Background:
Migraine is a complex, disabling disorder of the brain that manifests itself as attacks of severe, throbbing head pain with sensory sensitivity to light, sound and head movement. In the United States, more than 30 million people have one or more migraine headaches per year. Approximately 75% of all persons who experience migraines are women.
Unfortunately, many migraine sufferers have come to view their headaches as inevitable. Not so – there is much that can be done; but, it takes a bit of sensitivity and understanding. And there’s more individual variation than you might imagine.
History:
In the 1950s, the vascular theory was proposed to explain the pathophysiology of migraine headache. It was believed that the blood vessels in the brain were constricted, and that the dilation of the nerves around the blood vessels caused the headache. We couldn’t see into the brain then, but now we can…and it’s more complex than what we thought in the 50s.
With recent imaging technology, no consistent flow changes have been identified in patients suffering from migraine headache without aura. The neurovascular theory holds that a complex series of neural and vascular events initiates migraine. According to this theory, migraine is primarily a neurogenic process with secondary changes in cerebral perfusion.
Key factors:
Approximately 70% of patients have a close relative/family member with a history of migraine. In addition, a variety of environmental and behavioral factors are known to precipitate migraine attacks, including:
- Stress, insufficient sleep, medications (e.g., vasodilators, oral contraceptives), smoking
- Exposure to bright light and strong odors (e.g., perfumes, colognes, petroleum distillates)
- Hormonal changes, such as menstruation (pregnancy, and ovulation)
- Weather changes
- Physical exertion or fatigue, motion sickness and cold
Certain foods and food additives can also precipitate migraine. These include alcohol, caffeine, chocolates, artificial sweeteners (e.g., aspartame, saccharin), monosodium glutamate (MSG), citrus fruits, and meats with nitrites. A long list of foods containing tyramine—including meats that are pickled, aged, smoked, fermented, or marinated; most pork (except cured ham); chocolate; alcoholic beverages; and fermented foods, such as most cheeses—can also provoke migraine.
So, how does one make sense of these various triggers and determine how to best protect from migraine? First, we look at our “terrain”—the body as a whole biosystem. Genetics drive roughly 20% of our health. The other 80% is our genetics interacting with our environment. Individual choices make a huge difference:
- Consistent whole food nutrition, exercise, stress management including meditation give every body the best chance of being well
- Processed foods, sedentary lifestyle, depression and worry, environmental toxins and pollutants, antibiotic load, exposure to viruses and other infectious agents make it much more difficult for the body to function properly.
- They are pro-inflammatory, which promotes headache.
- In addition, they more broadly disrupt the balance of the body’s stress axis, the HPA axis. The HPA Axis is essentially the body’s communications network, including the immune, neural, and endocrine networks, all messengers that link all our body’s systems together.
These are broad principals. How can individuals best figure out how to ease our biosystems back into balance? We really benefit most from more individualized approaches. Why? Because, we respond better when someone treats us as an individual rather than an “average” data point in the population. In addition, we want more specific information about our own requirements.
A well-informed plan not only focuses on what we each need. It also gets our minds engaged, and the effect of our neurochemistry on our entire communications axis, becomes a very potent ally and tool.
The whole biosystem approach that we use is a team effort, not routinely found in traditional medical settings today. We believe that no one medical tradition, and no one practitioner, no matter how dedicated, brilliant, and caring, can handle both the symptoms of complex disorders and the underlying terrain.
In our clinic we use seven disciplines including Eastern and Western, modern and traditional medicine, and individualized support to establish the daily choices that enable each individual to be well. This more permanent approach to chronic illness isn’t easy but is best suited to manage many of our complex symptoms and illnesses such as migraines.
What you can do:
As much as we’d like to see everyone, we know we can’t, and traveling to San Francisco may not be feasible in your near term plans. Rest assured, you can take a more effective approach to migraines wherever you are though.