Authors: Elizabeth Lipski
Fish oil supplements contain high levels of DHA and EPA oils. They have been shown in many studies to reduce the severity, duration, and frequency of migraine headaches. Most of us can produce EPA and DHA by using flaxseed oil, borage oil, or evening primrose oil, or by taking alpha-linolenic acid (ALA) and gamma-linolenic acid (GLA) supplements. However, this conversion requires that we have
not only the genetic ability to complete the conversion but also adequate vitamin B
6
and magnesium. One study gave subjects 1,800 mg of GLA and ALA in six capsules daily, plus 3 mg of niacin, 20 mg of vitamin C, 25 IU of vitamin E, 20 mg of soy phosphatides, 50 mg of magnesium, 1.3 mg of beta-carotene, and 0.3 mg of vitamin B
6
. Of the 128 people who participated in the study, 86 percent had a reduction in the severity, frequency, and duration of their migraine headaches, 22 percent became migraine-free, and 90 percent had reduced nausea and vomiting. Fourteen percent of the subjects were able to reduce their medication to simple pain relievers. Stress reduction and relaxation are also recommended.
Twenty people with a history of migraines for more than one year and with a frequency of two to eight per month were given 1 mg vitamin B
12
daily for three months in a nasal spray. Half of the people had a 53 percent reduction in migraines. In these people there was a reduction from 5.2 to 1.9 attacks on average per month. In the other half, there was virtually no improvement. Vitamin B
12
is nontoxic, inexpensive, and widely available in sublingual and nasal sprays. Oral forms are not well absorbed.
Supplementing with vitamin B
6
, B
12
, and folic acid can be useful in people with genetic typing that allows for easy use of folic acid. One study found that in people with the CC and CT MTHFR 677 C to T genotypes, supplementing with 2 mg folic acid, 25 mg of B
6
, and 400 mcg of B
12
significantly lowered severity and frequency of headaches. Severity decreased from 75 percent to 28 percent. People with the TT genotype of MTHFR, in which people have difficulty utilizing folic acid, did not have these improvements. It’s possible that taking easily utilized folic acid, such as methyltetrahydrofolate, could have helped even these people.
Melatonin has been tested in several studies for migraines in children and adults. Melatonin levels have been demonstrated to be lower in people who have migraines than in people who don’t. Melatonin was given to 32 people with migraines at a dose of 3 mg given 30 minutes before bed, for three months. Headache frequency decreased 60.5 percent, intensity by 51.4 percent, and duration by 55.6 percent. The mechanism is unknown. Many of the medications used for migraines modulate serotonin, and serotonin is converted into melatonin. Perhaps that’s why this works. In another study, 22 children were given 3 mg of melatonin before bed. In two-thirds of the children, headaches decreased by half, and four children had no headaches at all. One child dropped out of the study because of daytime sleepiness.
Butterbur (Petasites hybridus) is a European herb that has been used for centuries for such diverse problems as plaque, cough, asthma, and skin wounds. It works by lowering inflammatory markers that cause pain. Most recently it has been shown to be effective for hay fever. In its natural state it contains liver toxins, but a patented
product, Petadolex, has removed these substances. In a 2004 study of 60 people with migraines, 33 were given 25 mg Petadolex twice daily and 27 were given a placebo twice daily. After three months, the average incidence of migraines decreased from 3.4 per month to 1.8 per month in the Petadolex group. Forty-five percent of the people responded really well and accounted for most of the results. In another study 108 children demonstrated benefits from butterbur: 77 percent had reduced frequency of headaches by at least 50 percent. Frequency was lessened by 63 percent overall. Ninety-one percent of the children felt substantially or slightly improved after four months of treatment.
Numerous studies have shown the herb feverfew (Tanacetum parthenium) to be effective in preventing and minimizing the severity of migraines. Others show no effectiveness. You can try it for yourself and see if it works for you. In one study by Drs. R. Shrivastava, J. C. Pechadre, and G. W. John, feverfew was given to 12 people with migraine without aura. They were given 300 mg feverfew twice daily, plus 300 mg white willow bark twice daily for 12 weeks. There was a significant reduction in frequency, severity, and duration of migraines.
Dr. Alan Gaby has given Meyers cocktail, an intravenous combination of magnesium, calcium, B-complex vitamins, and vitamin C, during migraine in six or more patients. Gaby reports that when given during a migraine, he has found complete or marked improvement within two minutes, with sustained improvement over 24 hours. One patient was treated more than 70 times in six years and responded well nearly all the time.
This is an emerging area of research that is worth exploring. Several studies have explored the link between H. pylori infection and migraine. Dr. K. G. Yiannopoulou and colleagues studied 49 people aged 19 to 47 for migraines without aura. In people who had migraines with menstruation or family members who also had migraines, the incidence of H. pylori from gastric mucosal biopsy was 36 percent and 37 percent, respectively. In people who had no predisposing factors, prevalence of H. pylori was 81 percent in men and 87 percent in women. Dr. I. Ciancarelli et al. report that of 30 people with migraine, 16.7 percent had H. pylori IgA and IgG antibodies. Dr. A. Gasbarrini and colleagues report that of 225 people with migraine with and without aura, 40 percent tested positive for H. pylori with 13-urea breath testing. Another study by the same group reports higher levels of H. pylori in people with aura than without aura. Dr. L. Hong and colleagues report that when H. pylori was treated
in people who had both migraine and cirrhosis, incidence, duration, and severity of migraines was reduced significantly.
I haven’t seen any studies on small intestinal bacterial overgrowth or fungal overgrowth in people with migraine. There is a large overlap among people who have irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia, allergic rhinitis, and migraine. I look forward to seeing further studies on this.
Many years ago, I worked with a woman who had severe migraines that decreased her quality of life. We discovered that she was hypothyroid. When her physician regulated her thyroid, her migraines were minimal. In 2007, A. J. Huete and colleagues reported in
Headache
the story of a person whose Hashimoto’s thyroiditis resulted in symptoms that looked exactly like a migraine headache with an aura. Her thyroid tests were within a normal range, yet she had elevated antithyroid antibodies. While the incidence of hypothyroidism, subclinical hypothyroidism, or autoimmune thyroid disease and migraines has not been well studied, it seems worth checking.
People with migraine often have mood and anxiety problems as well. Using strategies that address these at the same time is warranted: psychological counseling, biofeedback, acupuncture, chiropractic manipulation, emotional freedom technique, meditation, relaxation skills, and other mind-body modalities. Some of these modalities will also help with the neck pain that accompanies migraine so often.
Intracellular magnesium, either RBC or lymphocytes
H. pylori testing
Homocysteine levels (will give an indication about folate, B
6
, and B
12
status)
Elisa/Act testing for food and environmental allergies or sensitivities—IgG, IgE, and if possible IgA and IgM
Thyroid testing
Organic acid testing
Migraines have many triggers that vary from person to person. Finding your triggers and the treatments that work best for you is the key. You certainly won’t need all the therapies listed here, but hopefully you’ll find relief from some of them.