Migraine

Chronic Migraine Relief Starts in Childhood

January 31, 2015 by James Bogash

chronic migraines and childhood abuse — dmitrimaruta/Dollar Photo Club

As a parent, it breaks my heart to think of any child having to worry about things like being loved, fed properly and treated with respect. Unfortunately, the effects of childhood maltreatment can last a lifetime.

This maltreatment can come in the form of nutritional abuse, sexual abuse, physical abuse or emotional abuse. While I firmly believe that the damage from raising a malnourished child can be greatly reduced or even eliminated by better nutritional choices in the future, the other forms of abuse, however, leave scars that are worn on the inside. These scars can’t be seen with an MRI, CT scan or bloodwork. And far too often as the abused child grows into adulthood he or she may not even recognize the damage that has been done.

Or many may think that they have risen above it and it remains a dim memory. Little does he or she think that being raised in an abusive household is now playing a major role in why he or she is depressed, obese, has high blood pressure and heart disease. Or that abuse from decades ago may be a critical factor in the fact that he or she suffers from chronic migraines.

To understand just how strong these links can be, this particular study looked at the relationship between childhood maltreatment and headaches. Researchers looked at 8,305 people who suffered from chronic migraines and 1,429 people who had episodic tension-type headaches to see if recalled adverse childhood experiences (ACEs) played a role in the headaches. Here’s what they found:

24.5% of migraine sufferers had ACEs and 21.5% of chronic tension headache sufferers also had ACEs.
Migraines were linked to emotional abuse (22.5%) as well as tension headaches (16.7%).
Sexual abuse in migraines was 17.7% and 13.3% in tension headaches.
Overall, migraine sufferers were 23% more likely to have reported emotional neglect, 46% higher emotional abuse and 35% more likely to have experienced sexual abuse than those with chronic tension type headaches.

Overall, both groups of chronic headache sufferers had strong relationships to adverse childhood experiences, but the migraine sufferers were much more likely to have experienced childhood abuse.

This was a very large study, encompassing about 10,000 headache sufferers. It is astounding that almost 1/4 of this group had experienced childhood abuse. Maybe psychologists out there that deal with past childhood experiences may not be as surprised as I am about just how common this is, but quite frankly it disgusts me.

Even worse, this damage carries forward and can drastically affect the health of the child as he or she grows up. There is nothing fair at all to the adult who is suffering today as a result of abuse that happened in the past when it was well beyond his or her ability to control.

If you suffer from chronic migraine headaches and have been a victim of abuse as a child, it seems clear that developing a relationship with a skilled therapist to help you manage your health should be as essential as a part of your team as a chiropractor or neurologist.

Migraines and Stroke Risk

January 19, 2015 by James Bogash

IS YOUR MIGRAINE DANGEROUS?

Other than the obvious brain tumor causing a headache (which is actually not common for some brain tumors like gliomas), the answer is YES. First off, let’s clarify something. Many, if not most, patients who come in telling me they have a migraine do not actually, have migraines. Most are tension type headaches in disguise. Which is good, because these are usually pretty easy to treat. Migraines, however, are the brain’s way of screaming out that it’s not happy about the health of the body. So medications that suppress migraines and don’t fix the body do NOTHING for the long term risks of heart disease and stroke that migraines are at risk for. The ONLY correct approach to migraine treatment is to comprehensive address the patients lifestyle. If you have migraines and your neurologist or PCP has not talked to you about lifestyle changes for your migraines, maybe it’s time to find a new one.

Brain Damage in Epilepsy—Can it be Avoided?

January 16, 2015 by James Bogash

brain damage in seizures — abhijith3747/Dollar Photo Club

I don’t need to go into how epilepsy is a condition not limited to the brain, because I have covered this many times in the past.

This is also just one of the areas where migraines and seizures have similarities—migraines are also a brain condition that is not limited to the brain. Both are an indication that something is very, very wrong.

All of the evidence points to an underlying problem with the way the brain cells are able to produce and use energy. This problem is referred to as mitochondrial dysfunction (which just so happens to be one of my favorite phrases and, coincidentally, the root of all that is evil in chronic disease…).

In seizures, this problem generating energy leads to the brain cells firing before they are supposed to fire, resulting in a domino effect on other brain cells, producing the uncontrolled brain firing of a seizure.

In migraines, it is unclear whether the mitochondrial dysfunction creates the headaches by affecting the way blood vessels react in the brain, or whether a problem with the way blood vessels react (called flow mediated dilation) starves the brain for the nutrients it needs to generate energy. Luckily, the lifestyle changes for both conditions are the same.

Regardless, researchers seem to agree that there is a serious problem with the blood vessels in both migraines and seizures. Ultimately, blood vessel problems play a role in dementia and Alzheimer’s disease as well.

To clarify what I mean by “blood vessel problems,” you need to understand that your blood vessels are very dynamic. They expand and contract as needed based on signals they get from the cells they feed to provide nutrients. As an example, if you took a racquetball and started squeezing it repeatedly, the muscles cells in your hand and wrist will quickly need more nutrients to continue. As a result a signal is sent to the blood vessels of the arms, causing them to dilate (open) and increase blood flow into the forearm and hand.

Picture this same action in the brain. When the brain cells in an area need more oxygen, glucose or micronutrients, blood flow to this area of the brain increases. No imagine if the blood vessels were no longer as responsive. You end up with starving brain cells. Not a good scenario.

With this as background, I’d like to throw this particular article into the mix. In it, researchers reviewed the dangerous relationship between blood vessel function and damage and cognitive decline. They open with identifying findings that are common between chronic epilepsy, Alzheimer’s dementia and age-related cognitive decline. These include:

Increased plaquing in the carotid arteries (CA–IMT)
Elevated homocysteinemia levels
Lipid abnormalities (cholesterol, triglycerides, VLDL, low HDL, etc…)
Weight gain and obesity
Insulin resistance / prediabetes
High levels of inflammation
High levels of oxidative stress

All of these factors wreak havoc on blood vessel health. Poor vessel health not only damages the brain cells that it feeds, but the long-term dysfunction in the blood vessels ultimately damages the blood vessels themselves, leading to hardening of the arteries, making the starvation of the brain cells permanent.

All of this damage to the blood vessels lead to brain damage. The authors note a few of the well-accepted brain changes as a result of this damage. These include:

Decreased volume of the hippocampus (an area also shrunk by chronic stress and one of the areas that are damaged in Alzheimer’s dementia)
Increased cortical thinning of the frontal lobe (the area of the brain that deals with personality).
Ventricular expansion and increased white matter ischemic disease (a sign of brain cells dying)
Total brain atrophy (basically a shrinking brain)
β-amyloid protein in the brain (one of the principle proteins found in the brains of Alzheimer’s dementia patients)

If you’re still reading this far, then you now understand just how critically important it is to go beyond seizure control to making whatever lifestyle changes you need to make. A true anti-seizure treatment protocol needs to include a lifestyle that is anti-diabetic and anti-heart disease. Luckily, these lifestyles are pretty much the same.

And you may find that, once you have adopted a healthier lifestyle, your seizures will also improve. You’ve got nothing to lose.

Except your brain cells.

Epilepsy – Not Just a Brain Disorder

January 7, 2015 by James Bogash

epilepsy facts — waldemarus Dollar Photo Club

I have gone as far as writing a book on Migraines and Epilepsy to show that epilepsy needs to be treated from a full-body approach.

A treatment approach that just focuses on controlling the seizures is missing the real problem. Don’t get me wrong—controlling the seizures is the first goal. But it should never be the only goal.

A brain-health approach needs to evaluate the condition from all aspects, including dietary choices, exercise, stress management, environmental toxin exposures and supplementation. Medications are NOT a part of long-term brain health.

To really drive this point home, this particular study looked at what kind of medical services were used by 8388 epilepsy patients (based on claims from 8 different insurance plan claims). Of the data obtained, this is what I found the most interesting:

The top three procedures performed were an EKG, a CT scan and a chest X-ray.
The top five prescription drug classes anticonvulsants, analgesic-opioids, antidepressants, penicillins and dermatologicals.
58% of the patients had one or more of 29 prespecified comorbidities and health care costs increased markedly as the number of these increased.

There is a whole lot of information to be digested in this study. For starters, it’s probably highly, highly likely that epileptic patients are getting over radiated with CT scans. This is not a big surprise considering that ER docs in general have an itchy trigger finger when it comes to ordering CT scans. When a patient comes into the ER having seizures (and this is most likely from an episode of status-epilepticus) ER docs seem to ignore the guidelines on proper CT use and order one anyway.

This would be just fine if CT scans were not responsible for some 29,000 cancers per death per year because of the high levels of radiation involved. MRIs, while not a quick (and therefore profitable), would be a much better option.

As for the drugs used by epileptic patients, I think we can all agree that anticonvulsants are no big surprise. But what about the analgesic-opioids?? Personally, I found this a little bit surprising, especially to be the second most common class of drugs. The opioid class of drugs has been under the microscope for the past few years because of the number of deaths that occur annually from the use of this class of drugs. And we’re not talking about “misuse” here, but rather prescribed and used as directed deaths.

There is no doubt that it is an overused and dangerous class of drugs. To then use this class of drugs in epileptic patients, who already have concerns over SUDEP (sudden unexpected death in epilepsy) just doesn’t seem to make any sense to me.

The presence of antidepressants on this list is no surprise, given that depression and epilepsy have some very strong links and that many anti-seizure drugs are now being used to trip depression (Depakote and Topamax just to name a few). Both have similarities in that there is a problem with the brain cells communicating normally–making sure the right messages get passed and stopping the ones that are not supposed to move on. Many natural approaches like exercise and fish oils benefit both conditions.

The next on the list, the penicillins, was a disappointing shocker and really raises some interesting questions. The ketogenic diet is a very powerful tool used to treat even the most refractory of seizures, but despite the research about how effective it is, the mechanism by which this diet controls seizures is not quite known. One of the theories that makes sense is that the diet alters the bacterial flora of the gut.

If this is true, then the bacteria flora of your gut plays a massive role in controlling seizures. And, you are incredibly well aware of the fact that antibiotics absolutely decimate the bacterial flora in the gut, taking years and years to recover, if ever.

Because of this, the fact that penicillin is the third most common drug prescribed to epileptics is particularly worrisome because we just really have no idea what kind of negative effect any antibiotic is going to have on the delicate make up of the bacterial flora of the gut.

The final class, dermatologicals, is also an interesting one. Given the close relationship between the gut and the skin (there are many conditions known to affect both of these types of tissues) it may indicate that the gut is completely out of whack in epileptic patients.

The last two drugs both point to the GI tract as being out of balance in epileptic patients. For this reason, a natural approach to controlling seizures would have to address the gut as well as the brain. Sadly, the gut is rarely on the list of organ systems that need to be addressed when it comes to your neurologist’s management of your seizures.

Migraine Treatment and Heart Disease Risk

December 23, 2014 by James Bogash

Ok..let me get this straight. Migraines are really a local manifestation of a systemic problem, which is why we see increased risks of cardiovascular disease and stroke in patients who suffer from migraines. So, here we see that weight gain is common with drug treatment for headaches, and this weight gain comes with worsening heart disease risk markers??? That’s what we call a cure?

Marijuana and Seizures: Reality, or Just an Excuse?

December 20, 2014 by James Bogash

With seemingly half the states in the US passing some version of permissive cannabis laws, the list of conditions that benefit from its use just seems to grow.

But are there really benefits to marijuana use that extend beyond a different viewpoint while listening to Pink Floyd or attending a Parrothead event?

Before we answer that, let’s go over some background on marijuana by covering some of the more popular active constituents of cannabis. The plant is a veritable cornucopia of bioactive compounds–with some 483 compounds having been identified to date.

Tetrahydrocannabinol (THC) is the most famous component of the plant, known for producing the relaxation high associated with smoking marijuana. It also has pain-blocking and anti-nausea properties .
Cannabidiol (CBD) is another cannabinoid that has the most accepted medical use, especially with seizures.

CBD oil is something that has been gaining ground in the treatment of both migraines and seizures. Despite it’s name, CBD oil is really a mismosh of compounds, including multiple types of healthy fats, amino acids and fiber. It does contain a small amount of the CBD noted above. While we don’t really know which aspect of CBD oil is having a positive effect on the brain, it really doesn’t matter to those who see a benefit.

It is beyond the scope of this article to go into the different strains being grown with varying levels of THC and CBD, mainly because it’s outside of my realm of knowledge. It is clear that regular medical users seem to have different experiences with different strains.

One thing that is clear, if you can rise above the debate of its legalization, there are clear medical benefits of marijuana compounds in migraines and epilepsy. I’ve had patients over the years who have successfully controlled their seizures using marijuana when medications were not able to. In some cases I’ve felt it might have been just pure stress reduction from the euphoria, in other cases something else was at play.

This particular study, while a little detailed, takes in in-depth look at just what mechanisms may be at play in the anti-seizure effects of the cannabinoids. In it, researchers looked at one of the two main cannabinoid receptors (CB2R) in the brains of rats to see what effect a marijuana-like synthetic compound had inside the cell.

While I will not go into specifics (no really–if you want to read more about the compound used, termed WIN 55,212-2, (R)-(+)-[2,3-dihydro-5-methyl-3-(4-morpholinylmethyl) pyrrolo[1,2,3-de]-1,4-benzoxazin-6-Yl]-1-naphthalenylmethanone, then feel free to study it yourself….) suffice it to say that research has moved beyond the idea that compounds found in marijuana have anti-seizure effects to trying to figure out exactly how they work.

The skeptic in me would say that this is just so we can create a synthetic compound (like the $1.50 word above) to mimic marijuana’s effect so some drug company can patent it later. But only because this is the model they live by.

In the meantime, if you have migraines or seizures and your neurologist seems hesitant to discuss the medical use of marijuana, it might be time to find a new one.

Migraines "Under Control" with Meds? Better Think Twice

October 24, 2014 by James Bogash

chronic migraines and Parkinsons — Chronic migraines linked to Parkinson’s disease

Last Update December 18, 2014

I don’t mean to beat a dead horse, but merely managing your chronic migraine headaches with meds is not the answer.

I am not saying that it’s not the short-term goal. If you’ve ever spent time on some of the social networking sites that relate to migraine headaches, you’ll realize just how devastating and life-shattering migraine headaches can be. Jobs, relationships and lives in general can be restricted to living like a hermit in constant pain.

I understand that controlling the pain of the headaches is the first priority for a migraine sufferer. But not everyone gets relief from medications. This group spends their lives in a constant search for relief. Medication after medication after medication. When they’re lucky enough to find a medication to help, sometimes the side effects are just as debilitating.

The other group includes the ones who do find relief from medications. But then they stop there, blissfully unaware that this is just the first step.

I have written over and over that the headaches are the symptom of a much bigger problem. The headache is NOT a problem in the head. Rather, it is the brain that is the most sensitive organ to the unbalanced state of health, with the critical dysfunction coming from blood vessel health (also referred to as “vascular health”).

Poor vascular health is at the root of migraines. It is not always the only answer, but in most it is the principle problem. If you can address vascular health and improve the health of your blood vessels, it is highly likely that you’ll find that your migraines improve as your blood vessels do.

Just in case you think I’m crazy for suggesting this merely because your neurologist has never suggested it, I would like to present as evidence this particular study.

In it, researchers looked at the relationship between the development of Parkinson’s disease in migraine sufferers in the AGES-Reykjavik study. And the news isn’t good.

The Age, Gene/Environment Susceptibility-Reykjavik Study (AGES-Reykjavik) is a study that began in 2002 and is designed to look at the relationship between risk factors, including genetic susceptibility and gene/environment interaction, in relation to disease and disability in old age.

Between 2002 and 2006, 5,764 participants from this study were reexamined to look for symptoms of parkinsonism, Parkinson disease, a family history of Parkinsons and Restless Leg Syndrome. Here’s what they found:

People who experienced midlife migraine (especially migraine with aura) were 360% more likely to report parkinsonian symptoms.
They were also 250% more likely to be diagnosed with Parkinsons.
Women who had migraines with aura were 226% more likely to have a parent or 178% more likely to have a sibling who were diagnosed with Parkinsons.
All of those who experienced headaches were more likely to experience Restless Leg Syndrome.

Parkinson’s disease has been strongly linked to prediabetes and diabetes. The damage to the blood vessels that occurs in the diabetic process is pretty bad, leading to actual brain damage and dying brain cells. I don’t know about you, but I’m hoping to keep all my brain cells intact as long as possible.

While no single study or research finding is enough to set anything in stone, the links between poor vascular health and migraines is quite extensive. Extensive enough to warrant finding a new neurologist if this has never been discussed with you.

It is equally clear that vascular problems LEAD to migraine headaches, NOT the reverse. This means that all the bang for your buck is in improving the health of your blood vessels to help your migraine headaches, not improving blood vessel health by controlling your migraines. There is not a single medication used to control headaches that does anything to improve blood vessel health.

There are quite a few ways to improve the health of your blood vessels. While it is beyond the scope of this article (you can read all about it in my Migraines and Epilepsy eBook by clicking here) here are a few short tips:

Short-burst exercise is a must
Cocao products like dark chocolate and cocoa, are very good for the blood vessels
Berries
Wild caught fish
Not smoking (smoking DESTROYS the blood vessels)

While this is the short list, it should be enough to get you started.

What Causes Migraines? The Answer is Decades Old

July 3, 2014 by James Bogash

Looking over several Facebook pages related to migraines as well as some message boards, I am continually saddened by the continual search for treatments and lack of discussion on a cure.

And maybe “cure” is not the right word. Somewhere along the lines we decided that migraines were the problem and not just a symptom. Of course, “not just a symptom” is downplaying the experience of someone who suffers from migraine headaches. I truly understand the frustration and hopelessness that goes along with chronic, debilitating headaches.

All the evidence points to a combination of vascular dysfunction (basically a sickening of the health of your blood vessels) and mitochondrial dysfunction (an inability to make the energy needed for brain cells to survive and function the way they are supposed to. This particular article, while a few years old (2011), highlights the process known as cortical spreading depression.

Cortical spreading depression is a slow wave of brain cells firing that occurs in a wave-like pattern. Consider the proverbial wave at a sporting event, but when this wave occurs in the brain it wreaks havoc. This review article summarizes the research that links cortical spreading depression to neurological disorders like migraines, stroke, subarachnoid hemorrhage and traumatic brain injury. In migraines, this cortical spreading depression may be the wave that creates the headache, while in stroke, hemorrhage and traumatic brain injury it is the result of the damage. So, while cortical spreading depression is a principle piece of the migraine puzzle, the important question to ask is where does this come from in the first place?

Obviously in a stroke or traumatic brain injury there is damage that disrupts the brain cells. But where is the “damage” that kicks off a migraine? Rarely does this discussion come up between a migraine sufferer and the physician who is relied on for answers. Instead, we dive wholeheartedly into controlling the headaches with medications.

I have said this hundreds of times now, but I’ll say it again, medications used to treat migraines do absolutely, positively NOTHING to fix the underlying problem. And the underlying problem is a big one. Poor blood vessel health / vascular health has strong links with cardiovascular problems (heart attacks, stroke and dementia). Mitochondrial dysfunction is the root of all evil with links to pretty much every chronic disease.

The list of things to do to help improve the mitochondrial problem and improve blood vessel function is long enough to take up a book (which, conveniently, I happen to have written and can be found by clicking here). The short list begins by avoiding behaviors that abuse the mitochondria in our brain cells. Here are a few of the more dangerous risks:

After you’ve cleaned up the mess, the next thing to focus on is aspects of lifestyle that are well-known to protect the brain. The general recommendations that I promote for all chronic diseases remains the same and can be found by clicking here. Besides lifestyle, there are numerous supplements that have some pretty good support for protecting the brain. These include:

These are things that HAVE to be fixed if you are a chronic migraine sufferer. It’s not an option. Controlling the headaches may be a very important step, but it can’t be the goal. In the vast majority of patients, chronic migraine patients can be cured by making the right lifestyle choices.