Can a diet change make a difference for migraineurs?
Discover the Power of the 1-2-3 Program
Prevalence
Over a billion people worldwide suffer from migraines. That’s about 10% of the population.
Most are women. Most women who have suffered from migraines before menopause see a decline as they move through this change of life. For some women, however, migraines erupt as they enter menopause. As you can imagine, this further compounds some of the many other discomforts a woman feels during this time in their life. This creates further struggle for women as they age.
Treatments for the migraine syndrome
There are a number of approaches to treating the migraine syndrome. The most common approach is the use of rescue medications. This can range from over-the-counter pain relievers to prescribed medications such as those in the “triptan family” like Sumatriptan and Rizatriptan. It can also include opioids, like codeine and oxycodone, as well as Dopamine antagonists like Promethazine and Metoclopramide. The latter are used if nausea and vomiting are involved. Alternative treatments can also be implemented with some success. Some sufferers use essential oils like peppermint, or supplements that contain magnesium or B2 (Riboflavin), Butterbur and Feverfew. Some have found help in mitigating headaches by using a small plastic clamp-like tool on the tissue between the thumb and index finger. This pressure point has been found to help with headaches as well as facilitate weight loss. Lastly, somatic self-care in the form of exercises, self-massage, positioning and pressure, has been used to help alleviate or prevent a migraine. This Mundo method has been used in some instances, combined with dietary changes and trigger avoidances, to maintain health and well-being.
Ineffectiveness of medications
Quick-acting medications are usually the “go-to” for most headache sufferers. Unfortunately, those medications don’t always work and often are the source of what’s called “rebound headaches or rebound migraines”. This occurs when prescribed rescue medications are taken to relieve pain or other symptoms which then manifest into a cumulative effect over time. Dr. David Buchholz, in his book Heal Your Headache - The 1-2-3 Program, describes rebound in this way: “You take a quick fix to relieve your headache. The quick fix helps temporarily. As the quick fix wears off, your headache tendency increases”. This tendency sets you up for more and more migraines as opposed to being a helpful solution.
Alternative methods used for prevention – avoidance of triggers
In the absence of having treatments that are effective long-term, migraineurs often look to methods that prevent them from the start. Triggers are usually the culprit, and what those triggers are can vary for each person. They may be dietary, environmental, induced by stress, and related to poor sleep. For women who experienced the onset of migraines when their menses ceased to occur, the change in estrogen levels may be a contributing factor as well. It may involve some or all of the aforementioned triggers. Evaluating which triggers can be eliminated and which cannot allow a person to regain some control over when, or if they experience a migraine. Air pressure changes, for example, aren’t something migraineurs can control; lack of sleep or stress might be equally difficult to change or avoid. Avoiding strong odors like perfumes and candles, as well as minimizing exposure to bright lights and loud sounds, can help reduce the risk of migraines, particularly when combined with other triggers.
Dietary triggers to avoid
Professor Rodolfo Low studied the effects of certain dietary changes that were helpful to a number of participants he tried to help. By implementing his recommended diet, such dietary changes included eliminating sugar, caffeine, and alcohol consumption. The theory behind this approach is a bit complicated, but it has to do with what happens physiologically in our bodies when consuming these foods. He describes the effect sugar has on our endocrine system when it's converted into glucose and insulin is secreted within our bodies. He then explains how in some people, a hypersecretion of insulin can occur, causing the adrenal glands to compensate by secreting adrenaline. The adrenaline in turn, narrows the blood vessels in the brain initially but then triggers them to dilate, causing the headache. A similar mechanism occurs with the consumption of alcohol, which is also converted into glucose by the body. Caffeine behaves differently in the body and directly acts on the adrenal glands to secrete adrenaline, which initially constricts and then dilates the vessels of the brain.
Dehydration and skipping meals
Failing to address the role of dehydration in headache development would be a significant oversight. Water consumption plays an integral role in maintaining fluid balance within the body. Dehydration can affect the brain, circulation, and electrolyte balance, setting the individual up for a migraine syndromal-type episode. By skipping meals, the body can become hypoglycemic or a condition where their blood glucose plummets, causing the release of stress hormones that act on the brain’s blood vessels, causing painful dilation and constriction.
Three steps to Heal your headache another way
Step One
In a more recent attempt to help migraine sufferers, a neurologist by the name of Dr. David Buchholz had a different and more dynamic approach to not only diet, but the elimination of the use of rescue medications altogether. In his 2002 book, Heal Your Headache: The 1-2-3 Program, the first step is to avoid the use of any prescription quick-fix medications. Medications like the “Triptan family” should be avoided, however, the use of over-the-counter (OTC) pain relievers such as ibuprofen and naproxen are allowed. This step is to initiate the process of halting the rebound headache effect these medications can cause when taken regularly. This particular step can be a difficult one, since most migraineurs do not often find relief with OTC medications. He describes the rebound effect on blood vessels in this way, “migraine causes blood vessels to swell, certain drugs act on these blood vessels by constricting them, thus temporarily alleviating the painful swelling. When the drug wears off, the blood vessels react by swelling to an even greater degree than in the first place”. This is the cycle that step 1 is trying to eliminate permanently for the migraineur.
Step Two
Buchholz, as part of step 2, promotes the elimination of tyramine-containing foods. Most people likely have read about the most common high tyramine foods such as: aged cheeses, wine, beer, cured meats, and fermented vegetables. Many other foods and additives, frequently consumed daily, can interact with unavoidable triggers, increasing the likelihood of a migraine—often without individuals recognizing their combined impact. Foods like nuts and nut butters, vinegars except distilled white vinegar, citrus fruits, bananas, lentils, lima, fava, and navy beans are all on the do not eat list. The list can get quite long when you add such things as malted barley flour, guar gum, and carrageenan to the list. He also suggests avoiding any kind of caffeine, including chocolate. Even decaffeinated beverages can be triggers unless the decaffeination process uses water instead of chemicals. As the migraineur eliminates the number of triggers they consume, their threshold and tolerance will rise. After months of “clean eating,” they may be able to say they have been headache-free. Buchholz does suggest that at some point, the ability to consume a trigger food does not necessarily cause the onset of a migraine. This is due to the change in threshold that has occurred over time.
Step 3
The final step is not utilized by everyone. He mentions that even after careful dietary restrictions and the elimination of quick-fix medications, some individuals may still need to have a daily medication regime prescribed for them to eliminate headaches completely. Most, however, will have success with just implementing the first 2 steps. Step 3 involves the use of preventative medication, either by using antidepressants or tricyclics, antihistamines, calcium channel blockers, and other medications used for controlling high blood pressure, depression, and allergies, for example. These would be tailored for every individual’s comfort level.
Migraineurs have been around since 3000 BC. There have been descriptions of severe migraine-like pain noted in people in ancient Egyptian and Greek medicine. In modern times, globally, it is seen as the most common of the neurological diseases that patients seek help for. It can be a complex interconnected series of factors that influence a person’s tendency toward developing a migraine and its associated symptoms. It can be very debilitating and long term can affect a person’s outlook on life. It makes sense not to rely on medication alone to rid oneself of the malady. If a diet change can make that much of a difference in whether a migraine develops or not, it might be the new key to eradicating them.
Resources:
American Migraine Foundation. (2019, March 28). Migraine Triggers. Retrieved from americanmigrainefoundation.org
Amiri. P., Araj-Khodaei, M., Kazeminasab, S., Kolahi, A., Mohammadinasab, R., Nejadghaderi. S., Pourfathi, H., Safiri, S. & Sullman, M. (2022). Migraine: A review on its history, global epidemiology, risk factors, and comorbidities. Frontiers in Neurology, 12:800605. frontiersin.org
Buchholz, D. (2002). Heal your headache: The 1.2.3 program for taking charge of your pain.
New York, NY: Workman.
Low, R. (1987). Victory over migraine. New York, NY: Henry Holt.
Mundo, J. (2018). The headache healer’s handbook: A holistic, hands-on somatic self-care program for headache and migraine relief and prevention. Novato, CA: New World.
Walter, K. (2022). What is migraine? Journal of the American Medical Association, 327(1), 93. What Is Migraine? | Headache | JAMA.