Natural Migraine Treatment FAQ (1) Introduction (2) For Immediate Relief (3) Definition of Migraines (4) Chiropractic treatment (5) Biofeedback (5.1) Theory of biofeedback (5.2) Handwarming biofeedback (5.3) Other biofeedback (6) Nutritional Treatments (6.1) Food Sensitivity (6.2) Blood Sugar (6.3) Not Overusing Salt (6.4) Nutritional Supplements (6.5) Herbs (7) Psychology (8) Sex hormones (9) Books of interest (10) About the author of this FAQ (11) Disclaimer (1) Introduction This Natural Migraine Treatment FAQ attempts to summarize all non-medical treatments that help prevent or cure migraine headaches. Most treatments mentioned here have worked for many people, and usually have a theoretical basis as well. Please send me additional information you think should be included here, to help make this FAQ complete, accurate and useful, within its narrow focus. Information about acupuncture would be a welcome addition. More information about herbs would be good. Please don't send me information about drugs; they are beyond the scope of this FAQ. There is another FAQ, maintained by someone else, associated with the newsgroup alt.support.headaches.migraine. You may want to read it, too. Natural treatments are usually harmless (as opposed to drugs, which usually have side effects). Therefore, depending on cost and convenience, it can make sense to continue a natural treatment even if you're not sure whether it's doing any good. It often makes sense to apply several natural treatments at the same time. If one treatment reduces the number of headaches or the amount of pain, then several treatments used at once may completely or almost completely eliminate them. Different things work for different people. Some of the treatments mentioned here may actually increase headache pain for some people. Some may have no effect on some people. You may decide to try several things and choose the ones that help you. Note the disclaimer at the end of the FAQ. (2) For Immediate Relief Most of the treatments in this FAQ are used to prevent migraines from happening. This section describes things you can do when you're in pain, to reduce the pain. -- Have a bath or shower. -- Lie down to rest in a dark room. -- Avoid bright or flashing light. -- Put something cold on the back of your neck, such as a cold, wet cloth. -- Have a drink of water or natural juice. -- Eat a bananna or drink tomatoe juice; they contain something that can help. (serotonin?? potassium?? Somebody please supply this information.) -- Have some food, or a nutritious drink, if you haven't eaten for a while. -- Massage your own face, head, neck and shoulders, or get someone else to do those and your back. Relax your muscles. -- Press on two pressure points at the back of the neck. These points are about two inches apart, just below the base of the skull. Press for a minute or two. This releases endorphins that help against pain. -- Avoid sources of stress. Cancel activities so there's less to worry about. -- Avoid exercise during a headache if it makes throbbing pain in the head and neck worse. On the other hand, generally exercise improves health, and it may help you relax during a headache. -- Take some niacin (a form of vitamin B3). Taking enough niacin to cause a flush (blood rushing to the skin) can provide relief from headache pain, but this much niacin can also have side effects (flush, nausea, heartburn, liver damage, etc.) Niacinamide doesn't have such bad side effects, but isn't as much use against migraines, either. Smaller, safer amounts of niacin are also helpful. -- Take some vitamin C, vitamin B6, choline, tryptophan and niacin. (3) Definition of Migraines The word "migraine" comes from words meaning "half the head", and sounds like "demi-cranium", because migraine headaches often hurt on only the left or right side of the head. However, many people with migraines always have pain on the whole head. A migraine headache is caused by hormonal fluctuations which cause blood vessels in the head and neck to contract and then dilate. The first phase, or contraction phase, may last minutes, hours, or days. During this phase, symptoms can be spots in front of the eyes, difficulty concentrating, and cold fingertips and hands. This is called an "aura". Many people recognize this phase of their headaches; many others don't notice any symptoms at this time. Some people who think they don't have an "aura" can learn to recognize it. When the blood vessels dilate, the headache pain starts. Apparently the hormones over-react. Instead of just going from a contracted state back to normal, the blood vessels dilate much wider than normal, causing pain. Other things also happen about the same time: swelling of the brain, release of certain chemicals, and perhaps muscle tension. These things add to the pain. There are a number of different processes that can cause the interplay of hormones leading to contracted and then over-dilated blood vessels. It's not always the same hormones that are involved. Some of the natural treatments listed here focus on a single process. Different things work for different people. Some people may need to use several treatments at the same time. Some people who think they have "tension headaches" are actually helped by migraine treatments. Many headaches are probably a combination of muscle tension and migraine. (4) Chiropractic treatment Sometimes the bones in the neck are in the wrong place, and the little muscles near the bones are tense. This is called "subluxation". It's like having a crick in your neck. The nerves that lead out from the spine can be irritated when there is a subluxation. This can cause migraines. The bones are very close to being in the right place, so a medical doctor might say they are in the right place. A chiropractor treats people by gently pushing the bones back into place. Stress on any part of the spine, as from lifting heavy objects or sitting in a twisted position, can cause subluxations in the neck, leading to migraine. Some relief from migraine can be obtained by doing slow, gentle stretching exercises of the neck. (Rolling motions or sudden motions are not recommended.) Avoid sitting for a long time with the head leaning forward, straining the neck. Avoid lying on your back with your head raised on a pillow. Lying on your back is OK with no pillow, or with a pillow that supports the neck but doesn't raise the head much. When lying on your side, a pillow should support the head and neck. When sitting, for example at the computer, change position frequently and check for things like tension in the shoulders from supporting the arms. Chiropractors usually ask their patients to be x-rayed on the first visit. If you want to avoid the damage of x-rays, you can ask your chiropractor to treat you without doing an x-ray. They can do this; they do it for pregnant women all the time. Chiropractors usually do other simple tests at each visit to assess exactly what the person needs at that time. (5) Biofeedback (5.1) Theory of biofeedback With biofeedback, a person learns to control a body function which was not under direct conscious control, but was indirectly under conscious control. Here is an example to explain what is meant by a body function under indirect conscious control. Generally speaking, a person can't decide to do the following: "I'll flip a coin, and if it comes up heads, I'll immediately make my heart beat faster, even though I'll still be sitting down." However, a person can decide, "If the coin comes up heads, then I'll put up my hand to ask a question in front of this roomful of people, which I'm nervous about doing." As soon as the person sees the coin come up heads, their heart starts to pound because of their nervousness. Yet all that happened was that they made a decision and then flipped a coin. Thus, their conscious thoughts affected the heartrate. In this way, heartrate is indirectly under conscious control. Body functions such as muscle tension, finger temperature, and levels of some hormones in the blood (such as adrenalin in the above example) are under indirect conscious control. Some of these functions are involved in headaches. Biofeedback means making information about one's body available to the conscious mind. Devices which measure muscle tension, finger temperature etc. and which supply that information to the person are biofeedback devices. Gradually, a person learns the semi-conscious thought patterns that make the device show the desired result, such as warm fingers. It's like learning to ride a bicycle. Once the skill has been learned, the person can use it at any time, without needing the biofeedback device. For example, a person who has gone through many learning sessions with a thermometer and has learned to warm their fingers can then warm their fingers after that without using a thermometer. (5.2) Handwarming biofeedback Phase I of a migraine is similar to what the body does in response to fear, though the reaction may have been caused by a food the person ate rather than by actual fear. In phase I, blood is reallocated out of the hands and head and into the large muscles that would be used for running from danger. The hands, especially the fingertips, become cold when the blood is withdrawn. The feeling of confusion, or inability to think clearly, that can accompany phase I is similar to fainting from fear. The pain occurs in phase II, when the blood vessels of the head and neck over-react and re-expand to larger than the normal size. The headache can be prevented by reducing the severity of phase I, thus preventing phase II. The level of the hormones in the blood that contract the blood vessels, such as serotonin and adrenalin, can be brought under semi-conscious control. By thinking relaxed thoughts, the hormone level can be lowered. The serotonin level is monitored by checking the temperature of the fingertips and hands. During phase I, first the fingertips and then the hands become cold. The finger temperature can be checked either with a thermometer, or by touching the fingertips to your cheeks. If they feel warm or hot, that's good. They should at body temperature. If they're cool or cold, it could be either from being in a cold room, from poor blood circulation due to diabetes or some other condition, or from a phase I reaction. After many attempts of trying to think relaxed thoughts and checking the finger temperature, a person gradually learns how to get into the right frame of mind to affect the serotonin levels. Eventually, a person can decide to warm up the fingers, meditate for a while, and the fingers become warm. Under a lot of stress, for example if you're about to speak in front of an audience, it may be impossible to warm the fingers at that time, though attempting it may reduce the severity of a migraine later. For learning, it's best to use a low-stress situation such as sitting at home. It normally requires trying several times a day for several weeks before much progress is made. It helps to keep records of the finger temperature before and after attempting biofeedback. A person who has learned biofeedback can become aware of their finger temperature so that they notice when their hands suddenly become cold. They can then take a break from stressful activities, relax until their hands warm up, and prevent a headache from happening. The feeling of confusion and stress that usually accompanies phase I can mean that you tend not to notice things like finger temperature at that time -- you're too busy thinking about whatever is causing the stress -- but eventually you can learn to notice it. See Kohlenberg's book , which comes with a thermometer, for more information. (5.3) Other Biofeedback Biofeedback devices can be used to monitor the tenseness of muscles in the forehead, the amount of sweat on the fingers, and other things. The person spends time learning to make the muscles relaxed, the fingers dry, etc. These forms of biofeedback can help with headaches. A migraine usually involves some muscle tension in the head which adds to the pain. (6) Nutritional Treatments (6.1) Food Sensitivity Many books agree that chocolate is the most likely food to cause migraines. Other foods which can cause migraines include avocadoes, pineapples, beans, peas, lentils, MSG, pork, shrimp, pickled herring, alcohol, caffeine, cheese, and coconut. The caffeine in chocolate is not the main reason chocolate causes migraines. There's a group of substances called amines, common in food, which are the main food trigger of migraines. There are different amines in different foods. The one in chocolate is the worst. The one in cheese is called tyramine and is next worst. Hanington's book  describes an experiment in which it was shown that tyramine can cause migraines. Migraine people have less monoamine oxidase (MAO), the enzyme in platelets that breaks down amines. The amount of tyramine in cheese varies tremendously by type and even batch of cheese. Milk is OK, since the tyramine is produced in the cheesemaking process by microorganisms. Other amines are found in other types of food. The reaction to amines is not an allergy. The amines cause certain hormones to be released in the body. Different amines may cause migraines in different people. Each person needs to experiment to figure out which foods give them migraines. This is not always easy to do. A food might not cause a migraine every time it is eaten; perhaps only when another cause of migraines happens at the same time. It's better to go on a very restricted diet for a while, a week or a month, say, than to experiment by eliminating just one suspicious food at a time. To illustrate this, suppose you have a list of 20 suspicious foods, and that by eliminating 5 of them you can cut your headaches in half, from 10 a month down to 5 ... but you don't know that, and you don't know which 5 foods are the bad ones. If you spend 20 months, eating everything except one food each month, you will learn nothing. You will still have about 10 headaches a month. Some months you'll have about 9 instead of 10, but that's not enough to notice a difference: you probably vary from 8 to 12 headaches a month anyway. However, if you stop eating all 20 foods for a month, you'll notice something interesting: you'll have only 5 headaches instead of 10. You can then gradually re-introduce the suspicious foods. Now that you have fewer headaches, you'll notice it if you have a headache a few hours after eating a suspicious food. Make sure your restricted diet contains all the vitamins and other essential nutrients. If you combine advice from several books, there will be nothing left to eat! I recommend the restricted diet suggested by Brainard  as a starting point for experimentation. When I followed this diet, my migraines diminished significantly, and over the following weeks, months, and years I gradually tested and re-introduced to my diet most of the disallowed foods. Some I went on and off several times to test for subtle effects. (6.2) Blood Sugar Recent studies [Low, 6] show that when a migraine person eats refined sugar, their blood sugar level goes up very high, then quickly comes down again. Any kind of refined sugar causes this effect: sucrose, glucose, etc. The blood sugar level goes up and down so fast that a standard glucose tolerance test with blood samples taken less often than every 15 minutes can completely miss the effect. Many migraine people have been told they're very normal after a glucose tolerance test, but in fact they have a condition similar to hypoglycemia. Natural sugars, such as fruit, completely unprocessed sugar cane juice, etc. do not cause this effect. Eating natural sugar causes the blood sugar level to go up, but not very high, and it doesn't come down so fast. There's something in natural sugar that helps the body absorb it. Glucose Tolerance Factor (GTF), a molecule containing chromium, may be responsible. Chromium is usually present with natural sugars, and is missing in refined sugar. It works with insulin to help the body process sugar. Chromium must be in a bioavailable form such as GTF or chromium picolinate. However, there may be other factors present in natural sugars, such as vitamins, enzymes, etc., that are also important. When refined sugar is eaten, the pancreas releases a lot of insulin. For some reason, people who get migraines release more than the normal amount of insulin. Insulin stimulates the release of adrenalin. This starts phase I of a migraine. Going without eating for 3 to 4 or more hours causes low blood sugar levels which can also trigger a migraine. In his book  Rodolfo Low recommends the following for all migraine people. He claims that every person who has followed these recommendations, including himself, has completely eliminated migraines: -- Do not eat any refined sugar. Not even small amounts. Fruit should be fresh, not dried or cooked. Eat a wholesome balanced diet of natural foods including fruit. -- Eat every three hours. Have six small meals a day instead of three. Have snacks of healthy foods at midmorning, midafter- noon, and bedtime. -- Avoid drinking alcohol. -- Avoid drugs that stimulate the pancreas. Many drugs taken for other purposes also stimulate the pancreas, e.g. aspirin. See the book  for a list of drugs to avoid. [Above recommendations paraphrased by C.W.] Many people are deficient in chromium. Eating refined sugars leads to chromium deficiency. A supplement of GTF chromium or chromium picolinate is helpful to hypoglycemic people and can allow them to maintain good blood sugar levels when going several hours without eating. Low has shown that migraines are closely related to hypoglycemia, so perhaps chromium supplements would help migraine people too. I used to get a headache if I went 4 or 5 hours without eating; with a chromium supplement (200 mcg/day, not a megadose) this is no longer the case. (6.3) Salt A normal person who eats a very large amount of salt will get a headache. Brainard  claims that for people who get migraines, a small amount of salt can have the same effect. He describes the hormonal processes that occur when salt is eaten. Everyone needs some salt (sodium chloride) in order to live. Natural foods generally contain some salt. Processed foods often have too much added salt. Brainard recommends: -- Moderate amounts of salt with meals are OK. -- No large amounts of salt with meals. -- No salt at all between meals; not even a salted cracker or a cookie cooked with the usual large amount of salt. -- Avoid soups; these often contain large amounts of added salt. [Above recommendations paraphrased by C.W.] During a migraine, a person makes more urine than usual. One has to drink more in order to make up for the missing water and avoid getting dehydrated. Drink if you're thirsty. (6.4) Nutritional Supplements There are many vitamins and other essential nutrients which can have an effect on the complex hormonal processes that cause migraines. The following supplements, taken regularly, can help: -- vitamin C -- vitamin B6 -- niacin (see side effect warning under section 2) -- choline -- tryptophan -- omega-3 essential fatty acids, e.g. unrefined, cold-pressed, uncooked flax seed oil -- chromium? (See section 6.2.) -- magnesium; as much magnesium as you take calcium (magnesium deficiency can also cause a craving for chocolate.) (6.5) Herbs Feverfew helps many migraine sufferers. It's claimed by some to be best to eat fresh leaves, one small leaf per day. It should be taken regularly. I think it has some side effects, including possibly a sore mouth; I'm not sure. Reishi is also said to help against migraines. [Please send me information to expand this section.] (7) Psychology People often think thoughts that are just a little frightening. When normal people think these thoughts, nothing much happens. But migraine people have over-reactive hormone systems, and adrenalin and other hormones are released along with just slightly scary thoughts. A migraine person may not feel scared at all, may claim to be relaxed, but at the same time may be showing the physical symptoms of fear. These symptoms may be partly resulting from various chemical processes such as the foods the person ate. However, they are also the result of thoughts. The scary thoughts that bring on phase I of a migraine are usually semi-conscious ... just outside the range of conscious thinking. For instance, a migraine person may look at a report they're writing at work and consciously think, "I don't think this is good enough." But at the same time, in a semi-conscious way, the following thoughts flit rapidly through the mind: "And my boss may not like it. And I could lose my job. And I might not be able to get another job. And I wouldn't be able to buy food. So I would starve." These thoughts go by so fast it's hard to pin them down. But they're real, and are accompanied by cold fingers and other symptoms of phase I of a migraine. The person might not notice the symptoms. Later, when they have a headache, they might not realize they had been under stress. "I was just quietly working in my office, writing a report." It helps to write down such thoughts. Kohlenberg  recommends writing the thoughts down in the form of a proof that either there's a threat to one's life or health, or that a law of nature has been broken, i.e. that something "should" be happening and isn't. Writing the thoughts out slows them down so that they come under conscious scrutiny and control. Then, on another part of the page, write down arguments against each point. "My boss usually likes my reports. I'm very unlikely to lose my job. If I do lose it, I'll probably find another one. Even if I don't, I'll go on welfare and won't starve." It helps to avoid thoughts with words like "should" and "ought" in them. Instead of thinking, "I should wash the dishes now," think "I want to wash the dishes now." One good way to eliminate a "should" thought is to start doing the thing. If you don't want to, there's probably a good reason not to. Then, instead of thinking, "I should ...", think, "I decided not to... because ...". Accept that every decision has both good and bad results. It's useful to combine this technique with biofeedback. See Kohlenberg's book for both. (8) Sex hormones Apparently sex hormones are among the hormones that can be involved in migraines. For both men and women, it's common for migraines to begin around puberty. . Women often notice headaches corresponding to certain times of the menstrual cycle. Menopause can mean fewer or no headaches for some lucky women (or the onset of migraines for others). Nutritional treatments can help reduce symptoms of pre-menstrual syndrome (PMS), including headaches. (,). It's normal during breastfeeding for a woman to have no menstrual periods for a time which can be 3 months, 2 years or more, averaging about 14 months.  For some, this is a welcome rest from a range of symptoms which can include PMS and headaches. Unfortunately, breastfeeding is often disrupted, resulting in increased health risks to both mother and baby. This includes the inconvenience of early return of menstrual cycles, along with the familiar accompanying symptoms. The return of menstruation is an individual thing; a slight reduction of nursing may bring it on in one woman, while another may be nursing only a few (e.g. 4) times a day and still not menstruate. Early return of menstruation can be caused by: (Things to avoid, if you don't want to start menstruating soon:) -- early weaning -- use of bottles or pacifiers -- mother-baby separations, e.g. use of babysitters -- other foods given to baby before about 6 months of age -- encouraging baby to "sleep through the night" -- limiting breastfeeding, based on clocks and calendars Speculation: It is known that pollutants such as pesticides, PCB's and biproducts of chlorine bleaching can act as hormone mimics, disrupting the development of animals and humans. Chemicals which mimic estrogen have been most extensively studied, but pollutants mimic other hormones as well.  Hormones are involved in migraines. Are migraines more common these days than they used to be? Could migraines sometimes be partly caused by hormone-disrupting pollutants? (9) Books of interest  Brainard, John B., 1979. Control of Migraine. W.W. Norton & Co., New York -- London.  Colborn, Theo, Dianne Dumanoski, and John Peterson Myers, 1996. Our Stolen Future. Penguin Books, New York, NY.  Hanington, Edda, MD MRCP, 1980. The Headache Book. Technomic, Westport CT.  Kippley, Sheila. Breastfeeding and Natural Child Spacing.  Kohlenberg, R.J. Migraine Relief: A Personal Treatment Program  Low, Rodolfo, 1987. Migraine: The Breakthrough Study That Explains What Causes It and How it Can Be Completely Prevented Through Diet. Henry Holt & Co. Inc. New York NY.  Nazzarro, Dr. Ann, and Dr. Donald Lombard, with Dr. David Horrobin, 1985. The PMS Solution: Premenstrual Syndrome: The Nutritional Approach. Eden Press, Montreal -- London.  Shannon, M. Fertility, Cycles and Nutrition. (10) About the author of this FAQ I've had migraines since about age 16. For long periods I had mild headaches every day and often worse ones. Using some of the natural treatments listed here, I've mostly eliminated them. I'm interested in many things. Professionally, I'm a seismologist. I also like reading about nutrition, breastfeeding, non-violence, barter, evolution, mathematics, auto-free living, midwifery, effective communication of emotions, alternative medicine, and natural family planning. See a web page on natural family planning, co-authored by me, at http://www.usc.edu/hsc/info/newman/resources/primer.html. Please send me any comments and suggested additions at firstname.lastname@example.org. Cathy Woodgold (11) Disclaimer This information about natural migraine treatments, collected from various sources, is provided for your convenience. Though effort has been made to make it accurate, it may contain errors, omissions or inaccuracies. It is hoped that readers will supply information to help improve the FAQ. It is not to be considered to be medical advice. Different things work for different people. Some of the suggestions here may actually increase headache pain for some people, or cause other problems. If you decide to use any of the treatments mentioned here, you are responsible for that decision and for any effects that occur. You may collect information from other sources, if you wish, before beginning to use the treatments mentioned here. Some headaches are caused by other serious problems requiring other treatment; this FAQ only discusses migraines. If the author knows of serious safety problems, they will probably be mentioned here, but absence of specific warnings does not constitute a statement or guarantee that the treatments are safe. Any nutritional supplement can be harmful in very large amounts. This FAQ is provided with no warranty of any kind. Life is full of unknowns.
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