Naturalpath

What you need to know

1. Find your migraine triggers: A specialist can help you learn if your diet, environment, or lifestyle helps trigger your migraines

2. Try magnesium: Taking 200 mg of this mineral in a well-absorbed supplement two or three times a day may help you have fewer migraines

3. Check out feverfew: Take a standardized herbal extract providing 250 mcg of parthenolide a day to help reduce the frequency, severity, and length of migraine attacks

4. Consider seeing a chiropractor: A qualified practitioner may be able to correct spinal problems that may cause some migraines

5. Try acupuncture: See a qualified practitioner for help with stopping a migraine in its early stages or preventing future attacks These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full migraine headache article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.

About migraines

Migraines are very painful headaches that usually begin on only one side of the head and may become worse with exposure to light.

What are the symptoms?

Migraines are commonly preceded by warning symptoms (prodrome), that may include depression, irritability, restlessness, loss of appetite, and a characteristic aura - usually a visual disturbance such as flashing lights or a localized area of blindness that follows the appearance of brilliantly colored shimmering lights. Migraines may also involve nausea, vomiting, and changes in vision.

Medical options

Over the counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin (Bayer, Ecotrin, Bufferin), ibuprofen (Motrin, Advil), and naproxen (Aleve), may help provide pain relief in mild cases. Excedrin Migraine, which contains acetaminophen, aspirin, and caffeine, might also help with migraine pain.

The most commonly used prescription drugs are the serotonin receptor agonists, such as sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), and zolmitriptan (Zomig). Less frequently used agents include isometheptene-acetaminophen-dichloralphenazone (Midrin), dihydroergotamine (DHE), and ergotamine-caffeine (Cafergot). Many different drugs have been prescribed for migraine prevention, such as propranolol (Inderal), verapamil (Calan, Isoptin), and amitriptyline (Elavil).

Treatment might also include avoidance of certain triggers, such as alcohol and specific foods. Some individuals might benefit from the correction of vision, while others might benefit from biofeedback.

Dietary changes that may be helpful

Some migraine sufferers have an abnormality of blood-sugar regulation known as reactive hypoglycemia. In these people, improvement in the frequency and/or severity of migraines resulted from dietary changes designed to control the blood sugar. For the treatment of reactive hypoglycemia, many healthcare practitioners recommend strict avoidance of refined sugar, caffeine, and alcohol, and eating small, frequent meals (such as six times per day).

Migraines can be triggered by allergies and may be relieved by identifying and avoiding the problem foods. Uncovering these food allergies with the help of a doctor is often a useful way to prevent migraines. In children suffering migraines who also have epilepsy, there is evidence that eliminating offending foods will also reduce the frequency of seizures. Some people who suffer from migraines also react to salt, and reducing intake of salt is helpful for some of these people.

Some people with migraines have been reported to improve after removing all cows milk protein from their diet. The presence of lactose intolerance was found to be a strong predictor of improvement in that study. In addition, some migraine sufferers have an impaired capacity to break down tyramine, a substance found in many foods that is known to trigger migraines in some people. People with this defect are presumably more sensitive than others to the effects of tyramine.

Ingestion of the artificial sweetener, aspartame, has also been reported to trigger migraines in a small proportion of people. L-tryptophan, an amino acid found in protein-rich foods, is converted to serotonin, a substance that might worsen some migraines. For that reason, two studies have investigated the effect of a low-protein diet on migraines; in these studies some people experienced a reduction in migraine symptoms.

However, in a small double-blind trial, four of eight people had marked improvement in their migraine symptoms while receiving L-tryptophan (500 mg every six hours). Moreover, some preliminary evidence discussed below suggests that 5-hydroxytryptophan, a supplement related to L-tryptophan, may reduce symptoms in some migraine sufferers.

Therefore, the idea that a low-protein diet would help migraine patients due to its low L-tryptophan content appears doubtful.

Lifestyle changes that may be helpful

Some doctors have found that reactions to smoking and birth control pills can be additional contributing factors in migraines. Infection with Helicobacter pylori (H. pylori, an organism that causes peptic ulcers) may predispose people to migraine headaches. In a preliminary trial, 40% of migraine sufferers were found to have H. pylori infection.

Intensity, duration, and frequency of attacks of migraine were significantly reduced in all participants in whom the H. pylori was eradicated. Controlled clinical trials are needed to confirm these preliminary results.

Holistic approaches that may be helpful

Many reports have shown acupuncture to be useful in the treatment of migraines. In a preliminary trial, 18 of 26 people suffering from migraine headaches demonstrated an improvement in symptoms following therapy with acupuncture; they also had a 50% reduction in the use of pain medication. Previous preliminary trials have demonstrated similar results, which have also been confirmed in placebo-controlled trials.

Improvement has been maintained at one and three years of follow-up. In preliminary research, patients suffering from chronic headaches of various types (including migraine, cluster, or tension headaches) have also experienced an improvement in symptoms following acupuncture treatment. In a trial comparing acupuncture to traditional drug therapy, a significantly greater cure rate was achieved in the acupuncture group relative to the drug treatment group (75% vs. 34%). Dry needling is a form of acupuncture that does not utilize traditional Chinese medicine diagnosis or traditional acupuncture points for treatment.

Instead, acupuncture needles are inserted into painful muscle areas (trigger points). A study of 85 patients comparing dry needle acupuncture to conventional drug therapy found a similar reduction in frequency and duration of migraine attacks in both treatment groups.

Percutaneous Electrical Nerve Stimulation (PENS) is an electrical nerve stimulation technique that has become increasingly popular in the complementary and alternative management of pain syndromes. PENS involves insertion of needle probes, similar to acupuncture, at specific therapeutic points and then applying low levels of electrical current. In one study, PENS was significantly more effective than needles alone at relieving pain in migraine headaches (tension headaches and post-traumatic headaches were also improved).

Practitioners of manipulation report success in treating migraine with manipulation. Migraine sufferers are reported to often have neck pain, tenderness of the spinal joints of the neck, and limited ability to move the neck, all of which suggest the presence of neck problems that could respond to manipulation.

Two preliminary trials reported significant benefit to 7580% of migraine patients treated with manipulation, while a third preliminary trial reported reductions in headache frequency and duration, nausea, and sensitivity to light one year after the completion of a two-month course of manipulation. A controlled trial compared three types of manipulation and found all three provided significant improvement in headache frequency, severity, and duration.

Another controlled trial compared two months of manipulation to sham (fake) manipulation and to placebo treatment with a non-functioning electrical unit. People in the manipulation group had significantly more improvement of headache frequency and duration, and of ability to function in daily life; they also used less medication. The largest controlled trial to date compared eight weeks of manipulation, drug therapy, or both treatments in combination.

Manipulation was as effective as the medication in reducing an overall score of migraine suffering, but had fewer reported side effects.

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