Migraines are classified as a primary headache disorder.
For a headache to be diagnosed as a migraine, secondary causes must be ruled out, such as a tumor, cerebrovascular accident, or meningitis. Migraines cause an expansion of the blood vessels in the brain and inflammation of the surrounding tissue likely causing headache pain. Researchers know what happens to the brain during an attack, but there is still debate about underlying causes. The best hypothesis is that a vascular headache is caused by intracerebral constriction followed by extracranial vasodilation resulting in headache pain.
Migraine disease is a serious disability that affects approximately 23 to 26 million Americans. Statistics show that 18% of women and 6% of males suffer from migraines. 30% of all sufferers experience their first attack before age 10. The exact cause is unknown, and there is no known cure for the disease, only for the treatment of symptoms. Furthermore, no such treatments are wholly effective. Therefore, it is important for migraine sufferers to take a multifactorial approach to treating this illness. This includes drug use, preventative care, trigger management, a good diet, abortive treatment, nutrient balance, and general good pain management.
Migraines can induce a host of serious physical conditions: strokes, aneurysms, permanent visual loss, coma, dental problems, TMJ, and even death. The four types of chronic daily headache are: transformed migraine, which is drug induced or non-drug induced; chronic tension-type headache; daily persistent headache, and post-traumatic headache.
Factors That Trigger Migraine Headaches
- Low serotonin levels. Could be from genetics, depression, or a shunting of tryptophan into other pathways.
- Foods allergens. Histamine-releasing and histamine-containing foods are a common trigger (See diet and food elimination.)
- Alcohol induced. Especially red wine is a common trigger.
- Chemicals. Examples include MSG, aspartame, artificial sweeteners, nitrates, and nitroglycerin.
- Withdrawal from caffeine and other drugs that constrict blood vessels.
- Hormonal changes. Examples are menstruation, ovulation, taking birth control pills.
- Emotional changes. Especially letdown after stress, and intense emotions such as anger.
- Exhaustion, poor posture, too little sleep, muscle tension, weather changes.
Aspects Of Migraine Health Care
- Preventative Therapy. Initially, prophylactic medications may be prescribed to prevent or reduce the number of attacks in patients who experience frequent migraines. These drugs may act over time to prevent blood vessel swelling. They include beta-blockers, anti-depressants, calcium channel blockers and methysergide.
- Managing Migraine Triggers. Trigger factors can cause migraines and, if recognized, an attack may be avoided or aborted. These involve dietary triggers, atmospheric changes, air pressure, chemical fumes, menstrual cycles, bright sunlight, artificial flavorings/colorings, and stress.
- Aborting Migraine Attacks. There are a few drugs on the market that are excellent choices in mitigating a migraine attack. See your physician for these. In some instances, and IV push of magnesium has demonstrated 85% effectiveness in relieving an acute attack. See a qualified health care practitioner.
- Pain Management. Managing pain may include prescription drugs (analgesics and muscle relaxants), but supplementation to balance nutrient depletion may be as effective as any prescription and/or over-the-counter medication. Lidocaine has also been used.
Phases Of The Migraine
- Prodrome. May occur hours prior to the headache.
- Aura. Precedes migraine, developing over 5-20 minutes, and can last up to 60 minutes.
- Headache. May last 4-72 hours.
- Postdrome. Symptoms like exhaustion and scalp tenderness follows severe attacks.
Eliminate or limit your consumption of sugar, refined carbohydrates, alcohol and caffeine. A high fat diet will aggravate migraines producing series 2 prostaglandins that increase pain and inflammation.
Avoid vasoactive tyramine, found in certain foods: cheese, yogurt, beer, wine, liver and yeast. Patients with diabetic glucose curve or reactive hypoglycemia respond to low sucrose, six-meal regimen. Caffeine is a simple treatment that enhances the analgesic activity of aspirin, NSAIDs, or acetaminophen. Caffeine (drinking a cup of coffee at the onset of the migraine) may eliminate or greatly diminish over fifty percent of the pain associated with moderate to severe headaches.
Identify/eliminate Foods That Most Commonly Induce Migraine Headaches:
- Cow’s Milk (67%)
- Wheat and gluten (57%)
- Chocolate (55%)
- Eggs (50%)
- Oranges and other Citrus fruits (52%)
- Tomatoes (32%)
- Shellfish (29%)
- Beef (20%) and Pork (22%)
- OTHERS: Corn (20%); Coffee 915%); Peaches and apples (15%); Soy (17%); Peanuts (12%); Strawberries (7%); MSG (19%); Rye (20%)
It is advisable to try and determine the cause of an illness is a vital part of nutrient therapy. Proper treatment is to prevent it. Food allergies are a common risk factor, as is hypoglycemia (low blood sugar). It has been estimated that migraines are caused 20-40 percent of the time because of magnesium deficiency. Other possible nutrient deficiencies and toxicities that increase risk include:
- Migraines are frequently associated with high sodium and low potassium levels (protective adaptation). Excessive sodium in tissues results in retention of fluids in body tissues. If fluid occurs, migraine headaches are frequent.
- A high calcium level is indicative of a defensive posture and perfectionism, associated with migraine type headaches. Many people have bio-unavailable calcium and magnesium levels. They need to supplement both.
- High levels of iron in the body will raise blood pressure the cerebral arteries.
- Copper toxicity, often secondary to adrenal insufficiency, is a common biochemical cause of headaches and migraines. Copper stimulates epinephrine, norepinephrine, dopamine and serotonin. These chemicals may cause arterial spasms resulting in migraine headaches.
Pharmaceutical options are limited with most acute and mild attacks treated with non-steroidal anti-inflammatory drugs (NSAIDS). The most common NSAIDS taken are ibuprofen, ketorolac and naproxen sodium. Acetaminophen (Tylenol) may also be effective. Lidocaine given intra-nasally has been used with success.
- MAGNESIUM and CALCIUM
Both minerals help to regulate muscular tone and to transmit nerve impulses throughout the body and to the brain. Magnesium causes inhibition of vasospasm and platelet aggregation. Magnesium levels affect serotonin receptors, the synthesis and release of nitric oxide, and other migraine-related receptors and neurotransmitters. It stabilizes cell membrane and interferes with the synthesis or action of inflammatory mediators. (Effective in 80% of trails). Dosage: Magnesium 300-1,000 mg daily unless diarrhea occurs, then decrease. German researchers found 600mg of oral magnesium for 12 weeks significantly decreased migraine attack frequency (IV used also). Calcium: 500-2,000 mg daily.
- VITAMIN B2 (RIBOFLAVIN)
Supplementing with higher doses has proven remarkably effective in the treatment of migraine headaches. Vitamin B2, has few side effects, and acts to enhance the activity of the electron-transport chain, thus relieving cerebral vascular tone. Take for at least 3 months and has a 50% improvement ratio. Dosage: 100-400 mg daily. May discolor urine.
- COENZYME Q10
CoQ supplementation increases blood flow to the brain and improves circulation. Using CoQ10 in combination with magnesium supplementation may be the single most effective natural approach to migraine. In a recent study published in Neurology (2005, vol. 64; 713-715), supplementing with CoQ10 can reduce the frequency of migraines in chronic sufferers. Dosage: 60-120 mg daily.
- BUTTERBUR EXTRACT (PETASITES HYBRIDUS)
Butterbur is an herb that contains active compounds that prevent blood vessel expansion of a migraine and inflammation. Used extensively in Germany and well researched in its efficacy, butterbur use is restricted to its preventative properties. It is very effective (53% efficacy in after 3 months), and can be safely used in children and adolescents. Dosage: 50-150 mg daily for 4-6 months to decrease frequency
- OMEGA-3 FATTY ACIDS (FLAXSEED, FISH)
Migraine patients have significantly lower omega-3 fatty acids in platelet and red blood cell membranes. Omega fats are needed for brain cells and for fat metabolism and may act as an anti-inflammatory agent to keep blood vessels from constricting. Some of the fatty acids found in fish such as mackeral and salmon have an antispasmodic effect on cranial blood vessels that may prevent migraines. Fish and olive oil relieved migraines and headaches in adolescents. Dosage: 1,000-3,000 mg daily.
- FEVERFEW (TANACETUM PARTHENIUM)
Feverfew is a common and well-researched herb that appears to inhibit platelet aggregation and histamine release and assist in improvement in blood vessel tone. Feverfew also causes inhibition of vascular smooth muscle contractility. Feverfew taking in early stages of a headache can lesson pain. Feverfew may be less potent than Butterbur, but is a more researched herb. U.S. herbalists recommend feverfew products standardized to 0.25-5.0 percent partheomlide. Dosage: 50-600 mg daily for 8-26 weeks.
- MANAGE STRESS
Try engaging in gentle exercise, yoga, swimming, walking, other relaxation techniques.
- ACUPUNCTURE and ALTERNATIVE TREATMENTS
Acupuncture for migraines is the most common reason that physicians refer their patients to doctors of traditional Chinese medicine (TCM). In 1979, the World Health Organization recognized acupuncture as an effective migraine treatment. Other therapies Include biofeedback, TENS units to control secondary muscle spasm, and chiropractic manipulation.
If dysbiosis (bowels not working well) is caused by allergy symptoms, or any other criteria, supplement with probiotic (acidophilus and bifudus) support to balance flora. Dosage: as directed.
- L-TRYPTOPHAN (5-HTP)
5-HTP works in a pathway that may be related to low brain serotonin. 5-HTP can increase the body’s production of serotonin. Not for acute use. Dosage: 50-100 mg at bedtime.
- GINKGO BILOBA
This ancient Chinese herb acts as a platelet-activating factor antagonist and may increase circulation to the head, thus relieving pressure. Dosage: 60-180mg a day.
Several studies have examined endogenous melatonin secretion and its circadian rhythm in migraine patients. Studies utilizing doses of 20 mg IV infused over 4 hours, or a 3-5 mg oral dose for one month, reported decreases in migraine frequency, intensity, and duration. Dosage: See a qualified practitioner before taking melatonin for an extended period.
- B-COMPLEX VITAMINS
B vitamins can rejuvenate nerve and blood cells, thus may relieve stress associated with headaches or migraines. B vitamins can essential for a healthy nervous system and necessary for cell growth and respiration. Dosage: 50-200 mg daily.
- BLACK COHOSH
Black cohosh is an herb with phytoestrogen activity that has been known to help with headaches. Dosage: 40 mg twice daily.
- VITAMIN C W/BIOFLAVONOIDS
Vitamin C may help to control food allergies and relieve stress that may be associated with migraines. QUERCETIN helps block histamines associated with allergies, and RUTIN may help to remove toxic metals which may cause migraines. Dosage: Vitamin C 1,000-3,000 mg daily; Quercetin 500mg daily; Rutin 200mg daily.
Ginger shows some potential and promise for migraine relief. Dosage: 500-600 mg can be supplemented every 4 hours for 4 days.
Valerian may be helpful as a sedative-like herb, to be taken at bedtime, if needed for headache due to menstrual stress or anxiety. Dosage: See package.
- PROGESTERONE CREAM
Dr. John Lee recommends NATURAL PROGESTERONE CREAM when hormones or estrogen dominance is a cause of migraines or headaches. Dosage: See a qualified practitioner.
Aesoph, LM. Put Migraines to Bed. Nutrition Science News, Sept. 1998. 3(9): 506.
Balch, JF, Balch PA. Prescription for Nutritional Healing- 3rd edition. Penguin Putman Inc. New York, NY. 2000.
Brown, D, Gaby, A, Reichert, R. Clinical Applications of Natural Medicine Migraine. American Journal Of Natural Medicine, Nov. 1997. 4(9): 14-20.
Coleman, MJ, Burchfield, TM. Multifactorial Approach to Migraine Disease Treatment. International Journal of Integrative Medicine, May/June 1999. 1(3): 43-46.
Cunningham, M. Natural Therapeutic Approaches to Migraines. America’s Pharmacist, May 2002. 33.
Ferrone, M, Motl, S. Current Pharmacotherapy for the Treatment of Migraines. U.S. Pharmacist, March 2003. Pp. 33-55.
Lark, S. M. 149 Astonishing Healing Secrets Just for Women. Phillips Health, Inc. 2001.
Mahanian, M. Acupuncture for migraine. Alive #285. July 2006. Pp. 32-33.
Maizels, M. Intranasal Lidocaine for Treatment of Migraine. JAMA, July 24/31, 1996, 276(4); 319-322.
Melatonin- Monograph. Alternative Medicine Review, December 2005. 10(4): 326-332.
Murray, M. Migraine Headaches. Natural Medicine Journal, March 1998, 1(2); 5-15.
Neustadt, J, Oliff, H. Butterbur Extract Effective for Preventing Migraines in Adults and Children, Herbalgram, No, 67. 2005. Pp. 28-30.
Rosenblatt, S. Migraine Presentation. Presentation at JAG GROUP FORUM 2000. Feb. 24-27, 2000. Newport Beach, CA.
Weiss, D. Migraine Headaches & Nutritional Supplements. Ask the Doctor, Enzymatic brochure, 2002.
Whitaker, J. Dr. Whitaker’s Guide to Natural Healing. Prima Publishing, Rocklin, CA. 1996.