Migraines are recurrent neurovascular (pertaining to the brain’s blood vessels) headaches. They may last from 4 to 72 hours. They may happen only once or twice a year, or as often as daily.
There are two categories: (1) without aura (common migraine), and (2) with aura (preceded by visual or sensory aura).
How Common Is It?
What Causes It?
What Are the Symptoms?
How Is It Diagnosed?
What Should You Do Next?
- Statistics suggest that 18% of women and 6% of men have migraines.
- They are 3 times more common in women than men.
- The highest incidence is between ages 20 and 35.
- They occur in all races, cultures, and geographic locations.
- The exact cause of is not known, but there are several theories.
- They may be due to narrowing (vasoconstriction) of the arteries in the brain followed by widening (vasodilation). There may also be instability of these vessels with the person more susceptible to certain chemical and physical agents.
- Nerve cells in the head release inflammatory substances in response to stressors. These substances lead to dilation of the arteries, spilling of hormone-like chemicals (vasoactive substances-see below), and alterations in permeability of the blood vessels. These changes lead to changes in blood flow to the brain and result in migraine headache.
- Vasoactive substances that may play a role in migraine are serotonin in platelets (and increased platelet aggregation), tyramine, histamine, epinephrine, and norepinephrine.
- Serotonin levels: Migraine headaches seem to be caused in part by changes in the level of a body chemical called serotonin. Serotonin can have an effect on the blood vessels. When serotonin levels are high, blood vessels constrict (shrink and narrow). When serotonin levels fall, the blood vessels dilate (swell). This swelling can cause pain or other problems. Many things can affect the level of serotonin in your body, including your level of blood sugar, certain foods and changes in your estrogen level if you're a woman.
- Low Blood Sugar. Low blood sugar may trigger a headache.
- Hormonal. Estrogen helps to improve the motor tone of blood vessels. Withdrawal of estrogen (before menses) leads to a rebound dilation of arteries.
- Unified hypothesis: Migraine can be described as a three-stage process: initiation, prodrome, and headache.
- Initiation: Although a particular stressor may be associated with the onset of a specific attack, it appears that initiation is dependent on the accumulation over time of several stressors which initiate a cascade of events. These stressors are probably a combination of several of the above mentioned causes. Platelet changes occur which include increased adhesiveness, enhanced tendency to release serotonin, and increased levels of arachidonic acid in the membranes.
- Prodrome: Once the platelet is stimulated to secrete serotonin, platelet aggregation, vasospasm, and inflammatory processes result in decreased blood flow to certain parts of the brain.
- Headache: This is followed by rebound vasodilation and the release of peptide substance P and other mediators of pain.
Symptoms may include:
- Throbbing head pain which worsens with physical movement, usually one-sided
- Sensitivity to light
- Sensitivity to sound
- Sensitivity to smell
- Feeling tired and/or confused
- Congested nose
- Feeling cold or sweaty
- Stiff or tender neck
- Tender scalp
Remissions often occur in pregnancy and menopause.
- Diagnosed by meeting criteria that fit the definition of migraine headaches.
- Diagnostic imaging is not usually necessary in the diagnosis.
- Magnesium levels may be tested.
- Vitamin D levels may be tested.
Conventional treatments are primarily migraine medications such as NSAIDS, beta-blockers, tricyclic antidepressants (amitriptyline), ergotamine derivatives, and SSRIs (sumatriptan).
These treatments should only be undertaken with supervision of a physician who practices nutritional medicine.
Stress reduction and relaxation may help.
The following foods may trigger migraines:
- Food allergies/sensitivities. Common triggers are: cow’s milk, pork and other meats, wheat, nuts, citrus, eggs, pizza, hot dogs (nitrates), chocolate, coffee and tea, corn, yogurt, yeast, mushrooms.
- Tyramine containing foods (vasoactive amines): red wine, beer, chocolate, yogurt, processed meats, sausages, chicken livers, avocado, aged cheese, citrus, potato, pickled herring, pineapple, red plum, tomato, yeast extracts, spinach, eggplant, raspberry, canned fish
- Food Additives: MSG (Monosodium glutamate), meat tenderizer, soy sauce, dyes, aspartame, sodium nitrate, yellow dye #5 (tartrazine)
- Riboflavin. Several studies have shown high dose riboflavin to be helpful in prevention of migraines and leads to significant reduction in headache frequency, use of medications, and duration of headache.. Riboflavin.
- 5-HTP. Serotonin is made in the body from 5-HTP. Studies have shown a significant reduction in the frequency of attacks with supplementation of 5-HTP.
- Essential fatty acids. Supplementation raises levels of antiinflammatory hormones called prostaglandins and decreases platelet stickiness..
- Melatonin. Reaseach has shown melatonin abnormalities in people with migraines. Supplementations helps prevent headaches.
- Magnesium. Two of magnesium’s key functions are to maintain the tone of the blood vessels and to prevent overexcitability of nerve cells, both of which play a role in migraine headaches. Low brain and tissue magnesium concentrations have been found in patients with migraines, indicating a need for supplementation. IV magnesium in the form of Myer's cocktail is an effective treatment for migraine headaches.
- Vitamin B6. Vitamin B6 works with enzymes that break down histamine, improves tolerance of histamine, and decresease the number of histamine-caused headaches. Vitamin B6 has been shown to increase the intracellular accumulation of magnesium. Vitamin B6 is also helpful with hormonal headaches--those that come on with the menstrual cycle.
- Calcium is involved with Magnesium in maintaining the tone of the blood vessels.
- Vitamin D in high doses have been useful in treating several cases of migraines.
Botanical (Herbal) Medicine
Several herbs are helpful in the treatment and prevention of this type of headache:
- Feverfew reduces the number and severity of headaches.
- Ginkgo and Ginger inhibit the inflammatory substances that trigger migraines.
- Petasites decreased the frequency of migraine headaches.
Homeopathy targeted to the individual can be essential in the treatment of migraines.
The doctors at The Connecticut Center for Health are quite experienced in how to treat migraine headaches.
If you would like to learn more about natural medicine approaches to migraine headache, contact one of our clinics for a free consultation or an appointment.