Nov 10, 2010
As a migraine sufferer, what you want to know is what to do to prevent them, and what to do should one begin.
However, in order to prevent migraines and minimize them once they begin, I think people should at least understand the basics of what is going on in their bodies. It makes things a lot clearer, and it helps with things, such as controlling diet. While a host of new medications have been developed to help patients deal with these attacks, I’m going to tell you about safer and more effective natural ways to attain the same goal.
Migraine headaches can have many different types of symptoms:
• A migraine can have an aura (flashing lights sensation) or no aura. • Some migraines are very intense while others are mild. • Some can cause temporary paralysis on one side (hemiplegia) or numbness in the extremities or
face. • Migraines can cause loss of vision in one eye or in half of the visual field. • Some can even cause coma.
Scientists knew that drugs that regulated serotonin, a brain neurotransmitter, seemed to play a role, but there were contradictions. For example, if too much serotonin caused the headache, why did taking tryptophan often make
it better? Tryptophan is the precursor of serotonin — it should have made the headache worse.
In the beginning, migraine was considered to be a problem of the blood vessels around the brain
and scalp. Back then, scientists believed that the artery first went into spasm, which decreased blood supply
to the visual parts of the brain, and caused the flashing lights one sees in the beginning of an attack (the aura). Sudden dilation of the arteries followed, which triggered the pain. Unfortunately, this idea also left a lot to be explained. Most people who have had a migraine attack know it feels as if half of their head becomes
extremely sensitive to pain (hypersensitivity). That is, the pain fibers are firing like mad. In fact, they can become hypersensitive to all pain until the attack passes. Some people even have the aura and no headache,
which is called a “migraine without a migraine.” Then, there are those who do not experience the aura — this is called “migraine without an aura.” What occurs in the brain in these two types of migraine patients — those with an aura and those without — differs. Migraine Headaches: Serious Business Fortunately, most migraine attacks occur only
once or twice a month and last less than an hour. But for some unfortunate people, the attacks can occur almost daily and can last over 24 hours. When migraine attacks occur more often than 15 times a month for at least three months, we call it a chronic migraine. It is these unfortunate people who spend a lot of time in the emergency room.
Thus far, scientists studying this problem have concluded that the process begins with a focal point of over-excitation in the hyper-excitable cortex of the brain. From this site, a wave of suppressed brain cell activity spreads out like
circles of water when a pebble is thrown in a pond. This is called spreading depression. The wave of depressed brain-cell activity moves very slowly (3 mm per minute) over the cortex and then sends impulses into the deeper parts of the
brain, primarily the midbrain and trigeminal nerve nucleus. Interestingly, this spreading depression moves at the same rate as the appearance of the symptoms of the migraine attack. The flashing lights, often appearing as a slowly
growing, scintillating, zig-zag neon light in half of the visual field, occurs when the wave of brain depression spreads through the visual cortex of the brain. Migraine ‘Auras’ A number of symptoms can occur just before the headache begins, such as the visual aura, localized numbness, a feeling of weakness in a limb or side of the body, confusion, difficulty thinking or speaking, and in rare cases, vertigo. Usually these last for just five or 10 minutes and then subside, to be replaced by the throbbing, intense headache — which most often affects one side of the head.
In some people, the attack is so intense it triggers vomiting and extreme prostration.
Recent studies have shown that four major events occur in the brains of people who have migraine headaches:
• Localized inflammation
• Reduced production of energy
• Low ionic magnesium levels
• High levels of glutamate
. All of these also occur in epilepsy, a related neurological disorder.1 Interestingly, people with migraines are more
susceptible to epilepsy, and they also suffer from other disorders of immunoexcitotoxicity, such as depression, anxiety, and panic attacks. In addition, the same drugs used for treating epilepsy also improve migraines. Yet they differ in that seizures are a spreading of cortical electrical activity while migraine is a spreading depression.
There are other symptoms that migraine headache and seizures share:
• They are both triggered by flashing lights
• Food sensitivity from various foods
• Exposure to glutamate in the diet
• Both conditions are triggered by hypoglycemia — low blood sugar
In fact, people with epilepsy often experience headaches after a seizure. When the wave of electrical activity triggered by the spreading depression moves into the trigeminal nerve (a cranial nerve that provides sensation to the face), it triggers inflammation and excitotoxicity. This, in turn, causes the blood vessels of the brain and meninges (membranes between the skull and brain) to constrict and then dilate. It is the trigeminal nerve fibers from the brainstem that innervate (supply with nerves) these arteries and triggers the intense pain. The exact presentation of the migraine — numbness, speech problems, memory problems, hemiplegia (paralysis on one side of the body),
or coma, depends on the area of the brain most affected. Migraines without auras are thought to
originate in the hippocampus, an area essential for learning, memory, and emotional behavior. Hemiplegic migraines, which are much more serious, start in the motor cortex. The Genetic Link There is also a strong genetic link between
migraines and most of the genes involved in regulating brain cell ion channels — microscopic pores that regulate the passage of various essential ions into the brain cells2. Chief among them:
Interestingly, one of the most powerful links with epilepsy — glutamate — plays a role in both disorders. It is accepted that elevations in brain glutamate play a major role in causing seizures, and most of the newer seizure medications block various glutamate receptors. Several studies have shown that people, including children, with migraine have significantly higher levels of glutamate in their spinal fluid and plasma than people without migraine3,4. (Interestingly,
when people are starting to have an attack, their brain glutamate levels begin to rise tremendously and remain elevated throughout the attack.) Glutamate is the brain’s main excitatory neurotransmitter; that is, it excites the brain.
Too much glutamate and the brain becomes overexcited. Many studies of people with migraine have shown that their brain is in a hyper-excitable state, even between attacks. Children with migraine often cannot sit still — they are very excitable and restless, especially if an attack is imminent. The ‘Spreading’ Migraine Recent studies have tracked down the culprit for the “spreading depression,” and it is activation of a particular glutamate receptor called the NMDA
receptor. This is the same excitotoxicity process that scientists are now convinced is linked to any number of other neurological disorders:
• Panic attacks
• Obsessive-compulsive disorder
• Parkinson’s disease
• Alzheimer’s dementia
• Huntington’s disease
• Various tics
Pharmaceutical Treatments of Migraine Most studies of migraine drugs involve the milder cases, with virtually no studies examining effectiveness in chronic migraine patients. This make the drugs look more successful than they
really are. Most anti-migraine drugs, such as gabapentin, topiramate, and tiagabine, have been found to, in
one way or another, reduce immunoexcitotoxicity. Most, as stated, are also used to treat seizures. While these drugs are tolerated in most people, some can have serious and life-disrupting side effects. Newer drugs under development block NMDA receptors or one of the other glutamate receptors (such as the mGluR5), since they attack the problem at its origin.
One of the available drugs that has shown promise is memantine, a drug that reduces NMDA-receptor activity
without completely shutting it down. This is important since this receptor is essential for memory, learning, and many
other functions. Early studies using memantine have shown a significant effectiveness in preventing migraine attacks.
Studies have shown that the neurons within the trigeminal nucleus and ganglion secrete a powerful inflammation-generating substance (CGRP) during an attack. This substance plays a major role in initiating the intense pain and sensitization to pain associated with the migraine attack. Drugs are being developed to reduce the level of this substance. Migraines During Pregnancy And Menstruation In general, women who have menstrual migraine
(attacks with menstruation or with the onset of menarche), do not have migraine attacks when they are pregnant.
Yet, some unfortunate women will continue to have attacks during pregnancy. Because of its rarity, women who have migraines during pregnancy should be checked for other causes, such as cerebral aneurysms, venous cerebral thrombosis, and arteriovenous malformations (AVMs) or tangles of arteries and veins. A fall in estrogen levels can precipitate migraine attacks, and normal, stable levels prevent them. The highest incidence of migraine attacks occurs
in women during estrogen and progesterone fluctuations — during menarche, menstruation, and
the use of oral contraceptives. The incidence of menstrual migraine is as high as 60 percent to 70 percent.
Most women have attacks, usually without aura, during their period (menses), which is the time of greatest hormone fluctuation. Interestingly, estrogens have a significant effect on magnesium balance, especially the form most
associated with migraine headaches — ionic magnesium (Mg2+). High estrogen levels have been shown to lower Mg2+ levels, thus making an attack more likely. Normal, physiological levels of estrogens did not interfere with levels of Mg2+. Low concentrations (normal levels) of progesterone raised Mg2+ levels, and high doses significantly lowered it, again making an attack more likely. Testosterone had no effect on magnesium levels. Again, this emphasizes the importance of keeping one’s magnesium levels normal, which is especially important in pregnant women.
If a woman starts her pregnancy with low magnesium levels, she is more likely to suffer from a worsening of her migraine and a she will have a higher risk of blood-clotting disorders and cerebral vasospasm, should she have an AVM or aneurysm. Some studies have shown that magnesium supplementation also reduces the baby’s risk of
having a neurological birth defect. Treating and Preventing Migraine Attacks Many people with minor migraines are
successfully treated with a variety of drugs, but only a few of the complicated or chronic migraine sufferers benefit significantly. This means something is being overlooked, mainly the major pathophysiological cause of most
migraine attacks — immunoexcitotoxicity. Most of the migraines I treated were chronic migraines that had been failures of traditional drug treatments. Here are some natural treatments for migraine:
1) Correct your diet. A number of foods and food additives are known to precipitate a migraine attack. In many cases, the attack may occur hours or even days after exposure. The most common triggers include chocolate (which contains phenylethylamine and tyramine), aspartame, sulfites, nitrates, nitrites, alcohol, caffeine, and products containing excitotoxin additives. The most important triggers to remove from your diet are excitotoxin food additives.
It seems that most physicians who treat migraines ignore the strong connection between migraine
attacks and high levels of glutamate in blood and spinal fluid. In fact, the severity of the pain is directly related to the
level of the glutamate in the brain.
It makes no sense to pump patients full of drugs and narcotics and never tell them that their diet is a major source of their problem. It’s like trying to treat arsenic poisoning, but letting the patient continue to eat food contaminated with arsenic. Studies have shown that foods containing MSG (monosodium glutamate) can increase glutamate blood levels anywhere from twentyfold to fiftyfold, and that it can enter the brain, especially in areas known to trigger migraine (trigeminal nuclei). Glutamate also increases sensitivity to all types of pain.
MSG is not the only source of glutamate. The food industry uses disguised names so that they can add glutamate additives to food without the public knowing it. The following are just some of the names the industry has come up with:
• Natural flavoring
• Hydrolyzed proteins
• Isolated soy proteins and soy protein
• Whey protein
• Sodium or calcium caseinate
Many processed foods contain several forms of glutamate additives. Studies have shown that all of these can damage
the brain and precipitate migraine headaches. The only way to avoid food excitotoxins is to prepare your food fresh.
But even then there are foods that naturally contain high levels of glutamate. How the food is prepared also makes a
difference. For example, meat gravies, stock, and broth are all very high in excitotoxic glutamate. Tomatoes, when pureed as a sauce or as tomato paste, are very high in glutamate and can precipitate a migraine headache. Beans, nuts (peanut butter), mushrooms (especially portabella), cheeses (especially parmesan), and dried or condensed cow’s milk are all high in naturally occurring glutamate. All glutamate and aspartate is excitotoxic in high
concentrations. Another often-overlooked trigger for migraine is reactive hypoglycemia. With Americans consuming
massive amounts of sugar over a lifetime Turn to Natural Supplements for Relief Migraine attacks can be devastating.
While pharmaceutical drugs are pushed by doctors and drug companies for their own benefit, natural supplements
have been shown to be tremendously effective. Here are the dosages for the most effective supplements:
• Riboflavin — 200 mg twice a day
• Thiamine (vitamin B1) — 100 mg
three times a day
• Niacinamide — 100 mg three times
• Methylcobalamin — 5,000 mcg a day
• Folate — 400 mcg a day
• CoQ10 — 200 mg twice a day (Life
Extension CoQ10 www.LEF.com)
• L-carnitine — 500 mg two to three
times a day
• L-carnosine — 500 mg two to three
times a day
• R-lipoic acid — 100 mg twice a day