MIGRAINE HEADACHES
Migraine headaches are the most common type of vascular headache. The exact mechanism of how they occur is unknown. The brain neurotransmitter serotonin is low in most people with migraines. A classic migraine is one-sided and usually preceded by an “aura” of visual disturbances such as bright spots, zigzag lines, or blind spots. The headache that follows the aura is typically throbbing and severe and can cause nausea and vomiting.
Age on onset is usually before age 35. Women suffer from
migraines more often than men. As people age, the frequency
of migraines diminishes and often disappears. A genetic
predisposition towards migraines is known and up to one
half of people with migraines have a family history of migraines.
Factors known to trigger a migraine headache include smoking,
inadequate sleep, exhaustion, food sensitivities, tyramine
containing foods, caffeine withdrawal, food additives, medications,
magnesium deficiency, eyestrain and sun glare, stress, premenstrual
tension, anxiety, depression and chronic candidiasis (yeast
infection).
Conventional treatment includes medication from a number of classes. Narcotics, beta-blockers, antidepressants, vasoconstrictors and 5-HT agonists are all useful in relieving or preventing migraine pain. Drugs taken to prevent attacks must be taken regularly to work. Medication side effects are common. The ergotamines (which constrict blood vessels) can have serious side effects, including strokes.
Holistic treatments are often effective in reducing migraine frequency but they should be customized to each individual. Nutritional approaches include decreasing animal fats and eating a whole food diet high in anti-oxidants. Omega-3 oils and gamma linolenic acid (GLA) oil can reduce migraine frequency. Supplements of beta-carotene, Vitamins E and C, riboflavin, folic acid, magnesium and 5-hydroxytryptophan all have research evidence of effectiveness.
Food elimination diets have been shown to help the majority of migraine sufferers. The most common offending foods, in order of frequency, are cow’s milk, wheat, rye, corn, orange, eggs, tomato, beef, pork, yeast, shellfish, coffee, tea and chocolate.
For herbal therapy, the best evidence to date for prevention is taking feverfew daily. Dried ginger has been found to help also.
Homeopathy may be beneficial but a trained practitioner should be consulted in order to match the remedy to your specific symptoms. Use of homeopathy is very safe.
Chiropractic therapy can be very useful for some people.
This is especially so for people with chronic neck pain
due to vertebral misalignment and tightened muscles. Acupuncture
has a good track record in skilled hands. Self-use of head
and neck acupressure points may benefit some people.
Regular physical exercise releases tension and lowers the
frequency and intensity of migraines. Low-impact aerobic
exercise works well.
TENS (transcutaneous electrical nerve stimulation) has been used successfully. Biofeedback, relaxation exercises, and meditation all reduce the frequency of migraines by reducing the tension in our bodies. Hypnosis may be effective as well, especially for children.
Perceived stress is a big component to many sufferers of migraines. Cognitive therapy explores the attitudes, conditioned responses, emotional states and beliefs of people with migraines. When people learn to release their expectations of how life “should” be and accept it how it is, they often have reduced migraine attacks.
A conventional neurologist (physician specializing in nervous system disorders) will focus on ruling out other serious diseases with a detailed physical exam and a brain scan (CT or MRI). The treatment will then be primarily use of medications. Most people with migraine headaches can decrease the frequency and severity of their headaches by a careful examination of their lifestyle and making changes in the factors known to be involved in triggering the headaches. For those willing to accept the responsibility to do this, the rewards are great. Consulting a knowledgeable holistic health practitioner can be of great assistance in this process.
Daniel Blodgett MD