SLEEP HORMONE GOOD FOR MIGRAINES? I have to admit, when I first glanced at this article and saw in the conclusion that melatonin did not reduce migraine frequency, I was ready to move on. After all, we see in pharmaceutical studies that, all too often, what they report in the conclusions are overblown from the actual benefit we actually see in the study–so if the conclusions aren’t good, certainly the rest of the data’s got to be horrendous. But…actually reading the abstract tells you that 2 mg melatonin before bed (about $10 worth of melatonin) had 1/3 less migraine attacks during the month (almost 1.5 less headaches per month down from 4.2 per month). Any migraine sufferer will tell you that having one less headache per month for $10 is money very well spent. Compare this with a study done in 2007 on Topamax for migraines ($600 / month), that resulted in 1.5 less headaches in 3 MONTHS, yet the conclusion was that Topamax is safe (82% of study participants experienced side effects) and efficacious for migraines. Talk about perspective! In this recent study, there was little difference between placebo and melatonin (both were effective). So, same effects, one with massive levels of side effects and costing $600 / month, the other with little side effects at $10 / month. You choose…
Migraine
Migraine Doctor Mesa AZ Residents Trust
MIGRAINE SUFFERERS BEWARE NEW PREVENTATIVE APPROACH. You’ve all read me ranting and raving about how we are completely missing the boat on treatment of migraines. That migraineuers have an increased risk of heart disease and stroke because the problem is NOT in the brain, but it is in the body. It is the body screaming that something is wrong and sufferers bodies are using the brain to get the owner’s attention. Lifestyle needs to be fixed. Getting out processed foods, increasing intake of healthier fats, exercise, avoidance of as many chemicals as possible, stress management. This is the approach that is required. It’s NOT optional! If this approach is not taken, the migraine patient is going to die an early death. It’s that serious. The problem is that mainstream medicine still thinks treatment “success” is gauged by getting rid of the headache via medication. Now it’s getting worse. Beta blockers are well known to increase the risk of stroke and diabetes, so we’re just going to try to use them as “prevention” in patients suffering with migraines. UGH! Read More…
Mesa AZ Headache Doctor
Migraine Headaches and Blood Vessel Problems:
VERY EARLY ON, PATIENTS WITH MIGRAINES HAVE THIS PROBLEM
Ok, so this is not the first time I’ve rambled on about the fact that migraines are really a sign of things being wrong with the entire body, and if all we do is use drugs to suppress the headaches, we’ve done nothing at all for the patient except NOT help them make the right changes. In this particular study, researchers found alterations in the function of the blood vessels in young female patients with migraines. This is further indication that the problem with migraine is actually NOT in the head, but may revolve around the cardiovascular system. Problem…not a single drug used to treat migraine helps the cardiovascular system..
And don’t forget to check out the full Migraines and Epilepsy website by clicking here.
My Biggest Frustration with Migraines
I have dedicated a significant amount of time to migraines. From treatment in my office to hundreds of review articles of medical studies to publishing a book on Migraines And Epilepsy, I consider myself quite educated on the topic.
While there have been a few exceptions in my office (literally less than a handful over the past 18+ years), if patients are willing to make the changes I recommend, they get better. My recommendations range from a course of treatment in the office to exercise to managing stress to major lifestyle overhauls. If patients are willing to make these changes, I can almost guarantee that migraines will be history.
Why? How can patients get better with my recommendations versus the neurologist that they’ve been seeing for years and practice out of a very well-known hospital system?
Because the “why” is far more important to me than suppressing the symptoms of a migraine. It is VERY rare that I have a chronic migraine patients come into my office that has been educated on the underlying cause of his or her migraine headaches.
But before I get into the secret of migraine headaches I need to make a very important distinction.
By the time patients make it into my office they have accumulated multiple types of headaches. The two biggest classifications are structural and migrainous. And I can say, with a high degree of confidence, that every migraine patient has aspects of both.
The structural headaches are related to the soft tissues (ligaments, tendons, muscles and fascia) and joints. While my opinion is strongly biased, these types of headaches HAVE to be addressed by a chiropractor that understands and treats the soft tissues. Adjusting alone, exercises alone, Botox alone (and yes-if someone responds to Botox it is because they have been improperly diagnosed with migraines instead of a structural headache) or soft tissue work alone is not going to completely fix the problem.
But, as I mentioned, it’s my bias based on almost 20 years of treatment migraine patients who have not responded elsewhere.
The true migraine headaches, however, do not respond well to good structural care. This is because the true cause is not one that can be addressed from outside the body.
If you experience chronic migraine headaches and you really, really want to get rid of your headaches, you’re going to have to address the health of your blood vessels.
Period.
Anything less will not guarantee a fix for your headaches. And medications? Not a damn one of them will fix your blood vessels. Some will actually make it worse. And even if medications control your headaches, they have not fixed the problem.
Poor blood vessel health, endothelial dysfunction, vascular dysfunction. It goes by different names depending upon who you are speaking to, but they all mean the same thing.
The blood vessels of a true migraine patient have lost the ability to respond appropriate to changes in demand for blood supply. This system—where the blood vessels open and constrict based on how much oxygen the tissues need—is an incredibly dynamic process, with changes occurring by the second. If your blood vessel is no longer able to respond to needs of your brain cells your brain cells are not going to be happy with you and can trigger a migraine.
THIS is the key to understanding your migraines. THIS is the key to lifestyle changes that will help your chronic migraine headaches.
I have certainly spent time on migraine message boards and there are a lot of headache patients who get pissed off at my suggestion that headaches can be fixed. These patients, however, have not achieved ideal body weight. They are stressing too much. They are not eating the right foods (even if he or she thinks his or her diet is ideal). They are not exercising. They are smokers.
I would suggest that, as much as it may be offensive to some, patients with true migraine headaches have not made the correct choices for his or her blood vessels and brain.
The details of these changes are beyond the scope of this article, but are outlined very readily in my book Migraines and Epilepsy that can be purchased by clicking here.
While many migraine sufferers care about getting rid of or controlling headaches, there is a bigger problem looming. Poor blood vessel health has everything to do with risk of heart attack or stroke in the future. This is absolutely, unquestionable solidly demonstrated in medical research study after research study.
Most of these research studies, however, have focused on migraine with aura. Most of the studies that have linked future risk of heart disease or stroke have been on migraine with aura. This particular study is yet another one in the long list of studies linking heart disease risk and migraines, except this one covered ALL migraines, not just those with aura. Here’s the details on this large study of 17,531 women with migraines who were followed up for 20 years:
- Migraine was associated with a 50% higher risk for major cardiovascular disease.
- They had a 39% higher risk of a heart attack.
- There was a 62% higher risk of having suffered a stroke.’
- Sufferers had a 74% higher risk of having chest pain or having had a coronary angiogram.
- Furthermore, migraines were linked to a 37% higher risk of dying from heart disease.
The relationship is so strong that, in a linked editorial, the suggestion is that migraine should be viewed as a risk factor for heart disease just like high blood pressure and cholesterol. This is a strong statement and one that is not entertained by the average treating neurologist or primary care doctor.
It also reinforces my concern that the vast majority of true migraine patients are not getting the education needed to understand and improve the condition. Chronic migraine sufferers HAVE to address the underlying dysfunction of the blood vessels through lifestyle changes geared towards protecting the heart. This include diet, stress management, exercise and focus on reducing exposure to environmental chemicals that damage the heart and blood vessels.
Anything less is only a band-aid.
Should All Patients with a Migraine See a Chiropractor in Mesa?
Ok..given my bias everyone probably knows my answer here when it comes to chiropractic in Mesa.
It never ceases to amaze me when a patient has had headaches for years or even decades that have never been to a chiropractor. Given the evidence, it really should be considered malpractice (lack of informed consent) for a neurologist to NOT refer to a doctor of chiropractic for an evaluation of any headache patient.
And yet the referral to a chiropractor who specializes in soft tissue treatment of the neck almost never happens. It is the migraine sufferer that loses out.
Just how common is neck pain in migraine headache sufferers? This particular article looks at this question in 113 migraineurs, who had headache frequencies ranging from episodic to chronic migraine. These headaches sufferers were examined by headache medicine specialists to confirm the diagnosis of migraine and rule out both cervicogenic headache and fibromyalgia.
For each attack over the next few months, sufferers recorded the whether nausea was present as well as the intensity of headache and neck pain (graded as none, mild, moderate, or severe). Here’s what they found:
- There were 2411 headache days, 786 of which were migraines.
- The majority of migraines were in the moderate pain stage.
- Regardless of the intensity of headache pain, neck pain was a more frequently present than was nausea.
- Those diagnosed with chronic daily headache were more likely to have neck pain.
So what does this mean? From a standard migraine approach, this means that, although the presence of nausea is a characteristic of a migraine headache, neck pain (which is not a characteristic) is actually more common.
From my standpoint of almost 20 years of treating migraine patients, we have totally, absolutely missed the ball. Since most headache specialist do not touch the patient and wouldn’t even know how to treat problems in the neck is he or she found them, these patients are mis-diagnosed.
I can’t tell you how many times I’ve had patients come in with a diagnosis of “migraine” only to have the headaches go away with soft tissue treatment of the neck structures combined with manipulation. These were NOT migraines. Migraines generally do not respond as well to manual therapies, but most often need a lifestyle overhaul to manage the headaches.
The bottom line? Neck pain is strongly associated with headaches. If you have headaches, it is absolutely essential for you to find a chiropractor competent in soft tissue treatment to see if this will help.
Do Migraines Increase Your Risk of Dying?
Let me clarify this once more. Those experiencing migraines have something wrong with their physiology that just so happens to manifest as headaches.
The headaches are the downstream consequence of the problem, and are NOT the problem itself. So to fix the problem, you need to look upstream and fix what is wrong. If you experience migraines and your doctor has NOT talked to you about the absolute need to change your lifestyle, you should find a new doctor. Period.
Just in case you think this is a strong statement, pay attention to this particular study. In it, researchers looked at 18,725 men and women to see if migraine sufferers had a higher risk of dying from any cause (all-cause mortality). Here’s what they found:
- People with migraine with aura had a 21% higher risk of dying from any cause.
- People with migraine with aura had a 27% higher risk of dying from heart disease.
- People with migraine with aura had a 40% higher risk of dying from a stroke.
This is a pretty strong concern. And let me clarify again that taking medications to control your headaches (even if they work) will do NOTHING to alter your risk of these conditions because they haven’t actually fixed the problem.
Migraines Have Potentially Deadly Consequences
I frequently have patients tell me that this or that condition is “under control” with medication. As a society we have been completely duped into this type of thinking.
Migraines are no exception.
Regardless of whether someone is medicated or not, the fact that they are having migraines means that something is wrong. Merely the suppression of the symptoms does NOTHING for the underlying cause. In this particular study, the research strongly suggests that patients who experience migraines with aura are under much higher levels of oxidative stress and inflammation, which has consequences such as heart disease and stroke.
Here’s what they found:
- Women with active migraine with aura had a 225% higher risk of a haemorrhagic stroke.
- For bleeding within the cerebral cortex (intracerebral haemorrhage) the risk was slightly higher at 278%.
- For fatal strokes, the number skyrocketed at 356% higher risk.
This association plays out pretty consistently in the medical literature. The bottom line is that we have to make the changes necessary to get rid of the migraines or suffer the long term damage.
Migraine Patients at High Risk for Dangerous Condition
Have I mentioned that patients with migraines are at increased risk for all kinds of bad things because the headache is merely a reflection of something going very wrong with their physiology? I wasn’t sure if I had…
This particular study finds a strong association between migraines and prediabetes. Given how very dangerous prediabetes is for us (arguably more dangerous to our health than cigarette smoking), it does not surprise me that there is an association.
The good news for those with migraines? Regardless of whether the prediabetes is contributing to the headaches or the physiological disturbances leading to the migraines also increase the risk of diabetes, it really doesn’t matter. Improving the way your brain functions will impact both scenarios. Kind of simple, huh?
Every migraine sufferer should be leading a lifestyle that is anti-diabetic. This is of critical importance for chronic migraine relief and not usually a discussion that neurologists typically have with their headache patients. You can not rely on medications to be the answer–lifestyle is the key to long term relief.