A Natural Approach to Migraines
Research has shown surprising links between migraines and food. Certain foods
can cause migraines, while others can prevent or even treat them. Coffee, for
example, can sometimes knock out a migraine and foods rich in magnesium, calcium,
complex carbohydrates, and fiber have been used to cure migraines. Some reports
suggest that ginger-the ordinary kitchen spice-may help prevent and treat migraines
with none of the side-effects of drugs. The herb feverfew also effectively prevented
migraines in placebo-controlled research studies.
A migraine is not just
a bad headache. It has a characteristic pattern, usually involving just one side
of your head. It is a throbbing pain rather than a dull, constant ache, often
accompanied by nausea, vomiting, and sensitivity to light and sounds.
See
your doctor to evaluate your headache, especially if headaches are new for you,
are unusually severe or persistent, or are accompanied by any of these characteristics:
· fever
· a change in your strength, coordination, or
senses
· neck or back pain
· a chronic run-down feeling
with pain in your muscles or joints
· drowsiness
· difficulty
thinking or concentrating
· progressive worsening over time
·
the headache awakens you from sleep
· the headache follows head trauma
Find Your Migraine Triggers
In 1983, researchers at the Hospital for
Sick Children in London reported their results for 88 children with severe, frequent
migraines who began an elimination diet. Of this group, 78 recovered completely,
and 4 improved greatly. In addition, some children who also had seizures found
that their seizures stopped. The researchers then reintroduced various foods and
found that they sparked migraine recurrences in all but eight. In subsequent tests
using disguised foods, the vast majority of children again became symptom-free
when trigger foods were avoided. Migraines returned when trigger foods were added
to the diet.1
In adults, anywhere between 20 and 50 percent have a reduction
or elimination of their headaches when common trigger foods are avoided.
Pain-Safe
Foods
Pain-safe foods virtually never contribute to headaches or other painful
conditions. These include:
· Rice, especially brown rice
·
Cooked green vegetables, such as broccoli, spinach, Swiss chard, or collards
· Cooked orange vegetables, such as carrots or sweet potatoes
·
Cooked yellow vegetables, such as summer squash
· Cooked or dried
non-citrus fruits: cherries, cranberries, pears, prunes (but not citrus fruits,
apples, bananas, peaches, or tomatoes)
· Water: Plain water or carbonated
forms, such as Perrier, are fine. Other beverages-even herbal teas-can be triggers.
· Condiments: Modest amounts of salt, maple syrup, and vanilla extract
are usually well-tolerated.
Common Triggers
Common triggers often cause
headaches in susceptible people. Just as some food sensitivities manifest as a
rash on your skin, migraine sufferers have a reaction in the blood vessels and
nerves. Here are the common food triggers, also known as the "Dirty Dozen,"
in order of importance:
· dairy products*
· chocolate
· eggs
· citrus fruits
· meat**
·
wheat (bread, pasta, etc.)
· nuts and peanuts
· tomatoes
· onions
· corn
· apples
· bananas
* Includes skim or whole cow's milk, goat's milk, cheese, yogurt, etc.
** Includes beef, pork, chicken, turkey, fish, etc.
Certain beverages and
additives are also among the worst triggers, including alcoholic beverages (especially
red wine), caffeinated drinks (coffee, tea, and colas), monosodium glutamate,
aspartame (NutraSweet), and nitrites.
Foods that are neither on the pain-safe
list nor the common trigger list should be considered possible, but unlikely,
triggers. Almost any common food, other than the pain-safe list, has triggered
migraines in an isolated individual in a research study, so they cannot be considered
completely above suspicion, but they are far from the most likely culprits.
The Two-Week Test
The first step in tackling your migraines is to check whether
any of the common triggers are causing them. To do this, you simply avoid these
foods. At the same time, include generous amounts of pain-safe foods in your routine
and see whether migraines occur, and, if so, how often.
Here is how to start
with anti-migraine foods. For two weeks:
1. Have an abundance of foods from
the pain-safe list.
2. Avoid the common triggers completely.
3. Foods
that are not on either list can be eaten freely.
The key is to be very careful
in avoiding the common triggers. See Foods That Fight Pain by PCRM president Neal
Barnard, M.D., for trigger-free recipes.
Confirm Your Food Triggers
If
your diet change makes your headaches disappear or become much less frequent,
the next step is to confirm which foods are your triggers. To do this, simply
reintroduce the eliminated foods one at a time, every two days, to see whether
any symptoms result. Start at the bottom of the list (bananas), and work your
way up to the riskier foods, skipping any that you do not care for. If you wish,
you can then check the beverages and additives on the common triggers list.
As you do this, have a generous amount of each new food, so you will know whether
or not it causes symptoms. If it causes no problem, you can keep it in your diet.
Anything that causes a headache should be eliminated again. Then, after a week
or two, try the suspect food once again for confirmation. Keep your diet simple
so you can detect the effect of each newly added food.
Meats, dairy products,
and eggs are best left off your plate permanently. Aside from being among the
worst migraine triggers, they also tend to disturb your natural hormone balance,
which contributes to migraines, as we will see shortly. Their cholesterol, fat,
and animal proteins are linked to serious health concerns including heart disease,
high blood pressure, osteoporosis, and cancers of the breast, prostate, and colon,
so there is no need to welcome these problem foods back onto your plate.
Looking
for Other Food Triggers
If two weeks on the basic anti-migraine diet does
not reduce your headaches, the next step is to check whether a food that is not
on the list of common migraine triggers may be causing your symptoms. This occasionally
happens and, in fact, some people are sensitive to several different foods. An
elimination diet will help you sort this out.
A Simple Elimination Diet
The elimination diet is designed to track down any unusual pain triggers. It is
used for many other conditions, as well, particularly arthritis and digestive
problems. Start by building your menu entirely from the pain-safe foods, avoiding
all others for the moment.
Once your symptoms have gone or diminished, which
may take a week or so, you can add other foods one at a time, every other day,
to see which ones cause symptoms. Again, have a generous amount of each new food
so you can see whether it causes symptoms. If not, you can keep it in your diet.
Hold off adding any foods on the "Dirty Dozen" list and any of the beverage
and additive triggers until last.
Here are some tips to help you identify
triggers:
· Foods that have caused headaches were usually eaten within
three to six hours of the attack.
· The offending foods can be ones
you are very fond of, perhaps even foods for which you have cravings. They may
be the ones you might least suspect.
· Sometimes the headache will
not show up until a large amount of the culprit is eaten, perhaps over a few days.
· If you are affected by several foods, eliminating only one may make
no difference at all. This sometimes leads people to believe that foods are not
the problem.
· You might find that you can have a small amount of
a trigger food without getting a headache, while a larger amount brings on the
headache.
· Your tolerance might be different at different times.
For example, a woman might normally be able to eat half a box of chocolates with
no problem, but as she approaches her period a single piece might trigger the
migraine. The reason, presumably, is that the natural changes in hormones that
occur over the month affect her sensitivity.
· Your triggers can change
over time.
· Your doctor can arrange special blood tests to detect
food sensitivities. They can be rather expensive, but are faster than elimination
diets. Information is available from Serammune Physicians Lab, 1890 Preston White
Dr., Reston, VA 22091, 800-553-5472. Typical skin-patch tests are of little use
for migraine triggers, since they detect only certain kinds of allergies.
Feverfew: The Anti-Migraine Herb
Feverfew is an herb whose name comes from
the fact that the ancient Greeks and many later societies used it as a treatment
for fever. Researchers at the City of London Migraine Clinic found that feverfew
eliminated about two-thirds of migraines in a selected group of headache patients,
which is similar to the effectiveness of most migraine drugs.2 However, while
some people get a pronounced effect, others get none at all. Averaging everyone
together, it eliminates about one-fourth of all headaches.3 This does not mean
that it will eliminate precisely one-fourth of your headaches. It will more likely
either have a much more noticeable effect or no effect at all.
Feverfew is
sold at all health food stores. The amount that has been shown to prevent migraines
in research studies ranges from 50 to 114 milligrams per day. However, most practitioners
use capsules containing about 250 milligrams of a standardized-potency feverfew,
recommending one capsule per day taken on an empty stomach. If you find fresh
leaves, the usual dose is two to three leaves per day.
Thousands of people
have used feverfew over long periods with no apparent ill effects, and research
studies have shown no serious risks. However, there has been little effort to
systematically look for side-effects over prolonged periods. I would encourage
you to avoid it if you are (or might be) pregnant; there is no indication that
it causes birth defects, but not enough data are in to be sure. Also, people with
clotting disorders or who are taking anticoagulant medicines should consult with
their doctors about taking feverfew. Otherwise, our best information suggests
that you can stay on it indefinitely.
Using Foods to Fight Migraines
· Emphasize pain-safe foods: brown rice; cooked vegetables, such as broccoli,
collards, spinach, and chard; and cooked or dried non-citrus fruits.
·
Avoid the common trigger foods completely. If your migraines have diminished or
ceased, you can reintroduce the trigger foods one at a time to assess their effect.
· If steps one and two did not diminish your migraines, an elimination
diet can help you identify whether an unusual trigger is causing your problem.
· Minimize hormone shifts by avoiding animal products, keeping vegetable
oils minimal, and having plenty of high-fiber whole grains, beans, vegetables,
and fruits.
· Try these supplements, in consultation with your doctor:
o Feverfew: 250 milligrams per day or two to three fresh leaves.
o Ginger:
1/2 to 1 teaspoon (1 to 2 grams) of fresh powdered ginger per day.
o Magnesium:
400 to 700 milligrams per day total (foods plus supplements, if used) or 200 milligrams
per day as elemental supplement alone.
o Calcium: Reduce calcium losses by
avoiding animal protein, caffeine, tobacco, and excess sodium and sugar. If you
wish, you can take 1,000 to 2,000 milligrams per day of elemental calcium, with
200 IU (5 micrograms) of vitamin D. Regular physical activity will keep calcium
in your bones where it belongs.
If a Migraine Hits
If a migraine occurs,
try the following:
· Although caffeine can be a migraine trigger for
some people, for others it works as a treatment. The dose is one to two cups of
strong coffee at the first sign of an attack.
· Have a starchy food,
such as rice, potatoes, crackers, or bread. Yes, wheat products are migraine triggers
for some people, but if you can tolerate them, they might actually help. Some
people find that they actually crave starchy foods during migraines and that digging
into toast, crackers, pasta, potatoes, or other starchy foods reduces the headache
or nausea, and can even shorten the attack. Experience will tell you whether these
foods help.
· Fresh powdered ginger, 500 to 600 milligrams (about
1/4 teaspoon), in a glass of water has been helpful in anecdotal reports. It can
be repeated every few hours, up to about 2 grams per day.
· Calcium
might be able to treat migraines as well as prevent them. Researchers reported
a case of a woman who was able to stop an early migraine by chewing 1,200 to 1,600
milligrams of elemental calcium.4,5 Again, avoid the temptation to get calcium
from milk, yogurt, or any other animal source. They cause much more trouble than
they are worth.
· Lie down in a quiet, dark room, and sleep if you
can. Use hot or cold compresses, and massage the blood vessels at the temples.
· Biofeedback and acupuncture have been helpful for many people as
well.
References
1. Egger J, Carter CM, Wilson J, Turner MW. Is migraine
a food allergy? A double-blind controlled trial of oligoantigenic diet treatment.
Lancet 1983;2:865-9.
2. Johnson ES, Kadam NP, Hylands DM, Hylands PJ. Efficacy
of feverfew as prophylactic treatment of migraine. Br Med J 1985;291:569-73.
3. Murphy JJ, Heptinstall S, Mitchell JRA. Randomised double-blind placebo-controlled
trial of feverfew in migraine prevention. Lancet 1988;2:189-92.
4. Thys-Jacobs
S. Vitamin D and calcium in menstrual migraine. Headache 1994;34:544-6.
5.
Thys-Jacobs S. Alleviation of migraines with therapeutic vitamin D and calcium.
Headache 1994;34:590-2.