A Self Help Approach to Migraines

Migraine headaches can be caused by a variety of reasons. Food allergies, nutritional deficiencies, low blood sugar, overwork, stress, poor sleep, diet and exercise. Some of the usual suspects include alcohol (particularly beer and red wine), chocolate, cheese, caffeine, marinated foods, processed and tinned foods. Sometimes there doesn’t seem to be any apparent reason or pattern. There are several herbs that can help that I have talked about below, however I really recommend that you see a qualified medical herbalist to help to get to the bottom of your symptoms.

Botanicals

Feverfew (Tanecetum parthenium)

Feverfew has migraine-relieving activity believed to be due to parthenolide, an active compound that helps relieve smooth muscle spasms. It is often indicated where the migraine sufferer also experiences allergies or asthma.

In the 1980s, a survey of 270 migraine sufferers in Great Britain found that over 70% felt substantially better after eating an average of 2 – 3 fresh feverfew leaves daily. Another study of a feverfew extract showed the frequency of migraine attacks dropped from 4.76 per month to 1.9 per month. A 3 month study of 49 people found that feverfew combined with magnesium and vitamin B2 provided a 50% decrease in migraine attacks.

Try one of the following:
The best way of taking feverfew is fresh. The plant is easy to grow in a pot, window box or in the garden, self seeds each year and is hardy and prolific.

1. Take up to 3-4 fresh leaves per day. The fresh leaves seem to be far more effective than the dried. Try a few leaves in a Marmite sandwich to disguise the taste! Take two in the morning and two in the evening.

2. Take 0.25 to 0.5 mg parthenolide of a standardised extract. This is equivalent to 3-4 fresh leaves per day.

3. Take 100 – 300 mg, up to 4 times daily, if the extract is standardized to contain 0.2 – 0.4% parthenolides.

4. For carbon dioxide extracted feverfew, take 6.25 mg, 3 times daily, for up to 16 weeks.

Take feverfew regularly as a preventative. Don’t suddenly stop taking feverfew if you have taken it for more than 1 week as some people have had withdrawal symptoms such as rebound headache, anxiety, fatigue, muscle stiffness, and joint pain. It is not addictive but the dose should be lowered gradually.

Side effects from feverfew can include abdominal pain, indigestion, flatulence, diarrhea, nausea, vomiting, and anxiety. Mouth ulcers, loss of taste, and swelling of the lips, tongue, and mouth may occur in some individuals who chew raw feverfew leaves so they are best taken in bread or with food. Infrequent allergic reactions to feverfew have  been reported, mainly by people with allergies to chamomile, ragweed, or yarrow.

Talk to your doctor or medical herbalist first if you are taking:

  • Migraine medication from the triptan class of drugs
  • Have a bleeding disorder or take blood-thinning medications; such as aspirin or warfarin.


Ginger
(Zingiber officinale)

Ginger root has been valued for centuries for conditions such as nausea, morning and motion sickness, stomach upsets,cold and flu symptoms and also migraine headaches. Strong nausea or vertigo accompanying a migraine attack may be a guiding symptom for the use of ginger.

Try one of the following:
Fresh ginger: 10 g per day (approx 1.4 inch slice)
Dried ginger: 500 mg four times per day.
Ginger extract: Standardised to 20% gingerol and shogaol.
For prevention: 100=200 mg three times per day.
For treatment: 200 mg every two hours up to six times per day.
Do not take more than 4 g (4000 mg) ginger extract per day.

Personally I think fresh is best and you can add ginger into your daily juice or make as tea.

Side effects of Ginger are minimal. Very high doses (e.g., 6000 mg of dried ginger) on an empty stomach can cause stomach problems but most research studies used 1000 mg of dry powdered Ginger root. This is equivalent to about 10gm (1/3 oz. or about a 1/4 inch slice) of fresh Ginger root. High doses can be more effective initially for pain (e.g. 500-1000 mg 3-4 times a day of dry powder) with the dose lowered to the lowest effective dose in 4-6 weeks.

A Journal of Ethnopharmacology article records a detailed case study in which ginger (600 mg doses with plain water, four times a day, for four days, beginning with first signs of migraine) was effectively substituted for conventional anti-migraine drugs (aspirin, dihydroergotamine). The capsules prevented the onset of the migraine attack if taken at the first onset of symptoms. The patient also introduced fresh ginger into her daily diet and had a marked decline in the number of attacks over a year.

Talk to your doctor or medical herbalist first if you are taking:

  • Blood-thinning medications, such as aspirin and warfarin

Cayenne (Capsicum annuum)

Capsicum from the red pepper is a great painkiller. Capsicum cream rubbed into the neck, behind the ears, over the temples can help with a lot of severe headache conditions such as cluster headaches (severe one-sided headache that tends to occur in clusters, repeatedly every day at the same time for possibly several weeks). I personally use Capsicum and Ginger Cream for the weather headaches I often get just before thunderstorms. It is fast acting and my headaches tend to go in 10-15 minutes – around the same time as taking paracetamol. Cayenne is also available in tablets.

Capsaicin has very powerful pain-relieving properties as it temporarily reduces substance P, a chemical that carries pain messages to the brain. When substance P is depleted, the pain messages no longer reach the brain, and the person feels pain relief.

Capsaicin creams come in different strengths. Some may cause a burning or itching feeling on the skin. Mostly this  passes quickly but alway test a new capsaicin cream on a small area of your skin before using it on a large area. And always wash your hands after applying it and keep it out of your eyes!

Capsaicin capsules may cause stomach irritation and people with ulcers or heartburn should be wary of this. People who are allergic to latex, bananas, kiwi, chestnuts, and avocado sometimes also have an allergy to cayenne.

Talk to your doctor or medical herbalist first if you are taking:

  • ACE inhibitors (medication used to regulate blood pressure); such as captopril, enalapril and lisinopril.
  • Stomach acid reducers; such as cimetidine (Tagamet), famotidine (Pepcid), ranitidine (Zantac), omeprazole (Prilosec), and esomeprazole (Nexium), or over-the-counter drugs such as Maalox, Rolaids, Tums, and nonprescription versions of Tagamet, Pepcid, Zantac, and Prilosec.
  • Blood-thinning medications; such as warfarin, heparin and aspirin
  • Theophylline; a medication used for asthma

Diet

Many migraines are triggered by foods. The most common culprits in order of frequency are: Cows milk, Wheat, Chocolate, Eggs, Oranges, Benzoic acid, Cheese, Tomato, Tartrazine, Rye, Rice, Fish/Shellfish, Grapes, Onion, Soy, Pork, Peanut, Alcohol, MSG (monosodium glutamate), Walnuts, Beef, Tea, Coffee.

There is little logic in this list and it is worth doing a total detox to identify your own culprits. After 3 – 5 days of abstinence from solid food, sustained by vegetable juices, introduce foods slowly one at a time, day by day. Your body will quickly tell you what it is reacting to.

Other herbs that may help

One of the advantages of having a consultation with a qualified medical herbalist is that there are many other herbs which can be dispensed to suit your particular condition. No two people experience their symtoms in exactly the same way. Other herbs used in the treatment of headaches include Skullcap (Scutellaria laterifolia) and anti-spasmodic that helps especially where headaches are accompanied by irritability; Valerian (Valeriana officinalis) especially where headaches are accompanied by anxiety and worry; Butterbur (Petasites hybridus); Jamaica dogwood (Piscidia piscipula) and others.

Supplements that can help

Magnesium: 250-400 mg three times per day

Vitamin B6: 25 mg three times per day

5-HTP: 100-200 mg three times per day

Physical Therapies that can help

TENS
Acupuncture
Biofeedback

Clinical Trials

Feverfew and Ginger – Compound for acute treatment of migraine
Feverfew and Ginger – Double-blind, placebo-controlled pilot study
Feverfew – Prophylactic treatment of migraine
Feverfew – Efficacy and safety
Feverfew- Randomised, double-blind, placebo-controlled trial
Capsaicin – Topical application for migraine pain

What do you think?