Using the word headache to describe a migraine is like referring to the space shuttle as an airplane. Technically, migraines are headaches, of course-but the suffering they cause far exceeds that of most other types. An estimated 30 million Americans, most of them between ages 15 and 55, get migraines. Women sufferers outnumber men three to one, and while the onset of menopause sometimes brings relief, it doesn't always. Fewer than half of migraine sufferers are properly diagnosed-instead, many are incorrectly told that their headaches stem from sinus problems or tension. Because treatments for other types of headaches do not alleviate migraines, millions of people suffer needlessly.

Standard treatment for migraines includes prescription drugs, such as sumatriptan (Imitrex), zolmitriptan (Zomig) and rizatriptan (Maxalt). These are intended to prevent, halt or ease migraines—but they do not work for everyone. Potential side effects include nausea, dizziness, diarrhea and sweating, and in rare cases, an increased risk for heart attack and stroke, perhaps due to blood vessel damage. When the drugs are discontinued, patients may get rebound headaches.

Good news: It is possible to reduce the frequency of migraines or prevent them by using natural, nutritional, drug-free substances.

Getting The Right Diagnosis

Migraines may be caused when arteries in the brain dilate abnormally and nerves that coil around the arteries are stretched. In response, the nerves release chemicals that cause painful inflammation and further enlargement of arteries, magnifying pain even more.

Migraine symptoms are distinct from those of other types of headaches. If you experience two or more of the following symptoms, you probably are dealing with migraines. Migraine pain may...

  • Occur on one side of the head.
  • Last from four hours to as long as 72 hours.
  • Pulsate or throb.
  • Be triggered by certain situations or eating particular foods.
  • Worsen during exertion, such as when climbing stairs
  • Be accompanied by nausea or vomiting.
  • Be exacerbated by sound.
  • Be accompanied by oversensitivity to light.

About 20% of migraine sufferers experience aura, a visual disturbance that typically comes on 20 to 60 minutes before the onset of pain. Aura may be perceived as flashing lights, blind spots or wavy lines in the field of vision. It may be accompanied by facial tingling, muscle weakness and/or speech difficulties, such as slurring words or having trouble finding words. Aura occurs when certain nerve cells in the brain become temporarily hyperactive, triggering visual disturbances and tingling sensations...while in other nerve cells, activity is depressed, temporarily impairing vision, speech and muscle strength.

Another clue: Up to 80% of migraine sufferers have a family history of the condition-So if a close relative has migraines, you are more likely to get them, too.

If you suspect migraines, see a headache specialist or neurologist. He/she should take a detailed history that includes your migraine symptoms...pattern of attacks...other types of headaches you history of headaches.. and all of your medications. Many, such as hypertension drugs, birth control pills and nonsteroidal anti-inflammatory drugs (NSAIDs), can contribute to migraines. Hormone testing may be appropriate, as deficiencies of estrogen and/or progesterone (in women) or of thyroid hormone can lead to migraines. All of this information is vital, because no tests can definitively confirm a migraine diagnosis.

Natural Ways To Prevent Migraines

Numerous studies confirm the benefits of the vitamin-like coenzyme Q10 (CoQ10)...riboflavin (vitamin B-2).. and the mineral magnesium. Taking just one of these three natural substances can decrease migraine severity and/ or frequency by about half. In my experience, when patients regularly take all three, overall improvement can exceed 75%.

Theory: An abnormal lag in brain cells' energy production triggers the blood vessel dilation that leads to a migraine. These three nutrients support the mitochondria-structures in cells that convert oxygen and nutrients into chemical energy to power the cells' metabolic activities—helping them to work more effectively and thereby preventing migraines.

Daily prevention strategy: I suggest using all three of these substances if you get migraines once or more per month. Take them for four months. If you notice improvement, continue indefinitely. Dosages and guidelines for people age 12 and up...

  • CoQ10 at 100 mg three times daily. OCcasional side effects, such as mild heartburn or nausea, can be avoided by taking CoQ10 with meals.
  • Riboflavin at 400 mg once daily. B vitamins work best when in balance with one another, so take an additional B complex or multivitamin.
  • Magnesium at 200 mg twice daily (reduce dosage if you develop diarrhea). Least likely to cause loose stool is the magnesium glycinate form.

These supplements are sold in health food stores, are nontoxic, rarely have side effects and generally are safe. Evidence that they work…

  • CoQ10. In a study published in the journal Cephalalgia, 31 migraine patients took 150 mg of CoQ10 daily. After three months, the number of migraine attacks fell, on average, from 4.85 to 2.81 per month and duration of pain (measured in "migraine days") was significantly reduced. In another study, Swiss and Belgian researchers gave 42 patients a placebo or CoQ10 at 100 mg three times daily for three months. Migraine frequency fell by at least half in 47% of patients taking CoQ10, compared with 14% of the placebo group. CoQ10 users also had less nausea.
  • Riboflavin. In a Belgian study, 55 migraine patients took either a placebo or 400 mg of riboflavin daily. Frequency and duration of migraines decreased by at least half in 59% of riboflavin users, compared with 15% of placebo users. Research suggests that combining riboflavin with beta-blockers (cardiovascular drugs sometimes prescribed for migraines) may be more effective at preventing migraines than either therapy used alone.
  • Magnesium. Up to half of patients have a deficiency of magnesium during a migraine, as shown by testing of blood drawn during attacks. Oral magnesium supplementation may reduce the frequency and duration of migraines.

Possible reason: Upon exposure to a migraine trigger, excess calcium flows into brain cells, causing a sudden constriction of blood vessels...and magnesium supplementation combats this by normalizing the balance of minerals in the brain. In addition, intravenous (IV) magnesium can give fast relief from acute migraine symptoms. Although conventional doctors generally do not offer this therapy, some holistic practitioners do.

Beware These Migraine Triggers

In susceptible individuals, certain foods and/ lor situations can bring on migraines. To identify your triggers, keep a diary for four weeks, noting when your migraines occur and looking for patterns.

Common food culprits…

  • Alcohol, especially red wine and beer
  • Caffeine and/or caffeine withdrawal
  • Chocolate
  • Cheese, especially aged (Parmesan, Asiago)
  • Fermented foods (miso, sauerkraut)
  • Monosodium glutamate (a flavoring)
  • Nitrates (a type of preservative)
  • Pickled foods (dill pickles, olives)
  • Shellfish
  • Wheat

Situational triggers...

  • Changes in weather, altitude, time zone
  • Dehydration
  • Fatigue, sleep problems
  • Glaring lights
  • Perfumes, powerful odors
  • Stress

Botox for Migraines?

When other treatments fail, some doctors offer injections of prescription botulinim toxin (Botox). This use of Botox is "off label-meaning it is legal but the drug has not been FDA-approved for this purpose. Since the therapy is considered experimental, insurance generally does not cover it. If a clinical trial, now in its final stage, shows Botox to be effective against migraine, it may earn FDA approval within a few years.

Some evidence suggests that multiple Botox injections in the head and/or neck can reduce the severity and frequency of migraine attacks for three to four months by decreasing the release of certain chemicals from nerve endings. Cost varies widely, from $700 to $2,000 or more.

New Treatment Cuts Migraine Attacks by 46%

Injections of local anesthetic can reduce the I number and severity of attacks, reports Maria Adele Giamberardino, MD. Many migraine sufferers have trigger points in the neck that, when stimulated, elicit the same pain as their migraine attacks. In a recent study, anesthetic was injected into patients' trigger points four times over a two-month period.

Result: The number of attacks decreased by 46%, and the intensity decreased by 17%.

Better Migraine Treatment

In two recent studies involving a total of 2.956 I people, participants received pills containing the migraine drug sumatriptan Imitrex) or the nonsteroidal anti-inflammatory drug naproxen (Aleve)...pills containing both painkilling drugs ...or a placebo.

Result: Those who took the combination pill reported better headache relief than those who took either drug alone or a placebo.

Theory: The drug combination targets several neural pathways believed to trigger migraines. A combination pill is under review by the FDA.

New Treatment for Cluster Headaches

In a recent study, 63% of attacks in patients who were given 10 mg of the migraine nasal spray zolmitriptan (Zomig) were significantly relieved in as little as 30 minutes.

Some patients had relief within 10 minutes. Just 5 mg eased pain in half of participants.

Cluster headaches are among the most painful form of headaches, and there are few FDAapproved treatments available.

Zolmitriptan's side effects include drowsiness, tingling and chest discomfort. Zolmitriptan is a triptan, a type of drug that should not be given to patients who have heart disease, high blood pressure or blood vessel problems.

Hypnosis for Pain Reduction

In a recent study of 200 women scheduled for I breast cancer surgery, a psychologist treated one group with 15 minutes of hypnosis (including suggestions on how to reduce pain) within one hour prior to surgery, while the other group simply spoke with a psychologist about whatever they wished.

Result: The hypnosis group needed less anesthesia and reported less pain than the other group.

Theory: Hypnosis induces relaxation, which helps reduce pain.

To find a hypnotist: Contact the American Society of Clinical Hypnosis (630-980-4740,

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