Managing Migraines

Whether you've been hit with a classic low - grade migraine or a full blown migraine complete with aura and flashing lights, migraines are the worst type of headache, and can be debilitating for many people. Not to be confused with tension headaches, migraines are much more severe and incapacitating, lasting anywhere from 4 to 72 hours. More women experience migraines than men, most likely because of the role that hormones play (consider the fact that most women get them either right before or during menstruation and that most migraines actually disappear after menopause).

No one really knows for sure what causes a migraine; the triggers can be different and varied for each person. But when that switch is flipped on, a series of events takes place within the nerve cells of the brain. Substances called excitoxins over stimulate these nerve cells, which in turn send out impulses to the brain's blood vessels to release substances that cause inflammation and swelling. This process also causes the warning signs that commonly precede a migraine: depression, irritability, restlessness, loss of appetite and an aura that most describe as brightly colored lights

What causes the nerve cells to get excited? Finding your own trigger can be tricky, and it may not be as easy as eliminating chocolate or alcohol. Many factors in our environment can trigger an episode, including anxiety, stress, lack of food, lack of sleep, exposure to light and, as mentioned before, hormonal changes in women. There is some information that links migraine to the bacterial infection H. pylori, and other research that suggests that people who are prone to migraines are low in 5HTP or 5-Hydroxytryptophan, substance that helps to convert tryptophan into serotonin, that "feel good" neurotransmitter.

Additionally, there are those triggers that should come OUT of your diet and lifestyle, but there are also elements that you might want to think about putting INTO your diet. So this is all a little complicated, but nothing that some good detective work on your part can't fix.

Avoiding the trigger foods

It could be salt. It could be sugar It could be milk. It could be wine. It could be anything that flips on that brain switch and releases those excitotoxins. The most common culprits are refined sugar, caffeine, alcohol and foods that contain tyramine. Tyramine, which is derived from the amino acid tyrosine, can trigger migraines and also raise blood pressure. Some common foods that contain tyramine are aged cheeses and bananas, aged meats like pepperoni and sausage, processed foods, soy, nuts, chocolate, wines, liver and sauerkraut.

Reducing refined sugar and eating smaller, more frequent meals during the day will help balance blood sugar. Individuals who have "reactive hypoglycemia" - low blood sugar that occurs 1 - 3 hours after a meal-- may trigger severe headaches. But don't reach for aspartame in replace of sugar: it contains another amino acid migraine trigger called phenylalanine (not to mention the fact that it's just downright bad for you. That's another story).

Beneficial Nutrients and Herbs

Riboflavin, Magnesium and CoQ10 have been researched, reviewed and studied for their effectiveness in managing migraines. They are all good , effective alternative treatments and can help to prevent migraine occurrence.

Coenzyme Q10 is a nutrient that is normally associated with energy: it helps the cells utilize oxygen. Dr. Andrew Hershey, Associate Director of Neurology Research, looked at its relation to migraine in a recent study done at the University of Cincinnati. He examined 1,552 children and adolescents between the ages of 3 and 22 and found that most had CoQ10 levels that were insufficient. After supplementing with CoQ10 the frequency of headaches was significantly reduced, from an average frequency of 12.5 days per month to 19.2 days per month. That's a big difference when you are experiencing a migraine, and when you're a teen whose state of mind and feeling of well being plays a big role in determining the success of their social life. Another study done in 2005 examined CoQ10's effect on adult migraine sufferers. Those who took 300mg of CoQ10 for 4 months experienced a 50% or greater reduction in frequency of migraine attacks, significantly different than those just using a placebo. Side effects on both of these studies? None.

Riboflavin, or vitamin B2, is another nutrient that has been shown to be effective in the treatment of migraines. It can potentially decrease the number of migraine days by about 25% and lower the frequency of migraines by 30%. Similar to CoQ10, riboflavin is needed to convert food into energy. Dairy products, eggs and meat contain significant amounts of B2, but not the high doses you would need to treat a migraine. Keep in mind also that all the B vitamins work best when they work synergistically, so make sure to also use a B complex vitamin as a base, and then add some extra B2 to your diet.

Magnesium plays an important role in migraine prevention and reduction. Like 5HTP, it has an effect on serotonin, so when magnesium levels are low, the risk for a migraine may increase. Magnesium also improves energy production within the heart and dilates the arteries, which helps blood deliver oxygen more effectively. Up to 50% of patients who are experiencing acute migraines have been shown to have a magnesium deficiency. This is actually not surprising since most adults in the U.S. are low in this very important mineral.

Beneficial Herbs

A combo cocktail of herbs may also be beneficial for migraine sufferers. 108 children and adolescents between the ages of 6 and 17 tried butterbur root extract for 4 months and experienced a decrease in the frequency of attacks and they all reported that they felt better. The same results were found in adults. The most frequently used herb for the long-term prevention of migraines is feverfew. Using feverfew together with another herb, white willow bark also reduces the frequency, intensity and duration of migraine attacks, up to 60%.

Uncovering the causes behind migraine attacks is as personalized as choosing your style of coffee these days. My suggestion is to start with one item that you suspect and eliminate it for at least one month. Another option is to have a healthcare provider perform an allergy sensitivity test, a blood test to identify food intolerances. Keep track of the frequency of migraine occurrences as you eliminate each item and then reintroduce them, and don't forget to record your symptoms. It's important to experiment with diet and lifestyle changes one at a time, in order to identify the right antagonist. But-pardon the pun -- it's worth the headache. (send questions and comments to smnutrition@rcn.com)