Category Archives: migraine

Migraine and Magnesium

Medical specialists have recently recommended that all migraine sufferers should be treated with magnesium supplementation (1).

Migraine and Magnesium
Research shows the benefits of magnesium (citrate) supplementation in preventing and reducing migraines.

A migraine is more than just a headache, it has a huge impact on the lives of sufferers and costs the UK more than £2.25 billion per year. One in seven people in the UK suffers with migraine, with women more likely to be affected than men. Fortunately, nutritional strategies can be very successful in helping sufferers by reducing the severity of symptoms and the frequency of attacks.

Clients who come to see me about migraine often need a personalised approach, as the condition and its triggers can be very individual. It is always important to consider dietary factors that can trigger an attack. A diet high in sugary foods and processed ‘high glycemic’ carbohydrates can trigger a migraine by causing episodes of hypoglycaemia. Food intolerances are also fairly common, with sufferers reacting to substances such as amines in chocolate, cheese, beer and wine. Excess salt, artificial sweeteners and wheat have also been identified as possible culprits. Allergic reactions to food can cause platelets to release serotonin and histamine, triggering a migraine attack in sensitive individuals.

Because migraines can be so individual, it can be difficult to make blanket treatment recommendations to sufferers. However, a recent article published in the Journal of Neural Transmission last week may change this. The article, written by two doctors with a particular interest in headache and migraine, recommended that all migraine sufferers should be treated with magnesium supplementation.

Magnesium deficiency is very common, affecting around 15% of the population (2). Poor intake is a common reason for deficiency, as a diet high in natural, plant-based wholefoods is essential for sufficient magnesium intake. Likewise, a diet high in sugar and refined carbohydrates leads to depleted magnesium levels. The authors also explain that poor absorption, stress and excessive excretion of magnesium by the kidneys can contribute to magnesium deficiency.

The authors suggest several ways that magnesium levels can be linked with migraine. For example, adequate levels of magnesium are essential in maintaining vascular tone and preventing neural hyperexcitation. Magnesium is also linked to the availability of serotonin, a neurotransmitter than can contribute to migraine by affecting the constriction of blood vessels in the brain.

The problem with testing for magnesium deficiency is that blood tests are not a reliable way to determine magnesium levels. This is because magnesium tends to ‘hide away’ inside cells and in bone, and so cannot be measured accurately in a blood test.

For this reason, the authors recommend that all migraine sufferers should be treated with oral magnesium. Their reasoning is that it is difficult to determine whether somebody is deficient in magnesium. However, such supplementation is harmless for those who are not magnesium deficient, and is potentially very helpful for those who are indeed deficient.

The best forms of magnesium are organic forms such as magnesium citrate, malate or aspartate. Inorganic forms, such as magnesium oxide, are less well absorbed, and more likely to have a laxative effect. If magnesium produces loose stools or diarrhoea, then the dosage should be reduced to a more tolerable level. The form of magnesium I most often recommend is magnesium citrate, at a level of 300-400mg per day. Dividing the dose and taking a well-absorbed form helps to reduce the likelihood of any side-effects.

For a condition such as migraine, which can have a huge impact on the wellbeing of sufferers, magnesium could provide welcome relief. The authors conclude that “considering that up to 50% of patients with migraines could potentially benefit from this extremely safe and very inexpensive treatment, it should be recommended to all migraine patients.”

Written by Nadia Mason, BSc MBANT NTCC CNHC

References

1. Magnesium effective in the treatment of migraine
Maukop A, et al. Why all migraine patients should be treated with magnesium. J Neural Transm 2012 May;119(5):575-9

2. 2. Schimatschek HF, Rempis R (2001) Prevalence of hypomagnesemia
in an unselected German population of 16,000 individuals. Magnes Res 14:283–290

Share

Feverfew, botanical help for migraine sufferers


On Monday  I wrote about nutritional aids for migraine sufferers.   Help may also exist in the form of a botanical supplement known as feverfew (botanical name – Tanacetum parthenium).  Feverfew is a bushy, hardy, perennial plant from the Sunflower (Asteraceae) family.


 


For many hundreds of years feverfew has been used to treat and prevent migraines.  The effectiveness of this plant for the alleviation and prevention of headaches and migraine is believed to be attributable to the fact that it contains the natural plant chemical parthenolide.  Parthenolide is an active natural plant compound which seems to have an effect on serotonin release in the brain as well as having an effect on inflammatory chemicals.  This may be important since inflammation of brain blood vessels has been implicated in migraine.



Early studies (1,2,3) found that feverfew was effective in reducing the frequency, severity and duration of migraine attacks.  It may, however take several weeks for benefits to become apparent.  Two more recent, but small, studies (4,5) have also found feverfew to be beneficial to migraine sufferers and a recent review study (6) concludes with the authors recommending the use of feverfew in the preventative treatment of migraines.  Larger studies with feverfew are certainly warranted. 


The safety of this plant for use in migraine sufferers has also been assessed.  A large review study found that there were no serious side-effects to using feverfew in the treatment and prevention of migraine headaches (7).



Feverfew can be taken as a supplement, a tincture and is sometimes available as a tea.  If you regularly suffer from headaches or migraines then you may wish to try feverfew for a few months to see if it helps prevent attacks or reduce their frequency and intensity.  If you are taking migraine medication always check with your prescribing doctor before starting to take feverfew and always follow manufacturers dosage guidelines.  Please also read the post written about nutritional aids for migraine sufferers, a change of diet in addition to the feverfew supplements may bring some helpful relief.



(1) Murphy JJ, et al.  1988.   Randomized double-blind placebo controlled trial of feverfew in migraine prevention. Lancet 1988;ii:189-192
(2)Johnson ES, et al.  1985.   Efficacy of feverfew as prophylactic treatment of migraine. BMJ 1985;291:569-573
(3)  Palevitch D, et al.  1997.  Feverfew (Tanacetum parthenium) as a prophylactic treatment for migraine: A double-blind placebo-controlled study. Phytother Res 11:508-511
(4) Shrivastava R et al.  2006.  Tanacetum parthenium and Salix alba (Mig-RL) combination in migraine prophylaxis: a prospective, open-label study.  Clin Drug Investig. 2006;26(5):287-96.
(5) Diener HC et al.  2005.  Efficacy and safety of 6.25 mg t.i.d. feverfew CO2-extract (MIG-99) in migraine prevention–a randomized, double-blind, multicentre, placebo-controlled study. Cephalalgia. 25(11):1031-41.
(6)Sun-Edelstein C and Mauskop A.  2009.  Foods and supplements in the management of migraine headaches. Clin J Pain. 25(5):446-52.
(7) Pittler MH, Ernst E.  2004.  Feverfew for preventing migraine. Cochrane Database Syst Rev. 2004;(1):CD002286.
Written by Ani Kowal

Share

Natural approaches to dealing with migraine headaches

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:
*Specific foods
*Food additives, especially monosodium glutamate (MSG)
*Stress, emotional and physical
*Low blood sugar levels
*Strenuous exercise
*The environment – bright lights, flashing lights, strong smells, loud noise, the weather, smoking, stuffy atmosphere
*Certain medications



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.



Magnesium
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

Share