-IBIS-1.7.0-
tx
nervous system
headache: vascular
Nutrition

dietary guidelines

for headache due to common cold or influenza see Influenza, Wind-Cold, or Wind-Heat

eating principles:

Consider environmental allergens.

Treat underlying allergies (Grant, E. Lancet 1:966, 1979; Egger, J. Lancet Oct 15, p.865-9, 1983)

Increase consumption of EFA: This will change the membrane composition to more of the unsaturated fatty acids.

Increase fiber and complex carbohydrates: This will increase the number of bowel movements and decrease bowel transit time.

• Short fasts are recommended to rid the body of toxins (5-7 day fasts)

• Elimination/rotation diet, rotation diet, rotation diet expanded

fresh juices:

• Carrot, celery, spinach, and parsley (Walker, p. 140)

• Carrot and spinach (Walker, p. 140)

• Carrot, beet, and cucumber (Walker, p. 140)

• Celery (Walker, p. 140)

therapeutic foods:

• scent of green apples: Researchers found that patients who had a normal sense of smell and a fondness for the fragrance of green apples experienced reduced pain from migraine attack when they sniffed the odor of green apples. This study of 50 migraine sufferers over the course of three headache episodes compared the effects of sniffing the bottled scent of green apples versus sniffing from a bottle that contained no odor. (Anonymous. Med Tribune. August 14. 1991, p. 28.)

• Chrysanthemum flowers, mint, green onions, ginger, oyster shells, buckwheat,

pearl barley, carrots, prunes, celery (Ni, p. 130)

specific remedies:

• If headache is in left side, squirt carrot juice into left nostril; if on right side, squirt into right nostril, if both sides affected, squirt into both nostrils (Ni, p. 130)

• Lemon juice and 1/2 tbsp. baking soda mixed in glass of water and drink (Ni, p. 130)

• 2 p.m. headache or evening headache: increase Potassium foods

• Honey in water in morning before eating

• Liver headache: increase Liver foods and Cooling foods

avoid:

Food intolerances (Grant, E. Lancet 1:966, 1979; Egger, J. Lancet Oct 15, p.865-9, 1983)

Avoid dietary amines: such as chocolate, cheese, citrus and alcohol. They contain vasoactive amines, such as beta-phenylethylamine and tyramine. These amines cause vasoconstriction either directly or indirectly through the liberation of catecholamines. (see Materia Medica: foods containing tyramine) (Marz, p. 459, 1997)

Avoid arachidonic acid: This will decrease platelet aggregation, decrease histamine release, and decrease inflammation associated with migraine.

• Spicy foods, alcohol, excess stimulation, coffee, caffeine, chocolate, fried foods, stimulating foods

supplements

Quercetin: 500 mg per day 15 minutes prior to eating (Monro, J. Lancet Sept. 29, 1984

Magnesium: 400-800 mg per day. Magnesium is helpful in mitral valve prolapse. It also prevents release of catecholamines which is an important mediator of platelet aggregation. (Schoenen, J., et. al. Cephalalgia, 97-99,1991)

Vitamin B2 (Riboflavin): One study of fifty-six migraine patients found that 400 mg/day of riboflavin experienced significant reductions in frequency and severity of attacks than did a placebo group. Some 56% of the patients treated with riboflavin had at least a 50% reduction in attack frequency, compared with only 19% of placebo-treated patients. The only side effect of riboflavin was diarrhea in one patient.

(Schoenen J, et al. Cephalalgia 1997;17:244.)

Niacin: 100-400 mg at the first onset of symptoms and 100 mg/day prophylactically. (Marz, p. 459, 1997)

Vitamin B-complex IM every 2-10 days (Smith, 1983, p. 252)

Choline (cluster HA) (de Belleroche, p. 268ff)

Omega-3 fatty acids (e.g., MaxEPA) (for migraine HA) (Gleuck, 1986)

Omega-6 fatty acids

• EPO inhibits platelet aggregation. (Arregui, A, et. al. Neurology, Oct 41:1668-70,1991)

Garlic: Inhibits platelet aggregation.

Thyroid: especially for chronic non-migraine headaches.

» drug interaction:

• Potassium and indomethacin (Indocin): as a prostaglandin inhibitor, indomethacin reduces renin and aldosterone, and consequently reduces potassium excretion and causes hyperkalemia (Goldszer, et al., 1981; 141: 802-804; Tan, et al., 1979; 90: 783-785; MacCarthy, et al., 1979; 1: 550)

MAO inhibitors, phenelzine (Nardil) and pargyline (Eutonyl), and tyramines: gastrointestinal MAO is essential for adequate breakdown of tyramine (Sullivan and Shulman, 1984; 29: 707 - 711)

footnotes

Arregui, A., et. al. High Prevalence of Migraine in a High Altitude Population. Neurology, Oct 41:1668-70,1991.

Abstract: 205 families from a Peruvian mining town at an altitude of 14,000 feet was compared to over 1000 individuals in the same country at sea levels for the frequency of migraine. The rates of all headaches were increased 22.3% at high altitudes compared to 14.5% at the lower altitudes. For migraines it was 12.4% versus 3.6% at sea level.

Egger, J. Is Migraine Food Allergy?: A double blind controlled trial of oligoantigenic diet treatment. Lancet Oct 15,p.865-9, 1983.

Abstract: 93% of 88 children with severe frequent migraine recovered on oligoantigenic diets; the causative foods were established by a double-blind controlled trial in 40 of the children.

Grant, E. Food Allergies and migraine. Lancet 1:966,1979.

Abstract: 60 patients with frequent migraines were studied. Most of them had been using oral contraceptives, tobacco or ergotamine and had failed to improve by discontinuing these substance. Mean duration of migraines was 18 years for the women and 22 years for the men. Most of the patients had other symptoms including lethargy, depression, anxiety, flushing dizziness, abdominal pain, constipation, diarrhea, or rashes. Each patient ate an exclusion diet for 5 days, consisting only of 2 low risk foods usually lamb and pears and drank only bottled spring water. Migraines disappeared by the fifth day in most cases. Each patient then tested 1-3 common foods per day, looking for reactions. Mean number of foods causing symptoms was 10 per patient (range 1-30). Foods most frequently causing symptoms and/or pulse changes were wheat (78%), orange (65%), egg (45%), tea and coffee (40%) each, chocolate and milk (37%), beef (35%), corn, cane sugar, and yeast (33% each), mushrooms (30%), and peas (28%). When offending foods were avoided, all patients improved. The number of headaches in the group fell from 402 to 6 per month, with 85% of the patients becoming headache free. Exclusion only of amine-containing foods (e.g. cheese, chocolate, citrus, and alcohol) significantly reduced the number of headaches, but only 13% became headache free. All 15 patients with hypertension at the start of the study became normotensive with diet plus avoidance of other precipitants.

Monro, J. Migraine is a food-allergic disease. Lancet Sept. 29, 1984.

Abstract: Foods which provoked migraine in 9 patients with severe migraine refractory to medications were identified. The patients were then given either sodium cromoglycate or placebo in a double-blind manner along with provoking foods. Sodium cromoglycate exerted a protective effect on the symptoms and immune complexes were not produced in the protected patients.

Schoenen, J., et. al. Blood Magnesium Levels in Migraine. Cephalalgia, 97-99,1991. Abstract: In 88 migraine sufferers were studied with and without auras. It was found that patients without auras had a significant reduction in RBC magnesium compared to sufferers with auras. No difference was seen in serum magnesium.

Schoenen J, Jacquy J, Lenaerts M. Effectiveness of high-dose riboflavin in migraine prophylaxis. A randomized controlled trial. Neurology 1998 Feb;50(2):466-470.

Abstract: A deficit of mitochondrial energy metabolism may play a role in migraine pathogenesis. We found in a previous open study that high-dose riboflavin was effective in migraine prophylaxis. We now compared riboflavin (400 mg) and placebo in 55 patients with migraine in a randomized trial of 3 months duration. Using an intention-to-treat analysis, riboflavin was superior to placebo in reducing attack frequency (p = 0.005) and headache days (p = 0.012). Regarding the latter, the proportion of patients who improved by at least 50%, i.e. "responders," was 15% for placebo and 59% for riboflavin (p = 0.002) and the number-needed-to-treat for effectiveness was 2.3. Three minor adverse events occurred, two in the riboflavin group (diarrhea and polyuria) and one in the placebo group (abdominal cramps). None was serious. Because of its high efficacy, excellent tolerability, and low cost, riboflavin is an interesting option for migraine prophylaxis and a candidate for a comparative trial with an established prophylactic drug.