Migraine Headaches

information on nutrients, diet, lifestyle & research on treatment

Self Help   Symptoms   Causes   Natural treatment

Migraine headache symptoms can be extremely debilitating. There are a number of treatment modalities such as acupuncture and massage, along with targeted nutrients that can help prevent and/or reduce the intensity of migraine headaches.

Women experience migraines more often then men (17% to 6%). Migraine headaches still remain largely under-diagnosed and under-treated. Less than half of individuals suffering from migraine headaches are diagnosed by their doctors.

A migraine headache is a type of headache brought on by dilation (vasodilation) of the blood vessels in the brain. When the body is under chronic stress the autonomic nervous system constricts blood vessels, including those in the brain. Because the body's intelligence knows that blood flow to the brain is essential, it releases biochemicals at enlarge the brain's blood vessels. Nerve fibers around the blood vessels stretch causing inflammation and pain. The response to this further stress is additional dilation and more pain --- a migraine headache.

Symptoms

Early symptoms may include the "seeing" of auras, flashes of lights or vague shapes. (Also see ocular migraines.) Some lose vision temporarily to one side. Other early symptoms can include: dizziness, tingling or numbness in the fingertips or weakness to one side.

Full onset of symptoms include severe head pain, sometimes accompanied by nausea leading to vomiting and/or acute sensitivity to noise and light.

Symptoms can last anywhere from a few minutes or hours to days.

Causes

Migraine headaches are caused by enlargement of blood vessels and the subsequent release of specific chemicals from nerve fibers around the blood vessels causing inflammation, pain, and further enlargement of the artery. The increasing enlargement of the arteries magnifies the pain.

Though the specific causes are not directly known, the following are triggers for many sufferers: stress, specific odors, fluorescent lights, teeth clenching, sleep deprivation, low blood sugar levels, hormonal changes, caffeine, and specific foods including chocolate, aged cheeses, tyramine (found in wine, beer, sauerkraut and dry sausages), foods containing nitrites, monosodium glutamate and/or aspartame.

Some research also indicates that there is a connection between dry eye syndrome and migraines; that dry eye suffers who have migraines tend to have more severe and longer lasting migraines, or that dry eyes may trigger migraines.

Researchers have found that the thickness of the choroid, the layer of the retina containing blood vessels, was thinner during periods in which they were not suffering from migraine.² Similarly, in a pilot study, other researchers have found that the layer of the retina containing nerve fibers was thinner during migraine episodes.³

In one case study a woman presenting for migraine headache was found to actually have central retinal vein occlusion, even though her retinal exam at first appeared to be normal.

Magnesium deficiency Scientists have suggested a tie between magnesium deficiency and migraine but it is difficult to assess ionized magnesium levels which are the key indicator. A pilot study of 40 migraine patients found that half of them had low ionized magnesium levels while total magnesium levels were normal.⁶

Conventional Treatment

Abortive - to stop the migraine headache at the beginning of symptoms. Abortive drugs include the triptans, which specifically target serotonin. These drugs include: almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan and zolmitriptan.

Also used for treatment are acetaminophen, dihydroergotamine, ergotamine tartrate and over-the-counter medications such as ibuprofen, aspirin, acetaminophen and caffeine.

Some drugs are mainly used for nausea related to migraine headaches in addition to pain treatment such as metoclopramide and prochlorperazine.

However the NSAIDS and some of the other drugs cause photo-sensitivity, making the eyes more vulnerable to damaging UV and blue light and at greater risk for development of macular degeneration, cataracts, etc.

Natural Treatment

Nutraceuticals

A combination of ginger and the feverfew flower can reduce or even eliminate migraine pain - twice as effectively as ibuprofen, according to a 2011 study. Ginger reduces inflammation which contributes to migraine pain, and feverfew apparently has the effect of blocking responses in the brain that trigger migraines. The combination can be found as an elixir (which may be more effective) or tea. In the 2011 study, 60 patients treated 208 migraine episodes using either ginger/feverfew under the tongue or placebo. These were patients who had a history of migraine with more than 15 headaches per month and were capable of distinguishing a migraine headache from a normal headache. On average 32% of the patients were pain free after 2 hours with prescription medications, and 16% were pain free after 2 hours with placebo while 63% of the patients taking feverfew/ginger were pain free after two hours.¹ The only adverse side effect of feverfew/ginger were numbness in the mouth or nausea.

Researchers and reviewers of current research note that a number of nutraceuticals may be effective. One reviewer indicates A (high evidence) for butterbur (petasites, which also have potential liver toxicity issues); B (moderate evidence) for use of feverfew, magnesium and vitamin B2; level C (low) for CoQ10; and level D (very low) for melatonin. ⁵

Poor functioning of the mitochondria (energy system of cells) has been tied to migraine and is the reason that riboflavin, CoQ10 and alpha lipoic acid are considered in treatment.⁶

Magnesium Several studies have shown oral magnesium to be somewhat effective with 41.6% fewer migraine attacks. Use of intravenous magnesium showed mixed results.⁶

Vitamin B2 (riboflavin) plays an important role in cellular energy levels and has been found to be effective, especially when combined with beta-blockers. Riboflavin may also be more effective in European populations.^{6, 7}

CoQ10 is also involved in effective mitochondria functioning and because it is an antioxidant, may be helpful in migraine prevention. Several small studies have showed some promise, finding as much as a 50% reduction in migraine days as well as reductions in severity, frequency and duration of migraine incidents.⁶ Note: UBQH is a more readily absorbable form of CoQ10.

Alpha Lipoic Acid treatment did not conclusively demonstrate effectiveness, yet there was a trend toward reduction of migraine frequency, severity and duration.⁶

Butterbur has been used traditionally for pain, fever, spasms, and wound healing. Butterber also contains components that are harmful to the liver, but they are removed in the manufacturing process for commercially available sources of butterbur. Several studies have found significant reductions (58%) in migraine days as well as severity and duration of attacks.⁶

Feverfew is another traditional herb used for headaches and other conditions. Research has resulted in inconsistent conclusions probably due to variations in the type of preparation and strength of feverfew. Feverfew should not be used by pregnant women.⁶

Behavioral Therapy

Tepper indicates that behavioral therapy - referring to lifestyle, exercise, diet, etc as an effective preventative for migraine warrants level A (high) rating.⁵

One of the behavioral therapies that has been found effective is biofeedback, where a meta-analysis (a study of many studies) of 55 studies found biofeedback to be quite effective. Other therapies include relaxation training and cognitive behavioral therapy which looks at the relationship between stress, the ability to cope with stress and headaches.⁶

Ayurvedic Approach

Ayurvedic wisdom says that migraine headaches are usually caused by an abundance of pitta, or heat / fire. That being the case, you are more likely to have migraines when pitta is aggravated. Pitta is aggravated by fatigue, spicy foods, cheese, caffeine, tomato (especially sauce), onion and garlic. Pitta is greatest in the middle of the day and during hot summer months. Pitta is aggravated by the glare of the sun. The approaches above in the sidebar all will pacify pitta - stay rested, don't spend long hours in front of the computer, eat simple healthy foods, stay cool and refreshed, wear sunglasses and avoid pitta aggravating foods.

Physical Treatments

Acupuncture - The World Health Organization reports that acupuncture can be used to successfully treat migraine headache. Researchers comparing 'sham' and 'true' acupuncture find that while both may bring short term relief, only the true acupuncture has results that endure.⁸ In one case study a patient with a 10 year history of was treated with acupuncture, Chinese herbal medicine enemas and dietary changes for two months and experienced no migraines during that period.⁴ Other research substantiates this finding.⁶

Oxygen therapy is another potential treatment for cluster headaches, although additional research is needed to determine the safety of the treatment.⁶

Massage therapy and acupressure can be very helpful for immediate relief and relaxation. See the specifics in the sidebar.

Migraine News

Want to learn more? See our blog news on migraines.

Research

See footnotes and research on vitamins and supplements for migraines.

1. R. K. Cady, et al, A double-blind placebo-controlled pilot study of sublingual feverfew and ginger (LipiGesic™ M) in the treatment of migraine, Headache, July-Aug 51(7), 1078-86, 2011.
2. E.E. Karaca, et al, Choroidal thickness measurements in migraine patients during attack-free period, Neurological Science, August, 2015.
3. Y. F. Feng, et al, Retinal Nerve Fiber Layer Thickness Changes in Migraine: A Meta-Analysis of Case-Control Studies, Current Eye Research, August, 2015.
4. M.J. Payant, A single case study: treating migraine headache with acupuncture, chinese herbs, and diet, Global Advances in Health Medicine, January, 2014.
5. S. J. Tepper, Nutraceutical and Other Modalities for the Treatment of Headache, Continuum, August, 2015.
6. C. Sun-Edelstein, et al, Alternative Headache Treatments: Nutraceuticals, Behavioral and Physical Treatments, Headache Currents, March, 2011
7. J. Schoenen, et al, Effectiveness of high-dose riboflavin in migraine prophylaxis, Neurology, Vol. 50, 1998.
8. Y. Li, H. Zheng, et al, Acupuncture for migraine prophylaxis: a randomized controlled trial, Canadian Medical Association Journal, March, 2012.

Related Conditions

• Dry eyes
• Ocular migraines
• Asthenopia
• Computer eye strain
• Allergies and sensitivities