Solutions for Migraine Headaches

What Is Known About Migraines
Healthy Steps: Migraines—First Steps
Healthy Steps: Migraines—Full Program
From Dr. Deborah's Desk

A little twinkle in your field of vision catches your attention, perhaps, or a familiar uneasy or dizzy feeling. Unattended to, these seemingly harmless little symptoms can progress to a headache that is impossible to ignore. The pain becomes moderate to severe and is usually throbbing or pulsing, sometimes stabbing. Any movement, light or noise seems to make it worse. Something else is going wrong as well: flashing lights, dizziness, nausea or vomiting, even numbness, tingling, or weakness in your arms or legs. You have another migraine.

What Is Known About Migraines

About ten percent of people suffer from migraines, affecting women more than men, often in a predictable time of hormonal shift. Migraines tend to run in families, and the usual age of onset is between 10 and 45 years old. Migraines are more common in overweight children and teens. See our Low Carb Weight Loss plan if you think weight loss might be helpful for you.

Just what causes the episodes of neurological symptoms and pain is not well understood. Debate persists among those who attribute the cause of the pain either to blood vessels or nerves or messenger chemicals in the brain. The exact cause is probably a complex interaction of all those components, each active to a varying degree in different individuals.

For management and to distinguish a migraine from other more ominous forms of headache, it is important to consult your physician to have your headaches diagnosed. A headache tendency is considered to be a migraine if it repeats in predictable patterns, particularly if there is an aura, if the headache has a clear beginning and end - not necessarily abrupt but clear, the pain tends to be pulsating and affects one side, is aggravated by activity, light and noise, and is associated with nausea and or vomiting, and or other abnormal sensations not directly part of the headache.

One of the common features of a migraine is that with attention, the migraine sufferer can often identify predictable triggers for his or her individual headaches. Common triggers include stress, hunger, fatigue, dehydration, certain foods, and hormonal cycling.

Tyramine (found in aged meats, cheese, fermented foods, sausage, beer, wine, chocolate, and others) was long thought to be a common trigger, but is now considered less common, although certainly a possible trigger for any single individual. If you know that thunderstorms bring on a migraine for you, it doesn't matter that it isn't a common trigger - it is your trigger. The same is true for tyramine.

Two common avoidable triggers are sleep disturbance and overuse of migraine medication. It seems particularly true for transformed migraines (or persistent daily migraines), but somewhat true for all migraines that interrupted or inadequate sleep contributes to migraines. Using simple behavioral changes and improving sleep habits can reduce the frequency of migraine headaches. Similarly, overuse of migraine medication can cause an increase in migraine frequency which responds well to a reduction in the use of the medication.

Recent studies have identified an association between excess weight and pain, including migraines. Survey studies and twin comparisons indicate that the expected inflammation associated with obesity, presumably from excess insulin, is associated with increased experience of pain.

Conventional treatment for migraines has included both prevention and treatment. Prevention has relied on a class of drugs called "beta-blockers" with woefully poor efficacy: less than a 5% reduction traded for frequent side effects such as fatigue and weakness. Treatment of migraines is often accomplished with a prescription from the class of drugs called "triptans." Taken at the first sign of headache, they can abort the development of a migraine. The most common side effect is increased frequency of migraines, or a "rebound" headache that occurs when the drug effect fully wears off.

Migraines, on the other hand, respond well to lifestyle changes.

Healthy Steps: Migraine Headaches—First Steps

For the greatest improvement with the fewest steps, do the following: 

• Avoid monosodium glutamate and aspartame. Because they can be labeled by alternate names, it is worthwhile avoiding all processed foods to eliminate them completely. Avoid gluten for a month and see if your headaches are better.
• Include protein and fat every time you eat. Both hunger and reactive hypoglycemia can be triggers for migraines. A meal or snack of pure carbohydrate can raise blood sugar causing in increased insulin and secondary falls in blood sugar which can cause symptoms including headaches.
• Barleans Omega 3 Swirls are tasty ways to add this valuable nutrient to your diet on a regular basis.
• Thorne Research Magnesium Citrate. Take 2-4 capsules daily, or more if tolerated without getting diarrhea. Spread the doses out over the day to minimize bowel impact. Supplement your internal magnesium by taking Epsom salts baths.

Healthy Steps: Migraine Headaches—Full Program

A comprehensive program involves many areas in which action steps can be taken, gradually or all at once. Start by following the basic nutrition and healthy lifestyle guidelines, with the following modifications:

Savor Helpful Foods

• Include protein and fat every time you eat. Both hunger and reactive hypoglycemia can be triggers for migraines. A meal or snack of pure carbohydrate can raise blood sugar causing in increased insulin and secondary falls in blood sugar which can cause symptoms including headaches.
• Lose excess weight with carbohydrate reduction. Consult our Low Carb Weight Loss Plan for help shedding extra pounds.
• Choose Omega-3 rich fish. One or more times a week, choose wild Alaskan salmon or halibut for fresh whole food essential nutrients. Canned or fresh sardines, mackerel, and halibut are also good sources.
• Monounsaturated fats. Olive oil, avocados and nuts are good sources, as is organic lard, if you can find it. (Don't be afraid of lard, it's a great fat for cooking at moderate heats because it is so stable at higher temperatures.)
• Vitamin B2 containing foods. Mushrooms, organic liver, dark leafy greens and milk are all excellent sources of vitamin B2.

Avoid Problematic Foods

• Processed Foods can be hazardous. Many processed foods include either monosodium glutamate or aspartame, often difficult to spot in the labels. Both ingredients are suspected as common migraine triggers and should be avoided. Of course, processed foods in general are not healthful, so find fresh whole foods.
• Food triggers can cause migraines. Tyramine (aged cheese and meats, chocolate and red wine) has long been recognized as a potential trigger, but other frequently problematic foods are milk, eggs, citrus, wheat, tomatoes, alcohol and some meats. You may respond differently to beef than lamb or to fresh pork differently than cured pork. Fermented foods, nuts and chocolate are also triggers for some people. Sensitivity to gluten causes migraines in some people. Sugars and processed foods are unfriendly to a healthy brain: reduce or eliminate.
• Food allergies can cause migraines. Consult our Allergy Elimination Diet if you want to pursue this possibility for yourself.
• Monosodium glutamate and aspartame. Although mentioned above, they deserve a second mention because of the frequency with which they cause problems!
• Caffeine can aggravate. Although it may not appear as a trigger - such as when caffeine is consumed daily yet headaches appear only weekly - it is often the case that avoiding caffeine reduces the frequency and/or severity of headaches.

Supplements Can Help

• Barleans Omega 3 Swirls are delicious, so you'll take them regularly and boost your levels of these important fatty acids.
• Magnesium Citrate (Thorne Research) . Take 2-4 capsules daily, or more if tolerated without getting diarrhea. Supplement your internal magnesium by taking Epsom salts baths.
• Topical magnesium In the form of Ancient Minerals Magnesium Oil can be very helpful if headaches arise out of muscle tension. Apply 2 sprays once or twice daily or at the onset of a headache where your muscles feel the most tight.
• Feverfew and ginger. In one study, a combination of feverfew and ginger has been shown to reduce the severity of migraines when taken soon after the onset of an attack . Available as GelStat Migraine, but not for use during pregnancy.
• Migra-Clear Ultra 120 VegiCaps, combines many of the helpful migraine ingredients in one supplement.
• CoQ10. In an open label trial, supplemental CoQ10 reduced the severity and frequency of migraines . Take Integrative Therapeutics UBQH, which is ubiquinol, the biologically favorable form, 100 mg tablets, take one to two daily.
• Thorne Research 5-MTHF. For people with high homocysteine levels, the methylated version of folic acid, once or twice daily, can reduce headache frequency.
• Thorne Research Melaton-5. Taking 1-2 capsules at bedtime can prevent headaches that wake you from sleep either during the night or first thing in the morning.
• Innate Response Formulas, B Complex. Taking 1-3 tablets daily with meals can provide a full range of helpful B vitamins.

Daily Life Activities

As mentioned above, lifestyle interventions can frequently be very helpful in reducing the frequency or severity of migraine headaches.

• Improved sleeping habits can reduce migraines. The sleep advice that was effective in a clinical trial included scheduling 8 hours of bed time nightly, without reading or other entertainment. Sleep is also more effective if fluids are limited in the last 2 hours before bed and dinner is completed at least 4 hours before bed. Relaxation exercises performed in the evening or in bed can be helpful.
• If you are overweight, lose excess weight with carbohydrate reduction. Follow our Low Carb Weight Loss Plan for help shedding extra pounds and at the same time reducing insulin and inflammation.
• Regular relaxation exercises can reduce migraines. Meditation can help you relax and calm. Yoga relaxes the body and mind, with focus on posture and movement. Receiving a massage can help relax tense muscles.
• Regular exercise can reduce the frequency of migraines. People who are able to incorporate a regular program of exercise often have fewer migraines. For some people, exercise - particularly in the heat or bright sun - can trigger a migraine, so modification may be necessary on some days.
• Recognize the early warning signs and respond. Actions that can mitigate migraines in some sufferers include drinking abundant water, drinking a caffeinated beverage, or retreating to a cool, dark, and quiet resting place.
• Decrease exposures to estrogen mimics. A multitude of plastics in water bottles and common household plastics, as well as chemicals in pesticides, mimic the action of estrogen when absorbed in the body. Most people have significant levels of these elements in their blood, and avoiding plastics can slowly lower these levels.
• For stubborn migraines, try the Ketogenic Diet. Some neurologists note the similarities between epilepsy and migraine, and have had success with some patients by helping them get into ketosis.

Seeking Care

Several alternative care modalities have been found helpful in the treatment of migraines.

• Discuss with your physician. When headaches cycle with hormonal changes, sometimes hormonal adjustments can reduce the frequency of migraines
• Hands-on care can help.
  • CranioSacral therapy can be very effective in many situations including migraine headaches. Visit www.cranialacademy.org to locate a practitioner in your area.
  • Chiropractic treatment spans a wide range of treatments, from high velocity adjustments (“crack crack” treatment) to gentle treatments with pressure points and massage. I consider high velocity adjustments to be inappropriate when performed on a repeated basis; if one or two “adjustments” don't fix the problem, additional adjustments run the risk of overstretching the supportive ligaments creating potential future problems.
  • Acupuncture has been helpful in some clinical trials.

Homeopathic Treatment

A chronic tendency to migraine headaches is best treated in consultation with a homeopathic practitioner. Migraines that occur rarely can respond well to the correctly chosen remedy. Almost every homeopathic remedy is useful for some sort of headache, but the most commonly helpful ones are listed here.

Match the symptoms of your headache to the descriptions below and if one fits well, take the remedy in a 30C strength, 2-3 pellets every 15 minutes over one hour. Taper the remedy as your pain improves, taking it every 1-4 hours until the headache is gone.

Homeopathic remedies are available through my office. 

Belladonna

• Right-sided headaches with throbbing or bursting pain, a little better with a cold compress.
• Your face and your head may be red and/or quite warm.
• Your hands and feet may be cold.
• Light, heat, and noise aggravate the headache. Sudden movements, or “jarring” movements can aggravate.
• The headache may be worse at 3 p.m.

Bryonia Alba

• Throbbing headaches tend to be around the left side of the head, or left eye.
• Your mouth is very dry and you are quite thirsty.
• Your headache is worse from noise, light, and heat, but most particularly from movement - you must lie still and become irritable if disturbed.
• Worries about work, business, duties missed by headache.
• May accompany influenza.

Cimicifuga

• Throbbing unilateral headache, either side.
• Associated with the menstrual period.
• Accompanied by a stiff neck and a miserable mood or feeling of despair.

Cocculus

• Headaches with motion sickness, dizziness, nausea, or lightheaded feeling.
• Worse from loss of sleep, particularly after caring for a loved one.

Cyclamen

• Migraine associated with dizziness, blurred vision or aura before the headache.
• Easily upset, but more weepy than irritable.

Gelsemium

• Sense of heaviness in the head and great weariness.
• Head too heavy to hold up.
• May have diarrhea and/or trembling from exhaustion.

Iris Versicolor

• Throbbing one-sided headache that comes on during rest.
• Visual changes precede or accompany the headache.
• Nausea and/or vomiting come with the headache.

Lachesis

• Left-sided headaches that are associated with the menstrual cycle, usually relieved once the flow is established.
• Generally warm and worse from heat.
• May be loquacious, sarcastic or jealous - all can be characteristic, but not necessary if everything else fits.

Lycopodium

• Right-sided headache that is worse from 4 to 8 p.m.
• Associated with increased appetite and/or bloating and gassiness

Nux Vomica

• Migraines that come from toxic exposures: medications, odors, or alcohol.
• Headache somewhat relieved with warm compresses If alcohol gives you a migraine, consider withholding the medicine to remind yourself to skip the alcohol next time!

Sanguinaria Canadensis

• Headaches localized around the right eye, and may start with shoulder or neck tension.
• Associated with vomiting which relieves the pain

Sepia

• Left-sided headaches: left forehead or over left eye.
• Nausea and vomiting, with or without dizziness and weakness.
• Mood is whining or complaining.
• May be associated with menstrual cycle.
• Strangely, the headaches are better from exertion.

Spigelia

• Left-sided headache, often above the eye Stitching or neuralgic pain which feels sharp.

From Dr. Deborah's Desk

I'd say the “Three M's” have yielded the greatest benefit with my migraine patients: more magnesium, moderate melatonin and avoiding monosodium glutamate. Karen came to the office with more than just migraines: she also had been diagnosed with fibromyalgia and a kind of anxiety or agitated depression, with a sleep disturbance. She had gradually gained weight over the years, and was approaching menopause.

The first change we made was to what I call the Ideal Diet which meant the elimination of sugars, most flours, and those so-called healthy oils such as canola and soy oils. Processed foods were out, so she probably unloaded some MSG. Soy came out of her diet as well. The nutritional change eased many of her aches but not all. She had started a good multi-vitamin supplement Integrative Therapeutics Multi-plex Without Iron, Omega 3 fish oil, and a mild exercise program. The good news was that her headaches were no longer constant, but they had adopted a particular pattern of coming on early in the morning, around 4 a.m., and then she was awake for the rest of the night.

I suggested she start taking both of the other “M's” at bedtime, magnesium and melatonin, two to three capsules each of Thorne Research Magnesium Citrate and Thorne Research Melaton-3. Within two weeks she reported back that her sleep and headaches were much better, as well as the constipation which had seemed so minor she hadn't even mentioned it.

Her mood and extra weight resolved over the next few months, both certainly related to the improvements in her diet and the amelioration of both headache and sleep problems.