I am very excited that Dr. Hai Jin Kim has joined us to guest post on many topics. Please let us know what you would like to hear about in the future.
Migraine headaches, affecting an estimated 28 million people in the US, are a classification of headaches which are typically severe and often disabling. They are usually characterized as throbbing, intense, usually one-sided, often accompanied by sensitivities to light, sound or smell. They can be preceded by warning symptoms, called an ‘aura’. These are typically visual.
Possible triggers include foods (chocolate, citrus, MSG, red wines), hypoglycemia (low blood sugar), change in barometric pressures, estrogen (hormonal fluctuations with a menstrual cycle, hence ‘menstrual migraines), stress, lack of sleep and strong scents (perfumes, etc).
Migraines are thought to be a brought about by abnormal vascular (blood vessel) changes in the brain. There is an initial constriction or narrowing of the vessel followed by a dilation or relaxation of the vessel wall, creating that pounding pressure.
Current treatments involve trying to abort this process. Triptans, the first being Imitrex marketed in the US, presumably help with interrupting the vascular dilation. For migraine sufferers, some of these medication have worked fairly well, if taken early. Others experience significant side effects of nausea, dry mouth, flushing and drowsiness. The various triptans have different onset of activity, duration of effect and different metabolisms which distinguishes one from another.
There are herbal remedies in the literature that have had some effect on migraines. Butterbur (Petasites hybridus) has been used for centuries for multiple ailments. It works as an analgesic by reducing muscle and tissue spasms and reducing inflammation of affected blood vessels. A safe brand I am aware of available in health food stores is Petadolex by Enzymatic Therapy.
I have also had a patient try a mixture of peppermint oil and ethyl alcohol and dabbed it onto her forehead, which would always immediately lessen her headache. She would mix these together before applying it. I was surprised to find a small study from the University of Kiel in Germany of 32 participants in a double-blind, placebo-controlled study to support this remedy!
Dr. Bahman Guyuron, an American Plastic Surgeon discovered that 80% of his patients reported their migraines either disappeared or lessened after surgical removal of the muscles that lie underneath the eyebrows. As a desperate measure, he has had patients request this to rid themselves of their migraines. To be reasonably certain that the surgical procedure would produce long-lasting results, he first has them paralyze these muscles with botox to see if the effect can be achieved. I am definitely not suggesting surgery, as I think this is radical, but thought it was an interesting finding.
I have also talked with biological dentists (dentists who practice holistically) who have mentioned some success with use of oral appliances or night guards. Dr. Phillip Lamey, professor of oral medicine at the Royal Hospital in Northern Ireland discovered migraine sufferers have elevated saliva peptide (protein) levels while non-migraine sufferers had about ten times less. As long as the upper and lower teeth did not make contact, 70% of his patients after wearing the appliance nightly for one year no longer suffered migraines.
Riboflavin (vitamin B2), Magnesium and Betaine hydrochloride (a supplement that helps increase stomach acidity) have been studied and been effective with good tolerability. These are used primarily for prevention, but can also be used used intravenously to abort a migraine. Meyers’ cocktails, an intravenous concoction of Magnesium, Calcium, B vitamins and Vitamin C have had anecdotal success for aborting migraines.
While I have listed many approaches to remedy this condition, the question still begs to be asked: why does this vascular phenomenon occur? In my experience, certain food sensitivities and food allergens can be a culprit (gluten and dairy being the primary offenders). I have had several patients who have completely eliminated their migraines by eating the foods that were not irritants to their gastrointestinal system. When the upper digestive system becomes imbalanced, there are nerve signals to the brain which create chemical changes that can potentially trigger those vascular changes creating a migraine.
Hormonal changes are tightly regulated by the pituitary/hypothalamus which also have an effect on upper digestive function. If upper digestive function (stomach, liver, gallbladder, pancreas) is imbalanced or not functioning optimally, the hormonal fluctuations could create a trigger for migraines.
As an example of a patient of mine who suffered migraines, once we got her off her acid blocker, restored normal function to her stomach, her migraines disappeared. While acid blockers help relieve symptoms, it doesn’t rectify the situation which created the symptoms. Many folks who have heartburn actually suffer from having inadequate stomach acid, not too much. Without adequate acid, proper digestion of proteins do not occur, creating putrefecation and creation of organic acids translating out to ‘heartburn.’ Acid blockers do help with neutralizing the organic acids, but only perpetuates the problem, namely improper digestion. Many are simply unable to come off the acid blockers after long-term use. I surmise that downstream effects, like migraines, can come from creating an imbalance by use of long-term acid blockers.
I have tried to propose some likely scenarios of why migraines may occur in addition to offering remedies that may be better tolerated than traditional triptans. Any questions or comments are welcome!
–Hai Jin Kim, MD