Prescriptions
Several therapies work for migraine headaches

All races, cultures have sufferers

For many people, migraine headaches are painful and debilitating and they interfere with quality of life.

Jill, my 28-year-old patient from Mililani, came to see me because she was experiencing migraines when she ovulated (at mid-cycle) and at the time of her period. She also had less severe headaches throughout the month. She was missing work frequently and had to schedule her life in anticipation of her insufferable headaches.

Jill had tried Imitrex, a well-known prescription medication, but found that the drug didn’t help. She needed relief and was ready to make dietary and lifestyle changes, if necessary, to prevent her migraines.

Migraine headaches affect 6 percent of men, 18 percent of women and 2 to 4 percent of children. More than 50 percent of patients with migraines have a family member who has also experienced these debilitating headaches. Migraines know no boundaries; sufferers are found in all races, cultures and locations.

Migraines can come with or without warning. Warning comes in the form of an aura that can last a few minutes and includes symptoms of blurring or bright spots in the visual field. Nausea, vomiting, throbbing head pain, anxiety, fatigue, numbness or tingling on one side of the body usually accompany a migraine headache.

Research has suggested that hormonal changes (especially the changes associated with a woman’s menstrual cycle), platelet aggregation (platelets are small blood cells involved in the formation of blood clots), serotonin deficiency and various stressors may be responsible for causing migraine headaches. Constriction of blood vessels followed by excessive dilation of blood vessels in the head causes migraine headache pain.

What can you do to prevent migraine attacks?

Avoid triggers. In 1997, the Mayo Clinic Health Letter published an article estimating that 20 percent of migraines are caused by food sensitivities. The most common culprits are dietary amines (foods containing high levels of the amino acids tyramine and phenylalanine) such as chocolate, cheese, beer, red wine, pickled herring, yogurt and raspberries.

Dietary amines also contain increased amounts of histamine that can trigger migraines by causing blood vessels to expand in sensitive individuals. Food additives such as monosodium glutamate (MSG), aspartame (found in Nutrisweet) and sodium nitrite (found in many processed meats) are also migraine triggers.

Several studies also support the idea that migraines can be triggered by food allergies. Common culprits are dairy foods, wheat, eggs and oranges.

Consider nutritional therapy. A study published in the journal Neurology in 1998 found that riboflavin, also known as vitamin B2, taken at a dose of 400 milligrams per day, decreased the frequency and intensity of migraine headaches in 59 percent of the participants.

Another study using the same dosage of riboflavin found that the participants had a 68 percent improvement in migraine symptoms. Remember: Always take a vitamin B-complex when using riboflavin as a treatment for migraines. And don’t be alarmed — riboflavin will make your urine very yellow.

Consider herbal medicine. The herb feverfew has a long history of medicinal use for the prevention of migraines. Studies suggest the minimum recommended dosage is 125 milligrams of dried feverfew leaf standardized to 0.2 percent parthenolide content. Feverfew should be used continuously for at least four to six weeks to determine effectiveness. (Warning: This herb is not recommended during pregnancy and lactation, or for children younger than 2.)

Consider acupuncture. The use of acupuncture in the treatment of migraine headaches has been studied worldwide. Acupuncture works to relieve pain and to prevent those intense headaches by normalizing serotonin levels.

Consider hormone therapy. Dr. Glenn Rothfeld, a professor at Tufts University and author of several books on natural medicine, believes that hormonal imbalances can cause migraines in women. He has found that it is usually progesterone deficient to estrogen that causes the imbalance.

Other studies suggest that women experience migraines due to fluctuation in estrogen levels. Dr. Tori Hudson, author of "Women's Encyclopedia of Natural Medicine," said that a low-dose estrogen pill from mid-cycle until a woman’s menses starts can prevent hormonally driven migraines. (It is important to see your doctor and have your hormone levels checked before beginning any hormonal therapy.)

Jill feels like a new woman. She started taking feverfew and progesterone and did a series of acupuncture treatments and, after only two months, is headache free!

Dr. Laurie Steelsmith is a naturopathic physician and licensed acupuncturist in Honolulu.

Hawai‘i experts in traditional medicine, naturopathic medicine, diet and exercise take turns writing the Prescriptions column. Send your questions to: Prescriptions, ‘Ohana Section, The Honolulu Advertiser, P.O. Box 3110, Honolulu, HI 96802; e-mail ohana@honoluluadvertiser.com; fax 535-8170. This column is not intended to provide medical advice; you should consult your doctor.

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