Migraine Headaches

Migraine is a fascinating set of problems which allow us to examine the link between food, the circulating immune system and brain disturbances. While pain is the main event, many other symptoms occur before, during, and after a headache. The pain of migraine arises from blood vessels, supplying blood to the brain. Some brain disturbances are stroke-like, originating from reduced blood flow to the brain. This is most likely to occur before the headache occurs. Blood vessels constrict at this time, reducing blood flow. Typically, a migraine sufferer will follow a rhythmic or cyclic pattern. The underlying biorhythms and changes in tolerance for trigger substances will vary the response to ingestion of certain foods. The only solution to a frequently-occurring migraine headache is to alter the food intake while attending to the reduction of other trigger factors.

Dietary advice is often given to migraine sufferers. The most popular idea is to avoid tyramines, amino acid-like chemicals present in a number of foods, especially red wine and cheddar cheese. Other amines include the drug phenylethylamine, which is found in chocolate. Experiments using tyramine alone have failed to substantiate its primary role in causing migraine headaches.

The problem with many food-headache studies has been an overly simplistic view of the pain-causing sequence. In general, any food that has the property of imitating or releasing mediator substances in the bloodstream may produce pain. Any food that is capable of producing an internal allergic response can cause headache.

The solution to a headache problem involves complete diet revision and not simply the exclusion of one or two substances. Migraine headaches are caused by food allergy. In an English headache study , the authors state:  "The diagnosis of migraine is based on clinical criteria and should not depend on mechanism or aetiology. Migraine is a multifactorial disease which may be induced through the ingestion of large amounts of chemical mediators in some individuals, or through an allergic reaction to foods in others. In the latter group, the exact mechanism by which foods cause the migrainous attacks is not clear. Some food-allergic reactions arise through an immune-complex-mediated mechanism - that is, a form of serum sickness triggered by a type-I hypersensitivity reaction in the gut. In these circumstances, the composition of the immune complex or the mediators released govern the damaging capacity

A century of reports of the food-migraine connection often go ignored in the medical management of migraine.     In a study of children with migraine, excellent results were produced by dietary therapy:    "...93% of 88 children with severe frequent migraine recovered on oligoantigenic diets; the causative foods were identified...by a double-blind controlled trial in 40 of the children. Most patients responded to several foods. Many foods were involved, suggesting an allergic rather than an idiosyncratic (metabolic) pathogenesis. Associated symptoms which improved in addition to headache included abdominal pain, behavior disorder, fits, asthma, and eczema. In most of the patients in whom migraine was provoked by non-specific factors, such as blows to the head, exercise, and flashing lights, this provocation no longer occurred while they were on the diet. Introduction of cheese, chocolate, and red wine sometimes provoked migraine, allegedly owing to an idiosyncratic response to a pharmacologically active substance, tyramine. This response is perhaps due to monoamine oxidase deficiency... Double-blind administration of tyramine to patients who benefited from a low-tyramine diet did not provoke attacks of migraine... In this study, children with severe migraine were given an oligoantigenic diet and in those who improved the causative foods were identified by open reintroduction; responses were confirmed by a double-blind controlled trial of reintroduction of the causative foods."

Effective management of headaches depends on a multi-factorial plan. Ingested and inhaled chemical and allergenic triggers should be eliminated as much as possible through a series of progressive steps. Physical measures are instituted as the principal means of relieving pain. The use of strong analgesic medications, tranquilizers, and other drugs can generally be minimized or avoided if appropriate dietary and physical therapies are put into place. The simplest pain relievers are used when necessary.

The drug bias is so strong in medicine that, migraine announcements introduce yet another drug, better than the last for reducing headaches. The drug approach to migraine has varied from the atrocious to the interesting. The atrocious side of drug treatment is the over-prescription of narcotic pain-relievers. Narcotic addition can become a much greater problem than the original headache. Other drugs have little to offer but many side-effects and risk of dependency. These include sedative drugs, barbiturates and muscle relaxants.  A wide variety of drugs may reduce the severity of migraine; the diverse mechanisms by which these drugs act point to the multistage, complex mediator pattern of migraine.

For years, ergotamine was prescribed to abort the headache in its early stages, especially during the aura, before the pain had begun. Other ergot derivatives were prescribed daily as migraine prophylaxis. Sandomigran had some success but also very serious adverse effects. Drugs used to lower blood pressure (beta blockers and calcium channel blockers) were also sometimes useful if taken daily in reducing the frequency and severity of headaches. Aspirin or ASA remains one of the best pain-relieving drugs if taken in the first few minutes of an attack. Related anti-inflammatory drugs work by the same ASA mechanism of blocking the production of prostaglandins, mediators generated in the first stage of a migraine response. Later, blood platelets release serotonin, and other blood components come into play. When the headache is hours long and severe, oral prednisone can be helpful. Another drug, sumatriptan, blocks serotonin receptors. Injected sumatriptan was said to relieve headache in 70% of patients. The drug is expensive and has potentially serious side effects. The drug constricts blood vessels and like ergotamine may reduce blood flow to the heart or brain. Better than drugs, why not remove the original food causes of migraine headaches?

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Human Brain in Health and Disease

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The Human Brain in Health and Disease, 2010, is a Persona Digital Book. We encourage readers to quote and paraphrase topics from Human Brain in Health and Disease published online and expect proper citations to accompany all derivative writings. The author is Stephen Gislason and the publisher is Persona Digital Publications. The date of publication is 2010. The URL to the book description is Human Brain