Unlocking Your Migraine Solution
/It’s Not Just a Headache
Those who have never had a migraine may annoyingly suggest that you should drink more water, as if you haven’t thought of that. They may compare it to a their own experience of a simple headache, and not understand why you need to lay still for an entire day with the shades drawn. Neighbors have seen me walk my dog gray-faced, in the middle of a migraine. I can see concern and questions in their eyes - “Is she a meth addict?” Nope, just taking the dog to pee in between bouts of vomiting in yet another ring of Dante’s Inferno.
If you suffer from migraines, I want to send you a hug and tell you that I understand what you’re going through. Having had hundreds of them over the past ten years, and having tried just about everything in Eastern and Western medicine to fix it, I have finally (fingers crossed) unlocked my migraine solution and hope to share what I’ve learned in case it benefits you. Think of it as unlocking a safe, and each person has their own combination that they have to figure out. Unfortunately, there is no magic pill nor herb nor set of acupuncture points. Triptans, NSAIDS, and beta blockers may work for some people for some period of time, but very often they come with side effects like chest pain or stomach ulcers and even rebound headaches. Some patients find help with nerve blocks and Botox, but for me the idea of injecting Botulism into my head is enough of a deterrent. Acupuncture that is aimed at unblocking the affected channel has helped me diminish the pain or shorten the duration, but never to the extent I needed. When combined with all of the other measures I will share, acupuncture 100% contributes to my health balance, but never as a magical cure in the middle of a migraine episode.
Stages of a Migraine Episode
Everyone who gets migraines has some premonitory signs of an incoming episode. In the day or hours before one, my neck begins to twist and tighten like a tree trunk, and my brain feels heavy and odd like it isn’t getting oxygen or blood flow. For others, there can be visual aura, dizziness, sudden cravings or bouts of emotion, etc. A few hours or a day after the premonitory stage, the pain stage begins, and once there, no therapy or painkiller has helped me. Soaking my feet in hot water and putting ice on my head provides temporary pain relief because it helps the vasodilation imbalance, but until the next day or the one after, the stabbing and nausea and vomiting will continue. And life still has its demands. Kids still need to be fed and paychecks still need to be earned. In the days after an episode, I would feel weak and foggy, and in the back of my mind, I knew it was a matter of time before the next one. It’s no wonder that many migraineurs are also suffering from depression.
The Root Cause
As an acupuncturist, I try to diagnose any illness with the whole picture in mind. I believe true medicine is not simply treating symptoms formulaically. I want to know WHY the symptoms are manifesting and repair the root. In my experience, painkillers have no beneficial effect once I am in the pain stage of a migraine. Possibly, I have had good results with an NSAID at the beginning of the premonitory phase. But I have noticed that in the premonitory phase, my body is extremely sensitive to triggers. Any food or drink or substance that taxes my liver will usually just bring about the pain stage and I have a day of vomiting to look forward to. I have treated many patients with stomach ulcers due to regular consumption of NSAIDS. There is no question that taking them regularly is not a good strategy for your body. Getting to the root cause is more laborious but it is necessary.
Over the years I have consulted with biomedical doctors and I have read books such as The Migraine Brain as well as search Pubmed data to try to comprehend the pathophysiology of migraine disease. What I learned is that there is still very little understanding of the disease mechanism. During a migraine episode, there is an imbalance in vasodilation, the brain’s electrical charge, and impulses with the Trigeminal nerve that creates the throbbing or stabbing over the eye. But why does this happen? Scientists haven’t answered that question yet. Allopathic treatment strategies are aimed at blocking nerves, controlling vasodilation, and blocking pain signals.
Vitamins / Supplements
Data has shown that the following Vitamin deficiencies can lead to migraine: Iron, D3, Magnesium, Folate (B2), B6 and B12, and CoEnzyme Q10. Personally, I take a multivitamin that has Iron and B Vitamins in the morning, and I take Magnesium Glycinate at night. It’s important to be careful about reading the label of supplements to determine the quality. Often they can contain ingredients that are triggers (like potato starch for me) or they can have fillers or preservatives that are hard to digest. There is a debate about Magnesium Stearate and whether or not it blocks the absorption of magnesium. I figure it’s safer to stick with the one with the most simple ingredients.
Hormonal Migraines
Women are three times more likely than men to suffer from migraines. Mine were almost always linked to hormonal fluctuations during my menstrual cycle. The worst ones would come on the days where estrogen plummets (two or three days before menstruation). Sometimes I would have a migraine during the period, sometimes at the end of one, and sometimes on ovulation day. Women who suffer from hormonal migraines are having them due to estrogen dominance or deficiency, or trouble with the metabolism of hormones. Once I made the hormone connection, I researched how to create healthy hormone balance and began experimenting with herbal hormone supplements. This works for some people, but for me I just began to gather a supplement graveyard - half finished bottles of evening primrose, black cohosh, chaste berry, maca root, etc. Nothing by itself was effective. Again, no magic pill. I even saw a renowned herbalist and paid for expensive custom formulas taken twice a day, but after three months and still suffering, I gave it up. Herbalists might argue that it must not have been the right formula, but even if I had found the perfect formula, it should not be taken indefinitely, and I would still need to fix the root cause.
Phases of the Menstrual Cycle
I began to learn about each phase of my cycle and which hormones were increasing or decreasing on certain days. I started to try to sync up my lifestyle to support what was happening in different phases of my cycle. It’s an Eastern medical tenet that for lasting health balance, we must live in accordance with the seasons. We should rest and be insular in the winter time, and we should be active and most productive in the Spring and Summer. Similarly, women will feel more balanced if they live in accordance with their cycles. During menstruation, we feel more lethargic, and so we should respect the instinct to be more restful, insular, and restorative. Of course, our lives and work may not allow for the kind of rest we need, but if we can carve out the time to lie down, read a book, watch a movie, and rest during this time, we should not feel guilty about it. After all, chunks of bloody tissue are being purged from our bodies. It’s ok to be tired. If you’re like me, raised with a strong work ethic, and living in a city that always pushes your limits, even a rest day is full of the drive to feel productive. But every living being needs to rest. Sometimes we have to stop and mentally say to ourselves ‘my only task for the next ____ amount of time is to rest.’
After menstruation, we are more deficient in blood, body fluids, and minerals. It’s a good idea at this phase to eat healthy fats to support estrogen with omega rich foods like seeds, nuts, yams, and fish. Both very low and high levels of body fat are associated with low estradiol levels. My teacher used to say ‘fat is the house of estrogen.’ As estrogen increases and we feel more creative and productive, it will be less of a struggle to get out there and do our thing. If there is healthy ovulation mid cycle, progesterone levels will increase afterward. Many premenstrual symptoms like breast tenderness and mood swings are due to the spike of progesterone before the release phase of menstruation. At this premenstrual time, it’s beneficial to help the body metabolize hormones, so things like epsom salt baths, green juices, liquid chlorophyll, dandelion tea, and fibrous food are extra helpful to let the body eliminate waste that includes hormones.
Stress Disrupts Hormones
Here’s the thing - even if our diet is perfectly balanced to support healthy hormones, life stressors can disrupt hormone balance. If we are living a life of constant fight or flight mode, or we are constantly allowing our mental dialogue to be full of angry or anxious thoughts, our pituitary gland is listening, and will respond in accordance. If your body receives the message that you are too stressed out for pregnancy, you will not ovulate, and healthy levels of progesterone won’t be produced. So, not only does physical health require attention to diet, it demands that we pay attention to our mental well being. One thing I learned is how negatively I’m affected by watching the news. Listening to experts discuss the uncertainty, anxiety, and mess of the current world while I feel hopeless to change it stopped making sense to me. Instead, I spend a little time catching up on reading the news but I don’t let myself dive into rabbit holes with it. Also, I carve out time every day, even if it’s ten minutes, to do a breathing exercise or a restorative pose so my nervous system can restore. We cannot control all stressors of life, but we can pay attention to the ways that we can limit them or the ways we might exacerbate them.
What Are Your Triggers?
After making these changes with my cycle, I stopped having severe vomiting migraines. However, I still had milder ones, and I was determined to figure out why. I joined a Facebook support group for chronic migraines to see what methods were working or not working for people. The group was almost entirely devoted to discussing what pharmaceuticals they had tried, and no judgement there, but it was not what I was looking for. Many were suffering daily migraines despite their insurance covering abortive drugs, and I wondered if they were experiencing rebound headaches. I kept noticing people claiming to get some relief by taking Benadryl, and this led me to understand that migraines are an inflammatory response to a trigger. Every migraineur has their own set of triggers and thresholds and it requires some detective work to figure it out. I started tracking what I consumed the day before or during a migraine. Some triggers are out of our control - like sustained loud noises, barometric pressure changes, strong perfumes, or an angry boss. We can only do our best with those, like finding time every day to relax the nervous system, or to exercise and get serotonin levels up, or get up and move to a different subway car when someone wearing patchouli stands next to us. What many people do not realize is that many triggers are food sensitivities and therefore we can avoid them. I’m not saying this is easy, but it is possible. Every person has to discover their own food sensitivities and thresholds, and people do not want to hear that they should stop enjoying the food they love.
Once I paid close attention, I saw that nightshade vegetables and spices are a major migraine trigger for me. Nearly every time I had an episode, it was preceded by French fries or tomato sauce or a huge amount of hot peppers - all members of the nightshade family. Nightshades include potatoes, tomatoes, peppers of any kind (chili or bell), paprika, cayenne, eggplant, goji berries, Ashwagandha and tobacco. They contain alkaloids which have been found to destroy the membranes of gut epithelial cells. Some people have no apparent issues with nightshades while folks like me can’t tolerate more than a small amount. Studies have shown that nightshades increase intestinal permeability or leaky gut, which allows bacteria and other pathogens into the bloodstream, causing inflammation and sometimes autoimmune disorders like celiac disease, irritable bowels, multiple sclerosis, ulcerative colitis, and rheumatoid arthritis. Even if you don’t suffer from migraines, you could have a nightshade intolerance, and common signs include gas and bloating, diarrhea, nausea, and heartburn. Those that have a more permeable gut lining or unhealthy microbiome will not absorb nutrients well, and are often more anemic or deficient in important vitamins and minerals.
I was in denial about the nightshade trigger for weeks because spicy food and French fries equal joy for me. I also hated the idea of being that annoying person in the restaurant who asks a hundred questions about the menu. So I continued to eat them and kept learning that a day or two of suffering was maybe not worth a plate of fries. My suggestion to every migraineur is to keep a food journal that will detail what you eat at every meal and track the onset and symptoms of every migraine. This way, you will finally pin down the pattern and be able to avoid the causes as best you can. I believe that those who suffer from migraines and claim that food doesn’t make a difference are either consuming their triggers so often that they can’t differentiate the good days from the bad ones, or they are not paying close enough attention (sometimes triggers are lurking in food without our knowledge). Take bread or pasta, for example. Gluten intolerance has gone way up since the 90’s, along with celiac and lupus. This is the same time that it became standard practice to soak wheat harvests in glyphosate. Many people that can’t tolerate bread in the United States claim that they are fine eating bread in France or Italy.
The most common food related migraine triggers: Alcohol, Nightshades, Dairy, Tyramine (found in processed meats, aged cheese, fermented food, ice cream..), Nitrates (found in processed meats), MSG, Artificial sweeteners and refined sugar, Food Coloring
All of the above are triggers for me if taken in large amounts, or if I consume them on hormone shift days of my cycle when I am more sensitive. It’s no fun to cut out delicious things and eating should be enjoyable for food to be healing. I especially find it hard to eliminate sugar, but I know that it feeds the harmful bacteria and pathogens in our bodies and depletes our nutrients. I always want a little sweet thing every day and have a pretty strong bubble tea addiction, so I just do my best to substitute natural sweeteners like raw honey / molasses / maple syrup / date syrup, and then save the bubble tea indulgence for days where I feel more balanced. The trick in the end may not just be about avoiding the triggers. It has everything to do with healing the gut microbiome so that the triggers are not as damaging.
Healing Your Gut
Repairing the microbiome and the gut lining requires probiotics and prebiotics. Prebiotics are high in the type of fiber that feeds beneficial gut bacteria. Some prebiotics include garlic, onion, oats, leeks, asparagus, barley, apples, and flax seeds. For a boost of beneficial probiotics, you can try sauerkraut, miso, kimchi, tempeh, kefir. I also put collagen peptides in my coffee every morning and I stick to cooked vegetables instead of raw, because they are easier to digest. Instead of potatoes, I eat yams or yucca or plantains. Instead of soy sauce, I use coconut aminos. I still indulge in spice but I know when I’ve gone too far.
I realize that this unlocking of the migraine solution is complicated and an arduous task. But if you are like me and you want a lasting solution that gets to the root cause and doesn’t burden you with other health problems as a side effect, it is worth our best effort. It’s a gift to get to know your body well and understanding what keeps it balanced - a varied diet that supports gut health, watching and limiting triggers, finding good supplements if you are deficient in vitamins and minerals, and making time to relax the nervous system or get some movement therapy, and rest without guilt as much as possible. Sometimes life doesn’t allow for all of this, but It can be a very empowering experience to get healthy and I wish it for everyone.