MIGRAINE HEADACHES

IF YOU SUFFER from migraine headaches, you know how truly debilitating they can be. My migraine patients tell tales of being out of commission for days at a time, often when they can least afford to be. Most people know if their headaches are everyday tension headaches or migraines, but if you’re it might be tension headaches. There are typical symptoms of migraines that help identify them. If you experience at least three of the following, your headaches are probably migraines:

• You’ve had more than one attack.
• Only one side of the head is affected.
• You experience an “aura” of flashing lights, blind spots, or a feeling of irritability or depression immediately before the headache.
• You experience stomach distress possibly with nausea and vomiting along with the headache.
• Someone in your immediate family also suffers from migraines.

Natural approaches can help; unfortunately, once a migraine starts you may have to rely on drugs for pain relief.

But there are ways of avoiding migraines once you learn some of their causes.

Migraine headaches usually come at intervals, with complete freedom from pain between attacks. They can last anywhere from a few hours to a few days. The pain is severe and can be incapacitating. For many people, the headache is preceded by feelings of depression and irritability, as well as increased sensitivity to light and noise. A classic migraine is preceded by a characteristic “aura,” during which the person feels lightheaded, has a reduced field of vision, and may see flashing lights. The headaches usually starts on one side of the head, (the word migraine is derived from the Greek for “half a skull”) and is accompanied by nausea, abdominal discomfort, and sometimes vomiting.

Nearly 20 percent of all women and 10 percent of all men suffer from migraines, and most of them have a family history of the disorder. Some people may have daily attacks, others one every several months. The intensity and duration of the attacks may vary from one time to another. Though the symptoms vary, migraines always involve an abnormal constriction and swelling of the blood vessels in the head-constriction in the early warning phase, swelling concurrent with the pain.

Inherited instability of the vascular system is one of the causes of migraine. Migraine patients are more prone to fainting when standing up suddenly than other people, and they are also more sensitive than other people to the vasodilatory effects of physical and chemical agents. Blood platelet disorder has also been implicated, with the platelets of migraine sufferers aggregating more readily than normal platelets in response to neurotransmitters such as serotonin and adrenaline, the “stress” hormone. The nervous system itself may also be implicated, as it releases specific neurotransmitters, possibly in response to chronic stress.

Medications used to prevent the onset of migraines have had limited success, and, as do all medications, they have harmful side effects when used over the long range. Medications to reduce the pain can be of some help if taken immediately after the migraine starts. Once the headache takes hold and severe nausea sets in, the stomach shuts down, so oral medications can’t be properly absorbed. While biofeedback techniques and acupuncture can give relief for some people, I find that my patients have the most success by learning to recognize the triggers that cause migraine headaches and then avoiding those triggers.

Of course everyone is different: what causes your migraines may be completely different from what causes someone else’s.

Certain foods contain chemicals-amines-which dilate the blood vessels, causing a rebound vasodilation and may thus precipitate an attack. The most common foods implicated in migraine attacks as a result of amines include: avocado, plum, wine, banana, potato, beer, cabbage, tomato, aged or cured meat, eggplant, cheese, pineapple, canned fish, and yeast extract.

Other people are sensitive to foods containing MSG, the flavor enhancer, or nitrates, which are commonly found in bacon, hot dogs, and other preserved meats.

Some people are sensitive to artificial sweeteners like Aspartame which is found in Nutrasweet.

When I give my migraine patients this list of offending foods, they’re usually overwhelmed. How can they figure out which of these things could be causing their headaches? It’s not as difficult as it seems, although it does take some diligence. The first step is to keep a headache diary for two to three weeks (or for longer if you don’t get migraines frequently). Note not only when you get headaches but also when you eat any of the listed items. Many of my patients will see a migraine pattern that’s connected to their eating habits. Obviously, once you identify the causative substance, you must avoid it. One of my patients who drank enormous quantities of diet soda noticed a possible connection between her soda consumption and her headaches. When she eliminated all artificial sweeteners from her diet, her headaches occurred far less frequently.

Many women find that certain stimulants such as alcohol which have no effect on them regularly can trigger an attack if they’re consumed just before a menstrual period or at the time of ovulation. If you are a menstruating woman who suffers from migraines, be sure to make note of your menstrual cycle on your headache diary. Check to see if headaches occur just before you begin to menstruate or when you ovulate, and note any triggers during those times. If you are a postmenopausal woman on estrogen therapy, you may find that a change in your hormone treatment will help your headaches. Discuss this with your doctor.

While the food triggers listed above are common causes of migraines, there are a host of other foods that can cause migraine symptoms as a result of an allergy or sensitivity. Here is a list of some of the most common allergenic foods connected with migraines: apple, goat’s milk, soy, beef, grapes, tartrazine, benzoic acid, oats, tea, caffeine, onion, tomato, cane sugar, orange, walnuts, corn, peanuts, wheat, cow’s milk, pork, yeast, egg, rice, fish, and rye.

Food is not the only cause of migraines. Low blood sugar caused by fasting or irregular meals often brings on a headache, which, for the average individual, quickly disappears following a meal. But for people prone to migraines, the low blood sugar may start off a chain reaction that a belated meal will not stop. Balanced meals eaten on a regular schedule are a must for those suffering from migraines. Some of my patients find that they must eat something every few hours to prevent headaches. Chromium can help stabilize the blood sugar.

There’s an additional factor that could explain why women suffer from migraines so much more frequently than men. Recent research has pointed to fluctuating levels of estrogen as a factor in their development. For these women headaches can disappear during pregnancy, when estrogen levels are constant. If you get a headache every month just before your period, it could be because your blood-sugar levels are dropping. Again, chromium can remedy this. Muscle cramping can also contribute to period-related headaches-calcium and evening primrose oil are helpful. Menopause can bring complete relief from headaches, or, for some women, make them worse. Birth control pills affect migraines as well.

Stress, anxiety, and excitement promote the release of hormones and neurotransmitters, which can provoke a migraine attack. While it may be difficult to avoid stress, it can be alleviated through exercise. A doctor at the Neurology Department of the New Mexico School of Medicine reported that several of his patients became migraine-free after jogging 7 to 9 miles a day, at a speed of seven to nine minutes per mile. Of course jogging is not suitable for everyone, but even moderate exercise can relieve tension and stress. I recommend that all my migraine patients adopt a regular exercise program even if it’s just a brisk half-hour walk four or five days a week.

Other factors that have been known to precipitate migraines are changes in routine, such as late rising on a holiday or change of working hours; changes in climate, high winds, loud or high-pitched sounds; bright sunlight and bright artificial light, such as fluorescent; and prolonged staring at television, movie, or computer screens.

Identifying the factor responsible for your migraine may be complicated by the fact that there may be more than one. For instance, skipping breakfast may not affect you most days, but it may trigger a headache if you are also tired and under stress. Getting up unusually early may normally be no problem, but if you rise before dawn on the day before your period it may plunge you into a migraine. Keeping a diary of activities, including what and when you eat, is really the best way to pinpoint the causes of your migraines.

An herbal migraine treatment that has long been popular in Europe and is now available here is feverfew. A double-blind study of patients who reported they had been helped by feverfew was performed at the London Migraine Clinic. A test group was given a placebo to determine if their symptoms worsened. They did, increasing in both the frequency and severity of the attack.

Feverfew has some of the same antiinflammatory effects as aspirin, without aspirin’s side effects. It must be taken for several weeks before the effects are felt.

One aspirin taken every other day has also been found to reduce the risk of migraine, presumably by preventing the platelets in the blood from clumping together. These bunches of platelets form serotonin, a neurotransmitter that has been linked to migraines. They can also form blood clots that lead to heart attacks, which is why aspirin is helpful in preventing recurrences of heart attacks.

Fish oils (omega-3’s) are beginning to be widely recognized for their anti-inflammatory properties, and have proven effective for a variety of conditions including migraines.

Magnesium is also helpful, as low brain magnesium has been identified as an important factor in the mechanism of a migraine attack.

One last thing: Sometimes people go for long periods thinking that they’re suffering from migraine headaches when, in fact, they have chronic sinusitis, which can cause regular painful headaches.

NATURAL PRESCRIPTION FOR MIGRAINE HEADACHES

• Try to identify the cause of your migraine by keeping a daily food or activity diary. Especially note foods listed here as possible triggers of migraine headaches. You may be sensitive to a chemical in a food or you may have a food allergy that triggers your headaches. See if you can establish a pattern between something you ate or some unusual activity that caused your headache.
• Other migraine causes include changes in routine, such as late rising on a holiday or change of working hours; changes in climate, high winds, loud or high-pitched sounds; bright sunlight or bright artificial light; and prolonged stating at television, movie, or computer screens. Keep these in mind when you compile your diary.
• If you are a woman, pay particular attention to the hormonal fluctuations of your menstrual cycle to see if your migraines are connected to changing estrogen levels. Headaches caused by low blood sugar can be helped by chromium-100 mcg: of the trivalent form three times daily.
• Headaches caused by muscle cramping can be helped by evening primrose oil and calcium. The dose for evening primrose oil is four 500-mg. capsules in the morning and four 500-mg. capsules in the evening for five cycles; if no improvement, discontinue; for calcium, 1,200 mg. at bedtime.
• If you are postmenopausal and on estrogen: replacement therapy, your medication could be a factor In your migraines. Discuss this with your doctor.
• Eat regular meals at regular times to avoid low blood sugar. Never skip meals.
• Keep stress under control with stress-reducing techniques.
• Adopt a regular exercise program.

IN ADDITION TO YOUR DAILY SUPPLEMENTS, TAKE:

• One aspirin every other day.
• The herb feverfew: 150 mg. twice a day or as directed on package.
• Fish oils: 1,000 mg. three times a day.
• Magnesium: 250 mg. twice daily.

IN ADDITION: Sumatriptan, a medication used widely in Europe, has recently been approved for use in the United States. It is self-injected to help stop a migraine headache. Consult with your physician to determine if this may be helpful to you.