Disarm Migraine Triggers
Prevention is the key to easing headache agony

By Joan Friedrich, PhD

Imagine an excruciating headache that manifests as a spectacular light show, pulsating and exploding in sync with the pain in your skull, or an incessant stabbing coupled with nausea and narrowed vision. These are classic symptoms of a migraine headache, debilitating by any description—a pain so vivid it can only be understood by fellow sufferers. Pharmaceuticals such as aspirin, Midrin, Migranal or oral triptans (including Imitrex and Zomig) can work wonders in alleviating the pain, but for some these remedies carry unwanted side effects, making prevention the obvious alternative for these agonizing attacks.

Migraines, the most frequently occurring and widely studied form of headache, strike 10 percent of the population for no single determined biological reason. According to the Centers for Disease Control in Atlanta, the prevalence of migraines among the U.S. population has increased nearly 60 percent since the late 1980s—an increase many attribute to poor nutrition, environmental pollution and increased allergic reactions. Women ages 25 to 44 suffer the most, often experiencing migraines during ovulation or just before, during, or following a menstrual period.

Anatomy Of A Migraine
Migraines appear to have a strong genetic component and commonly occur among family members. The typical migraine lasts from one to 72 hours and usually hits once a month. Oftentimes migraine sufferers see shimmering lights, feel pins and needles, or have difficulty thinking and speaking shortly before the agony strikes. "The classic sign is the aura—seeing lights just before it hits," says Steven Ottariano, RPh, a clinical herbal pharmacist in Manchester, New Hampshire, and author of Medicinal Herbal Therapy (Nicolin Fields Publishing, 1999). "That's when you need to do something because the longer you wait, the worse it's going to get."

Many scientists believe migraines result from a sequence of chemical changes that cause the brain's blood vessels to constrict, then dilate—producing throbbing pain. While the constriction/dilation cycle does play a role, current medical thinking holds that migraines are primarily an inflammatory disorder initiated by fluctuations of serotonin, a naturally occurring neurotransmitter that influences pain mediation, sleep, mood, digestion, cardiovascular function and temperature control.

The mystery of it all
Though no one really knows what causes migraines, understanding what triggers them—diet, stress, hormonal fluctuations—is more than half the battle. Keep track of the foods you eat and the circumstances affecting you to root out the causes of your migraine pain. While genetics or acquired neurochemical changes are the source of most recurring headaches, various other circumstances can provoke, aggravate or intensify painful episodes. "You have to be a really good detective to find what causes migraines for you in particular," says Ottariano. "I advise people to check everything they've been eating, to track hormonal changes, even to pay attention to low blood sugar from not eating regularly." Stress and hormonal responses, as well as reactions to foods and pollution, cause chemical changes in the brain and possibly affect cranial blood vessels. People with migraines in particular are affected by certain foods (for example, chocolate and red wine) and dietary chemicals (such as tyramine), stress, disturbed wake/sleep cycles, bright light, television viewing, hormone fluctuations, fumes, odors, weather and environmental changes.

Pain-beating Nutrients
Fortunately, numerous nutrients and natural therapies can help combat migraine misery.

Magnesium—one of the most promising nutrients in headache research—is a mineral naturally found in soybeans, whole grains, nuts, seeds, vegetables and fish. Necessary for healthy muscle, nerve and blood vessel tone, magnesium is thought to help prevent blood vessel spasms and regulate pain receptors. In a 1996 German study of 81 migraine patients, 42 percent of subjects taking oral magnesium reduced both the duration and intensity of migraine attacks, as well as their reliance on medications to control migraines (Cephalalgia, 1996, vol. 16, no. 4).

Essential fatty acids also show promise for migraine relief. A 1997 study showed that gamma-linolenic (GLA) and alpha-linolenic (ALA) fatty acid supplements reduced the severity, frequency, and duration of migraine attacks by 86 percent (Cephalalgia, 1997, vol. 17, no. 2). During the six-month study, 22 percent of the 168 patients no longer had migraine attacks, and 90 percent experienced less nausea and vomiting.

Research also supports the role of certain vitamins in headache treatment. In a double-blind 1998 study, Belgian scientists found that a high dose (400 mg per day) of vitamin B2 (riboflavin), a nutrient necessary for energy metabolism, provided more effective relief than placebo. Other studies conducted on perimenopausal and postmenopausal women experiencing migraines demonstrated that vitamin D and calcium therapy provided relief.

On the herbal front, feverfew (Tanacetum parthenium), traditionally used in Europe for headache relief, appears to help many migraine sufferers. Feverfew slows the production of inflammatory substances and helps maintain proper blood vessel tone. In a double-blind, placebo-controlled study, standardized feverfew reduced the number and severity of migraine attacks and the incidence of vomiting (Lancet, 1988, vol. 2, no. 8604). Ottariano recommends feverfew as an excellent preventive if taken routinely—not just when a migraine starts. "People want a substance that's going to take away their problem quick, right now," he says, "but feverfew really works best if it's taken for at least two months. You have to give it time to work."

Understanding what triggers migraines is half the battle in treating them—and at this point, no one can say for sure what does cause them. If you suffer from migraines, consult a health care practitioner to get an accurate diagnosis and rule out any other health problems that may be contributing to your headaches.

Joan A. Friedrich, PhD, is a New York-based clinical educator, diplomate in herbology and consultant holding board certifications in clinical nutrition and biofeedback therapy.