Got migraines? Here's some help.

3/24/2014

It might start with just feeling 'off'. Then the vision starts to go. Then the blinky lights set in. Then it's a frantic search for the meds of any type to try and get it before the pain starts. Sound familiar?

I'm down to maaaaybe one migraine per year (the last one was post-superbowl weekend if that's any idea). I used up all my sick days in a month at my previous-life cubicle job so this is a massive improvement, obviously. At the time, the neurologist just said it was genetic. Okee doke. This is actually how I found naturopathic medicine.

Diet, hormones, stress, genetics - all of these can cause an attack at any time. The good news is that there's a pretty good list of where to start and it's usually quite easy to determine where the culprit is based on a thorough history and seeing what else, beyond your migraines, is going on.

1. Check your food sensitivities. This goes beyond red wine and strong cheese (thankfully... not sure I could imagine a life without those). There's a simple finger-prick blood test to find food antibodies in the blood. Cut these foods out and there's likely to be a huge improvement. This is especially great if there's digestive symptoms such as IBS. Also, lots of studies link artificial sweeteners such as aspartame and now possibly sucralose to migraines. It's not a far leap to try cutting out other food additives (i.e. packaged foods) to see if you get some relief. Definitely no harm done there.

2. How's your blood sugar? Does the Incredible Hulk come out if you go to long without eating? Hint: ask your loved ones about that question. Fluctuations in blood sugar and subsequent insulin reactions can also be the cause. Generally there's also other symptoms of poor blood sugar regulation present such as fatigue, yeast infections, ovarian cysts, skin tags, or a family history of diabetes. You may be chronically stressed where elevated cortisol (our stress hormone) is causing these fluctuations.

3. Have your full menstrual cycle evaluated. From Day 1-Day__. Particularly if you're prone to migraines before your period, chances are there's other symptoms of PMS and heavier or more painful periods. Determining if it's estrogen, progesterone, or testosterone can help target where hormone regulation needs to happen. No matter which hormone's involved, supporting the liver and digestion is a must to help clear out the hormonal metabolites and remove them from the body.

4. Stress management. It's not what happens or how big or small the stress is, it's what we do with it that matters. Find a healthy outlet: exercise, talk, walk, knit, write, rock, pet a dog, etc. Cortisol influences just about every other hormone in our body, and not in a pleasant way, when it's chronically elevated. Acupuncture can help decrease cortisol as can many herbs. Magnesium is also great here as it's relaxing for muscles especially if you have charlie horses, cramps, or twitches, but it also stabilizes blood vessel spasms which can trigger migraines.

It might not be just one of these factors that are affecting you; it might be a combination of them. It might be genetics but there are common genetic mutations that are implicated in migraines, particularly surrounding vitamin B12 activation and metabolism. In my practice, the majority of migraines, if not all, have been helped by assessing each one of these factors and treating there.

Just because we all have migraines, doesn't mean they're the same migraine and that one study can apply to everyone. Gosh, this philosophy is how I fell in love with naturopathic medicine in the first place. Aw.

References:
Aydinlar EI, et al. IgG-based elimination diet in migraine plus irritable bowel syndrome. Headache. 2013 Mar;53(3):514-25.

Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med. 2012 Jul;34(3):255-62.

Finocchi C1, Sivori G. Food as trigger and aggravating factor of migraine. Neurol Sci. 2012 May;33 Suppl 1:S77-80.

Kokavec A, Crebbin SJ. Sugar alters the level of serum insulin and plasma glucose and the serum cortisol:DHEAS ratio in female migraine sufferers. Appetite. 2010 Dec;55(3):582-8.

Krejza J, Rudzinski W, Arkuszewski M, Onuoha O, Melhem ER. Cerebrovascular reactivity across the menstrual cycle in young healthy women. Neuroradiol J. 2013 Aug;26(4):413-9.

Lea R, Colson N, Quinlan S, Macmillan J, Griffiths L. The effects of vitamin supplementation and MTHFR (C677T) genotype on homocysteine-lowering and migraine disability. Pharmacogenet Genomics. 2009 Jun;19(6):422-8.

Li QQ, et al. Acupuncture effect and central autonomic regulation. Evid Based Complement Alternat Med;2013:267959. Mathew PG, Dun EC, Luo JJ. A cyclic pain: the pathophysiology and treatment of menstrual migraine. Obstet Gynecol Surv. 2013 Feb;68(2):130-40.

Panossian A, Wikman G, Sarris J. Rosenroot (Rhodiola rosea): traditional use, chemical composition, pharmacology and clinical efficacy. Phytomedicine. 2010 Jun;17(7):481-93.

2 Comments

Sweetener Council link

11/26/2014 12:06:14 pm

Although a lot of misunderstanding surrounds the ingredient, aspartame is among the most extensively studied and reviewed ingredient and has been deemed safe and approved of by all regulatory agencies around the globe, including the European Food Safety Authority, Health Canada, and the FDA. Most recently, the European Food Safety Authority conducted a large-scale risk assessment on the ingredient and, once again, determined that aspartame is safe for consumption by the general population and does not cause cancer, or other conditions that have been alleged. Given the vast body of evidence, more than all major regulatory agencies approve low-calorie sweeteners, and leading health organizations from the American Diabetes Association to the Academy of Nutrition and Dietetics condone their use too.
Therefore, consumers should have every confidence in enjoying products that contain low- and no-calories sweeteners, which can also be an effective calorie-cutting tool.

Lindsay Self, ND

11/27/2014 11:51:02 am

Thanks for your comment! I completely recognize that aspartame has been extensively studied and has been deemed 'safe for consumption'. This doesn't mean that there is a subset of migraine sufferers for whom this is a common trigger (myself included) and research has been documented on this connection. I've had a number of my patients who also find this common and have found benefit by simply avoiding it. While it's not true for all migraine sufferers, if someone can make the simple change to produce a big difference in their health and quality of life, that's wonderful! Similar to how peanuts and white sugar are also safe for consumption, there are many who have a large reaction to them. Every body is different, and that needs to be respected.

With regards to weight loss, there is some emerging research surrounding some artificial sweeteners skewing insulin responses and gut flora, making it difficult for some (again, not all). This is still new information though. While this is another topic altogether, we definitely know that weight loss isn't always as simple the old calories-in-calories-out approach, though I wish it was!

Got migraines? Here's some help.

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