Migraine Headache How to manage migraines WHAT IS A MIGRAINE HEADACHE? A migraine is not to be confused with a really bad headache. Migraines are generally diagnosed by a GP, and although it is indeed a severe headache, it is often associated with other symptoms. These migraine symptoms make you feel so much worse, and include sensitivity to light, a feeling of nausea or actual vomiting, and experiencing ‘flashing lights’ before your eyes. Migraines are very unpleasant and can be really debilitating. Anyone who suffers from migraine headaches will tell you that they are not just a headache. Migraines can vary from moderate to severe and can last anything from a couple of hours up to 3 days. WHO GETS MIGRAINE HEADACHES? Migraines affect around 1 in 4 women and 1 in 12 men in the UK. It is possible for migraines to begin later in life but it is more usual for the condition to begin in childhood or as a young adult. About 90 per cent of people who experience migraines have their first one before they are 40 years old. Some people experience migraine attacks frequently, up to several times a week. Other people only experience a migraine occasionally. For example, it is possible for years to pass between migraine attacks. WHAT CAN CAUSE A MIGRAINE HEADACHE? Unfortunately, there is no definitive answer as to what causes a migraine headache. There is no reliable diagnostic test to see if you will suffer from migraines or to predict when one may occur. Sadly, there is as yet no cure for a migraine headache. Although migraine headaches are thought to be the result of an excessive dilation of blood vessels in the head, there are various hypotheses as to why this happens. Many sufferers know what triggers their attacks, for example certain foods, but others suffer randomly. Research into the causes of a migraine headache has identified a number of triggers in different people that can lead to a migraine, but the exact triggers vary from one individual to another. WHAT CAN TRIGGER A MIGRAINE HEADACHE? There are several triggers of a migraine headache, with some being more common than others. These can be broadly split into these different categories: Emotional imbalance or stress Migraine sufferers often report that a migraine occurs at times of stress, when they are worried or tense or experiencing anger. Conversely, the happier emotion of overexcitement can also lead to a migraine attack. Foods Many migraine sufferers have particular foods that will trigger a migraine headache. The most common foods associated with migraines are cheese, chocolate and coffee. However, there are several other foods that are known as migraine triggers and include citrus fruits, onions, seafood and wheat. Drinking coffee is often associated with a migraine, but any drink containing caffeine can have the same effect, as can alcoholic drinks, in particular red wine and sherry. Many of these foods and drinks are high in histamine, which is involved in our immune response and also seems to be involved in migraine headaches. Physical stress Physical stress can also often lead to a migraine headache. This is most often associated with over-tiredness from late nights, a change in sleeping pattern, or over-exertion. Many sufferers report migraines when travelling which is unsurprising as long-haul travel often involves the other symptoms mentioned. Environmental factors Many migraine sufferers become sensitive to light when having a migraine, but bright light or flickering and flashing lights can often be the trigger for a migraine. Loud environments or loud noise is often a trigger. Intense, penetrating smells can also trigger a migraine. Many sufferers report that changes in climate can cause an attack. A change in humidity or temperature when bad weather occurs can also have an impact, believed to be due to a sensitivity to the change in pressure. Hormonal factors There are also several hormonal triggers that can lead to a migraine. PMS and menstruation makes it more likely that you will suffer from a migraine. Likewise, other hormonal changes such as going through puberty, pregnancy and the menopause are all times when there is a heightened likelihood of suffering from a migraine. Other factors There are other more isolated triggers for a migraine headache which can be associated with a particular incident. Having toothache, suffering from sinusitis or eye strain can often be attributing factors to a migraine attack, for example. HOW CAN I PREVENT A MIGRAINE HEADACHE? Although there is no cure for migraines so far, they can be treated with painkillers. However, many sufferers would prefer not to experience a migraine in the first place. Many migraine suffers will recognise some or all of the triggers mentioned so far, and the best advice to avoid a migraine is to try and avoid those triggers – or combination of triggers – that can lead to a migraine. The NHS recommends a number of treatments that may help: Painkillers including over-the-counter medications such as paracetamol and ibuprofen Triptans: medications that can help reverse the changes in the brain that may cause migraines (consult your GP) Anti-emetics: medications often used to reduce nausea and vomiting (consult your GP) During an attack, many people find that sleeping or lying in a darkened room can also help. The NHS also recommends that you try and lead a healthy lifestyle which includes taking regular exercise, getting the correct amount of sleep and limiting the amount of caffeine and alcohol that you consume. However there is a traditional herbal remedy which can help in preventing migraine attacks. NATURAL REMEDIES FOR MIGRAINE HEADACHES Feverfew The herb Feverfew has been used for headaches since at least the 17th Century when the famous herbalist Nicholas Culpepper wrote “It is very effectual for all pains in the head”. It is said to provide ‘mild and transient’ benefits resulting in fewer migraine headaches per month. Feverfew also appears to block the release of histamine and helps widen blood vessels, helping to reduce severity of migraine attacks. Feverfew is found in MigraHerb Migraine Relief – a traditional herbal medicinal product used for the prevention of migraine headaches exclusively based upon long-standing use as a traditional remedy. It should only be taken by patients who have been diagnosed with migraine by their doctor. Taking one capsule per day can help to prevent migraine attacks and the maximum beneficial effect of this product may take several months for some people. DIETARY CHANGES There are some nutrients and dietary changes which may help prevent migraine headaches. Clinical nutritionist Suzie Sawyer shares some ‘food’ for thought. Serotonin Studies on migraine patients have found they frequently suffer from lack of serotonin in the blood stream. Many prescription drugs for migraine raise serotonin levels, often leading to an increase in pain threshold in patients with chronic headaches. While increasing foods to boost serotonin may help, a more effective way is to take a serotonin precursor, such as 5-hydroxytryptophan (known as 5-HTP). This can be taken in supplement form and is often most effective when taken for 60 days or more. 5-HTP can also raise levels of endorphins, the body’s own happy hormones. Foods containing the amino acid tryptophan, which produces serotonin, include oats, turkey, chicken, salmon, tofu and seeds, so try to include these in your diet as much as possible. Magnesium Low magnesium levels play a significant role in many headaches partly due to magnesium’s role in muscle relaxation; a migraine attack can often stem from tension or a stressful situation. Great magnesium-rich foods include green leafy vegetables, whole grains, avocados, bananas and all types of fish. If you’re a migraine sufferer, it’s a good idea to also take a supplement of at least 500 mg daily of magnesium for best effect. Vitamin B2 Studies in Europe have found some evidence that taking Vitamin B2 everyday resulted in half as many migraine headaches than was usual. Eggs, milk and organ meats (such as liver and kidneys) are particularly rich in Vitamin B2. Fortified cereals, breads and grains, and green vegetables are also good sources. Omega-3’s Blood flow is restricted to the brain during a migraine attack but a regular intake of the essential omega-3 fatty acids can help to keep blood thin and lower the risk of platelet or red blood stickiness. Good sources of omega-3 fatty acids include oily fish such as salmon, mackerel, sardines and tuna, avocados and nuts. Try to include them in your diet at least three times a week or try an omega-3 fish oil supplement. Ginger Although there is not much research available on the beneficial effect of ginger on migraine, excellent anecdotal evidence suggests that including plenty of ginger in the diet, or a supplement containing around 500 mg of ginger extract, may help prevent migraine attacks. Ginger can be used to flavour a variety of dishes and also makes a delicious tea. For more information on migraine headaches visit the Migraine Action Website.