Headache

Description

Two common forms of headaches are the common headache and migraine headache.

The Common headache is most often characterized by a steady, dull pain, which is spread throughout both hemispheres of the brain. Onset is usually gradual and can extend over several days.

Migraine

The Migraine headache, in contrast, is typically a throbbing pain which is unilateral. The severity of migraine headaches can vary from minor to incapacitating. Warning signs such as distorted vision and/or distorted hearing frequently signal the onset of a migraine.

The incidence of migraine headaches is significantly higher among women than men. Up to 20% of men and 30% of women, mostly young adults (20 - 35 years) suffer from it.

Migraine may be divided into 3 sub-categories: classic, common and cluster headache, although only the first two qualify in current nomenclature.

It seems to run in families (50% confirmed).

Basically, it comprises an incapacitating headache which can endure for several days usually accompanied by visual disturbances and/or nausea.

It may well constitute a symptom, rather than a disease, because it is so poorly understood.

Causes

Common headache

Depression
Anxiety
Stress
Muscle tension in neck and scalp
Toxins such as fumes, alcohol, tobacco
Disturbances of body function such as constipation
Impairment of sense organ such as conjunctivitis
Constriction of head
Sunstroke
Fatigue

Migraine headache

There appears to be an association with vascular system instability but the precise mechanisms have not yet been delineated.

The prodromal (warning) stage of reduced blood flow indicates intracranial vasoconstriction. However, the attack reflects increased blood flow to the cerebral cortex.

There may also be platelet aggregation, affecting blood flow. This is often associated with mitral valve prolapse.

Metabolically, hormones affecting blood flow increase i.e. serotonin and substance P. A similar brain chemistry dysfunction ( postsynaptic 5-HT ) may be common to migraine sufferers and those who develop bulimia.

Food allergens are frequently correlated with attacks. These are usually amines, which are vasoconstrictive and present in, notably: chocolate, cheese and cured meats while red wine acts indirectly to inhibit the enzyme which digests these amines.

This mechanism has been criticized: symptom relief from dietary modification, does not necessarily mean an immunologically based allergic reaction. The high IgE incidence rate is not greater than in the population at large. Other allergic reactions, unrelated to diet, may be associated with migraine attacks. On the other hand, substances in food may be the cause of modifications in vascular tone and bring migraine on in those so prone. Among such substances are tyramine, phenylalanine, phenolic flavonoids, alcohol, food additives (sodium nitrate, monosodium glutamate, aspartame) and caffeine. Hence, food intolerance may not be IgE-mediated but caused by histamine.

These amines include several well-known neurotransmitters: serotonin, tryptamine, tyramine and dopamine.

Bacteria in the colon are also responsible for the conversion of tyrosine to tyramine.

Physical causes must also be ruled out, especially with a history of trauma, including “whiplash” and/or TMJ.


The definite cause of migraines is still uncertain. The most widely accepted theory at this time is that there is a dilation of cranial blood vessels caused by certain biochemical changes in the body. Other contributing factors are:

Personality type
Certain foods such as chocolate, wine, and cheese
Menstruation

Signs & Symptoms

Common headache

Dull pain generalized throughout the head.

Migraine headache

The blood vessels over the temples may become visibly dilated and compression of these (as well as at the carotid artery) temporarily relieves the pain. Nonetheless, the patient will be pale.

Sufferers are usually forced to lie down in a darkened room. If they are able to relax, or go to sleep, they benefit from some degree of pain relief, or at least an interruption of it.

The classic form, which is quite rare (10%), involves an area of blindness surrounded by a sparkling edge ("aura") that may occupy half of the field of vision in each eye.

Possible distorted vision and/or distorted hearing
Unilateral throbbing pain
Nausea
Vomiting
Diarrhea
Sensitivity to light

Nutritional Supplements

---------------------------------
General Supplements
---------------------------------

B Complex*
Bioflavanoids*
Bromelain*
Fish oil*
Germanium	150 mg
Niacin	1,000 mg
Superoxide dismutase*
Vitamin C*

Dietary Considerations

Headache may be a symptom of a food allergy. The most common allergenic foods are: fruit juices, nuts, chocolate, and milk.

According to one author, more than 140 foods have been implicated as causing food allergies. The Elimination Diet should be used to identify the offending substance or substances. The allergen can then be excluded from the diet.

MAOIs and Headaches

Headaches may result from the consumption of tyramine-containing foods, while on monoamine oxidase inhibitor (MAOI) therapy for depression or hypertension.

Ordinarily, monoamine oxidase metabolizes tyramine in the intestines. MAOI's prevent this breakdown, and norepinephrine is released into the system in response to intact tyramine. The food-drug combination may cause migraines, hypertensive crises, or even death in extremely sensitive individuals.

Foods to avoid if taking MAOI's:

Ripened cheese	Meats (canned)
Pickled, and dried, salted herring	Soysauce
Fermented sausage	Yeast concentrates
Beef liver	Bologna
Chicken liver	Salami
Chianti

Foods to consume with caution if taking MAOI's:

Red wine	Yogurt
Beans	Vanilla
Beer	Coffee
Sherry	Hot chocolate
Bananas	Cola drinks
Avocados	Processed cheese (American)
Figs (canned)	Gouda
Chocolate

Alcohol, being a vasodilator, may bring on migraines in sensitive people, in which case, it should be avoided.

Plenty of fluids should be taken after the nausea and vomiting of a migraine have subsided to prevent dehydration.

Headaches resulting from folic acid deficiency are treated by nutritional supplementation.


Migraine

Dietary migraine is widely recognized, now, affecting up to 90% of migraine sufferers. The sufferer needs to be careful about excluding particular foods, which is sometimes difficult, if the ingredients of a particular meal (packaged, restaurant, friends etc.) are not known - until it is too late.

This is especially true if the food in question is fairly ubiquitous e.g. wheat, or corn flour, which may have different guises, including starch and syrup!

Identification is also complicated by the fact that many reactions take as long as 2 weeks to manifest themselves.

There are several protocols available, ranging from sophisticated testing procedures (e.g. the RAST - radio-allergo-sorbent test) offered by specialists in environmental medicine, to a water fast. Some form of modified diet will also be used, eliminating suspect foods, before reintroducing them at a later stage. The oligoantigenic regimen includes 8 simple foods. Food cravings often provide a clue as to those foods which should be closely monitored and no food should become a staple within a 4-day rotation period.

A recent listing cited: citrus fruits, tea, coffee, pork, chocolate, milk, nuts, vegetables and cola drinks as possible allergens associated with migraine. Other foods include: cheese, bananas, 'cured' meats, cereals, beans, hot dogs, pizza, food additives (sodium nitrate, MSG, aspartame), alcoholic drinks such as red wine, beer or whisky distilled in copper stills.

Another recognized trigger for migraine is hypoglycemia.

Platelet aggregation can be reduced through an avoidance of animal fats and increased intake of fish oils, or other fatty acids.

The vasodilatory action of niacin make it an obvious choice. Clinically, it may be administered by IV.

If mitral valve prolapse is present, magnesium levels should be checked and any deficiencies call for supplementation.

Beneficial microflora are useful when bowel bacteria are suspected, as in other symptoms consistent with candida.

A physical problem ( e.g. “cervocogenic”) may be relieved by chiropractic manipulation.

An energetic imbalance may respond to acupuncture therapy.

Homeopathic Remedy

1. Glonoinum tinct. 30C - 10M
2. Usnea barbata - 6X - tincture
3. Belladonna tinct. - 30C

Advanced , by symptoms:

1. Head feels like it has a tightening band around it - Aconitum Napellus tinct. or Gelsemium sempervirens.

2. Throbbing headache, flushed face, better for sitting up, warmth of the sun - Belladonna tinct..

3. Worse for the slightest movement e.g. eyes - Bryonia alba tinct..

4. Spreading to, or from, the neck - Cimicifuga racemosa tinct..

5. Feels like a nail being driven into the side of the head - Ignatia amara.

6. Blinding headache, desires salt - Natrum Muriaticum.

7. Hangover headache - Nux vomica.

Migraines

1. Worse on left side - Ipecacuanha.

2. Severe, blinding, throbbing - Nux vomica.

3. Hormonal migraine (weepy) - Pulsatilla nigricans .

4. Worse on right side (eye) - Sanguinaria canadensis.

5. Settles over one eye, desire to cover head - Silicea tinct..

Treatment Schedule

Doses cited are to be administered on a 3X daily schedule, unless otherwise indicated. Dose usually continued for 2 weeks. Liquid preparations usually use 8-10 drops per dose. Solid preps are usually 3 pellets per dose. Children use 1/2 dose.

Legend

X = 1 to 10 dilution - weak (triturition)
C = 1 to 100 dilution - weak (potency)
M = 1 to 1 million dilution (very strong)
X or C underlined means it is most useful potency
Asterisk (*) = Primary remedy. Means most necessary remedy. There may be more than one remedy - if so, use all of them.


Discussion

One Hungarian group led by Dr. Judith Nagy, working with a homeopathic company in Ireland, has elucidated a diagnostic basis for the treatment of headaches, as follows: VINDICATE.

V - refers to vascular origins, e.g. is the head hot and the hands cold? This requires a circulation formula.

I - intoxication , or other form of substance abuse, requiring a substance abuse formula.

N - "Neo", cancer produces a headache which gets progressively worse.

D - deficiency (or excess) of pyridoxine, or other nutrient. This requires a multivitamin preparation.

I - Infection : Infections within the cerebrospinal system cause low-grade headaches.

C - Congenital, if headaches have been present from infancy?

A - Allergies, if headaches worsen around certain aromas?

T - Trauma, a blow to the head?

E - Endocrine, hormonal imbalance e.g. pituitary gland.

E - Emotional, do headaches accompany mood swings, or episodes of stress?


References

Boericke, D.E., 1988. Homeopathic Materia Medica.

Coulter, C.R., 1986. Portraits of Homeopathic Medicines.

Kent, J.T., 1989. Repertory of the Homeopathic Materia Medica.

Koehler, G., 1989. Handbook of Homeopathy.

Nagy, J. (Ed.) Treatment of Headache Disorders. Maitreya, Limerick, Ireland.

Shingale, J.N., 1992. Bedside Prescriber.

Smith, Trevor, 1989. Homeopathic Medicine.

Ullman, Dana, 1991. The One Minute (or so) Healer.

Tissue Salts

Calc. Phos.	headaches with cold feelings;
Ferr. Phos.	congestive headaches, including periods;
Kali Mur	biliousness, white-coated tongue;
Kali Phos.	nervous strain;
Kali Sulf.	headaches which worsen in the evening and heated rooms, better in the open air;
Mag. Phos.	neuralgic headaches, excruciating, heat relieves, cold aggravates;
Nat. Mur.	dull, heavy headaches with watery discharges (eyes, nose, mouth);
Nat. Phos.	headache at the crown of the head with acidosis;
Nat. Sulf.	bilious headache, vomiting bile, diarrhea;

Herbal Approaches

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Herbs
-----------

Angelica
Blessed thistle
Ground ivy
Lady's slipper
Lemon balm
Pulsatilla
Skullcap
Wood betony

Migraine

Cayenne pepper (Capsicum frutescens)
Cloves
Feverfew
Ginger plant
Ginkgo
Valerian root

Note: The misdirected use of an herb can produce severely adverse effects, especially in combination with prescription drugs. This Herbal information is for educational purposes and is not intended as a replacement for medical advice.

Discussion:

Migraine

Belladonna is an old remedy, although intramuscular injection of its derivative, ergotamine tartrate, is the contemporary version.

Cayenne pepper (Capsicum frutescens) may be effective by depleting substance P, thereby providing pain control. Additionally, it inhibits platelet aggregation. Platelet aggregation and its improvement may now be monitored in some clinics with the capability for microscopic evaluation of blood samples.

Intranasal application has been found efficacious for cluster headaches, a special form of migraine that occurs around one eye.

Cloves contain the same agent as cayenne, particularly when concentrated in clove oil. This may be most effective for the trigeminal nerve. Involvement of the trigeminal nerve may also be indicated by the presence of cold sores. Again, this is often associated with stress.

The best-known is Feverfew (Tanacetum parthenium), as a result of work at the London Migraine Clinic. Ginkgo has also been recommended, specifically for migraines. It appears to be effective by preventing the release of 5-HT (i.e. serotonin) from platelets.

Scalzo differentiates between vasoconstrictive and vasodilative migraines. Ginkgo would be the choice for the former and Feverfew for the latter.

Ginger plant: the constituents of ginger inhibit cyclooxygenase and lipoxygenase formation. These are the branches of the arachidonic cascade which normally result in inflammation and pain as in migraine.

Dr. Grabowski also recommends valerian root extract. Valerian root extract is useful because of its sedative effect. (2 tablets b.i.d.)

References:

Batchelder, HJ & Hudson, T: Naturopathic specific condition review: migraine. The Protocol J. of Botanical Medicine, Autumn, 1995:181-208.

Grabowski, RJ: Current Nutritional Therapy: A Clinical Reference. Image Press. 1995.

Groenewegen, WA et al., Compounds extracted from Feverfew that have anti-secretory activity contain an alpha-methylene butyrolactone unit. J. Pharm. Pharmacol. 1986, 38:709-712.

Groenewegen, WA & Heptinstall, S: A comparison of the effects of an extract of feverfew and parthenolide, a component of feverfew, on human platelet activity in vitro. J. of Pharmacy & Pharmacol. 1990, 42:553-557.

Johnson, ES et al., Efficacy of feverfew as prophylactic treatment of migraine. BMJ, 1985, 291:569-573.

Marks, DR et al., A double-blind placebo-controlled trial of intranasal capsaicin for cluster headache. Cephalalgia, 1993, 13:114-116.

Murphy, JJ et al., Randomized double-blind placebo-controlled trial of feverfew in migraine prevention. Lancet, 1988(2):189-192.

Scalzo, R: Therapeutic botanical protocol for migraine. Autumn, 1995:195-196.

Aromatherapy - Essential Oils

Basil Essence,	Cajeput Essence,
Chamomile Essence,	Clary Sage Essence,
Juniper Essence,	Lavender Essence,
Marjoram Essence,	Melissa Essence,
Pepper Essence,	Peppermint Essence,
Rose Essence,	Rosemary Essence,
Rosewood Essence,	Tea Tree Essence.

Massage Lavender oil into the temples at first sign of a migraine attack.

Related Health Conditions

        Allergy
        Anxiety
        Cold sores (Herpes)
        Depression
        Eye disorders
        Fatigue
        Infection
        Menstruation
        Mitral valve prolapse
        Stress

Abstracts

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