by admin | Sep 16, 2015 | Complementary & Alternative Medicine
What is the Role of Magnesium in Migraine?
Two double-blind studies have shown that magnesium supplementation may reduce the frequency of migraine.1,2 Research studies reveal that magnesium levels affect serotonin receptors, and also have an effect on nitric oxide synthesis and release, as well as on NMDA receptors—all brain structures and chemicals suspected to be important in migraine. In small studies, both migraine and cluster headache patients have responded during headache attacks to intravenous magnesium. In a larger double-blind controlled study looking at prevention, the treatment group receiving 600 mg of magnesium for a 12 week period experienced a 41.6% reduction in headaches as compared to only 15.8% reduction in migraine headaches in the placebo group.2 Another controlled trial at a dose of 485 mg did not show benefit.3
What magnesium does in your body
It is responsible for over 300 essential metabolic reactions in the body. It is required for synthesizing proteins in the mitochondria, the metabolic powerhouses of your cells, and for generating energy in most of the body’s basic cellular reactions. It is necessary for several steps in the synthesis of DNA and RNA. Magnesium is also present in a number of other important enzymes. As important as it is intracellularly, 60% of the body’s magnesium is present in bone, and 27% in muscle.
Magnesium supplements
If you decide to take supplemental magnesium, the recommended starting dose is 400-500 mg/day in divided doses. The limiting factor for most people is diarrhea. If you are on a migraine preventative medication that is constipating, like amitriptyline or verapamil, this might be a plus. It’s always wise to check with your doctor before starting on magnesium, especially if you are on medication. Warning: If you have heart disease or kidney disease, or are prone to kidney stones, be sure to talk to your doctor before starting on magnesium or a calcium magnesium supplement.
To be metabolized effectively, magnesium must be taken with calcium, or with adequate calcium in the diet. The amount of calcium should be no more than double the amount of magnesium— this is the ratio commonly recommended for women. Men may require less calcium, and sometimes take a ratio of calcium/magnesium that is equivalent mg/mg. Many people take in only 60-70% of the recommended daily allowance in the first place, and then things like stress and caffeine can deplete that further throughout the day. There is emerging evidence to suggest that dietary intake of calcium may be preferable to calcium supplements in women and men who are middle-aged or elderly.
Migraine sufferers have been found to have a relative magnesium deficiency in their bloodstream between migraine attacks, and intracellular magnesium levels drop even further during a migraine attack. Magnesium oxide, magnesium citrate, and magnesium sulfate, are bioavailable—look for mixed salts of these forms, or magnesium gluconate or magnesium glycinate, which are ionized, and biologically active; if you develop diarrhea from those forms of magnesium, look for chelated magnesium. Magnesium carbonate dissolved in CO2- rich water is 30% more bioavailable than magnesium found in foods or in pill-format.
Magnesium–drug interactions
Some medications may not be completely absorbed if taken at the same time as magnesium. Digoxin absorption, for example, may be decreased due to magnesium. Nitrofurantoin and anti-malarials may also be decreased in absorption due to magnesium. Magnesium may interfere with quinolone or tetracycline antibiotics, and can interfere with anticoagulants. Diuretics such as furosemide (Lasix®) or hydrochlorothiazide can result in magnesium depletion. Iron supplements may interfere with magnesium supplement absorption. It is best not to take magnesium at the same time as medications. If you have concerns about whether or not you should be taking magnesium, or about the timing of magnesium and your medications, your pharmacist may be of help in advising you.
Foods rich in magnesium:
Potential headache triggers: Not usually headache triggers:
| peanuts |
brown rice |
| almonds |
blackstrap molasses |
| hazel nuts |
kiwi fruit |
| bananas |
broccoli |
| tofu |
spinach |
| soy beans |
swiss chard |
| avocado |
tomato paste |
| peanut butter |
sweet potato |
| chocolate |
pumpkin seeds |
| cocoa powder |
succotash |
| black-eyed peas |
cooked artichoke |
| whole grain cereals |
cooked okra |
| chick peas |
beet greens |
| split peas |
acorn squash |
| lentils |
baked potato |
| beans |
fresh apricots |
| dried apricots |
raisins |
| yogurt |
milk |
Note: not all suspect trigger foods are triggers in all headache sufferers.
References:
1. Mauskop A, Altura BM. Role of magnesium in the pathogenesis and treatment of migraines. Clin Neurosci. 1998;5(1):24-27
2. Peikert A, Wilimzig C, Kohne-Volland R. Prophylaxis of migraine with oral magnesium: results from a prospective, multi-center, placebo-controlled and double-blind randomized study. Cephalalgia. 1996;16(4):257-263
3. Pfaffenrath V, Wessely P, Meyer C, et al. Magnesium in the prophylaxis of migraine–a double-blind placebo-controlled study. Cephalalgia. 1996;16(6):436-440
by Christina Peterson, M.D.
by admin | Aug 8, 2015 | Migraine Survival
Anne MacGregor, MB BS, MD, MFSRH, MICR, DIPM
Dr. Anne MacGregor, Harley Street Consultant, is the former Clinical Research Director at the City of London Migraine Clinic, an independent medical charity, and Honorary Senior Clinical Lecturer at the Research Centre for Neuroscience within the Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, University of London. She is also an Instructing Doctor and examiner for the Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists. She has served on the board of the International Headache Society, serving as General Secretary from 1999 to 2005. She is a Trustee of the Migraine Trust, and member of the Medical Advisory Board of Migraine Action Association, both lay organizations. Through her interest in pain management, she is an Executive Committee member of the Academic Pain Group at Barts and the London School of Medicine and Dentistry. She is a co-author of BASH Headache Management Guidelines, which are now in their third edition. In the past, she was a Trustee and member for the Board of Directors of the British Association for the Study of Headache (BASH) and the Anglo-Dutch Migraine Association (ADMA). She was a member of the IHS Classification Subcommittees for Menstrual Migraine, and Tension-Type headache and the IHS Task Force on oral contraceptives and hormone replacement therapy use in migraine sufferers.
Dr. MacGregor received her miedical degree from St. Bartholomew’s Hospital, University of London. She become interested in the association between migraine and female hormones at an early stage of her career, crossing between neurology and reproductive health, in order to pursue this interest. She has now published extensively on migraine in women and continues to research in this field. She has also been involved in numerous clinical therapeutic trials for migraine.
Dr. MacGregor is an ad hoc reviewer for many publications including the British Medical Journal, The Lancet, The Lancet Neurology, Drugs and Therapeutics Bulletin, Headache, Cephalalgia, Climacteric, and Maturitas.
Dr. MacGregor has over 150 publications and 5 single-author books to her credit. She lectures extensively.
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by admin | Aug 8, 2015 | Migraine Survival
Christian Spies, M.D.
Dr. Spies is presently an interventional cardiologist at Palo Alto Foundation Medical Group, and Co-Director Structural Heart at Sutter Health, Bay Area.
He has served as a Clinical Assistant Professor, Department of Medicine at the University of Hawaii, and attending cardiologist at The Queen’s Medical Center, Honolulu, HI. He is a member of the American Medical Association, the American College of Cardiology, the Society of Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Medicine. Dr. Spies serves as a reviewer for Heart, Catheterization and Cardiovascular Interventions, American Journal of Cardiology, Expert Review of Cardiovascular Therapy, Journal of Cardiothoracic Surgery, Nature Clinical Practice Cardiovascular Medicine, and Cardiology.
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by admin | Aug 8, 2015 | Migraine Survival
Mario Peres, M.D.
Director of the São Paulo Headache Center, and Professor of Neurology at ABC Medical School. He is a member of the American Academy of Neurology, Brazilian Headache Society, International Headache Society, and a Fellow of the American College of Physicians. Dr. Peres currently serves as a reviewer for the journals Headache, Cephalalgia, Arquivos de Neuropsiquiatrica, and Journal of Psychosomatic Research. Dr. Peres is a Senior Research Associate at the Brain Research Institute – Albert Einstein Hospital and has research interests in sleep disorders and psychiatric comorbidities in headache.
Dr. Peres’ websites are www.cefeleas.com and dordecabeca.net
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by admin | Aug 8, 2015 | Migraine Survival
Christina Peterson, M.D.
Dr. Peterson is a physician specializing in neurology who over thirty years has treated thousands of patients with headache pain. She has also been asked to consult on the topic of headache and migraine in a variety of business and clinical settings.
Dr. Peterson has served as Medical Director of the Oregon Headache Clinic, President of HEADquarters Migraine Management, Inc., and is the owner of MigraineSurvival, focusing on a wellness-based approach to headache. Dr. Peterson is a member of the American Academy of Neurology, The American Headache Society, the National Headache Foundation, the International Headache Society, and the Headache Cooperative of the Pacific.
Dr. Peterson has been a frequent speaker on the topic, and has also written about headache for the lay public. She is the author of The Women’s Migraine Survival Guide, published by HarperPerennial. She has also contributed to the “Differential Diagnosis of Headache” in two editions of Chiropractic Management of Spine-Related Disorders, and a chapter on whiplash and headache in Whiplash: A Patient-Centered Approach to Management.
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by admin | Aug 8, 2015 | Migraine Survival
Dr. Ingo Anderle
Dr. Ingo Anderle is an optometrist with over 20 years private practice experience. He practiced in Germany and in New Zealand before relocating to work in Spain and Gibraltar. He speaks Spanish, English, and German fluently. He has run his own practice in La Linea, Spain, and also works as an independent consultant for the optical industry.
His expertise in general optometry is complemented by specialist knowledge in vision, training, behavioral optometry, pediatric optometry, low vision, low vision aids, contact lenses, contact lens fitting, cataract screening, pre and post-operative care for cataract treatment and refractive surgery, restoring vision after failed refractive surgery, and post-operative management.
Dr. Anderle is passionate about exceeding patient expectations. He has broad experience in working with children, people with disabilities, low vision patients, headache and migraine sufferers, and those with cataracts.
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by admin | May 2, 2015 | Miscellaneous
Acquired Head Injuries an Increasing Source of Headache?
The Centers for Disease Control have recently released updated information regarding traumatic brain injury. From this data, the leading cause of TBI was unintentional falls, and the second most common cause was due to motor vehicle-traffic injury. Motor vehicle-related injury was the primary cause of death due to head injury, and was more common in men.
Groups at highest risk were children from birth to age four, and adults aged 75 years and older. Adolescents aged 15-19 years were at somewhat increased risk over other groups. In all age ranges, males were more affected by TBI than were females.
The direct medical costs in addition to the indirect costs of TBI, from things such as lost productivity in the workplace, totaled an estimated $60 billion in the US in 2000. With the rate of TBI increasing, these costs will also increase accordingly.
Consensus has been reached that headache is common in the initial phases of MTBI. Thus, an increase in the rate of posttraumatic headache can be expected if the rate of TBI is increasing.
References:
1 Faul M, Xu L, Wald MM, Coronado VG. Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths 2002–2006. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2010.
2 Carroll LJ, Cassidy JD, Peloso PM, Borg J. von Holst H, Holm L, Paniak C, Pepin M. Prognosis for Mild Traumatic Brain Injury: Results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. J Rehabil Med 2004; Suppl. 43: 84–105.
3 Finkelstein E, Corso P, Miller T and Associates. The Incidence and Economic Burden of Injuries in the United States. New York (NY): Oxford University Press; 2006.
by admin | Feb 8, 2015 | Children & Headaches
Children and Headaches
Migraine
Children can begin having migraine headaches at an early age. Migraines in children tend to be shorter than in adults, but are no less painful or frightening to a child, especially if a child experiences an aura.
Prior to puberty, migraines are slightly more prevalent in boys. At puberty, however, more girls begin to experience migraine headaches. migraine can be a significant problem in adolescence and, in this age group, new daily persistent headache may occur as well. New daily persistent headache starts out as a daily headache.
Other Headache Types
Tension-type headaches also occur in children, and are common in adolescents.
One type of migraine syndrome that occurs primarily in children is abdominal migraine, which usually involves nausea, vomiting, and possible abdominal pain, with or without headache. Children may appear either pale or flushed, and there may be a warning of tiredness or drowsiness.
Posttraumatic headaches are an increasingly common problem in child athletes, who should be carefully evaluated after any head injury, even if it is seemingly minor.
by Christina Peterson, MD
updated Feb 8, 2015
by admin | Oct 2, 2014 | Comorbidity
Migraine and Obesity Related
It has been well-established that there is a connection between obesity and migraine headaches. The number of headaches a month is higher in the overweight, and even higher in the obese population. The reasons for this are complex, and are still being studied by scientists to figure it all out—but it looks like at least part of the reasons have to do with creating an environment of increased inflammation.
So, we know that, basically, the fatter you get, the more migraine headaches you are likely to have. What has been less clear is whether weight loss can reverse this trend.
A small study was done of severely morbidly obese patients who underwent bariatric surgery. Twenty-four patients with a BMI of 35 or greater were identified with migraine headache by using the ID-Migraine Screener. Migraine severity was measured with the Migraine Disability Assessment Scale (MIDAS). A 50% reduction in the number of headache days was seen after surgery. Prior to surgery, half the patients reported moderate or severe disability from their migraines; this number dropped to 3 patients after surgery. Headache improvement occurred with weight loss even though, during the time of the study, many participants were still in the obese range of weight.
Postoperative complications after bariatric surgery can be significant, and living after bariatric surgery can be challenging as the rate of vitamin deficiencies is high, and can result in neuropathies and other neurologic problems. While weight loss may be beneficial for the prevention of medical conditions related to obesity, it is premature to recommend it solely for migraine.
References:
1. Keith SW, Wang C, Fontaine KR, Cowan CD, Allison DB. BMI and headache among women: results from 11 epidemiologic datasets.
Obesity (Silver Spring). 2008;16(2):377-383. Available at:
http://www.ncbi.nlm.nih.gov/pubmed/18239647.
by admin | May 16, 2014 | Types of Headaches
Exercise-Induced Headache—Benign or Ominous?
Exertional headache can be a relatively minor thing, in which case it is called benign exertional headache, or it can represent something more serious. Since no one can tell the difference by just looking at you or by hearing about your symptoms, it’s best to seek medical evaluation if you have exercise-induced headaches.
Usually this headache is a pulsating or throbbing headache lasting up to two days, brought on by exercise or strenuous physical activity. The headache can occur during or after the activity, and is more likely to occur in hot weather or at high altitude. Occasionally this headache occurs as what is called a thunderclap headache, which means that it strikes suddenly as a severe headache without any warning.
You should see a doctor the first time an exertional headache happens—it can mimic other disorders that are not benign. And you should definitely seek care if you have a thunderclap headache, which may be warning you of something ominous.
Most of the time, exertional headaches are nothing serious, but it is better to be safe than sorry. Hydrating before exercise may help prevent this headache. If it does not, your doctor may be able to recommend treatment.
by Christina Peterson, M.D.
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