Nearly every week, I get patients who assume that any time they have a really bad headache, it must be a migraine. Not true. In fact, migraines are a specific condition, with symptoms, causes, and treatments that differ from other headaches. To begin, what sets migraines apart is the throbbing pain–often on one side of the head–which can be intense and even incapacitating. At WholeHealth Chicago, we find a two-prong approach to migraines is often the most successful: Deal decisively with the pain of an attack (including using prescription medications, if necessary) and also find the best strategies to prevent these headaches from happening in the first place.
For a full view of all the treatment options our doctors can provide, enter our Healing Path for Migraine.
What is Migraine?
A migraine is a severe, pounding headache so intense and overwhelming that it can be debilitating. Though migraines can affect the entire head, they usually begin on one side (hence the name migraine, from the Greek word hemikrania, meaning “half the skull”). A migraine attack may last for just a few minutes or continue for up to several days. (If severe head pain persists for more than a few days, it’s probably not caused by a migraine, so you should see your doctor.) In some cases, a migraine is preceded by a series of early warning signs, known collectively as an aura. These visual disturbances may include flashing lights, wavy lines, blind spots, or even a temporary loss of peripheral vision.
Migraines afflict about 10% of the population, striking women far more often than men. Episodes can vary in frequency from several times in one week to once every few years. While the intensity and frequency of migraines often subside with age, auras may continue unabated; in older people, they are sometimes mistaken for symptoms of a stroke.
- Throbbing, pulsating pain, starting near one eye or temple and extending throughout one or both sides of the head
- Nausea and vomiting
- Loss of appetite
- Sensitivity or painful aversion to light or noise
- Symptoms may be preceded by visual distortion or disturbances (called an aura), such as patterns of flashing lights, wavy lines, blind spots, or loss of peripheral vision
- Other early warning signs include dizziness, numbness on one side of face, tingling, chills, fatigue, irritability
What Causes Migraine?
Although heredity is believed to play a role, the exact underlying cause of migraines isn’t known. Scientists currently think that migraines are the result of spasms in the arteries that supply blood to the brain and scalp. The affected blood vessels constrict, causing other arteries in the brain to rapidly dilate, which triggers the release of chemicals that cause intense pain and inflammation. Some research indicates that a low level of the brain chemical serotonin may also play a role in this process. Migraines may also be triggered by a host of other factors that include:
- Stress, overwork, or even relaxing periods that follow hectic ones, such as weekends and vacations
- Insufficient sleep–or too much sleep
- Sudden changes in weather (barometric pressure)
- Exposure to bright lights or certain visual patterns
- Fluctuations in blood sugar levels
- Caffeine withdrawal
- Cigarette smoke
- Certain odors
- Hormonal swings during menstrual cycles
- Birth control pills
- Vasodilating drugs
- Certain foods and beverages, especially those containing compounds known as amines
- Nitrites (chemicals found in bacon, hot dogs, and other cured meats)
- Foods containing tyramine, a chemical found naturally in pepperoni, red wine, chicken livers, active yeast preparations, and aged cheeses
Treatment and Prevention
If your migraines are mild or infrequent, you may be able to get sufficient relief from an over-the-counter pain reliever such as aspirin, acetaminophen, or ibuprofren–provided you take the pain reliever during the first 30 minutes of an attack. A combination of acetaminophen, aspirin, and caffeine–available in nonprescription headache formulations–can even relieve the pain of severe migraine in some people.
For those who get frequent migraines (two or more disabling attacks per month), prescription medications may be the only way to prevent or reduce symptoms. Drugs used for this purpose include beta-blockers, antidepressants, and special antimigraine drugs. Other drugs are available for halting migraine symptoms once they begin; these include so-called triptan medications, such as sumatriptan. Your doctor may also prescribe drugs for general pain relief and for controlling nausea (which can result from a headache itself or as a side effect of other migraine drugs).
While prescription drugs are available for treating and preventing severe migraines, there are a number of natural remedies that can be beneficial and also have fewer side effects than prescription medications. For some sufferers, supplements may eventually replace the drugs used for preventing migraines–though conventional medications are usually necessary for treating the severe pain of ongoing attacks.
In addition, you might try using alternative medicine approaches for your migraine. Acupuncture, aromatherapy, craniosacral therapy, biofeedback (and other relaxation techniques) have all been shown to benefit migraine sufferers. One important point: Don’t stop taking any medication without consulting a physician.
Just a reminder: If you have a serious medical condition, it’s always a good idea to talk to your doctor before beginning a program of supplements.
How Supplements Can Help
Because magnesium and calcium help to maintain healthy blood vessels, they should be taken long term by anyone who gets migraines.
Two supplements may be useful in reducing the intensity and frequency of attacks. The herb feverfew, one of the most popular migraine remedies, has anti-inflammatory and pain-relieving properties. 5-HTP (5-hydroxytryptophan), an amino acid derivative, helps boost serotonin levels in the brain, and has been found to prevent migraines as effectively as some prescription medications. Both may need to be taken daily over several months for maximum benefit. 5-HTP should be used with caution when using certain antidepressants, called SSRI drugs.
For people who average four attacks per month, the B vitamin riboflavin may provide some significant relief.
Get supplement dosages and tips in our WholeHealth Chicago Supplement Recommendations for Migraines.
Holding an ice pack (or even a bag of frozen vegetables) against your forehead can bring temporary relief–the cold numbs the pain and also helps contract dilated blood vessels.
Many migraine sufferers obtain relief by resting in a dark, quiet room with an ice pack or cold compress against the forehead.
Some research has shown that wearing a headband–one with movable rubber disks to apply pressure over the most painful areas–can provide partial relief.
Self-massage with rosemary oil is a migraine reliever. Using a circular motion, massage your temples, then repeat in the hollows at the sides of your eyes, behind your ears, and over your neck.
To help reduce or avoid future migraines, keep a migraine diary–a daily record of your food and beverage intake as well as any migraine attacks–in order to identify and avoid suspected migraine triggers.
The following foods and substances should be avoided, since they are thought to trigger migraines in some people: nuts, peanut butter, yogurt, sour cream, onions, pickles, eggs, tomatoes, citrus fruits, freshly baked yeast products, alcohol- and caffeine-rich drinks, MSG (monosodium glutamate), and aspartame (artificial sweetener).Some European studies have shown improvement in migraines when dairy and wheat are removed from the diet.
Consuming fish with a high content of omega-3 fatty acids, such as tuna and salmon, may aid in migraine prevention.
Exercising regularly can reduce the frequency and severity of migraine headaches. Meditating once or twice a day may also contribute to long-term prevention.
When to Call a Doctor
- If you experience a sudden onset of severe headaches or if there is a change in your pattern of headaches (they become more severe or more frequent or there is a change in the type and location of the pain).
- If your headache is accompanied by vomiting; limb weakness; double vision; difficulty in swallowing; fever; neck stiffness; confusion; slurred speech or loss of speech. In a small number of cases, a severe headache could be the sign of a serious medical problem, such as high blood pressure, a concussion, or a stroke.
- If your headaches don’t respond to self-treatment. A wide variety of drugs are available, ranging from pain relievers and muscle relaxants to prescription drugs that control blood vessel constriction and dilation. Your doctor may suggest trying different medications until you find the one (or a combination) that works best.
From David Edelberg, M.D. at WholeHealth Chicago: I advise patients with migraines to start by assessing the aggravating factors in their lives. This means identifying and trying to eliminate such known triggers as stress, excessive salt, birth control pills, PMS, and any food that may be setting off your headaches.
In addition, certain supplements can be very effective at preventing or lessening migraine attacks, although none will stop the pain once a migraine begins. Most of the nutrients suggested here have few side effects, and some have even been found to be as effective as prescription drugs.
All the following supplements can be taken with each other and with prescription migraine medications. Anyone who takes prescription antidepressants called SSRIs (such as Prozac), which some doctors may prescribe as migraine preventives, should not combine them with 5-HTP.
How to Take the Supplements
Calcium and magnesium are a good place to start, since both help maintain blood vessels and nerve transmissions. Studies have also shown that some migraine sufferers are magnesium-deficient. Both minerals can be taken long-term.
A number of substances affect the mechanism of how a migraine originates. All three of the following supplements have been shown to prevent or reduce the incidence of migraines.
The herb feverfew blocks the release of chemicals that dilate small vessels in the brain. The amino acid 5-HTP raises the brain’s levels of the neurotransmitter serotonin, thought to play a key role in migraines. The B vitamin riboflavin improves the energy production in the cells of the blood vessels.
These supplements can all be used together. Or you can try one of them at a time, allowing at least three weeks before discontinuing it as ineffective.
Finally, physicians frequently prescribe conventional antidepressant medications (such as Prozac and Elavil) for migraine control. Although the herb St. John’s wort has not been tested specifically for migraine relief, its effect on serotonin production should make it a safe and effective alternative to the prescription antidepressants. Like these medications, however, you need to give St. John’s wort at least 4 to 6 weeks of continuous use at 900 mg a day (in divided doses) before maximum benefit is reached.
Of special note
If you’re female with a premenstrual component to your migraine, consider the herb chasteberry (200-225 mg standardized extract a day.) It will take two or even three cycles for it to reach its maximum effect.
If stress is a major cause of your migraines, the nonsedating tranquilizer kava (250 mg 3 times a day) may be helpful.
If insomnia seems to predispose you to a migraine attack, try the mild sleeping aid melatonin (1-3 mg before bedtime for insomnia). Important:
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions. The Healing Path for Migraines provides more extensive therapeutic information about this condition.
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