Living with Migraine
While patients often refer to a severe headache as migraine, migraines are in fact a very specific kind of headache involving changes in the blood vessels of the brain, head and face.
While there are other headaches that are caused by blood vessel dysfunction, Migraine is the most common. Brain arteries become inflamed and highly sensitive to certain triggers resulting in spasm of the arterial wall. This inhibits blood and oxygen flow, stimulating the arteries on the surface to dilate, resulting in a throbbing pain on one side of the head. Other symptoms related to migraine are nausea and vomiting, aura or flashing lights, nerve symptoms and extreme light or sound sensitivity.
There are 4 phases of a migraine attack though not every patient experiences all of these:
One or two days before a migraine, you may notice subtle changes that signify an oncoming migraine, including:
- Food cravings
- Neck stiffness
- Uncontrollable yawning
Most often an aura is experienced just before the onset of pain. Most commonly patient report a change in their vision, from flashing lights to near blindness on one side. Migraine can also cause sensory auras like the sensation of something crawling on the skin, motor auras with strange movements or lameness or even verbal auras where patients have changes to their speech.
When untreated, a migraine usually lasts from four to 72 hours, but the frequency with which headaches occur varies from person to person. During a migraine, you may experience the following symptoms:
- Pain on one side or uncommonly both sides of your head
- Pain that has a pulsating, throbbing quality
- Sensitivity to light, sounds and sometimes smells
- Nausea and vomiting
- Blurred vision
- Lightheadedness, sometimes followed by fainting
The final phase, known as postdrome, occurs after a migraine attack. During this time you may feel drained and washed out, though some people report feeling mildly euphoric.
Causes vs Triggers
Every migraine sufferer will report certain known triggers for their headaches, these are not to be confused with the underlying cause of migraine attacks.
Some of the causes of migraine include the following:
- Generalised body inflammation
- Leaky gut
- Hormonal dysfunction or changes including pregnancy, menopause or menarche
- Psychological problems
- Chronic stress
- Magnesium and Vitamin B deficiency
- genetics or family history
- Mitochondrial dysfunction or chronic fatigue
A useful pneumonic is the word CHOCOLATES when trying to remember what some of the most common migraine triggers are.
CH: Cheese and chocolate
O: Oral contraceptives
A: Anxiety or stress
T: Travel especially into different weather conditions.
S: Sleep – too much and too little sleep
Salty foods and processed foods may trigger migraines. Skipping meals or fasting can also trigger attacks. The sweetener aspartame and the preservative monosodium glutamate, found in many foods should also be avoided by migraine sufferers
- Acupuncture and Chinese Herbs
- Osteopathy, chiropractise or cranniosaccral therapy
- Unani Tibb and Ayurveda
- Herbal medicines
- Therapeutic massage
Elimination Diet – elimination diet helps patients to discover which foods are causing inflammation in their bodies. Cutting these out consistently reduces both headache severity as well as frequency.
Ketogenic diet / Banting – in this diet patients are to strictly cut out carbohydrates so that the body preferentially uses fat as a fuel instead of carbs. I believe that part of its success lies in the benefit of cutting out gluten and processed food too.
Even though exercise can trigger a headache, regular exercise promotes relaxation of muscles and release of endorphins. Yoga is well known for its benefit in reducing stress, promoting healthy energy and blood flow and releasing muscle tension. Though simple stretching exercise can also be beneficial.
This ancient practice of stilling the mind has been scientifically proven again and again to promote wellness and healing. Besides reducing chronic stress, regular meditation actually promotes brain cell regeneration and promotes healthy flow of energy through the body.
Botox is used to temporarily paralyse muscles in selected areas. In the treatment of migraine, we inject botox into specific muscles around the face and head. These are the muscles that generally become tense during migraine and contribute significantly to pain. The treatment lasts about 6 months at a time and has no known systemic side effects, though can be quite pricey.
Herbs, vitamins and minerals
There are a few herbs that have shown promise in treating migraine. Butterbur and Feverfew may help to reduce frequency and severity of migraines.
High doses of riboflavin (vitamin B2) either by oral or intravenous route may also prevent migraines or reduce the frequency. Oral vitamin B3 or Niacin has shown remarkable promise in acutely managing a migraine attack as well as preventing recurrence.
Coenzyme Q10 supplements can help to decrease the frequency of migraines, but they have little effect on the severity of the headache. They work by treating the mitochondrial dysfunction in many migraine sufferers.
Magnesium is often used in my practice as first line in treating migraine. Oral supplements combined with intravenous Magnesium works in most cases to abort an attack and reduce recurrence, if not stop them completely.
We also recommend our Vitamin drips for chronic migraine as the blend of vitamins include all of the above plus some other ingredients to inhibit inflammation and promote detoxification.
The build up of toxins is a common cause of inflammation and by detoxifying the system safely one can target one of the most common causes of migraine. Do not attempt just any detox for this, it can be dangerous, so please consult with a doctor trained in detoxification.
Migraine and the energy body
In a very simplistic viewpoint of headache and the energy body, the head is reflected in 2 energy centers, the Brow and Crown chakras. The Brow being the chakra related to intuition and the crown being related to connection with spirit. When there is Brow / Third Eye chakra dysfunction we relate it to stubborness, inflexibility, a rigidness about life that assumes we are in control and that there is no room for divine intent. Over-thinking and stressful worry also manifest in this area. The Crown chakra governs ones ability to connect to the divinity inside all of us. When one feels alone in the world, or separated from God, it creates real trauma and the Crown chakra is where it is manifest. There is also a connection with the Base / Root chakra in Migraine, in this space there is conflict related to the tribe or ones connections to family, religion or culture. This often results in a judgement space of self and other, feeding into the belief that we are not all connected to the Divine power, resulting in Crown chakra dysfunction and potentially migraine.
There are many practices aimed at treating the energy body, including reiki, acupuncture, acupressure and reflexology, which are all available at Renascent Health.
Though not my favorite management of migraine, it is sometimes necessary to prescribe a pharmaceutical drug for a migraine. These are the classes of medicines most commonly used:
- General pain relief
One of the most commonly used pain killers are anti-inflammatories called NSAIDS. These reduce inflammation throughout the body and temporarily provide mild relief for migraine sufferers with significant side effect risk. Opiods are another commonly used and abused drug for migraines. There have much more effective generalised pain relief but are highly addictive if used often and can cause significant side effects. Cortisones have also been prescribed for migraine though their systemic side effects are quite alarming, especially considering their limited effectiveness in migraine.
- Specific anti migraine
These medications have been designed to specifically work on the nerves, arteries and veins causing the pain in migraine. Triptans (Imigran) and Ergots (Migril) are the most commonly used and seem to be the most effective in aborting a headache, though once again the list of side effects is long and includes symptoms from diarrhoea to stroke.
- Preventative medication
There are many medications prescribed to patients who suffer from chronic recurrent migraine. Among them are drugs for epilepsy, depression and schizophrenia. I would only ever consider these if all other safer measures have been explored.
Keep a headache diary
Every migraine sufferer is different. Every patient has a different set of causes and triggers and the only way to really figure out your own is to monitor your own headaches. Most of my migraine patients keep a diary of what foods they’ve eaten, their sleeping patterns, the weather, and anything else that may have affected the homeostasis of their body. They also track the severity, duration and timing of their headaches. All of this helps to identify the unique triggers for the individual patient.
For a fully integrated and holistic viewpoint of your migraine, come and visit one of the doctors at Renascent Health 021 8242170 or mail us at reception@