Migraine Headaches  Elizabeth Lipski, Ph.D., CCN

Excerpt from Digestive Wellness (McGraw Hill)

 

Migraine headaches cause periodic disruption in the lives of 28 million Americans, affecting 6% of men and more than 18% of women every year.  It averages just over 10% of our population, making it the most prevalent neurologic illness. Costs to the society are $13 billion annually which includes 157 million work days that are lost each year.  Migraines have genetic, hormonal, immune and environmental components.

 

Migraines usually begin with a throbbing pain on one side of the head, which can spread to both sides. About 60% of people experience symptoms 24 hours prior to the actual migraine which include: mood changes, food cravings, repetitive yawning, thirst, fluid retention, stiff neck, irritability, fatigue, numbness, or tingling on one side of the body, lack of appetite, diarrhea, constipation, feeling of coldness, lethargy, changes in vision, or seeing bright spots. Medications and other techniques work best if used at this point. These symptoms may disappear when the headache appears or remain. Although symptoms vary from person to person, they have a consistent pattern in each individual. Migraine attacks may last from hours to days and may be accompanied by nausea, vomiting, and extreme sensitivity to light.

 

Migraines usually come on in response to a "trigger." Common triggers are foods and beverages, alcohol, stress, emotions, hormone changes, medications such as estrogen therapy, visual stimuli, or changes in routine. A recent study of 494 people with migraines cited the following triggers: stress in 62 percent, weather changes in 43 percent, missing a meal in 40 percent, and bright sunlight in 38 percent. Cigarettes, perfumes, and sexual activity also provoked migraines in some people. Other triggers are red wines, exhaustion, and monosodium glutamate (MSG).

 

Jean Munro, M.D., an English doctor who specializes in working with people with multiple chemical sensitivities, breaks migraines into four types. The first type is a classic migraine, which begins with a visual disturbance of some sort--flashing lights, blackening, or blurred vision. It usually involves one side of the head, and people often vomit. The migraine usually lasts one to three days and can be quite severe. The second type is called a common migraine and is almost identical to the first except that there is no visual warning. It begins on one side, sometimes progressing to both, and there may be vomiting. The third type is called a basilar migraine, when the blood vessels at the base of the head dilate. It can be quite frightening and often causes a panicky feeling, accompanied by a sense of doom. A generalized headache is accompanied by a pins-and-needles sensation around the mouth, nausea, and tingling hands. The fourth type, called a motor migraine, is a variation on the basilar and may be quite severe. Half the body feels weak, head pain centers around the eye, and vision is distorted.

 

Of 282 patients with migraines whom Dr. Munro studied, 100 percent had food allergies or sensitivities. Over 200 of them were sensitive to wheat and/or dairy products. Other common trigger foods were tea, oranges, apples, onions, pork, and beef. She found that foods eaten daily provoked more reactions than chocolate, alcohol, and cheese, which are thought to be the most common triggers. Dr. Munro also found that people who eliminated these foods from their diet and cleared their homes of environmental contaminants had the best results in prevention of migraines. Using mild household cleaners, getting rid of gas appliances, removing house plants with molds and fungus, frequent cleaning, and making a bedroom an oasis by removal of carpets and curtains resulted in fewer migraines. Although these people were still exposed to smoke, perfume, and other environmental triggers outside the home, changing the home environment and their diets lowered their threshold enough so that they became more tolerant. More recent studies show that IgG4 and anti-IgG antibodies increased after food challenges in people with migraines, which supports the food-sensitivity/allergy hypothesis. Other researchers have confirmed that many of the foods that Dr. Munro found also provoked symptoms. However, virtually any food can be a trigger.

 

John Diamond, M.D., of the Diamond Headache Clinic in Chicago believes that foods high in amines also provoke migraines in some people. Dietary amines, which promote constriction of blood vessels, are normally broken down by enzymes, but some people with migraines have lower than normal amounts of the appropriate enzymes. The amines that provoke vasoconstriction are serotonin, tyramine, tryptamine, and dopamine. They are found in the greatest quantities in avocados, bananas, cabbage, eggplant, pineapple, plums, potatoes, tomatoes, cheese, canned fish, wine (especially red), beer, aged meats, and yeast extracts.

 

Some physicians give intravenous (M nutrients to people with migraines. An IV with 23 grams of magnesium sulfate, 200-300 milligrams of vitamin B6, and 1,000 milligrams of arginine will often give migraine relief in just minutes. This injection must be given slowly to prevent a sudden drop in blood pressure.

 

Hormone fluctuations in women can worsen, improve, or trigger migraines. Many women only experience migraines at specific times in their menstrual cycle from ovulation through menstruation. Birth control pills and other estrogen-containing medications are widely recognized to trigger migraines in susceptible women. When women stop taking the medications, their migraines typically disappear.

 

The truth is that migraines have many triggers that vary from person to person. Finding your triggers and the treatments that work best for you is the key. You certainly won't need all the therapies listed below, but hopefully you'll find relief from some of them.

 

{C}Functional Laboratory Testing

 

1.       Intracellular magnesium, either RBC or lymptocytes.

2.       IgG, IgE  and if possible IgA and IgM Elisa testing for food and environmental allergies/sensitivities.

3.       Intestinal permeability screening.

4.       Comprehensive digestion and stool analysis with parasitology

5.       Candida antibodies or CDSA.

         

 

{C}Healing Options

 

Clean up your diet: Remove all sugars, alcohol, refined carbohydrates, and caffeine. One study found that a low-fat diet of less than 20 grams daily lowered the incidence of headache from nine each month to three each month. Headache intensity and the need for medications also dropped substantially. This information shows the importance of the diet and the quality of fats. In combination with good-quality omega-3 fatty acids, this could give great results for many people.

 

Food sensitivities and allergies: Avoid foods you are sensitive to. Make your home environmentally safe by using only natural cleaning supplies, removing gas appliances, cleaning out mold and mildew, using a dehumidifier, and making your bedroom into a safe harbor by removing unnecessary items, such as carpeting and drapery.

 

Riboflavin (vitamin B2): Forty-nine people with recurrent migraines were given 400 milligrams of vitamin B2 daily with breakfast for three months. The number of migraines declined by 67 percent and the severity diminished by 68 percent. Its maximum effect is reached after two or three months, so be patient and give it a good try. In another study, fifty-five people were given either a placebo or 400 milligrams of riboflavin daily. Over three months, 59 percent of the people on riboflavin improved by at least 50 percent. There were minor side effects in two people--one had diarrhea and the other had frequent urination. If you experience either of these side effects, decrease the dosage.

 

Vitamin B12:  20 people with a history of migraines for over one year and with a frequency of 2-8 per month were given 1 mg. vitamin B12 daily for three months in a nasal spray.  Half of the people had a 53% reduction in migraines.  In these people there was a reduction from 5.2 to 1.9 attacks per month.  In the other half of people, there was virtually no improvement.  Vitamin B12 is non-toxic, inexpensive, and widely available in sublingual and nasal sprays.  Oral forms are not well-absorbed.  Dosage:  1 mg. daily for 3 months.  If you get good results, continue. Over time, dosage needed may decrease.

 

Candida: A recent study of the relationship between Candida and migraines found that thirteen out of seventeen migraine sufferers responded to a three-month program of diet and medication with fewer and less severe headaches. Blood testing showed a lowering of Candida antibodies as well. The four people who did not respond well didn't stick to the program! If you have migraines, take the home test for Candida infections and have your physician order additional testing.

 

Eat often: Low blood sugar levels often trigger migraines so don't skip meals. You may find that eating five to six small meals each day works better for you than three main meals.

 

Magnesium: Numerous studies have documented the relationship between low magnesium levels and migraine headaches. It is estimated that magnesium plays a role in at least half of all people with migraines. When magnesium is supplemented at levels of 600 milligrams daily, there is a significant decrease in the number of migraines. Alan Gaby, M.D., offers his patients magnesium injections (of B-complex, vitamin C, and calcium) which alleviate their migraine headaches within minutes. A recent study used injectable magnesium sulfate with good results. Dosage: Try 600-2000 mg. milligrams magnesium citrate or magnesium glycinate for at least three to four months.  When you’ve reached saturation, you’ll get diarrhea.  I use this with my clients to figure out the correct dose. If you need more than 1000 mg daily before your stools loosen, add 1 tsp. choline citrate to facilitate the magnesium absorption.

 

Omega-3 fatty acids/Olive oil/Polyunsaturated Fats: Fish oil supplements contain high levels of DHA and EPA oils. They have been shown in many studies to reduce the severity, duration, and frequency of migraine headaches. Most of us can produce EPA and DHA by using flaxseed oil, borage oil, or evening primrose oil, or by taking alpha-linolenic acid (ALA) and gamma-linolenic acid (GLA) supplements. However, this conversion requires that we have not only the genetic ability to complete the conversion, but also adequate vitamin B6 and magnesium. One study gave subjects 1,800 milligrams of GLA and ALA in six capsules daily, plus 3 milligrams of niacin, 20 milligrams of vitamin Q 2 5 milligrams of vitamin E, 2 0 milligrams of soy phosphatides, 5 0 milligrams of magnesium, 1. 3 milligrams of beta-carotene, and 0.3 milligrams of vitamin B6. Of the 128 people who participated in the study, 86 percent had a reduction in the severity, frequency, and duration of their migraine headaches, 22 percent became migraine-free, and 90 percent had reduced nausea and vomiting. All of 14 percent of the subjects were able to reduce their medication to simple pain relievers. Stress reduction and relaxation are also recommended. Omega-3 fatty acids promote anti-inflammatory prostaglandins PG31 and the PGE3 series. High protein and omega-6 fatty acids promote inflammation and pain through the conversion of arachadonic acid to PGE2 and leukotrienes. Dosage: 1,800 milligrams GLA/ALA, 2,000-3,000 milligrams of fish oil daily.

 

Feverfew: Numerous studies have shown the herb feverfew (Tanacetum parthenium) to be effective in preventing and minimizing the severity of migraines.  Others show no effectiveness.  You can try it for yourself and see if it works for you.

          Feverfew needs to be taken on a daily basis as a preventive rather than as a medication. There is a difference between fresh and dried feverfew and between various samples. If you don't get relief from one type, try another. Fresh feverfew seems to work best. It is easy to grow, so you could just eat a few leaves each day. Tinctures are available and would best approximate fresh leaves. It also comes in a freeze-dried form that seems to be effective. Dosage: Twice daily fifteen to twenty drops tincture, one to three capsules  or one to three fresh leaves daily.

 

Acupuncture: Acupuncture has been shown to reduce the incidence and severity of migraine headaches in some people.  Study results vary.  You may find great or no benefit.

 

Behavioral techniques:  Many studies have been done using biofeedback, hypnotherapy, and stress reduction techniques have all proven useful to some migraine sufferers. They may be 35-50% effective.  Plus you’ll have better stress management skills to use in all areas of life. Behavioral techniques help us better understand stressors and how to cope more effectively. 

 

Avoid monosodium glutamate: MSG can provoke migraine headaches, asthma, diarrhea, vomiting, and gastric symptoms. These problems can occur immediately after eating or may be delayed up to seventy-two hours, which makes their relationship to MSG more difficult to discover. Food product labels may be misleading, with MSG labeled "natural coloring"; some hydrolyzed vegetable protein contains MSG. You can challenge yourself with MSG to see if it brings on a migraine. The Elisa/Act blood test includes tests for MSG and glutamate sensitivity.

 

Quercetin: Quercetin, the most effective bioflavonoid due to its anti-inflammatory effects, can be used to reduce pain and inflammatory responses and control allergies. Dosage: 500-1,000 milligrams three to four times daily at onset of migraine; 500 milligrams daily as a preventive.

 

Chiropractic and massage: Chiropractic manipulation and massage can help blood and lymphatic supply and lessen muscle tension.

 

Caffeine: Caffeine plays a mixed role in migraines. For some people, it significantly reduces the number and severity of headaches; for others it triggers them.

 

Niacin: There have been reports of physicians who use niacin intravenously during a migraine to lessen severity and duration of headaches. The dose contains at least 100 milligrams niacin, which is infused slowly.

 

Antioxidants: Migraines are often triggered by substances that promote free radicals like cigarette smoke, perfume, hair spray, pollution, and household chemicals. One researcher found lower levels of superoxide dismutase in platelets of people with migraines than in people with tension headaches. More research needs to be done in this area, but taking adequate antioxidants in a multivitamin with minerals may help prevent migraines.

 

Excerpt from Digestive Wellness by Elizabeth Lipski, PhD, CCN (McGraw Hill, 2005)

 

© 2005 Elizabeth Lipski. All rights reserved. Reprinted by permission of the author.

 

Elizabeth Lipski, Ph.D., CCN is a clinical nutritionist, an expert on integrative medicine, a national speaker and media personality with expertise in digestion, diet, and disease, and the author of Digestive Wellness (McGraw-Hill, 3^rd edition, 2005).  Dr. Lipski is board-certified in Clinical Nutrition, and earned her doctorate in Clinical Nutrition with a specialization in Integrative Medicine from the

Union Institute in Cincinnati, Ohio. In private practice for more than two decades, she also serves corporate and community clients through public teaching and education programs, offering instruction on nutrition, weight control, cardiovascular health, women’s self-care, and stress management. She aired a weekly radio segment called “Eater’s Digest,” on the nationally syndicated Jesse Dylan Show, and hosted the talk show “Health Matters,” on KKCR radio, out of Princeville, Hawaii. She has been a guest on The Gary Null Show and The Deborah Ray Show, and has appeared as an expert for Fox-TV and on Chicago’s WGNTV, among others. The author of numerous articles for peer-reviewed medical journals and health-oriented media, Dr. Lipski is author of a previous book, The Leaky Gut Syndrome (Keats Publishing, 1998). She lives and practices in Asheville, North Carolina, and is currently offering teleseminars nationally. For more information: www.innovativehealing.com.