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If you’ve ever suffered a migraine, I don’t need to describe the feeling.
These severe, nearly disabling headaches can last from hours to days and create nausea, vomiting, and severe throbbing pain on one or both sides of your head. In extreme cases, migraines can even carry stroke-like symptoms or paralysis.
Migraines are not inexpensive to treat. One survey found they cost U.S. employers over 24 billion dollars each year in direct and indirect healthcare costs. A 2014 study at the University of Michigan Medical School found one in eight visits to a doctor for a headache or migraine end up with the patient going for a brain scan, at a total cost of about one billion dollars each year.
Migraines have indirect costs as well. One study in The American Journal of Managed Care found that the annual cost to employers exceeded $14.5 billion, of which $7.9 billion was due to absenteeism and $5.4 billion was due to diminished productivity.
Migraines drain more than just money. “Worldwide, migraine on its own is the cause of 1.3 % of all years of life lost to disability,” says a 2011 report in the World Health Organization (WHO). If a migraine forced you to take a sick day or miss out on an important event, you understand just how debilitating and life draining they can become.
Conventional Approaches Don’t Work
Doctors know how to look at a migraine’s effects, but not its underlying causes. Conventional approaches for migraines can have poor results, and prescription drugs often become ineffective and carry adverse side effects.
A newer class of medication called triptans can stop a migraine once it starts, but they can be expensive, carry serious potential side effects (including strokes), and create addiction or dependence.
Migraines are simply a set of symptoms. The name tells us nothing about the symptom’s causes, of which there are over 20 that vary with each person.
Even if you’ve struggled with migraines for years without relief, your case isn’t hopeless. Using Functional Medicine, I have been able to get nearly 100 percent of my patients migraine-free in days or weeks.
Rather than simply prescribe drugs to treat migraines, as a medical detective I search for underlying causes. My initial approach involves evaluating a patient’s symptoms including palpitations, severe constipation, anxiety, insomnia, muscle cramps, and menstrual cramps. All these symptoms are connected.
From that approach, I’ve found these five most frequent migraine culprits and how to approach them and find relief.
1. Food Allergies/Bowel and Gut Imbalances
- Brain fog
- Irritable bowel syndrome
- Joint or muscle pain
- Postnasal drip
- Sinus congestion
Testing: Do an IgG food allergy panel and a celiac panel because wheat and gluten are among the biggest causes of headaches and migraines. One study in the journal Headache found migraines more prevalent in people with celiac disease and irritable bowel disease (IBD). You should also consider stool testing and urine testing for yeast or bacterial imbalances.
Treatment: An elimination diet—getting rid of gluten, dairy, eggs, corn, and yeast—is a good way to start. Adding in enzymes, probiotics, and omega-3 fats help create and maintain a healthy gut.
2. Chemical Triggers
Causes: A processed-food diet including:
- MSG (monosodium glutamate)
- Nitrates (in deli meats)
- Sulfites (found in wine, dried fruit, and food from salad bars)
- Tyramine-containing foods like chocolate and cheese
Treatment: Remove processed foods, additives, sweeteners, and sulfites. Focus on whole, phytonutrient-rich foods.
3. Hormonal Imbalances
- Premenstrual syndrome (PMS) with bloating, fluid retention, cravings, irritability, breast tenderness, menstrual cramps
- Oral contraceptive pills or hormone replacement therapy
- Being pre-menopausal, which leads to too much estrogen and not enough progesterone because of ovulation changes
- Studies associate insulin resistance with chronic migraines
Testing: Blood or saliva hormone testing looks for menopausal changes or too much estrogen.
- Eat a whole-foods, low-glycemic load, high-phytonutrient diet with flax, soy, and cruciferous vegetables
- Use herbs such as Vitex, along with magnesium and B6
- Avoid alcohol, caffeine, sugar, and refined carbohydrates
- Focus on exercise and stress reduction
- Cramps or a tight feeling
- Anxiety, insomnia
- Sensitivity to loud noises
- Muscle cramps or twitching
Testing: Check red blood cell magnesium levels, though keep in mind you might have total body deficiencies.
Treatment: Supplement with a highly absorbable form of magnesium, such as magnesium citrate powder. One study in the journal Clinical Neuroscience found oral magnesium supplementation provides a low-cost way to reduce migraine frequency. If you have kidney disease of any kind, do this only with a doctor’s supervision.
5. Mitochondrial Imbalances
Symptoms: While sometimes migraines are the only symptoms, sometimes the migraines occur with:
- Muscle aching
- Brain fog
Testing: Check urinary organic acids to assess mitochondria function and energy production.
- Taking 400 mg of riboflavin (B2) twice a day
- Take 100 to 400 mg of coenzyme Q10. One study in the journal Cephalagia gave 32 patients with a history of episodic migraine 150 mg of CoQ10 daily. Researchers found after one month, CoQ10 lowered migraines 13.1 percent. After three months, CoQ10 lowered migraines an impressive 55.3 percent
- Other mitochondrial support nutrients
Consider combining treatments, try herbal therapies, and consider complementary approaches like acupuncture, homeopathy, massage, and osteopathic treatment to fix structural problems.
If you’ve struggled with migraines, what strategy worked best to find relief? Have you implemented complementary or alternative therapies to alleviate migraines? Share your thoughts below or on my Facebook fan page.
AK Dimi et al., “Prevalence of migraine in patients with celiac disease and inflammatory bowel disease,” Headache 53, no 2 (2013):344-55.
A Fava et al., “Chronic migraine in women is associated with insulin resistance: a cross-sectional study,” European Journal of Neurology 21, no 2 (2014):267-72.
A Mauskopet al., “Role of magnesium in the pathogenesis and treatment of migraines,” Clinical Neuroscience 5, no 1 (1998):24-7.
TD Rosen et al., “Open label trial of coenzyme Q10 as a migraine preventive,” Celphalgia22, no 2 (2002):137-41.
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Editor: Rachel Nussbaum
Photo: Wikimedia Commons