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Migraines and Headache

by Theresa Coe(more info)

listed in medical conditions, originally published in issue 34 - November 1998

Migraine or Headache?

Simply put, migraine is a severe episodic headache accompanied by abdominal or visual disturbances, dizziness or even temporary paralysis. Attacks last from four hours to three days and can leave sufferers extremely fatigued. The pain of migraine is caused by a widening of the blood vessels in the lower part of the brain which brings on the throbbing head pain. Although the causes are not fully understood, certain foods or activities can bring on an attack. The most common type of headache, however, is muscular, with pain spreading upwards from the neck. If not, all the muscles of the scalp are involved, the pain may be centred in one area where muscles have contracted, such as above an eye. In her book, Headaches and Migraine, Shirley Trickett writes 'If your headache is relieved by a head and shoulder massage, you can be fairly sure it is a tight muscle or tension headache.'

Common Causes and Triggers

Headaches can be caused by mental, emotional or physical stress. Physical triggers are many and varied, including lack of sleep, poor posture (sitting hunched over a computer for long periods), being in a polluted environment or eating foods of which the body is intolerant. As a combination of factors may be involved, the first step to finding the cause of your pain is to keep a diary of what you ate and your state of mind before the headache started; you might start to notice a pattern.

Other common triggers for headaches and migraine include hormonal changes in the body; migraines are suffered by three times as many women as men and most are affected during their menstruating years. Some women's headaches are pre-menstrual, while taking the contraceptive pill or HRT can also alter hormone levels and trigger headaches (in fact, if there is a family history of migraine, most doctors will not prescribe the Pill).

Sinusitis, on the other hand, is usually triggered by frequent colds or being in a smoky or polluted environment. Nasal washouts with salt water, acupuncture and certain homoeopathic remedies can bring relief; it's also advisable to avoid dairy produce and to take garlic supplements.

Stress and tension – let it out!

Once you learn to recognise the telltale signs of increasing tension, you can consciously relax before the headache starts. Indicators are a tight neck and shoulders, tight feeling in the chest or tummy, shallow breathing or clenched teeth. Try using affirmations such as 'I feel calm, confident and in control', or practice deep breathing exercises (count to yourself as you breathe in and out, and with each breath, focus on making the out breath last a bit longer). Other stress-busting activities include taking up aerobic exercise, and working towards a calmer state of mind so that you are able to cope with day-to-day challenges in a more positive way. To this end, learning yoga, hypnotherapy and meditation or talking through negative feelings with a counsellor may prove helpful.

For more ideas, read The Calm Technique by Paul Wilson or contact Unwind (Pain and Stress Management) on 0191-384 2056.

Recommended Homeopathic Remedies for the Emergency Treatment of Migraines

Specific remedies to be taken – hourly for up to ten doses, if possible at the first signs of an attack

• Blurring of vision before headache comes on, tight feeling in scalp, headache right-sided but less insistent if person moves around, vomit mostly bile Iris 6c

• Headache worse on right side, feels as if temples are being screwed into each other, trying to concentrate makes pain worse, dizziness Lycopodium 6c

• Throbbing, blinding headache, warmth and moving around makes headache worse, head feels over-stuffed and congested, attack preceded by numbness and tingling in lips, nose and tongue Natrum mur 6c

• Headache worse in evening or during a period, aggravated by rich, fatty food, head feels as if it is about to burst, person easily bursts into tears Pulsatilla 6c

• Headache worse in morning, bursting pain which is right-sided and seems to start at back of head, with pain extending into right shoulder, some improvement later in day Sanguinaria 6c

• Pain starts at back of head, then shifts and settles above one eye, aggravated by cold, alleviated by wrapping head up warmly and tightly, person prone to head sweats Silicea 6c

• Sharp, darting, severe pain over left eye, pain seems to pulse with every heartbeat, stooping or moving suddenly makes pain worse Spigelia 6c

• Left-sided headache, as if head is being pierced by a nail Thuja 6c

Extract taken from The Family Guide to Homoeopathy by Dr Andrew Lockie. Reproduced with kind permission of Hamish Hamilton

 

Headaches and Food Intolerance

It's well known that there are foods which commonly trigger migraine, namely the three 'c's (caffeine, chocolate and citrus), shellfish, alcohol and phenolics such as nicotine and tyramine. According to Bolton GP Dr Andy Wright, tyramine is the commonest of the food triggers for severe headache, and is found in the highest quantities in cheese, Marmite and other yeast extracts, beer, wine, chocolate and beef.

There is also a theory that certain vitamin and mineral deficiencies can occur in chronic headache sufferers, which may respond to supplementation. Dr Mike Whiteside, in his book Headaches – Finding relief without drugs, points out that sinusitis sufferers, for example, have been shown to be deficient in vitamins A, B and C.

Anna-Marie had suffered severe head pain and migraines for six months so she decided to try an elimination diet to find out if she had a food allergy. Starting with just rice cakes and tuna, she initially had 'withdrawal' symptoms of severe migraine and vomiting, but three days later, the difference was remarkable. She says, "It was like a cloud had been lifted. I used to take eight pain killers a day and now I hardly ever need them." Anna-Marie has gradually been able to introduce more foods but still cannot tolerate wheat, yeast, sugar or dairy produce.

Allergy testing can take many forms. Some tests are available on the NHS – ask to be referred to a dietician or an allergy clinic or ring Allergycare on 01823 325022 who charge £30 for a basic test.

Further information is available from the charity Action Against Allergy; send an SAE to PO Box 278, Middlesex TW1 4QQ.

An Exclusion Diet for Migraine

Cut out the following:

  • smoking

  • the Pill

  • tea, coffee and other foods containing caffeine such as cola drinks,cocoa and chocolate

  • alcohol, especially red wine

  • sugar.

The above may be all that is necessary in a significant percentage ofpatients. If not, then the following should also be avoided:

  • foods containing tyramine, such as chocolate, yeast extracts and yeastproducts (e.g. Marmite), liver, sausages, broad beans, pickled herrings and cheese

  • foods containing histamine such as cheese, sauerkraut, salami andsausage meat

  • foods containing other natural chemicals likely to precipitate migraine,such as oranges and bananas

  • food additives – tartrazine (E102), benzoate (E210-219), butylatedhydroxytoluene (E321), monosodium glutamate (E621)

  • wheat

  • milk.

These are the major foods associated with migraine and this diet,preferably in whole, should be followed for four weeks or at least for long enough to beable to judge whether there is a clinical response in the frequency or severity ofmigraine attacks.
If you find you do not have migraines while on this programme, then introduce individualfoods at three to seven day intervals to see if you can determine which foods on the listtrigger your attacks. If a migraine headache is triggered, it is pointless to try afurther food in the next three or four days as platelet abnormalities may not be apparentduring this period, and the precipitation of migraine, even if you are eating anothercausative food, will be most unlikely.

 

Extract taken from Nutritional Medicine by Dr Stephen Davies & Dr AlanStewart.

Reproduced with kind permission of Macmillan Publishers

 

More on the gut connection

There is a theory is that yeasts and parasites in the gut can spread out of control, putting down spores which pierce the gut wall and allow undigested food particles to get into the blood stream. This is known as 'leaky gut syndrome', and can cause a range of allergic symptoms, including a crashing headache. Likely causes of this include a history of antibiotic use, a high sugar diet and a weakened immune system. Treatment involves cutting out yeast and sugar, putting back the 'friendly' bacteria which keep the yeast in check, and taking natural anti-fungal food supplements such as garlic.

More information is available from the National Candida Society by sending an SAE to P.O. Box 151, Orpington, Kent BR5 1UJ or Tel: 01689 813039.

Unstable blood sugar levels can also cause problems. In his book Migraines and Headaches – Treating the Whole Person, Dr Richard Petty writes, "If you have headaches which occur only when you are hungry and which are associated with feelings of shakiness, then . . . eat little and often and avoid white bread and sugar."

For more advice, or to find a qualified nutritionist in your area, send an SAE plus £1 to the Society for the Promotion of Nutritional Therapy, PO Box 47, Heathfield, East Sussex, TN21 8ZX Tel: 01825 872921.

Herbs for Headaches and Migraines

     Headaches and migraines may be warning signs of stress or fatigue, but they are also related to women’s hormonal problems, allergy, pollution, candidiasis, nutritional deficiency/poor diet, high blood pressure, low blood sugar, liver and digestive problems, alcohol, eye strain, and back problems. A warm herbal bath with strong infusions or oils of either lavender, peppermint, or marjoram will relax muscles and soothe pain. Massage, particularly of the head and neck, and feet, and inhalations can bring swift relief. As a preventative take, either as a mixture or individually, teas or tinctures of feverfew, meadowsweet, wood betony, and rosemary three times daily. For tension, especially in the neck and shoulders, add either rosemary, valerian, or cramp bark. For menstrual problems add devil’s bit/false unicorn root, or vitex. For stress and anxiety add either chamomile, vervain, skullcap, wild oats, or pasque flower. At the first signs of pain take teas or tinctures of passionflower, feverfew, rosemary, or wood betony and repeat as necessary. Inhale lavender or rosemary oils or massage them into the temples.
     Warning Headaches may indicate potentially serious, albeit uncommon problems.

Extract taken from Herbs for Common Ailments by Anne McIntyre. Reproduced with kind permission of Gaia Books Limited.

 

Conditions to exclude

Although life-threatening conditions such as meningitis are extremely rare, it's important that a patient is not 'fobbed off' with painkillers when frightened and in agony.

J, who is a long-term sufferer of M.E./CFS, suddenly presented with severe head pain which was dismissed by her doctor as 'just another symptom of M.E.' By the time she was admitted to hospital with a suspected blood clot several days later, it was too late: she had lost her sight.

Nigel, on the other hand, used to wake up with head pain which lasted throughout the day. Professor Lamey at the Pain Research Institute at Rice Lane, Liverpool, made him a special brace to wear at night, believing the pain to come from excessive teeth grinding during sleep. Nigel said "within two weeks of wearing the brace my headache disappeared and has never come back."

You may also want to consider seeing an osteopath to check that the vertebrae in your neck aren't out of place and impeding blood flow to the brain, as this can also cause head pain.

Nutritional Approaches

     The American nutritionist Dr. Melvyn Werbach cites a case of a migraine sufferer forced to go on a bland diet to heal his gastro-intestinal bleeding caused by a high intake of aspirin. A scrupulous diary-writer, he found that in the previous year he had taken 1,316 aspirin. He had had a headache on 326 days!

So if you are a headache or migraine sufferer it is well worthlooking at your diet or nutritional status to see if they can help.

Are your headaches or migraines caused by caffeine withdrawal?

This is a very common cause. Hospital Doctors have recently found that severe headaches previously thought to be caused by general anaesthetics given for operations were, in fact, caused by caffeine withdrawal. 18-20 hours after the first cupof tea, coffee or cola is when they strike.

Are they caused by hypoglycaemia?

The key question here is “if you usually eatat regular mealtimes what happens if you miss one or two meals?” If the answer isfaintness, weakness, undue fatigue, irritability or headaches, then you have a degree ofreactive hypoglycaemia.

Reactive because it is a reaction to the increase in blood sugar produced by a meal. If that meal is especially large, or contains too much sugar or refined carbohydrate then your blood sugar will rise more than it should and will be followed by a fall to below the normal level, and some or all of the symptoms mentioned. Many headaches are caused by this and some migraines, so make sure you eat at least once every four hours and avoid foods that have a high glycaemic index (ones thatraise your blood sugar too quickly).

Are they caused by foods high in tyramine?

Tyramine is a brain chemical in high concentrations in certain foods such as chocolate, red wine, aged cheeses such as stilton or camembert, Marmite or other yeast extracts, salami, broad beans. Avoid these foods.

Are they caused by food intolerances?

A 1983 study at Great Ormond Street hospital reported in the Lancet found that 93% of children suffering severe frequent migraine recovered completely once the offending foods were omitted. So be especially wary of the foods you eat most often such as wheat or dairy products or citrus or eggs, as these are the ones that are the most common offenders. If you are eating any food more than four times a week, cut it out for 14 days along with the high tyramine foods mentioned above. Then reintroduce the healthy foods you have eliminated slowly and carefully, no faster than one every two days, and see which, if any, provokes a headache or migraine.

Liver congestion can be a contributory factor so takethe herb silymarin (milk thistle) or the amino acid L cysteine, that is important for adetoxification (best taken as N: acetyl cysteine 500 mg 3 x a day at least an hour beforemeals). Constipation can also play a part so eat a high fibre diet, take linseeds soakedovernight in water, eat lots of raw vegetables and salads, avoid too much meat or alcohol,drink plenty of water, get lots of fresh air and exercise.

Nutritional supplements

     A recent study found high doses, 400 mg a day of vitamin B2 to be helpful. But this is very high so make sure you take a B complex containing at least 50 mg of the other vitamins. Magnesium is known as the calming mineral because it curbs irritability and muscle spasms. Anyone with low magnesium is liable to be headache-prone, but women are especially prone at the time of their period. 400 mg a day is a good preventive dose or 100 mg per hour in acute attacks (no more than 6-8 doses). Chromium is the most important supplement if hypoglycaemia is a cause of your headaches. Best taken as chromium polynicotinate, the liquid form is the most absorbable.

 

Michael Franklin is a registered nutritional therapist. He sees patients in Oxford (01865 511357) and also operates a postal/telephone consultancy for those living in remote areas.

 

Natural pain relief – some individual experiences

Chemical imbalances in the brain, particularly of the neurotransmitter serotonin, are another cause of migraine and headache. Although there are drugs which can help with this, former sufferer Michael Lamprell has found relief through the herbal remedy 'Feverfew', available from health shops. (More information on this is available from the Migraine Action Association, who have a helpline on 01932 352468).

Amarjit, however, takes a natural painkiller for his severe headaches called DLPA, which consists of two amino acids. It's made by Solgar and is quite pricey, but, adds Amarjit, "It's worth it for me because it really works." Meanwhile, Tami swears by an amethyst crystal on the forehead to relieve her throbbing headaches.

Hilary, on the other hand, put a stop to her migraines with a product called 'Empulse'. This is a small watch-like device one wears which is set to emit a specific pattern of electromagnetic waves, chosen to stimulate and influence individual brain wave imbalances. Dr David Dowson in Bath says "I have been using Empulse since the 1980s for my migraine patients and the fact that symptoms return when the battery runs flat suggests that the benefits are not due to a placebo effect." For more information about Empulse, call 0116-277 2051. Remember that for those who are sensitive, some electromagnetic fields can be harmful as well as helpful, so try not to sleep surrounded by electrical equipment like TVs and stereos.

Chinese acupuncture can also help with pain relief. A case history of the symptom pattern is taken to determine which meridians or energy channels in the body are involved, and needles are applied to particular points to stimulate the flow of 'Qi' or life force.

Finally, as undue tension and poor posture can lead to cranial disturbance, cranial osteopathy can ease headaches and sinusitis through the gentle manipulation of the many tiny bones that make up the skull. For more information, call the Cranial Osteopathic Association on 0181 367 5561.

Aromatherapy for Headaches

Tension headaches resulting from stress or overwork are common and respond well to aromatherapy treatments. Symptoms usually include muscular tension, particularly of the scalp, shoulders and neck. Headaches may also stem from factors such as sinus congestion, menstruation, a deficient diet, food allergy, and certain disorders of the eyes, ears and teeth. The discomfort experienced may also give rise to tension and can similarly be eased through use of aromatherapy.

A migraine is a type of headache, typically felton one side of the head only, that can last for two to three days. Eyesight can beaffected and you may experience some nausea. Stress or an irritant substance in your dietor environment may trigger an attack. While you may be sensitive to touch in the form ofmassage, inhalation can bring welcome relief.

Caution: Headaches can have more serious causes.Consult your doctor if the pain is sudden or severe, or if it recurs frequently.

Useful Oils

Lavender and Sweet Marjoram will both help to relieve pain, while Roman Chamomile is generally soothing. For sinus congestion, add Eucalyptus and/or Peppermint for their decongestant properties. Sweet Marjoram is particularly useful for headaches association with menstruation, while True Melissa or Rosemary can help to relieve a migraine.

Treatment

Diet It is wise to seek the advice of a professional nutritionist if you think that your headache or migraine may be related to food allergy, but you can begin by excluding foods, such as coffee, chocolate, cheese, and red wine, that are commonly linked with migraine attacks.

Inhalation This method can bring relief toheadaches and migraines if used as soon as symptoms begin. Sprinkle 2 drops each ofSweet Marjoram, Lavender, and Peppermint onto to a tissue; for a migraine, add 1drop of True Melissa. Inhale deeply three times.

Application To relieve a tension headache, moisten your forefinger with 2 drops of Lavender and rub gently over your temples, behind your ears, and across the back of your neck. Apply twice more, if necessary. Caution: Keep your fingers away from your eyes. To reduce the intensity of a headache, add a total of 12 drops of your chosen blend to 1fl oz (30ml/5tsp) of carrier oil, andapply the mix to your face and neck.

Massage Dilute 3 drops each of Lavender andEucalyptus in ½ fl oz (15ml/2½ tsp) of carrier oil and use the mix to massage yourforehead and behind your ears, pausing to apply gentle pressure around the hollows on theouter corners of the eye bone. Work along your shoulders and neck or ask a friend tomassage these areas.

Bath Add 3 drops each of Sweet Marjoram,Roman Chamomile, and Lavender to a bath to help relive tension headaches.

Extract taken from Aromatherapy for Common Ailments by Shirley Price. Reproduced with kind permission of Gaia Books Limited.

 

Useful Information

PainWise UK send out useful information on managing chronic pain or stress. Call their helpline on 01227 277993.
The Migraine Trust can offer advice and information for sufferers. Contact them on 0171-831 4818.
Petty, R (Dr.) (1987) Migraines and Headaches – Treating the whole person Unwin
Trickett, S (1996) Headaches and Migraine Penguin
Whiteside, M (Dr.) (1995) Headaches – Finding relief without drugs Thorsons
Wilson, P (1995) The Calm Technique Thorsons

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About Theresa Coe

Theresa Coe is contributing editor of InterAction, the journal of the Action for M.E. charity. She has suffered from M.E. for eight years. As a member of the Council of Management at Action for M.E. and through her involvement with her local M.E. support group, most of her time is spent trying to help other sufferers to find the best quality of life they can.

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