Those of you who suffer from migraine headaches will know how traumatic these attacks can be. A migraine is more than just a severe headache. Migraine is characterised by acute pain often in conjunction with visual disturbance, nausea and vomiting. Bright lights, noise, smells and movement can often aggravate a migraine with many sufferers opting to take refuge in silent, dark rooms until the attack has passed, which can be anything up to a couple of days.
Migraine is a multi-factorial condition, thought to occur due to the sudden widening of blood vessels supporting the brain. Genetics and pre-menstrual hormones appear to play a part and there also seem to be many triggers associated with migraine attacks such as:
*Food additives, especially monosodium glutamate (MSG)
*Stress, emotional and physical
*Low blood sugar levels
*The environment – bright lights, flashing lights, strong smells, loud noise, the weather, smoking, stuffy atmosphere
For many people there is not just one trigger but a combination of factors which, individually can be tolerated but when several occur together a threshold is passed causing an attack. Around 3-5% of the population are affected by migraine, in children the incidence is equal in boys and girls but after puberty more women than men will suffer from the condition, probably due to pre-menstrual hormone actions.
There are two main types of migraine:
1.Classical migraine – this is when the migraine headache and nausea are preceded or accompanied by what is known as an ‘aura’. The aura, which can last for up to an hour before the headache starts, can involve a host of phenomenon such as visual problems, tingling in various body parts, depression or feelings of restlessness. This type of migraine is less common occurring in 10-15% of sufferers
2.Common migraine – occurs in 85-90% of sufferers, there is no aura that occurs preceding the headache attack. The headache will be intense and often throbbing, typically affecting only one side of the head.
Studies indicate food sensitivity may be a major contributing factor in migraine (1,2,3,4). There is some evidence to suggest that certain foods are more of a trigger for migraine attack and are often referred to as ‘the five Cs’; chocolate, cheese, claret (and other red wines), caffeine and citrus fruits. Uncovering a food sensitivity may be a useful way to treat migraines, this should always be done under medical supervision. Food sensitivity is unlikely to be a sole trigger for migraine, often a food will only trigger an attack if other factors are at play e.g. emotional stress or premenstrual hormonal factors.
Migraine has been related to low magnesium levels and magnesium deficiency (5). During a migraine attack the blood vessels around the brain tend to constrict (shut down) and then dilate (open out). The second phase of dilation is believed to cause the pain characteristic of migraine. Magnesium deficiency tends to increase the risk of spasm in the lining of the arteries, increasing the risk of subsequent dilation and pain. Magnesium may be particularly helpful for women who suffer from premenstrual migraines. Research has found that 360mg of magnesium a day decreases menstrual migraine (6). A recent small study (7) investigated the effects of magnesium supplementation in the prevention of common migraine (migraine without aura). In the study 600mg of magnesium citrate was used per day and it was found to be significantly helpful, when compared to placebo, in the prevention of migraine.
Many individuals in the UK do not get enough magnesium in the diet, this is particularly true in women. Foods that are rich in magnesium include nuts, seeds, pulses (such as beans and lentils) and wholegrains. Migraine sufferers may wish to consider taking take 200mg magnesium 1-2 times a day as a preventative measure.
Omega 3 fatty acids
Certain essential fatty acids, particularly omega 3 fatty acids (found abundantly in oily fish and flaxseeds), have been found to be helpful to migraine sufferers. These fatty acids probably act by preventing or reducing the release of inflammatory chemicals in the body, known as eicosanoids, which have been implicated in the causation of headaches. One study (8) found that supplementation with alpha-linolenic acid, an essential omega 3 fatty acid found in flaxseeds, reduced the frequency, severity and total duration of migraine attacks by 86%. During the sixth month of the study, 22% of the patients became free of migraine and more than 90% experienced less nausea and vomiting. Studies (9,10) also show that fish oils (which contain the long chain fatty acids EPA and DHA) may be beneficial in the treatment of recurrent migraines.
Migraine sufferers may benefit from consuming a diet rich in omega 3 fatty acids, found in oily fish such as salmon, mackerel, sardines and trout and certain nuts and seeds e.g. flaxseeds and walnuts. If you suffer from migraine you may also want to consider a daily fish oil supplement to provide around 300mg EPA and 300mg DHA per day. Vegetarians could consider a flaxseed oil supplement providing 500-1000mg alpha linolenic acid daily. Most fatty acid supplements also contain vitamin E which acts to protect the oil from degradation or rancidity, this may have other benefits too: a recent study(11) found that vitamin E supplements may be helpful for women who suffer from premenstrual migraines. These fatty acids are incredibly important for many aspects of health.
For more information about migraines, symptoms and helpful resources please visit the charity Migraine Action. If you are taking prescribed migraine medication please check with your doctor before starting any supplement regimen.
(1)Egger J, et al. 1983. Is migraine food allergy? A double-blind trial of oligoantigenic diet treatment. Lancet. ii:865-869
(2)Grant EC. 1979. Food allergies and migraine. Lancet. I:966-969
(3)Hughs EC, et al. 1985. Migraine: a diagnostic test for etiology of food sensitivity by a nutritionally supported fast and confirmed by long-term report. Ann Allergy. 55:28-32
(4)Monro J, et al. 1980. Food allergy in migraine. Lancet. ii:1-4
(5)Gallai V, et al. 1992. Serum and salivary magnesium levels in migraine. Results in a group of juvenile patients. Headache. 32:132-135.
(6)Facchinetti F, et al. 1991. Magnesium prophylaxis of menstrual migraine: effects on intracellular magnesium. Headache. 31:298-301.
(7) Köseoglu E et al. 2008. The effects of magnesium prophylaxis in migraine without aura. Magnes Res. 21(2):101-8.
(8) Wagner, W., et al. 1997. Prophylactic treatment of migraine with gamma-linolenic and alpha-linolenic acids. Cephalagia. 17(2):127-130.
(9) Glueck, C. J., et al. Amelioration of severe migraine with omega-3 fatty acids: a double-blind placebo controlled clinical trial. American Journal of Clinical Nutrition. 43(4):710, 1986
(10)Harel, Z., et al. 2002. Supplementation with omega-3 polyunsaturated fatty acids in the management of recurrent migraines in adolescents. J Adolesc Health. 31(2):154-61
(11)Ziaei S et al. 2009. The effect of vitamin E on the treatment of menstrual migraine. Med Sci Monit. 15(1):CR16-9.
Written by Ani Kowal