Archive for Migraine
My near-mantra is that migraines are not a problem in the head. Rather, these headaches are a sign that something is wrong with your overall health. The evidence supporting this position is plentiful and some of this research can be found in a recent blog post that refers to migraines as a “progressive brain disorder.”
While migraines can begin at any age, it is not unusual to have them start as a toddler. I recently had a patient whose migraines began as early as 2 years of age. As a parent, I can think of few things more achingly painful than watching your innocent child suffer the debilitating pain of a migraine while all you can do is watch helplessly. No wonder some parents who seek help from pediatric neurologists resort to neurotransmitter-altering medications given at a time when the brain is undergoing some of the most dramatic changes of his or her lifespan.
But what if there is another answer? What if there was an early warning sign that something was wrong with your little one’s system?
What if you could change it THEN, possibly derailing the chance that your small child will suffer with migraines?
As you can guess, I wouldn’t bring this up unless there was an answer.
This particular study looks at the relationship between an infant who experienced infantile colic and his or her later risk of developing chronic migraine headaches. Here’s what they found:
- Children with migraine were 661% more likely to have had infantile colic.
- If the child had migraine without aura the risk was still massive at 701%.
- Migraine with aura 573% .
- However, this association was not present with tension-type headaches.
In other words, somewhere there is an incredibly strong connection between infantile colic and migraines. There are several mechanisms that might explain the association.
One possible explanation is that the gut produces a very high level of neurotransmitters, which is why the gut is frequently referred to as the “second brain.” An alteration in the production of these neurotransmitters in the gut could clearly affect brain function.
As an example, 2/3 of the body’s serotonin comes from the gut. When the gut is inflamed, it will produce even more serotonin. This could result in the infant’s brain being bathed in an unnaturally high level of serotonin, resulting in a lifetime of a sort of serotonin deficency. Serotonin clearly has an influence on the brain and some migraine medications (like amytriptaline) are used to treat migraines.
The other explanation can start with a personal story. When my little Keegan was an infant, he experienced colic. As any parent can tell you, colic can be heartbreaking and frustrating, especially in the middle of the night when the parent is going on virtually no sleep.
While most cases of colic are said to last about 3 months, Keegan’s was handled in about 4 weeks through a combination of probiotics, a visit to a pediatric chiropractor and cutting dairy out of mom’s diet while she continued to nurse.
There is absolutely NO doubt that food allergies can contribute to chronic migraine headaches. The changes made for Keegan were designed to shift his immune system back into balance (probiotics for Th1 stimulation, allergen avoidance to tone down Th2 pathways). An altered immune system can produce inflammation that is bad for the brain and bad for the blood vessels leading to the brain.
This study can give us further insight into what might cause migraines later in life. It may be that, in those who suffer from chronic migraine headaches AND had infantile colic, the identification and avoidance of food allergies and calming any inflammation in the gut may be a critical piece to the puzzle of solving migraine headaches for you or someone you care about.
Sounds like a scary title, huh? Good, because if you suffer from migraines, you NEED to understand how serious this truly is.
And it is not about controlling the headache. Although this may be the immediate need, this limited approach does nothing for protecting your brain. And make no mistake–migraine sufferers have a greatly increased risk for things like heart disease, stroke and dementia. Masking the headache with medication does not change your increased risk–it’s still going to happen unless you do something about it.
The current research on migraines follow two related pathways: mitochondrial dysfunction and vascular dysfunction. Both share aspects in common, but the best thing is that lifestyle changes to improve one also effects the other. Here’s the basics.
The mitochondrial dysfunction model begins with, shockingly, the mitochondria. Think way back to your high school biology class and the anatomy of a cell when you first learned about the mitochondria. The little “powerhouse of the cell.” That little organelle within the cell that helps to generate energy for a cell. And the “energy currency” for every cell is adenosine triphosphate, or ATP. There are some billion or so reactions that occur in our body EVERY SECOND, and each one of these requires a molecule of ATP to get the job done. Some tissues, like fat, use very little energy. Others, like the heart, our muscles and our brain, use much more. At rest, the nervous system, which includes our brain, is the greatest utilizer of ATP in the body. Once we start moving, the muscles take over and have the greatest need.
Imagine that. As you sit here reading this, your brain is requiring mass amounts of energy just to process the information. So what does this mean? It means that each cell of the nervous system requires thousands of mitochondria just to generate the energy needed for a brain cell just to perform its basic functions. And each of these mitochondria are little factories churning out ATP for the brain cell to use at an enormous rate. Evidence has been present for several decades that the protection and nutritional support of the mitochondria needs to be an integral part of avoiding, reducing the severity of and reducing the long-term ramifications of migraines and seizures.
With this model, anything that harms the mitochondria and interferes with a brain cell’s ability to make energy will contribute to chronic migraine headaches. Anything that helps the mitochondria can provide chronic migraine relief.
In the vascular dysfunction model, problems with the blood vessels, especially the very tiny blood vessels that feed the tissues of the brain, lead to the headaches. Imagine the flow through a blood vessel becoming rapidly choked off or the flow at least becoming more turbulent and restricted. The brain cells that depend on this blood flow are going to get pretty pissed off when it is cut off. With this model, an anti-cardiovascular disease lifestyle is the best option. Ironically, this lifestyle will also improve mitochondrial dysfunction.
With either model, typical medications used to treat migraine headaches do not fix anything. And yet most of the migraine-oriented websites and online communities are still funded by drug companies and never promote real discussions about underlying pathology or how to improve brain function. Without this open conversation about these two models of migraine headaches, migraine sufferers will continue to be at long term risk of cognitive decline, stroke and heart disease. This particular article delves into the concept that chronic migraine headaches are a progressive brain disorder and should be addressed as such.
We need to wake up and start to realize that migraines CAN be improved or cured with the right lifestyle changes.
For those of you not familiar with the jargon, a refractory seizure is one that does not respond to medication.
Unfortunately, this is not a tiny fraction of epileptics. Rather, upwards of 1/3 of epileptics have seizures that do not respond to any medication that is used. The options that mainstream medicine have at this point are not pleasant. Vagal nerve stimulators embedded in your neck. Surgery to remove a part of your brain. Or, just deal with it.
The impact on the lives of these patients is severe. Restricted driving, inability to work and social isolation can be the result.
However, I have long felt that mainstream medicine’s approach to seizures is an inherently faulty one. In almost all cases, the initial, and sometimes only, goal is to use medication to control the seizure. If this doesn’t work, a different medication is used or they are used in combination. Statistically, if the first doesn’t work at controlling your seizures, the likelihood of being able to control your seizures with medication just goes down from there.
But there is rarely the thought to heal the brain and restore the way it is supposed to function. The medications do not do this (in some cases it is actually worsening brain cell function), rather, they are designed to keep one sick brain cell from communicating with its neighbor. Ramp up the suppression strong enough and hopefully you can stop the seizures. But you haven’t fixed the sick neuron that started the mess in the first place.
Which brings us to this particular article.
My book, Migraines and Epilepsy, How to Find Relief, Live Well and Protect Your Brian, has a strong focus on the mitochondrial aspect of both migraines and epilepsy. In a nutshell, when your brain cells cannot produce the energy they need to function optimally, things break down. Chronic migraine headaches and seizures can result. While it’s not that simple, this is the basic concept.
When you understand the mitochondria and the role it plays, you can better understand the factors that contribute to migraines and seizures as well as the natural remedies for seizures and migraines that improve brain cell function.
As mentioned by the author, treatments geared towards improving energy needs of the brain cells are “untapped.” This is probably an understatement, but you begin to see the point.
Overall, by NOT looking at natural remedies for seizures and migraines, researchers have might have missed out on therapies that are more effective and far safer than current medications. The difference is that this type of an approach to treatment works on healing the brain at it’s most fundamental level–the energy needs of the cell.
Only the most learned will view migraine headaches and seizures through the same lens, despite some very apparent similarities in the underlying causes.
One of the learned would of course be me. I can say this because I’ve written a book on the integrative management of migraines and epilepsy (which is, unfortunately not the name of the book–my select members of a focus group nixed this title pretty quickly, leaving me with less dramatic: Migraines and Epilepsy; How to find relief, Live well and Heal your brain).
As this particular article points out, the mechanisms leading to chronic migraine headaches and epileptic seizures overlap. These include (but are not limited to):
- Neurotransmitter problems (GABA, glutamate)
- Ion channel dysfunctions (such as sodium and potassium pumps)
- Photosensitivity plays a role in the connection
- Medications used to treat seizures are now well accepted for migraine treatment as well
The nice thing about this relationship is that natural approaches that have been shown to be effective for one can be tried in the other without waiting years for clinical studies to be done to demonstrate efficacy. You can almost consider it double the research.
As an example, let’s look at the ketogenic diet. This has been shown to be a very powerful tool in the management of refractory seizures (as to why we wait to use a dietary approach last, I haven’t yet figured that one out…) across many studies. The use of the ketogenic diet in migraines, however, is not as well studied, and yet it’s use certainly seems to make sense.
Another very compelling argument is the contribution of gluten sensitivity to both migraines and seizures. Several studies have found strong links in migraine sufferers and epileptics and the presence of gluten sensitivity. This data is solid enough to recommend a trial of gluten free living to see if it has an impact on your condition.
The benefit of supplementation like CoQ10, magnesium and vitamin D are established in both conditions as well.
The bottom line is that, luckily for chronic migraine headache sufferers and epileptics, the research community seems to be coming together around the linkage between these two conditions, albeit slowly. Personally, I think this bodes well for the future of these conditions and medicine’s ability to manage, improve or even eliminate them.
You suffer from headaches and have been searching for some type of chronic migraine relief; so your PCP should send you to a neurologist, right?
It sounds like a great place to start. After all, your headache is in your head and deals with your nervous system, right? If you’ve been reading the Rantings for any time now, you understand how flawed this method of thinking is. Migraines may be felt in the head, but they are really a problem with your entire body. Something is wrong, and your body is screaming at you to fix it in the loudest way possible.
If this is the case, it certainly makes medicating a headache without finding the root cause shortsighted, if not downright dangerous. Dangerous because, in those who experience migraines (particularly with aura and in women), there is an increased risk for things like stroke and heart disease. Merely treating the headache with medications does not lower this increased risk.
So what does all this have to do with this particular study?
There is a well established relationship between food allergies and neurological problems, most notably wheat allergies to gluten. The list is quite long, but does include seizures, which I have written in a previous blog article that can be read by clicking here.
Given that I’ve written a book on the relationship between migraines and seizures, it should come as no big shocker to you that, if gluten is related to seizures, it just might be related to chronic migraines headaches as well.
Researchers looked at patients with gluten sensitivity and inflammatory bowel disease to see how many of them experienced headaches. Here’s what they found:
- Celiac disease led to a 379% higher risk of experiencing headaches.
- Gluten sensitivity led to a whopping 953% increased risk of migraine headaches (Tweet this).
- For inflammatory bowel disease, there was an increased risk of 266%.
- 72% of celiac disease subjects graded their migraine as severe.
- 30% of IBD graded their migraines as severe.
- 60% of GS rated his or her headache as severe.
These are some very strong associations. Strong enough so that any physician treating a patient with migraines should be asking about diet and, more specifically, gluten intake. If they do not, and the first recommendations are medications, it’s probably time to run the other way. It would be a strong indication that the physician does not stay current with medical literature. This is not someone I would want taking care of my brain.
If you suffer from migraines, have you tried a gluten free diet? If so, did it seem to help?
Closure of patent foramen ovale reduces the frequency of migraine attacks
I’m finding this article very interesting. Fixing a patent foramen ovale (this is an opening from right to left ventricle that bypasses the lungs in the fetus who does not use the lungs, this should shut at birth) cuts migraine frequency in these patients by HALF. This really opens up a can of worms here. I’ve always had a problem with mainstream medicine’s approach to headaches in general. There is almost always an underlying physiological or anatomical imbalance that creates headaches. This needs to be found and fixed NOT COVERED UP WITH PAIN MEDS!!!! I cannot tell you how many times patients come into my office after years of unsuccessful treatment of headaches from the medical community and they are gone in 2-3 weeks.
This article would suggest that some degree of oxygen deprivation (patent foramen ovale leads to some blood skipping the lungs) was a major contributor to these patient’s migraines. Might some degree of this be present in patients without PDA? Maybe approaches designed to improve oxygenation, oxygen delivery and facilitate efficient use of the oxygen that is there might show strong benefits in migraine patients.
Neurology — Abstracts: Schwerzmann et al. 62 (8): 1399
I have stated for years that the causes of chronic migraine headaches and epilepsy are the same. While not generally accepted, it is consistent with current research.
The finding of a genetic link between migraines and epilepsy have been all over the news since this article hit the mainstream media earlier this month. I have had a standing Google alert for “migraines and epilepsy” for quite some time now. Nothing was on the radar screen on the Internet until this study hit.
For those of you who know, I have a particularly strong interest in migraines and epilepsy and have spent the past 6-7 years working on my book, “Migraines and Eplepsy: You Are Not Alone.” During the writing of this book, it has been very common for me to be asked about the combination of the two conditions, because they are not generally thought of in the same sentence. This includes most specialists dealing with epilepsy and with migraines.
However, the underlying problem with both of these conditions are very, very similiar and this particular study lends weight to this concept.
Basically, researchers looked for families that had several epileptics in the family so they could basically single out a family with a strong genetic predisposition to seizures. Seizures don’t always run strongly in families, so this was the researchers way to kind of “narrow the pool” so to speak. They then looked at the presence of migraine with aura within these families and found a definite link between the two (Tweet this).
So what does this really mean? When I think genetics traits, I think of enzymes, because genetic uniquenesses that change the speed of how an enzyme runs is the most common difference or commonality in conditions that run in families (this is called a single nucleotide polymorphism, or SNP for short). With a genetic link between migraines and epilepsy, I can clearly envision an enzyme that affects how our cells generate energy (the technical term would be SNPs present that affect the mitochondrial energetic pathway).
If several family members have problems generating energy for the brain cells, this can result in different outcomes along the same path. In one family member it produces a seizure disorder. In another family member a migraine with aura.
My hope for this study is that we don’t view these as “comorbidites,” meaning that these two conditions just happen to coexist but don’t have much relationship to each other (like high triglyerides and high blood pressure). Rather, we need to view these two conditions as having the same basic problem, but with a different outcome depending upon the individual.
As an example, (and a bad one, but it’s close to bedtime as I write this) consider stress. People under extreme levels of stress may experience different outcomes. Stroke in one, heart attack in another. And cancer in a third. All stemming from the same problem, but leading to different outcomes dependent upon uniquenesses present within the individual’s makeup.
Overall, this post was designed less to educate and more to inform. If you are a migraine headache sufferer or someone who experiences seizures, pay attention to things that you may learn that help the other condition–it may benefit you as well.
Some of the meds used for chronic migraine relief can have a long list of side effects. Because of this, patients look for natural remedies for migraines.
One of the more popular migraine support group type websites promotes the idea that migraines are genetically based and there is really nothing that can be done to “cure” migraines. The best we can do is hope to manage them successfully with medications and, to a lessor extent, dietary choices.
I personally think this is one of the most damaging thought processes to promote when it comes to pretty much anything in healthcare. This attitude removes personal responsibility for recovery and a solution. Some feel safer here, but will never achieve ideal health. Only until a sick patient adopts the belief that healing comes from within will they truly get better. Anything else is “management.”
So why they rant on locus of control? This particular study demonstrates how much power lifestyle can have on the experience of the patient who experiences chronic migraines.
Researchers looked at migraine sufferers who also experienced irritable bowel syndrome and checked them for 270 food allergies, including some of the most common food allergies, via IgG4 testing in the blood. Before we go into the results of this study we need to cover a very important aspect of this study.
To the uninformed, the presence of irritable bowel syndrome and chronic migraine headaches would be considered “comorbidities.” This means that they are occurring together in the same patient but are generally viewed as separate diseases that need to be managed separately (typically using two different sets of medications). An example would be high blood pressure and diabetes. These are absolutely, positively being caused by the same mechanism in the body (related to insulin affecting AMDA levels and driving up blood pressure) and can both be addressed by fixing the problem. But mainstream medicine does not share this viewpoint; rather, they medicate each separately, warning doctors to look for high blood pressure in diabetics and treat (i.e. “medicate”) if found.
In this particular situation, irritable bowel syndrome and chronic migraine headaches are not comorbidities. Rather, it is easy to see that something is wrong with the gut, thereby producing the irritable bowel syndrome. When the gut becomes inflamed there are direct connections between the nervous system of the gut and the cells in the brain. If the irritating factor to the gut is a food, then essentially this food can be a factor in the migraine.
Not two ships passing in the night, but rather one problem leading to another. Don’t think that identifying and avoiding some of the most common food allergies could play a role in chronic migraine relief? Then you need to look at the results of this study I mentioned earlier:
- The average number of reactions was 23
- An elimination diet led to a 44% reduction in the number of migraine attacks.
- The attack duration dropped from 2.6 to 1.4 days (46% drop).
- The migraine duration dropped from1.8 to 1.1 days (39% drop).
- Migraine headache severity dropped from 8.5/10 to 6.6 (22% drop).
- The number of needing rescue meds dropped from 4.0 to 1.9 (53% drop) (Tweet this).
- Overall, there were improvements in pain and bloating with the irritable bowel syndrome as well with an overall improvement in quality of life.
So basically, avoiding the most common food allergies for these patients who also had problems with his or her gut led to very strong improvements in all aspects of the chronic migraine headaches experienced.
I go back to my earlier statement. This demonstrates that the irritable bowel and the migraine headaches are not comorbidities. Rather, the dysfunction in one system (the gut) led to problems in another system (the brain). Let me emphasize this last line:
ANY PHYSICIAN WHO THINKS TO TREAT YOUR CHRONIC MIGRAINE HEADACHES WITHOUT LOOKING AT YOUR ENTIRE HEALTH PICTURE DOES NOT UNDERSTAND MIGRAINES.
And that means that it is time to find another one who does.
Combination of Riboflavin, Magnesium, and Feverfew for Migraine Prophylaxis
Talk about an unexpected result! This trial used 25 mg riboflavin as a placebo, and, when all the data was in, both placebo and active arm experienced similar, positive effect. Remember that riboflavin is a part of flavin adenine dinucleotide (FAD) which participates in the formation of ATP through the electron transport chain. Recall from previous Updates that I feel we are moving towards an oxidative stress etiology for migraines. The benefit of riboflavin on migraine once again goes into the evidence pool suggesting that poor mitochondrial function leading to oxidative stress is a main contributing factor to onset of migraines.
A Combination of Riboflavin, Magnesium, and Feverfew for Migraine Prophylaxis: A Randomized Trial – Headache, Vol 10, Issue 1, Pages 33-34 -
Brain power. We want to preserve it as we age, but are there brain supplements that can protect our brain? One form of magnesium may be able to do just that.
Magnesium is one of those minerals that never seems to get the press it deserves. It’s not as glamorous as CoQ10, doesn’t sound as fancy as N-acetylcysteine and isn’t found in high concentrations in milk like calcium. Worse, if you take too much, you get the wonderful side effect of loose stools (which isn’t such a bad thing if you suffer from chronic constipation).
On the other side, magnesium is required in over 300 critical enzymes in the human body and is absolutely essential to our survival and to optimal health. The problem is that many of us are deficient in magnesium. Good food sources include:
- Nuts and seeds
- Whole grains
Overall the number of Americans getting less than the recommended daily intake of magnesium is quite high. Looking at the list above, you can imagine that these types of foods may not be commonplace on the average American dinner plate.
But the story gets more interesting.
Magnesium is very, very important for your brain power and should be on the list of important brain supplements. But it’s just not easy to get most forms of magnesium to the brain because it just doesn’t cross the blood brain barrier very easily to enter the cerebral spinal fluid (CSF). CSF is the fluid the brain floats in and the source of much of the nutrients the brain needs. Even if you ramp up the magnesium levels in the blood to much higher levels, only a small percentage of this makes it to the brain.
Under normal circumstances, for good brain power, this is enough. Magnesium can work alongside of phytonutrients and vitamins from our diet to counteract life’s daily stresses. But what about those with more challenged brain power, like…
All of these groups may benefit from higher levels of brain supplements like magnesium in the brain. What about someone with concerns over memory such as Alzheimer’s dementia? You bet. And maybe more so than the others on the list.
So how might we get more magnesium to the brain for these people who may benefit greatly from higher concentrations of magnesium for better brain power?
Turns out some researchers may have developed an answer in a specific form of magnesium called magnesium-L-threonate. In this particular article, researchers looked at the ability of magnesium threonate to increase magnesium levels in the CSF of rats.
Once they had established that it was effective, they looked at the ability of magnesium threonate to improve brain plasticity. What is brain plasticity? Remember how you thought you killed off all those brain cells in college, never to be replaced? Sure, you’re liver and stomach lining can replace itself, but not the brain.
Wrong. The brain has the ability to replace old, worn out cells. This process is called plasticity and it is generally a good thing in the brain.
Overall, the researchers found that magnesium threonate had a strong ability to improve plasticity in the brains of these rats. While this does not necessarily mean the same thing would happen in humans, I wouldn’t bet against it.
If you think you may fit into one of the categories that may benefit from some extra brain supplements, magnesium threonate may be for you. The form is a little more expensive, but it might make the difference.
If you have tried magnesium threonate yourself, what kind of changes did you experience?