The Truth About Migraines
By Mark Hyman, M.D.
What disabling condition affects one in five Americans and is poorly treated with conventional medicine – yet is nearly 100 percent preventable by addressing the underlying causes? Migraines!
But these aren’t just any headaches. These severe, nearly disabling headaches can occur from once a year to three to four times a week. They can last from hours to days, creating suffering for millions of people.
They are often associated with an aura, light sensitivity, nausea, vomiting, and severe throbbing pain on one or both sides of the head. They can even be associated with stroke-like symptoms or paralysis. And the cost to society is enormous.
Migraine headaches add $13 billion to $17 billion to our healthcare costs each year.
These costs include medications, emergency department visits, hospitalization, physician services (primary care and specialty), laboratory and diagnostic services, and managing the side effects of treatment.
Those are the direct costs from treatment. But migraines have indirect costs too.
Headache is the most frequent pain-related complaint among workers. Focusing specifically on migraine, one study found that the annual cost to employers exceeded $14.5 billion, of which $7.9 billion was due to absenteeism and $5.4 billion to diminished productivity.
So this is a HUGE problem – both to those who suffer and to society as a whole.
Worse, migraines are hard to treat and very difficult to prevent with conventional approaches.
There are a host of preventive drugs – calcium channel blockers, beta-blockers, anti-seizure medications, antidepressants, and more – which work poorly, if at all, and are accompanied by frequent side effects. Some doctors are now even using Botox to paralyze neck muscles in the hopes of easing migraines.
There is a new class of medication called triptans (like Imitrex, Maxalt, and Zomig) that can stop a migraine once it starts. Though these have made migraine sufferers handle the attacks better, they also have serious potential side effects, including strokes, and are expensive. Still other treatments can lead to addiction or dependence.
Not a pretty picture. And for many, none of these treatments work very well or at all.
The problem with migraines is the same that we see so often in medicine: We treat the symptoms, not the cause.
We only deal with the effects of something and not the underlying 7 keys to UltraWellness. In fact, using Functional medicine and UltraWellness I have been able to get nearly 100 percent of my patients migraine free – within days to weeks.
Many of my patients are doctors themselves and are often at the end of their rope.
One was a physician from the Mayo Clinic, the Mecca of conventional medicine. This woman had severe, disabling migraines and barely functioned at work. She depended on oxycodone (a strong morphine-like narcotic) and Zofran (a powerful anti-nausea drug used for chemotherapy patients). She had seen every specialist at the Mayo Clinic and had traveled far and wide to other top neurology headache centers but never found relief.
Why Couldn’t the Mayo Clinic End Her Severe Migraines?
Everybody focused on her headaches, not her other symptoms – which held all of the clues to her problem. You see, migraine is no different from any other disease. It’s simply the NAME we call a set of symptoms that are common in groups of people.
The NAME tells us NOTHING about the CAUSE of the symptoms, which may be very different depending on the person.
In fact, there may be more than 20 different causes of migraine headaches!
My job is to be a medical detective and find these causes.
It is not to simply prescribe powerful symptom-suppressive drugs. I remember very well working in the emergency room, treating all the chronic migraine patients with intravenous narcotics and nausea medication. I felt bad for them, but worse that I didn’t have a way to prevent them from coming back. Now I do.
So what happened to this doctor who suffered migraines nearly every day for years with no relief? First, I asked her a lot of questions. She had many symptoms – including palpitations, severe constipation, anxiety, insomnia, muscle cramps, and menstrual cramps – in addition to her migraines. All of these symptoms are connected.
They told me that her whole system was tight and irritable and crampy. That usually means severe magnesium deficiency, which often results from poor diet, caffeine, sugar, alcohol, and stress. So I put her on high doses of magnesium and cleaned up her diet. Within a couple of days, she was migraine free and never had another migraine.
She’s not the only success story. Another patient had disabling migraines for 45 years and could not have a social life or plan anything because she spent most of her time in bed with the lights out. She had an allergy to eggs. No eggs, no migraines – except when she felt so good after 3 months that she decided to have an egg and ended up in the hospital with a 3-day migraine.
Another patient always had migraines before her period, along with severe PMS, bloating, sugar cravings, breast tenderness, and irritability. This is related to hormonal imbalances, with too much estrogen and too little progesterone. Getting her hormones back in balance relieved her of her migraines.
Yet another patient had genetic problems with her mitochondria and energy metabolism and needed high doses of vitamin B2 and coenzyme Q10 to get relief. And one recent patient had persistent abdominal bloating after eating, which told me she had overgrowth of bacteria in her small bowel. When we cleared out these bacteria with a non-absorbed antibiotic, all of her migraines went away.
One patient who lived on Diet Coke didn’t get rid of her migraines until she gave up the artificial sweetener aspartame. Another patient had low blood sugar episodes that triggered migraines, so eating small, frequent meals of whole foods stopped the headaches.
And lastly, one patient always got her headaches after exercise in the heat or with dehydration. As you can see, even though these patients may all have the SAME symptoms, their treatment must be DIFFERENT.
So getting the full story – with the keys of UltraWellness – is so important.
Keep in mind that sometimes a combination of treatments is necessary. Other treatments can be helpful in selected cases, such as herbal therapies (feverfew and butterbur), acupuncture, homeopathy, massage, and osteopathic treatment to fix structural problems.
The bottom line is that this problem – which affects one in five Americans and costs society $17 billion a year – is almost entirely preventable, simply by following the principles of Functional Medicine and UltraWellness. So get to the bottom of your symptoms – and get ready for migraine relief.
Here are the most important causes of migraines and their associated symptoms, and the tests to identify problems.
Food Allergy/Bowel and Gut Imbalances
The symptoms: Fatigue, brain fog, bloating, irritable bowel syndrome, joint or muscle pain, postnasal drip and sinus congestion, and more.
The testing: Check an IgG food allergy panel and also check a celiac panel because wheat and gluten are among the biggest causes of headaches and migraines. Stool testing and urine testing for yeast or bacterial imbalances that come from the gut can also be helpful.
The treatment: An elimination diet – getting rid of gluten, dairy, eggs, and yeast – is a good way to start. Corn can also be a common problem. Getting the gut healthy with enzymes, probiotics, and omega-3 fats is also important.
The causes: A processed food diet including aspartame, MSG (monosodium glutamate), nitrates (in deli meats), sulfites (found in wine, dried fruit, and food from salad bars) is to blame. Tyramine-containing foods like chocolate and cheese are also triggers.
The treatment: Get rid of additives, sweeteners, sulfites and processed food. Eat a diet rich in whole foods and phytonutrients.
The causes: Premenstrual syndrome with bloating, fluid retention, cravings, irritability, breast tenderness, menstrual cramps; use of an oral contraceptive pill or hormone replacement therapy; or even just being pre-menopausal, which leads to too much estrogen and not enough progesterone because of changes in ovulation.
The testing: Blood or saliva hormone testing looks for menopausal changes or too much estrogen.
The treatment: Eat a whole-foods, low-glycemic-load, high-phytonutrient diet with flax, soy, and cruciferous vegetables. Use herbs such as Vitex, along with magnesium and B6. Avoid alcohol, caffeine, sugar, and refined carbohydrates. Exercise and stress reduction also help.
The symptoms: Anything that feels tight or crampy, like headaches, constipation, anxiety, insomnia, irritability, sensitivity to loud noises, muscle cramps or twitching, palpitations, etc.
The testing: Check red blood cell magnesium levels. Even this can be normal in the face of total body deficiency, so treatment with magnesium based on the symptoms is the first choice.
The treatment: Magnesium glycinate, citrate or aspartate in doses that relieve symptoms or until you get loose bowels. If you have kidney disease of any kind, do this only with a doctor’s supervision.
The symptoms: Fatigue, muscle aching, and brain fog, although sometimes the only symptom can be migraines.
The testing: Checking urinary organic acids can be helpful to assess the function of the mitochondria and energy production.
The treatment: Taking 400 mg of riboflavin (B2) twice a day and 100 to 400 mg a day of coenzyme Q10 can be helpful, as can as other treatments to support the mitochondria.
Keep in mind that sometimes a combination of treatments is necessary. Other treatments can be helpful in selected cases, such as herbal therapies (like feverfew and butterbur), acupuncture, homeopathy, massage, and osteopathic treatment to fix structural problems.
The bottom line is that this problem — which affects one in five Americans and costs society $24 billion a year — is almost entirely preventable, simply by following the principles of Functional Medicine and UltraWellness. So get to the bottom of your symptoms — and get ready for migraine relief. It’s the best way to move toward lifelong vibrant health.
Now I’d like to hear from you…
Do you suffer from migraines?
What treatments have you tried and how are they working?
Have you found a connection between the causes I’ve mentioned and your headaches?
What steps have you taken to address them?
Please share your thoughts by leaving a comment below.
To your good health,
Mark Hyman, M.D.
Written By: Updated: December 7,2010