Migraines are the worst! They are painful, debilitating and take us away from doing the things we want to do. Having dealt with them since I was a teenager, I know how terrible they are. Mine have changed over time to become less painful and less frequent, but even a mild migraine feels awful. If you are a migraineur, someone who suffers from migraines, read on to learn about why they happen and how to treat them naturally.
What Are The Symptoms of Migraine?
Women are mostly affected and migraines tend to run in families. There are often symptoms that occur before the headache starts, known as the prodrome, and these symptoms can include aura (seeing bright spots or blurred vision), feeling tired, feeling anxious, and distorted thinking. Once the headache starts it's usually pounding or throbbing pain and is one-sided although it can involve both sides of the head. Other symptoms may include loss of appetite, nausea, vomiting, sensitivity to light, sound, and smells. There may be a recovery phase after the migraine has ended where the person may feel fatigued.
Why Do Migraines Occur?
There are a lot of things that need to happen to trigger the migraine and initiate the blood vessel and neuronal changes that lead to the headache.
Triggers initiate the headache
Migraine triggers can be any number of things such as food intolerances, hormonal changes, chronic stress, alcohol use, caffeine or drug withdrawal (drugs that constrict blood vessels), emotional stress, lack of or too much sleep, poor posture, muscle tension, weather changes, glare or eyestrain.
Serotonin and inflammation
All of these stressors lead to the fight-or-flight (sympathetic) response and neurotransmitters that are released in response to that. Cells called platelets store a neurotransmitter called serotonin, which is released when we're exposed to the stress of the triggers. Platelets also have higher levels of arachidonic acid, which the body converts to substances that promote inflammation. Migraineurs may have low serotonin in general which lowers our pain threshold and contributes to blood vessel dysregulation in the head.
Blood vessel dysfunction
Once the platelets release serotonin they also become more "sticky" and more likely to clot together. This causes changes in the blood vessels of the head. In general, there is abnormal control of blood vessel constriction and dilation and migraineurs are very sensitive to these changes. The prodromal stage may be due to constriction and reduced blood flow, which slows neuron activity. To make up for this, the nerves release substances that dilate the blood vessels and cause inflammation and pain for up to 48 hours.
How Can Naturopathic Medicine Help With Migraines?
The causes of migraine are numerous and it's important to find what may be contributing to the initiation of the migraine. This may not be easy and may require some trial and error, but I think it's an essential part of migraine treatment because it addresses the cause of the migraines and can reduce their frequency and severity.
Common triggers include:
Diet - food allergies and intolerances may be contributing to the initiation of inflammation and serotonin release from platelets leading to the migraine. Common food allergies and intolerances include cow's milk, wheat, egg, cheese, chocolate, citrus fruits, tomato, and rye. Alcohol and MSG can interfere with the breakdown of histamine, which contributes to inflammation, so should be reduced or avoided. To find out if foods are contributing to your migraines try keeping a migraine diary and look for associations between what you ate and when you have a migraine. You can also try an elimination-rechallenge diet where you avoid the food for a few weeks and then eat it again to see if it causes a reaction. Low blood sugar can also be a trigger so make sure you're eating regularly and avoiding the ups and downs that sugary snacks can have on your blood glucose. Drinking enough water and preventing dehydration can also help.
Lifestyle - chronic stress can be a trigger because it keeps the body in a fight or flight state and this is part of the initiation of the migraine. Stress reduction techniques can include exercise, meditation, self-care, socializing, massage, craniosacral therapy, journaling and counseling. Too little or too much sleep can also be a trigger so make sure you're getting the right amount for you to feel rested.
Hormones - Some women tend to have migraines around the times when their hormones are fluctuating such as ovulation and menstruation. Addressing any issues with the menstrual cycle and PMS can help to relieve migraines by regulating the metabolism of estrogen and progesterone. The diet and lifestyle recommendations above can be a good place to start if you're trying to relieve menstrual issues and there are also nutrients and herbs that can help.
Essential fatty acids - omega-3 fats from fish, flaxseeds and chia seeds help to decrease inflammation, reduce platelets from sticking to each other and reduce the release of serotonin from platelets. The brain is made up of mostly fat and giving it healthy fats can help neurons work as they should.
Mitochondrial support - the mitochondria are considered the "powerhouses" of our cells because they're responsible for producing a compound called ATP that provides energy for our body. Migraines may be related to low energy output by the mitochondria. You can support the mitochondria with coQ10 and vitamin B2 (riboflavin) because both of these nutrients play a role in the energy production process. CoQ10 may reduce migraine frequency and is generally safe. Use caution if you are taking blood thinning medication as it may increase this effect. Vitamin B2 is usually well tolerated and may take a few months to achieve therapeutic effects.
Magnesium - this mineral is depleted in chronic stress, hormonal dysfunction, and high alcohol intake. Magnesium is involved in controlling blood vessel relaxation and constriction, the neurotransmitters involved in initiating migraine and platelet activity. Migraineurs may be magnesium deficient and supplementation may help prevent migraine or reduce pain in acute migraine. Magnesium bound to glycine, aspartate, citrate and malate are well absorbed forms and it's also good to pair it with vitamin B6 to help improve absorption into the cells.
Feverfew (Tanacetum parthenium) - this herb can be used to prevent and reduce the severity of migraines if taken for at least a few months. It works by decreasing serotonin release from platelets and inhibiting inflammatory substances such as histamine. Feverfew is generally well tolerated but may cause digestive upset. Avoid use if pregnant, using blood thinning medications or if you are allergic to plants like chamomile and ragweed because it's in the same family as these plants.
Butterbur (Petasides hybridus) - this herb has an affinity for the blood vessels in the brain, plays a role in regulating blood vessel relaxation and in reducing pro-inflammatory compounds. It's best used for prevention and benefit may not be seen for about 4 months. It may be most effective for women who experience menstrual related migraines. Butterbur is usually well tolerated although it may cause diarrhea and should not be used during pregnancy or breastfeeding. There is a compound in this plant called pyrrolizidine alkaloids (PAs) that can be toxic to the liver so make sure to get a formulation that has these removed. Any reputable herb company will do this and include this information on the bottle.
Headaches During Pregnancy
As I mentioned earlier in this post, hormonal changes can be a trigger for migraines including hormonal changes during pregnancy. Some of the lifestyle recommendations can be used by pregnant women, but always talk to your OBGYN or midwife about what they would recommend if you're experiencing headaches or migraines when you're pregnant. If you'd like more tips check out Mom Loves Best's blog "How To Prevent Headaches and Migraines During Pregnancy."
Symptoms of migraine include aura, one-sided throbbing or pounding pain, loss of appetite, nausea, vomiting and changes in cognitive thinking. Migraines are generally thought to be triggered by a variety of stressors that lead to changes in serotonin levels, altered blood flow to the brain and increases in histamine and other substances that promote inflammation. Naturopathic medicine can help with migraines in a number of ways including identifying triggers, diet and lifestyle changes, and vitamin and herbal supplements that can prevent migraine and reduce the severity of migraine pain.
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Pizzorno, J. E., & Murray, M. (2013). Textbook of Natural Medicine(4th ed.). St. Louis, MO: Elsevier.