April 22, 2011 Migraine Headaches
Many people suffer from migraine headaches. In fact, most headaches are migraines. Symptoms include moderate to severe pain, which may be confined to one side of the head or affect both sides. Pulsing or throbbing pain. Pain that worsens with physical activity. Nausea and or vomiting. Sensitivity to light and sound.
Some migraines are proceeded by an Aura (changes to vision, flashes of light, feeling of pins and needles in an arm or leg), and others are not.
The cause of migraines is not completely known but it is suspected that they result from changes in the trigeminal nerve, and/or imbalances in chemicals in the brain like serotonin.
There are a number of different triggers for a migraine. Understanding these may help people avoid them. The first is hormonal changes in women. Fluctuations in estrogen can trigger a migraine. Often women report a headache immediately before or during their periods when they have a drop in estrogen. Oral contraceptives and hormone replacement therapy can sometimes worsen migraines. However, some women find it useful to take a monophasic birth control pill without a rest period between packages. This can help to keep estrogen levels constant
Migraines can also be triggered by certain foods. The most commonly reported are; alcohol (especially beer and red wine,) aged cheeses; chocolate; aspartame; overuse of caffeine; MSG; salty food; processed foods; and foods containing nitrates like hot dogs and salami.
Eliminating gluten from the diet has been shown to reduce migraines in some people. Migraine sufferers were ten times more likely than the general population to have Celiac disease (a disease characterized by an intolerance to gluten). Patients on a gluten-free diet have been shown to have a decrease in migraines. (Celiac testing can be performed at certain pharmacies).
Other triggers include, stress, bright lights, loud sounds, unusual smells, changes in sleep patterns, physical exertion, a change in the weather and certain medications.
Treatments for migraines are readily available. Some over the counter remedies include non-steroidal anti-inflammatory drugs like Advil. A good starting dose is 400mg. You need to make sure it is safe for you to take this because it can cause side effects such as stomach ulcers, and an increased risk of bleeding. Tylenol can also provide some benefit. A good starting dose is 500mg. Patients need to be careful they do not exceed four grams of Tylenol a day as it can cause liver toxicity. Caffeine is also recognized as a treatment for migraine when it is combined with Tylenol and Aspirin.
One thing to be aware of is that if you take these headache medications more than nine days a month in high doses you may be at risk for rebound headaches. This can occur when your medication not only stops relieving the pain but actually begins to cause headaches.
Antiemetics such as Gravol can also help relieve symptoms of nausea and prevent vomiting. This improves the effectiveness of the oral medications taken.
Serotonin agonists like Zomig and Imitrex require a prescription but can be very effective. These medications are also quite expensive but are usually covered by drug plans. It is best to take these medications at the first sign of a migraine for them to be most effective.
Tricyclic antidepressants such as Amitriptyline have been used to prevent migraines but they have some adverse effects such as insomnia, sedation, sexual dysfunction, and withdrawl symptoms.
Some herbal treatments have shown some evidence of effectiveness. These include feverfew, butterbur, riboflavin, and Coenzyme Q10. Of course you should consult your physician to see if it is safe for you to take these, and pregnant women should avoid them.
Migraines can be debilitating. If you are a chronic migraine sufferer there are steps you can take to avoid the number of attacks, and there are safe effective medications you can take to help eliminate them. Talk to your pharmacist to see what approach is best for you.
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