We used to have a group that talked about treatments like Botox, massage therapy, bio-feedback, nutrition, and various triptans and herbs. Then interest waned and we no longer meet. Through the group I learned how to avoid migraines. This page is a summary of what has helped me and other people.
Preface: Understanding and ending your migraines is a very difficult process. It's hard, it's very hard. It takes lots of work. You will have to deviate from social norms at times and be conspicuous. You will have to meticulously record your life. You will have to forgo many of your everyday pleasures to achieve success. This is too much sacrifice for most people. They would rather continue drinking Coke and eating brownies than to end their migraines. If you are like most people stop reading this web page right now, go to your browser's URL entry box and type in "usatoday.com" and read about the latest movies.
If you are willing to work and sacrifice take a deep breath and keep reading.
- Recording Your Headaches
You must be willing to record your daily activities in minute detail. You need to record every bite of food, and every medicine that passes through your lips. You need to get on a regular sleep schedule. Here is a paper example Migraine Diary, a weekly template for recording food, exercise, and sleep. An online spreadsheet is an even better option.
- Pain Scale
For recording in your migraine diary, I would recommend the 4 point Functional Pain Scale
1. No impact on activities. Headache is annoying, and you forget about it occasionally.
2. You can still work, but this requires concentration to get past the pain.
3. The pain is so bad you can't work, but must retire to your bed.
4. This is the worst pain you've ever felt.
- Migraine triggers
- Drug Induced Rebound
Taking too much of a medicine over time causes rebound headache. Drugs like Tylenol, Excedrin and triptans (like Imitrix) can actually start to cause headaches. Some estimate that 70% of chronic headaches are caused by drug overuse.
- Food Triggers
Food Triggers are often vasoactive, that is, chemicals that either dilate or constrict the blood vessels in our brains.
- Monosodium Glutamate (MSG)
MSG is found in most commercial soups, some corn and potato chips, salad dressings, frozen dinners, canned meats, croutons, bread stuffings, and many oriental foods.
MSG is also found in steaks prepared in finer restaurants. The helpful staff will marinate steak in sauces containing MSG to make it tender and flavorful.
I love coffee; there's nothing like a piping hot cup in the morning with a pastry. The caffeine in coffee actually helps migraines in the short term by constricting the blood vessels, but it's a Faustian bargain. After being constricted the blood vessels can then swell back beyond their original size, stretch those tender nerves that cover the blood vessels and cause a worse headache.
Beware of decaf coffees. The chemicals used to decaffeinate coffee cause me a headache. I have been successful with one cup of water-decaffeinated coffee in the morning. Many stores with a large selection of coffees will have a decaf processed only by water.
- Monoamine Containing Foods
From https://www.migraeniker.dk/ "Since 1974 it has been well known that the chemical compound phenylethylamine may trigger a migraine attack. But little effort has been directed to finding where this chemical is found in our food. Recent research has demonstrated that some strains of bacteria, particularly Lactobaccilli, decompose bitter tasting compounds thus making wine taste better, morning fruit juice becomes 'soft' and smooth to the taste, and chocolate a bit less bitter."
- Citrus concentrate
- Alcohol/Red Wine
- Tyramine (see also here).
- Aged Cheeses
- Yogurt/Tofu, miso, teriyaki sauce
- Smoked or pickled fish or meat
- Lima beans, Italian beans, lentils, navy beans
- Snow peas
- Tannin Containing foods
- Bruised fruits
- The red skin of apples and pears
- Most berries, blackberries
- Alfalfa, Barley
- Cigarette Smoke
- Apple Juice, Apple Cider
- Grape Juice
- Black and Red Beans
- Apricots, ripe Bananas, unripe Peaches, Pomegranates, Persimmons, Cranberries
- Smoked meats
- Nitrate preserved foods (bacon, hot dogs, pepperoni, salami)
- Peanuts / Foods fried in peanut oil
- Histamine-releasing foods
- Histamine-containing foods
- Allergic Foods
Being allergic to a food may cause a migraine. Common foods: cow's milk, wheat, chocolate, eggs.
- Some movie popcorn (peanut oil? MSG in salt?)
- Carrageenan - a seaweed extract used to make ice cream and other diary products smoother
- Maple Syrup / Brown sugar
- Dunkin' Donuts (don't ask me why, Krispy Kremes are OK with me, perhaps the oil?)
- Normal Decaf Coffee (For me, its a one way ticket to migraineland)
- Nutrasweet, aspartame, and other artificial sweeteners - give up Diet drinks
- Sulfates and Sulfides used to preserve lettuce at some salad bars
- Food dyes - especially Red 40, Yellow 5 (Doritos, Mountain Dew, and Peeps)
- Active yeasts - hot bread and yogurt
- Monosodium Glutamate (MSG)
- Release of Stress
I'd been working months on a new release of our software and we finally released it. Walking out of the building at 5pm I got a migraine
- Conflict with Family
- Heat / Direct Sunlight
A 2009 Harvard study discovered for each 9 degrees (F) increase in temperature the risk of migraines rose by 7.5 percent.
- Neck strain
- Overexertion. A heart monitor can help diagnose your maximum safe heart rate during workouts.
- Eye strain
- Not eating something soon after waking in the morning
- Sensory Overload
Headaches can be triggered by too much information being sent to the brain too quickly. Any of our senses will do especially: sight, smell, hearing, taste, touch. The brain of migraineurs cannot recover from a rush of stimuli and a cascade effect of neural activity starts. The end of this trip is not a happy one.
- Computer monitors flickering (see note below)
- Bright flashes of light, like the sun reflecting off the car in front of you. The optic nerve sends too much information and overloads the brain.
- Loud or repeating noises
- Pungent odors like freshly cut grass, second hand smoke, perfume
- Intense tastes
- Changes of temperature
- Changes in barometric pressure, especially lower pressure (think about buying a barometer to chart if you have a connection)
- Personal Triggers.
I have read personal testimonies on the web of people who had migraines for years that was cured by: removing milk or wheat from their diets. These are not normally migraine triggers but for some people they are. Try a low glycemic diet.
- Drug Induced Rebound
- What helps to prevent headaches?
- Exercise - gentle regular workouts.
- Getting regular "Goldilocks" sleep, not too much and not too little. Do not change routine for the weekends.
- Relaxing the facial muscles during the day
- Often suggested dietary supplements from various sources. Do not take all these at the same time, just try one of them at a time to see if it helps.
- Magnesium Glycinate 600 mg/day
- Co-Q10 100-150 mg in morning
- Riboflavin (Vitamin B2) 400 mg/day at night
- Petadolex (Butterbur extract) 150 mg/day
- Omega Brite (omega-3 oil) 1-2 with meal
- Feverfew herb
- Diversity in Diet
We all know that a diverse diet is a key to good health, but with migraines you should consider spreading the diversity over time. Eat fewer foods per day to determine what your triggers are. If you get a headache from eating a salad with ranch dressing, croutons, walnuts, and cranberries, you don't really know which of the toppings triggered the headache. Eat the same variety, but one new food item per meal until you know your triggers.
- Before starting a treatment plan
After personally trying chiropractic, acupuncture, physical therapy, muscular and brainwave biofeedback, stem units, massage therapy, Botox, occipital nerve blocks, vision therapy, and muscular-jaw realignment, I've learned to ask these questions to my potential health care providers.
I think in school, the health care providers learn to promote a positive image of their specialty; they always assure me that they can help. Here's my list of questions:
- How long will it take before I see my symptoms getting better?
You need to know when the treatment is not working for you so you can stop it, save your money, and move on to something else that may help you.
- How much will it cost to get to that point?
- How many patients like me have you seen in the last year?
- What percentage get better?
In my experience they will always be vague, "Oh, it's hard to tell. Some people get better, some don't." What I'd like is a real scientific response like, "Well, in my practice I've kept careful notes on patients and 35% get their migraine frequency reduced in half, 30% reduced by at least 25%, and the rest have no benefit." (I'm a dreamer).
- Do any patients experience bad side-effects from this treatment?
All treatments carry some risk. It's good to know what those are and what percentage of the people experience those side effects.
- How much will my insurance pay?
Find out quickly how much your insurance will pay. Some extra charges may be your responsibility and may not reach you until many weeks later. It's no fun to go to a chiropractor twice a week and after 6 weeks you start getting bills from your first visit that you thought insurance covered.
- How long will it take before I see my symptoms getting better?
- Recipe sites where you can type in your allowed ingredients:
- Eating Out.
Traveling is the worst. I've found a few foods I can eat at commercial fast food places, but not many:
I can eat burgers at WhatABurger, McDonald's, Five Guys, and Burger King. Many burger places use some sort of MSG to enhance the flavor.
At some Indian restaurants, the Saag Paneer is OK, without the Paneer.
Plain Baked potatoes without any margarine are always a good choice.
- Prepared Foods
I eat Arrowhead Mills Organic Spelt Flakes. While traveling, I will often take a baggie of cereal for snacks.
Yoplait Strawberry yogurt is fine, be sure to get the regular and not the lite version. For some reason the peach gives me a headache, but the strawberry is great.
Bryer's Natural Vanilla ice cream is great; no carrageenan or artificial flavors. Simple, plain, delicious.
- Favorite Links on Migraines:
- Agonist: A drug or other chemical that can combine with a receptor on a cell to produce a physiologic reaction typical of a naturally occurring substance. So 'serotonin agonists' like sumatriptan, dihydroergotamine (DHE), and ergotamine trigger an increase in serotonin levels.
- Antagonist: A chemical substance that interferes with the physiological action of another, especially by combining with and blocking its nerve receptor.
New Migraine-Friendly Recipes
- What causes the actual pain in a migraine?
People used to think it's the nerves that wrap around the blood vessels in our brains. If the blood vessels swell, those nerves get stretched and don't like it and they don't mind telling you they don't like it. This view is no longer seen as sufficient. Something else is going on causing the pain and the swelling of the blood vessels is more a side-effect.
- White Lights
The bright colors on a computer monitor hurts my eyes. On a Windows 10 machine you can invert the colors by launching the "Magnifier" program and then Ctrl-i for invert. This will invert all the colors. Ctrl-i again will bring it back to normal.
If you are fortunate enough to have a Mac, you can reverse video with ctl-alt-command-8, although you may have to go to System Preferences/Keyboard/Short Cuts/Accessability to turn on the feature.
Heal Your Headache: The 1-2-3 Program for Taking Charge of Your Pain
Don't let the cover scare you away; this is the best book I've found. I don't recommend strictly following his program and giving up all medication, but he has many good ideas.
Final thoughts on foods
Editor's Note: OK, I'm not a doctor - I don't even play one on TV, but here is my best guess on foods:
For some people foods can trigger their migraines. Perhaps people are sensitive to a small number of substances. If you can determine the 'family' of foods containing that substance, you may be able to remove all those foods and lessen your headaches. The major families are: MSG, Caffeine, Phenylethylamine, Tyramine, and Tannin. If chocolate gives you a headache, then orange juice from concentrate and red wine may also since they all contain Phenylethylamine. Try to remove all of them for a time and then reintroduce to determine if that's true. To make things more interesting, many of these foods have two or more common migraine inducing ingredients.
If you are a student studying to be a nutritionist or looking for a thesis project, what migraineurs really need is a chart like this: