In this article we will discuss migraines and headaches in general. I don’t like to draw a line between these two, as it is often not clear what type of a headache a patient has, and we just try different treatment modalities until we find the one or a combination of several modalities that the patient responds to best, regardless of the “diagnostic code” entered on the billing form.
There are several theories about the pathophysiologic causes of migraines. The ones most commonly talked about are vascular and serotonin theories. The vascular theory states that brain blood vessel dilation causes the pain. The serotonin theory blames the migraine on some abnormality of serotonin synapse function.
A typical migraine may affect just one side of the head and be associated with an aura. However, it can also affect the whole head and have no typical aura. Sometimes a migraine actually presents as abdominal pain, and is then called abdominal migraine. Migraines are often associated with nausea and vomiting, increased sensitivity to light, noises, touch, etc. Sometimes they take place around menstrual period.
In most cases knowing the exact type of your migraine is immaterial, because the treatment ends up being the same. So let’s discuss the treatment methods. They can be classified as conventional vs. alternative, curative vs. palliative (helps only as long as you take the therapy), abortive vs. preventive (to stop the headache once it has already developed vs. prevent it) and “hardware” vs. “software”.
We will start with what you can expect a conventional doctor to offer you in the clinic. The most common palliative modality is a drug from the class of drugs called triptans: Imitrex, Maxalt and others. These drugs imitate serotonin in the brain and are often very effective in aborting a migraine that has already started. They are often associated with unpleasant side effects, including elevated blood pressure and are contraindicated in patients with coronary heart disease. However, most patients tolerate them. Other pain killers can be used, such as Tylenol (acetaminophen), non-steroidal anti-inflammatory drugs like ibuprofen, etc. In some patients with particularly severe migraines narcotics are used for pain relief.
A doctor may also offer therapy to prevent migrains. Antidepressants with particular affinity for serotonin system are often used: Celexa, Lexapro, Zoloft, Paxil, Prozac, and others. Beta-blockers, like propranolol, and calcium channel blockers, like amlodipine are also sometimes effective in preventing migraines.
We should talk about the antidepressants listed above, also called serotonin selective reuptake inhibitors. They do work sometimes, but in many studies their effect has been shown to be only about 10% better than placebo (a sugar pill). They have many unpleasant side effects and are highly addictive (don’t believe anybody telling you otherwise). And, worst of all, even if they do work, the effect often wears off after a few months. This is due directly to their mechanism of action. They are supposed to redistribute serotonin to where it is needed most, but in the process deplete the other parts of the nervous system of this important neurotransmitter. After a few months of use, the whole system becomes so depleted, that the drug has nothing to redistribute anymore and stops working. This concept is very well discussed on the website developed by Dr. Martin Hinz, a Duluth physician, who came up with a great alternative to using these drugs: www.NeuroAssist.com.
The complementary/alternative community has a variety of effective modalities that can be used for migraines. Let’s take a look at some of them.
Chiropractic is often effective. This is a mechanical “hardware” method, which is often curative. In my experience, NUCCA chiropractic method has cured a few patients where the treatment I offered was ineffective. Other chiropractic methods may also be effective. This website by one of my chiropractic colleagues offers good information on NUCCA: www.mightyoak.org.
Nutritional therapy using NeuroReplete supplements, developed by Dr. Hinz has been extremely effective in the majority of migraine cases in my experience. This is another “hardware” modality, but of the “chemical” type. It is used to prevent migraines from occurring. The theory here is the same as behind the use of the SSRI antidepressants mentioned above, but here we don’t try to redistribute serotonin. We provide the brain with the building blocks (all natural substances, including specific amino acids and vitamins) to make more of it, so it does not need to be redistributed. In the process we also balance catecholamins (dopamine, norepinephrine and epinephrine), neurotransmitters as important as serotonin. In fact, it turns out that if you increase only serotonin without regard for catecholamins, you may get into some trouble, so these supplements are designed to keep the balance. Again Dr. Hinz’ website has volumes of information on this subject and I highly recommend everybody with some interest in this therapy to visit it and learn.
I am sure that by now some of you are asking the question, if these supplements increase the overall serotonin and catecholamine levels in the brain, wouldn’t they be also useful in treating depression? Bingo! These supplements are a potent antidepressant. In fact, they are much more effective in treating depression than any of the antidepressants on the market, and in most cases the effect is accomplished with no side effects. Occasionally patients may experience nausea in the beginning of the treatment with NeuroReplete supplements, due to overall neurotransmitter depletion affecting the gut even more than the brain. The gut just reacts to serotonin stores being replenished. This is a fairly rare side effect and in most cases quite minimal and easily manageable. Other uses for these supplements are in conditions like anxiety, ADD/ADHD, childhood behavior problems, fibromyalgia, etc. They are also used as an aid in weight loss program. There is no more effective and safe appetite suppressant on the market. And this is a personal testimony: the only way I can keep my weight in a healthy range is by taking these supplements regularly. What can I say, some of us are born pigs, and this method offers us real help. Interestingly, those without abnormal hunger issue usually do not experience appetite suppression. For information on our weight loss program click here.
While NeuroReplete supplements are very effective and I use them widely, they are not curative. Once you stop the supplements, your symptoms come right back. Homeopathy is a curative option. This is one of the “software” modalities. This approach is the most difficult for the practitioner, the results are slow, but it does offer a way to improve the patient’s general state of health permanently, and in many cases, in the process the presenting physical symptoms slowly recede and sometimes totally go away. I believe homeopathy is the right approach in almost all cases of just about any disease, but, like I said in the beginning, I am biased. For information on homeopathy click here.