpubh.2026.1829471
    6. Lipton RB, Buse DC, Hall CB, et al. Reduction in perceived stress as a migraine trigger: testing the “let-down headache” hypothesis. Neurology. 2014;82(16):1395-1401. doi:10.1212/WNL.0000000000000332
    7. Li X, Li J, Zhou J, et al. Mapping the association between environmental pollutants and steatotic liver disease: a systematic review and meta-analysis. Environ Res. 2025;285(Pt 5):122623. doi:10.1016/j.envres.2025.122623
    8. Vermeer LM, Gregory E, Winter MK, McCarson KE, Berman NE. Exposure to bisphenol A exacerbates migraine-like behaviors in a multibehavior model of rat migraine. Toxicol Sci. 2014;137(2):416-427. doi:10.1093/toxsci/kft245
    9. Shah N, Patel D, Sousa A, Leder AN. Changes in migraine headaches following SARS-CoV-2 infection: a case series. Cureus. 2025;17(4):e82708. doi:10.7759/cureus.82708
    10. Bertisch SM, Li W, Buettner C, et al. Nightly sleep duration, fragmentation, and quality and daily risk of migraine. Neurology. 2020;94(5):e489-e496. doi:10.1212/WNL.0000000000008740
    11. Goadsby PJ, Edvinsson L, Ekman R. Vasoactive peptide release in the extracerebral circulation of humans during migraine headache. Ann Neurol. 1990;28(2):183-187. doi:10.1002/ana.410280213
    12. Khasawneh RR, Almahasneh FA, Abu-El-Rub E, et al. Neurovascular-immune mediator dynamics in migraine: state-dependent effects of caffeine. Neurol Sci. 2026;47(7). doi:10.1007/s10072-026-09161-7
    13. Yan YY, Dai JZ, Yang CX, Zhang GM. Analysis of traditional Chinese medicine syndromes in 159 German migraine patients [in Chinese]. Zhongguo Zhong Yao Za Zhi. 2017;42(13):2599-2605. doi:10.19540/j.cnki.cjcmm.20170523.006
    14. Hsu YY, Chen CJ, Wu SH, Chen KH. Cold intervention for relieving migraine symptoms: a systematic review and meta-analysis. J Clin Nurs. 2023;32(11-12):2455-2465. doi:10.1111/jocn.16368
    15. Sujan MU, Rao MR, Kisan R, et al. Influence of hydrotherapy on clinical and cardiac autonomic function in migraine patients. J Neurosci Rural Pract. 2016;7(1):109-113. doi:10.4103/0976-3147.165389
    16. Cai YW, Pei J, Fu QH, et al. Electroacupuncture at Siguan points for migraine of liver yang hyperactivity: a randomized controlled trial [in Chinese]. Zhongguo Zhen Jiu. 2022;42(5):498-502. doi:10.13703/j.0255-2930.20210403-0001
    17. Celikbilek A, Celikbilek M, Okur A, et al. Non-alcoholic fatty liver disease in patients with migraine. Neurol Sci. 2014;35(10):1573-1578. doi:10.1007/s10072-014-1798-1