If you or someone you know suffers from migraines you’ll know it is a pretty nasty and often debilitating condition, sometimes lasting days or even longer. Believed to be the third most common disease in the world, it affects 3 times more women than men and many women cite hormones as a trigger. In the UK estimates suggest that we lose 25 million days from work or school due to migraine. Absenteeism from work costs £2.25 billion and NHS prescription costs around £250 million per year. It is thought that less than 50% will consult their family doctor and that most self medicate for migraine.
In addition to pain, migraine can include
Tension headaches are considered to be non vascular while migraine is a vascular headache involving excessive dilation of blood vessels in the head. Migraine attacks can often be preceded by visual disturbance, blurring of vision, bright lights , anxiety, disturbed thinking, mood swings, numbness and tingling.
So what causes them?
There is a genetic component here which many of you will identity with and I do see this in my clients. In my own family, it is common down the female line and has been a very debilitating condition for many over the years.
Blood vessel instability
Research supports a link between blood vessel instability and migraine headaches With excessive constriction being followed by rebound dilation. There does seem to be an inherited tendency here as some have an abnormality in their constriction and dilation of blood vessels.
The platelets of some migraine sufferers have been found to be different from normal platelets during and between attacks. Platelets are the cells involved in clotting and migraine sufferers can have an increase in platelet aggregation which means a clumping together. Interestingly it is thought that the amount of serotonin released by patients in response to a serotonin stimulation (eg food allergy/intolerance) can rise leading to a migraine. Another interesting phenomenon related to platelets is that migraine sufferers have been shown to have a twofold increase in mitral valve prolapse, with this leaky valve causing damage to blood platelets. Research has shown 16% migraine patients to have a mitral valve prolapse
Even more interesting to me is that mitral valve prolapse is also three time more prevalent in those who are deficient in magnesium, since I find that many of the sufferers I see in clinic are also magnesium deficient. Indeed, in practice I find that a combination of dealing with food allergies/intolerances and supplementing magnesium to correct deficiency can be the most helpful means to prevention and the above challenges in some part explain some important links here.
Serotonin deficiency Syndrome
Another hypothesis is that migraines are linked to serotonin deficiency state. Research going back to the 1960’s found a serotonin breakdown product in the urine (5-HIAA) during a migraine. New research suggests this is due to increased breakdown of serotonin from increased activity of monoamine oxidase. The link with low serotonin levels has been the basis of many prescription drugs for migraine e.g. sumatriptan a serotonin agonist. Numerous studies have also shown a link between supplementing with 5HTP and prevention. It should be noted that this works best of taken for at least 6 months.
Keeping a migraine diary
It can be very helpful to notice what is happening around the time of migraine attacks to look for repeated patterns. There may be an accumulation of stressors over time which come to a head and that domino effect begins to happen which results in a headache. Susceptibility may be due to reduced tissue serotonin and changes in platelets and a build up of histamine and other inflammatory mediators.
Factors that trigger migraine
What can we do about it?
Firstly find your root cause and eliminate where possible or avoid the build up of triggers. We can Test for food intolerances/allergies, nutrient deficiencies, hormonal imbalances. Modern drug treatment is inadequate because it fails to address root cause. In the 1980’s it became apparent that using analgesics on a regular basis could backfire and actually lead to increased frequency of attacks and many doctors were talking about analgesic rebound headaches. Another interesting point to note here is that regular use of NSAID’s like ibuprofen can suppress ovulation and also cause damage to the gut contributing to intestinal permeability which puts us at risk of food intolerance and poor absorption of nutrients therefore feeding into the problem.
Magnesium is a muscle relaxant and anti-inflammatory. It is therefore commonly used for period pain, joint pain as well as headaches and migraines. Dosing from 400-600mg but take advice from a Nutritional therapist on any dosing. Magnesium is a common deficiency which is well researched in migraine. Also, 50% of Migraine sufferers have been found to have reduced concentrations of iodised magneisum. Levels are depleted by stress, poor diet, excess alcohol, high oestrogen, certain drug meds among others.
Vitamin B2 can help many reduce the number of migraines they have. As a preventative it needs to be taken for more than one month to see an effect and ideally for 3 months. It can also be depleted by the oral contraceptive pill. This study showed a 68% reduction in attacks after 3 months at a 400mg dose
5HTP has been shown in several studies to be effective in prevention of migraine attacks and has been shown to be as effective as pharmaceuticals but without the side effects in prevention of migraine. 5HTP works by regulating serotonin levels. Do not take this if you are taking antidepressants.
Turmeric is well known as an anti-inflammatory and can be incorporated into the diet regularly in both food and as a warm drink. It is useful when having an acute attack and some supplements are combined with ginger which is another anti-inflammatory.
Ginger can rival NSAID’s as an analgesic and can be used regularly in the diet, as a tea or supplement. I normally recommend this combined with turmeric for the best results. For example turmeric active. Studies have shown ginger to be as effective as commonly prescribed sumatriptan for migraine relief
Omega 3 are essential fatty acids found commonly in oily fish. They lower inflammation and can help with hormone balancing. Aim for 3 servings of oily fish per week or supplement. Flax seeds, chia seeds and walnuts also provide omega 3 as do organic grass fed meats and chicken. We can test omega 3 levels for you to help us identify any deficiencies.
CoQ10 used as the active form ubiquinol has been shown in studies to be effective in migraine prophylaxis and has a similar mode of action to riboflavin as it improves energy metabolism and mitochondrial function.
Feverfew is perhaps the most well known herbal preventative for migraine and a number of studies have shown a reduction in frequency and severity including this one published in the lancet
Hydration you probably know about but it’s so easy to forget this one. Remember herb teas also count towards good hydration. How about choosing some turmeric and ginger teas throughout the day and you will tick more than one box!
Essential oils be very helpful especially if you are feeling too nauseas to take annoying else. Peppermint and lavender are good starting points and can be rubbed into the temple with one or two drops or can be diffused.
Acupuncture can be helpful for migraine pain relief and and may have a mechanism involved in normalising serotonin levels.
Massage and Indian head massage are also recommended for regular use to modulate cortisol and reduce muscular tension.
Reflexology is also helpful in modulating cortisol and in hormone balancing
Whatever you decide to try to support your migraines, the key to all things health is prevention and that means finding out your root cause. Otherwise you might just try endless rounds of supplements only to discover that you were shooting at the wrong target. The supplements above will all offer support via different mechanisms of action but if you are still eating your trigger food or you are not answering your body’s need for a regular sleep pattern or reducing screen time etc., then you are just going to go round in circles and get frustrated. In addition, it may be that the dose you are taking is not right for you or maybe you are taking medication that interacts with that particular supplement. It’s never a one size fits all approach and each case is different. There may be multiple factors setting you up for migraine and each one needs to be addressed. Migraine often goes hand in hand with other co-morbidities eg IBS, especially constipation which is often linked to hormonal imbalance. For more information on Nutritional therapy have a look here or arrange a call to discuss your needs. More information on our testing services here.
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