Getting ahead of migraine

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Publication Date: 
Mon, 2013-07-01

The liver also plays a vital role in cleaning the blood, processing wastes and excreting excess hormones. If the liver is not breaking down substances efficiently, Wales will direct treatment to that end. “Even a small decrease in liver function can cause symptoms,” she says. Improving the body’s detoxification processes is a key factor in enhancing basic overall health. “Hormones play a role but I don’t think they are the causative factor,” says Wales. Though there may be a hormonal imbalance, she looks at what is happening to a patient on a daily basis: “Because migraines seem to be a confluence of things coming together, the more factors involved the more likely there is to be a migraine.”

Wales stresses that the two things a patient can control are diet and how she responds to stress. Adequate sleep, exercise, and drinking water to keep tissues and blood vessels hydrated are basic but important steps in maintaining general good health overall. Most patients do an elimination diet to find out what foods trigger migraine, although it takes time and patience and involves some “detective work.”

Managing migraine: preventatives and pain relief

To alleviate pain, Wales may recommend magnesium, niacin (vitamin B3), quercetin (a bioflavonoid), fish oils, or evening primrose oil. She says that essential fatty acids keep blood vessels pliable and allow platelets to move through the blood vessels easily. She adds that botanical medicines such as feverfew and butterbur have been shown to “damp down the blood vessel response” so that a migraineur is not so sensitive. As for finding relief that works for individuals, that too takes a trial and error approach.

When Shulman was about 23 years old her migraines worsened. Her family doctor prescribed propranolol (a beta-blocker used to treat tremors, angina, hypertension and, at that time, migraine). It caused a serious drop in Shulman’s blood pressure leaving her feeling dizzy and tired. “I tried at least six or eight different medications and none of them worked,” she says. In an emergency, she tried Imitrex (also known as sumatryptan, a member of the tryptamine-based family of drugs used to stop the progression of migraines and cluster headaches), but found that in her case, like most of the medications she had already tried, it actually made the migraine worse.

Today Shulman takes vitamin B2 (riboflavin) twice daily to reduce the frequency and intensity of the migraines. She eats organically grown fruits and vegetables, avoiding chemicals and additives as much as possible. She invests in regular acupuncture treatments, although it can be “very expensive” she adds. She cut back on acupuncture treatments for a while but the migraines became so bad she felt she “could not afford to not do them.” For Shulman, meditation and visualization also helps, but “in terms of pharmaceuticals I haven’t had any success at all.” However, she opts for over the counter medication such as Motrin (ibuprofen, a non-steroidal anti-inflammatory) and Extra Strength Tylenol (acetaminophen, a pain reliever) with caffeine, when she feels a migraine coming on.

As a preventative and early treatment, especially for stress-related migraine, Reynolds practices meditation, yoga and massage. Although she was prescribed painkillers with codeine she found they only made her more nauseous and did not stop the pain, but if she can catch a migraine early enough she will take a couple of Extra Strength Tylenol to reduce its severity. Neck massage and the practice of Qi Gong meditation also help, but “if it’s a severe migraine, I can’t do much except lie down in a darkened room, cover my eyes and try to relax as much as possible.” 

Managing migraine: herbs may help

Vancouver Island-based medical herbalist Chanchal Cabrera suggests two strategies for treating migraine in women: a long-term treatment plan for balancing hormones, which can take anywhere from three to six months to be effective, and a quicker fix for pain management. She warns, however, that some of the herbal painkillers can make a person drowsy, which is fine if that person can lie down, but will defeat the purpose if the she has to be alert and functioning. Cabrera, herself an occasional migraineur, takes ibuprophen in those situations because “it knocks the edge off, it’s not enough, but it’s better than nothing and doesn’t make me drowsy.” 

Cabrera notes that there is a constitutional difference in people and will prescribe herbs accordingly. If a patient feels chilly and has a tight constrictive headache, she may suggest taking warming herbs that increase blood flow to the head, such as rosemary, ginger, cinnamon and cayenne; even a cup of strong chai tea with added black pepper can help. For a patient with a throbbing type headache, flushed face, and who may want a cold drink, she may prescribe the herb feverfew. However, feverfew is best used as a preventive and can take three to six months to come into effect. In the short term, Cabrera suggests taking the pain killing herbs that are not going to change the body temperature, such as willow that has pain killing affects similar to aspirin. 

But it is not all about taking herbs: “There are a lot of things that we look at doing. I definitely try to identify hormone connections, diet connections. I almost always send that person in for a good chiropractic assessment because quite often there is some kind of neuromuscular disturbance as well, and even if it doesn’t cause the migraine, it might be a trigger or aggravating factor.”