Cure Your Migraines the Natural Way

8/2/2019 Cure Your Migraines the Natural Way

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Aggie E. Krl

Cure YourMigraines the

Natural WayJourney to Wellness:

A Step-by-Step Guide to

a Headache-Free Life

whollydesign

Aggie weaves together the

science and art o healing ones

body in a holistic way in Cure Your

Migraines The Natural Way

Joh Gray, Ph.D. auhor o

M Ar ro Mar, Wo Ar ro Vu


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Aggie E. Krl

Cure YourMigraines the

Natural WayJourney to Wellness

A Step-by-Step Guide to

a Headache-Free Life


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Wh you xrc wh corrc pour, you rorc poor

pour. Wh you wgh or work ou o a rad wh

huchd ck ad houdr - youv ju crad a bad pour

ha hardr o corrc.

Jo Gurrz, Proa Trar

Thr oo uch o a dcy o ubu drug or pop

Joa Lv

. Why Eat Raw 4

. The Truth About Fats

. Hydration Is Not Just For Plants!

. Chees and Whine? (Alcohol) 0

Bibliography

. Migraine and the Psyche

. The Answer to Stress:

Psychological Resilence 4

. Emergency Measures 0

. Prevention:

Developind Treatment Plan 0

Part 4 Mind And Body

Epilogue (Thank Your Body For Your Migraine) 0

. The Brain in Migraine

. What causes Migraine

. Is It All in the Genes 4

. Landing on the Chiropractors Table 51

. In Morpheus Arms (sleep) 62

. The Punk at the Gym 73

. Body Posture Vademecum 88

. Allow Your Neck to be Free:

Alexander Technique 92

. Happy Points Therapy

Massage 0

. Cravings 0

. Chamomile Tea at

Starbucks?? (Caeine)

. Sugar Junkie

. Going Raw:

The Giant Leap

Part - The Science

Part The Therapie 0

Part Nutrition 0

Begining the Journey

Note , Acknowledgment 0, Foreword , Introduction 4,


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My goal in writing this book is to share with all migraine

suerers the therapies and strategies that have allowed me

to remain migraine-ree. It is my belie that most o the strategies

youll nd in these pages will work or most migraineurs, but somemay not work or all migraineurs. No single therapeutic approach is

guaranteed to work or all o us. We are all dierent.

This book is not meant to be a complete academic treatise, nor is it

meant to be used as a diagnostic tool or substitute or any treatment

that you nd works or you. Rather, its meant to be used as a guide

to increase your awareness and understanding o all the possible

causes and triggers o your migraines and help you develop proactive

strategies or preventing them.

Ive made every eort to ensure that the inormation and research

provided in this book is accurate and current; however, I cannot

warranty its reliability, completeness, or timeliness. Research is

a moving target. Science makes new discoveries every day.

I encourage you to consult with a competent physician beore

you make any signicant changes to your liestyle, such as to diet

or exercise. Ask questions. Expect answers. I you dont receive

thorough and convincing answers, dont be araid to seek a second

opinion, or even a third, i necessary.

First and oremost, I encourage to take responsibility or your own

health and well-being. Once you nd the path to true Wellness, there

is no turning back.


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Foreword

I have never had a migraine headache. I have never

experienced an aura. As a matter o act, I would be hard-

pressed to tell you the last time I had any type o head pain.

Although I have no personal experience with the physiological

eects o migraine, I have been treating this condition

indirectly and directly or a good part o my lie.

You see, my mother had migraines.

I was a young boy, not currently in school. I was the one

who walked into that cold, dark, silent room with a cup o tea

and a dry piece o toast. There was very little conversation

with my mother during her episodes; i any. Most interesting

were the trips to the hospital and visiting the doctors.

I spent a lot o time in waiting rooms, looking at magazines,

and watching the doctor and his patients.

Migraine headache is a process. There are many types oheadaches o which migraine is one. Migraine headache is

clinically represented in a class o other benign headache

types. The brain, in and o itsel, is pain insensitive. It is the

pain sensitive structures such as the meninges, skull, sinuses,

neck muscles, ligaments, blood vessels, temporomandibular

joint, and dental constructs that are responsible or

delivering their unique neurological inormation to the brain.

There are good and bad stories in lie. The same can be

said or headaches. Although the vast majority o headaches

are benign, there are other presentations o head pain that

are not. It is axiomatic that diagnosis steers treatment.

Getting the right diagnosis is undamental. Treatment,

depending on diagnosis, may involve other specialty

physicians and providers. This integrative approach must

foreword


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again ollow guidelines or responsible clinical decision

making; investigate your team, do your homework, and have

your team communicate eectively with you and each other.

A great many people suer rom migraine headaches.

The disease-centric conventional medical approach may work

or some; but not or others. I you are reading this book,

chances are that you are in the latter category; you are not

alone. Quite oten in clinical practice, or a patient to attain

adequate improvement with their primary complaint, they

must look beyond the primary problem to the diet, liestyle,

attitudes, belies, habits, emotions and environment thatorm the oundation or the individual patients overall health

and well being.

Our current healthcare system is primarily ocused on acute

care ollowed by chronic disease management with little to

no attention paid to preventive care.

This book provides a shit in consciousness toward prevention

and promotion o health and tness and not on the disease

specic condition; migraine headaches. Our conscious and

unconscious inuences, eelings, and inclinations support

and perpetuate our health behavior.

Motivation or upgrading your health promoting aspects

o living and willingness to overcome disease promoting

behaviors are the key tenants or re-establishing youroundations or health. However, change involves

commitment to sel-autonomy and being responsible or your

personal ownership o health.

This book has the necessary ingredients to get you started

on the right path. I you are ready or your transormation,

buckle up and read on.

Robr Zobok, DC, FACO

foreword


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What have you been told about your migraine?

The clinical world is ull o treatments or migraine.

Chances are, or every treatment you discover, your researchwill reveal hundreds o dierent opinions.

With so much misinormation out there, choosing the right

path out o the wilderness can be daunting. Its no wonder

that so many people linger, untreated, or years in pain and

misery. And choosing the wrong treatment can have negative

consequences, such as exacerbating your migraines, or

creating a new illness altogether. You can waste thousands

o dollars and years o your lie on ailed treatments, never

getting better, never living a ullled lie.

I remember researching migraine treatments online one

night, while battling yet another headache with medication.

I believed that cure was hopeless; ater all, the consensus

in the medical community was: There is no cure or

migraines. Still, I wasnt ready to give up.

That evening, I read a website post rom a man sharing the

pain and suering wrought by his migraines. He described

lying in bed with a gun in his hand, thinking o simply pulling

the trigger and irrevocably, once and or all, ending the pain.

This is what a true migraine can do to you. And only a ellow

migraine suerer understands.

Thats why I wrote this book. Ive become passionate abouthelping migraine suerers understand what migraines really

are, what triggers them, and how to prevent them.

My goal is to help you avoid the pitalls and landmines, and

take charge o your health today.

I you, or someone close to you is a migraineur, Cure Your

Migraines the Natural Way will be both a journey o sel-

discovery and a roadmap to a healthier, happier uture.

introduction


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I encourage you to begin this journey with an open mind.

For the ew hours it will take to read this book, orget what

youve read, orget what others have told you. Try to set

aside your preconceived notions about what works and whatdoesnt.

What you are about to read may change the way you view

migraines orever. This book will give you the strength and

condence to trust your own inner wisdom, and empower

you to make healthy choices that have a lasting impact on

your health. Within these pages, Ill reveal the step-by-step

healing process that reed me rom the shackles o migraine

attacks, and the strategies I employ every day to prevent

migraines return.

And youll learn how to develop a migraine-vanquishing

system that works or you.

Also, while liting weights, every muscle o your core

should be contracted this allows you to practice overall good

posture, as well as train individual muscles. Core muscles

include not only abdominal muscles, but all other muscles

except limb muscles, as well. Strong core muscles help you

maintain proper spinal alignment.

introduction


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begenning the journey

Beginning the Journey

Someone or something is piercing the side o your head with

a little nail you cross your ngers, hope it will stop

But it doesnt. Youre lled with dreadyou know its going

to get worse. It doesthe nail plunges deeper into your brain,

the pain grows sharper, more intense. Soon, the pain spreads

you can eel it creeping across your entire head, behind your

eyes, across your ace. The nail has become a railroad spike, and

someone is hammering it down through your skull, drilling into

your brain, splitting your head wide open you have a split-

ting headache

A gra aack

Sound amiliar? I so, youre not alone. Around percent o

women and 6 percent o men have suered migraine attacks.

I was one o them.

The book youre about to read is the book I wish someone else

had written rst, so that all I had to do was read a book, ollow

instructions, and banish my migraines orever.

I wasted seventeen years o my lie living like a lab rat, experi-

menting with dierent cures. I took nutritional supplements.

I cut back on chocolate. I eliminated certain oods.

I took painkillers. I tried anything and everything just to get by.

Nothing worked. At some point, those excruciating headaches

just became part o my reality. They were simply always there,

whether I was at school, at work or at home, no matter what

country I lived in or what treatments I used to stop them.

I was a migraine suerer. I was stuck with migraine, and mi-

graine stuck to me.

Usually, my migraines were accompanied by nausea, and oten

at the most inopportune times. I would be hungry but araid toeat because I knew I couldnt hold the ood down.


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When migraine attacked me at work, I couldnt get anything

done, but I usually had to tough it out. I couldnt endanger my

job by going home sick. My sel-esteem plunged. I elt ineri-

or to my coworkers who were healthy and energetic and couldsometimes work circles around me when I was in the throes o

a migraine attack. It seemed that I was orever making pacts

with mysel to catch up the next day.

Sometimes the pain would grow so intense and the nau-

sea so strong that I was orced to leave work, no matter what

the consequences. I had to get home and just get to bed. Sleep

seemed to be the only thing that helped ease the paini I could all asleep. Fighting the throbbing pain, praying that

the headache wouldnt keep waking me up during the night.

Hoping that when I awakened in the morning, that terrible

headache would be gone.

In my early twenties, I didnt understand the mechanisms un-

derpinning migraine. I would vomit i I ate, but I thought per-

haps I just had stomach problems that happened to coincide

with a headache. So many times, I abused my body, and allowed

my body to continue abusing itsel.

Regular painkillers, like the over-the-counter naproxen and

ibuproen classes, never worked or me. Then I discovered trip-

tans, a class o medication unknown to me growing up in East-

ern Europe. Once I began living in the United States, I graduated

to selective serotonin receptor agonists. I didnt even know-

what serotonin was. I didnt really care. I just wanted the pain

to go away.

I believed that a miracle would happen i I took this magic pill

at the onset o a migraine. It not only took away the headache

completely, but made me want to dance and sing with joy that

the headache had vanished so quickly.

The doctor had warned me that these magic pills were not be

taken too oten, only or a migraine attack. What he didnt tell


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8 begenning the journey

me, however, was that this medication could cause rebound.

I started noticing that I needed triptans more requently, and

that the short, initial miracle reaction didnt happen so quick-

ly anymore. It took longer or the drug to work. Sometimes, theheadache would come back, and in less than twenty-our hours,

Id need another pill.

That was it. I knew I couldnt keep relying on this medication

to heal me. I started rebounding my usual average o to

migraines per month became 7 to migraines per month. Plus,

Id get several regular (non-migraine) headaches each week.

On rare occasions, I had a workweek ree o headaches, butthat only ensured that I would get a severe headache during the

weekend. Something was always out o balance its so clear

to me now.

Sometimes I prayed or healing, but those prayers were nev-

er answered. I resigned mysel to the notion that this was just

how it was going to be or the rest o my lie. Deep down, I

knew that something was very wrong. I wasnt supposed to eel

like this. Lie was not supposed to be like this, and this was no

way to live. I wasted so many days o my lie simply trying to es-

cape the throbbing pain.

Well, I knew this denitely wasnt good health. But what was

good health anyway? I never knew, had never experienced

true wellness beore. I was oten sick throughout childhood.

I never really took proper care o my body, never had a healthy

exercise routine, never paid much attention to my diet, aside

rom dieting occasionally, which never really worked or me,

anyway.

Why me? I didnt understand. Other people could party all

night, get no sleep, drink as much alcohol as they wanted, and

pop out o bed the next morning eeling ne. Not me. I could

never do that. Normal or me was already a lie o headaches

and pain. We humans are highly adaptive; evolutionarily, weve


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had to adapt to survive. We tend to adapt to our symptoms and

come to believe that this is simply how lie must be, or at least,

this is how our lives will be. We orget what it elt like to eel

good.

My breakthrough would come at the age o . It was a very

difcult time in my personal lie that happened to coincide with

the announcement that I was going to be laid o rom my job

within a ew months. Desperation set in.

I nally surrendered and agreed to go back on an antidepres-

sant. I was back at my doctors ofce or more triptan rells,

and the doctor is asking me i I wouldnt preer to take pre-ventative medication on a daily basis. Id always reused the

maintenance regimen beore because I believed it would be

a prison sentence. I convinced mysel that I wasnt that bad.

I was determined not to become dependent on medication to

survive. But I simply made sure that this medication was not

habit-orming and surrendered to the prescription. It was

a low dose, ater all.

A couple o months went by I didnt eel any better. The mi-

graines didnt go away, the depression didnt budge. At times,

thoughts o suicide even accompanied my bouts o depression.

Most o us have considered ending it all at one time or anoth-

er, even i only briey, even i only during periods o severe psy-

chological or physical pain. But the depression conspired with

the migraines, hovering overhead ominously, a big gray cloud

ollowing me everywhere I went, always threatening another

storm.

Did I simply needed a stronger dose? Or a dierent drug?

I wanted to stop the medication altogether. But I was even more

earul o what might happen i I stopped taking it. Would lie be

even more unbearable? Living in ear was so unlike me, yet ear

began to consume my lie. I kept praying or a solution to my

problems emotional and physical.


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0 begenning the journey

Five months on the antidepressant, stressed to the limit, wait-

ing to be laid o rom my job o six years, I got out o bed one

night to go to the bathroom and elt a piercing pain in my back.

My spine going out was an additional measure o pain thatI was totally unprepared or. The simplest daily task suddenly

became a major undertaking taking a shower, sitting still at

a desk or longer than minutes holding mysel upright re-

quired all the willpower I could muster.

But, as is oten said, it is darkest beore the dawn.

Today, I am so grateul or that night o torturous pain. It was

a warning sign. It was a clue. And, as youll learn in Chapter ,it was the turning point that put me on the path to health and

happiness.


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The Science

PART

. The Brain Migraine


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Migraineurs are complicated creatures. We are all alike.

And we are all dierent. We come rom dierent gene pools

and dierent environments. We have dierent physiologies

and chemistries. Weve each experienced dierent stressors

throughout our lives, and weve developed varying levels o

emotional resilience to cope with those stressors.

So, its no surprise that treatment or migraine doesnt come

in one-size-ts all. There is no single cure or migraine thats

guaranteed to work or everyone. Finding the right treatment

means nding the treatment thats right or you.Migraine is a neurological disorder that has always been

shrouded in mystique. Its causes, as well as eective treatment

approaches, have historically been conusing, complicated and

controversial. But there are some certainties. Youll learn about

a handul o deadly culprits that are all but guaranteed to trig-

ger migraine attacks. Some may be amiliar, some may surprise

you. The good news is, most o those culprits are easy to re-move rom your lie.

Migraine may happen inside your head, but the ripple eect is

tremendous. Migraine spills over into our personal lives, insinu-

ating itsel into our relationships, depriving us o energy and joy.

And migraine trails its victims to the workplace, negatively im-

pacting perormance, career satisaction, job security, and, ulti-

mately, sel-esteem.

Ultimately, there is no such thing as a mind-body split.

Our mental and physical states are inextricably bound. Psycho-

logical symptoms what we think about have just as much im-

pact on our health as physical symptoms, and any treatment plan

must consider both. An integrated mind-body view o migraine

as a complex o symptoms that are activated by abnormalities in

the whole person mind-brain, body, and spirit will empow-

er you, and help you develop your own personalized approach to

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complete wellness.

This book will show you how migraine is linked to psycho-

logical disorders, as well as other medical conditions, and why

this matters. Well explore a balanced holistic (whole-body) ap-

proach to preventing migraines that will not only dramatical-

ly improve your long-term migraine prognosis but your overall

mental and physical health, as well. The techniques youll learn

in this book will help you lessen the severity o a migraine at-

tack, or head it o altogether.

Conquering migraine it not a strategy. Its a liestyle. In order

to develop a treatment plan that works or you, you must rstunderstand what migraine is and what causes it.

What I Migraine?

Migraine is no respecter o age, ethnicity or socioeconomic

class. It inltrates every population across the globe. Nearly one

in ve women ( percent) and one in men (6 percent) suer

migraine attacks. And roughly percent o migraine suerersexperience severe unctional impairment and oten require com-

plete bed rest to recover rom an attack. Migraine is more com-

mon than diabetes or asthma, and is most common during our

peak productive years o ages to .

Whats going on in a brain under attack by migraine? Mi-

graine is a neurological disorder, and while the exact mecha-

nism behind migraine is not known, most researchers believethat migraine is caused by a genetic abnormality that makes the

neurovascular system hyperexcitable.

Once prodromal activation occurs (e.g., symptoms might in-

clude sugar cravings, neck and back pain, insomnia, depression,

anxiety), the trigeminal nerves in the brain release certain brain

chemicals neurotransmitter substances P and KA that ini-

tiate a cascade o events. These chemicals bind to receptors on

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intercranial blood vessels, which causes vessel dilation or en-

largement, plasma protein extravasation (blood plasma owing

into surrounding tissue), and ultimately inammation.

Activation o the trigeminal nerve cluster relays a signal to the

trigeminal nucleus caudalis, a brain stem structure at the top o

the spine whose job it is to orward pain impulses to the thala-

mus and ultimately to the sensory cortex. Once these rst order

trigeminal neurons become oversensitized, even a benign stimu-

lus (such as a pulsating artery) results in throbbing pain that is,

as youre no doubt aware, made worse by physical activity.

This phenomenon, known as peripheral sensitization, triggersa domino eect i the pain is not quickly and eectively treated.

Second and third order neurons extending through the midbrain

to the thalamus and cortex become (and remain) continuously

activated, which leads to central sensitization.

The skin becomes so hypersensitive that youll experience pain

rom cutaneous (skin) stimuli that are normally not painul,

such as brushing your hair or wearing eyeglasses.

Johns Hopkins University researchers have another theory

about migraines that shits traditional explanations o dilating

or constricting blood vessels at the back o the head to chang-

es within the meninges, the protective tissue layers covering

the brain. SPECT studies have revealed inammation at areas

in the meninges that precisely matched places where patients

reported eeling their headaches, thus linking abnormalities in

the meninges with the pain. Electrical overstimulation o the

trigeminal nerve inames the meninges and causes migraine

symptoms that are similar to bacterial or viral meningitis symp-

toms throbbing headache, nausea, and sensitivity to light and

sound. (Centoanti, Marjorie, 999)

A migraine attack may include cortical spreading depression

(CSD), an electrical phenomenon that may start in the occipi-

tal lobe o the brain and slowly progress orward across the

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cerebral cortex. CSD is a wave o strong neuronal depolarization

that disturbs the delicate balance between neuronal (nerve cell)

states o excitation and inhibition. CSD generates a hyperactive

urry o electrical signals, ollowed by long-lasting neural sup-pression. Most researchers believe that CSD triggers migraine

aura and makes the brain more vulnerable to migraine attacks.

Some research suggests that CSD may even trigger the mecha-

nisms that initiate the headache.

Do You Have Migraine?

I you have any doubts about whether you have migraine, ID

Migraine, a quick three-question test developed by migraine re-

searchers at the Albert Einstein College o Medicine in may

provide conrmation:

Has a headache limited your activities or a day or more in

the last three months?

Are you nauseated or sick to your stomach when you have

a headache?

Does light bother you when you have a headache?

I you answered Yes to at least two o these questions, odds

are good that youre a migraine suerer.

Migraine is mysterious, in part, because its a moving target

the symptoms can sometimes be hard to evaluate and can

change rom one attack to the next. Although symptoms arenot perect clues to the underlying biological abnormalities rom

which they arise, theyre oten our best guides to the intricate

workings o brain-mind and body. Think o migraine as a syn-

drome, a collection o debilitating neurological symptoms that

arise rom a common cause. This syndrome oten maniests in

an increasingly worsening series o symptoms or phases. (They

dont call em attacks or nothin!)

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Migraine phases include:

Prodrome, which occurs hours or days beore the headache

Aura, which immediately precedes the headache

Pain phase, or headache phase

Postdrome

Attacks are oten preceded by prodromal symptoms (o-

ten called premonitions) several hours or even a day or so be-

ore the headache sets in. Premonitions may include eelings

o elation or intense energy, ood cravings (e.g., sugar), thirst,

increased requency o urination, neck and back pain, drows-

iness, irritability, sleep problems, anxiety or depression. In

act, depression, anxiety, and sleep disturbances are common

or chronic migraine suers. (Youll soon learn why.) The pro-

drome is a warning o oncoming migraine, and an opportunity

to thwart a ull-blown migraine attack.

For some migraineurs ( to percent), the prodrome may

be ollowed by an aura phase, symptoms that typically last or

twenty minutes to an hour just prior to the headache stage o

an attack. Aura symptoms include visual disturbances; hyper-

sensitivity to light sound, odors, touch and eel; vertigo; and

speech disruptions.

The headache or pain phase typically includes intense, throb-

bing pain on one side o the head (both sides are aected in

about one-third o attacks). Attacks last between to 7 hours

and are oten accompanied by one or more o the ollowingsymptoms: visual disturbances, nausea, vomiting, dizziness,

extreme sensitivity to sound (phonophobia) and light (photo-

phobia), touch and smell, and tingling or numbness in the ex-

tremities or ace. Why do these secondary symptoms occur?

The headache pain causes the sympathetic nervous system to

kick into gear, responding with nausea, diarrhea and vomit-

ing. This sympathetic response also delays the emptying o the

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8 the science

stomach into the small intestine (aecting ood absorption), de-

creases blood circulation (causes cold hands and eet), and in-

creases sensitivity to light and sound.

The postdromal period ollowing the headache phase can last

up to hours ater the headache ends. Symptoms that persist

through the postdrome include, moodiness, lack o concentra-

tion, atigue and weakness.

How do phyca dago gra?

In diagnosing migraine without aura, physicians typically use

whats known as the , , , , criteria

5 or more attacks

4 hours to 3 days in duration

At least 2 o the ollowing: unilateral location, pulsating

quality, moderate to severe pain, aggravation by or avoidance

o routine physical activity

At least 1 additional symptom, such as nausea,

vomiting, sensitivity to light, sensitivity to sound

Only two attacks are required to warrant a diagnosis o mi-

graine with aura.

Your physician may also rely on neuroimaging and lab tests

to conrm a diagnosis, including electroencephalography (EEG),

computed tomography (CT), magnetic resonance imaging (MRI),

and spinal tap. Theyre looking or such symptoms as:

Bleeding within the skull

Blood clot within the membrane that covers the brain Stroke

Dilated blood vessel in the brain

Too much or too little cerebrospinal uid

Inammation o the membranes o the brain or spinal cord

Nasal sinus blockage

Postictal headache (ater stroke or seizure)

Tumors


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the science

Pulling the Trigger

One o the most important aspects o designing your personal

wellness system is identiying your personal migraine triggers

so that you can develop the right treatment approach. (For ex-

ample, i your primary trigger is stress, stress relievers like chi-

ropractic, yoga, meditation, massage and aerobic exercise may

help.) The more triggers you can identiy, the more likely you

are to prevent the onset o migraine. I cant overemphasize the

importance o becoming a high sel-monitor!

Dierent migraineurs have dierent triggers. Your triggers

may change over time, and your response to triggers may even

vary rom migraine to migraine. For most migraineurs, mi-

graines are set o by a combination o triggers (e.g., dietary,

hormonal and environmental), as opposed to a single thing or

event.

To illustrate, in one large study o migraineurs, most people

had at least one dietary trigger asting was the most com-mon, ollowed by alcohol and chocolate. Hormonal actors ap-

peared in percent o migraines, the pre-menstrual period

being the most requent trigger. Physical activities caused mi-

graine in percent, sexual activities in . percent and 6 per-

cent cited emotional stress as a primary trigger. percent

reported sleep problems as a trigger. Smells were cited as

a trigger by 6. percent. (Fukul, )

Lets take a closer look at some notorious oenders

The Trigger Lit

Possible migraine triggers include:

Bright lights, loud noises, and certain odors or perumes1.

Physical or emotional stress2.


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0 the science

Sleep pattern changes, insomnia,3.

hypersomnia (too much sleep)

Smoking or exposure to smoke. Studies suggest that4.

smoking more than 5 cigarettes per day can trigger

migraine. (L-M, M, P, 2)

Skipping meals, asting (especially with dehydration)5.

Alcohol (oten red wine).

Menstrual cycle uctuations, birth control pills, hormone.

uctuations during menopause onset. Two-thirds o

migraines in women are hormone-related. 5 percent o

women get migraines at ovulation or near the start o their

cycle. Menstrual migraines, which occur within two days

beore the onset o menses and our days ater, are believed

to be caused by changes and/or imbalances in estrogen

and progesterone levels. Low levels o these hormones,

variations in the ratio between them, or a sudden drop in

circulating estrogen can all precipitate a migraine. Women

who are prone to menstrual migraines may also experiencean escalation in requency as they approach menopause,

when hormone uctuations can intensiy.

Tip: Saliva tests can provide ast, accurate answers about hormone

levels and track hormone uctuations levels throughout the

month, which can help establish an eective treatment plan.

Allergies and allergic reactions, including ood.

allergies (e.g., wheat, sugar, corn and dairy oods)

Foods containing tyramine (red wine, aged cheeses,.

soy products, smoked sh, chicken livers)

Foods that contain nitrates, such as1.

hot dogs and lunch meats

Foods that contain MSG (monosodium glutamate), a avor11.


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. What Caue Migraine


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There is no single cause o migraine. The etiology or causes

can vary rom person to person, and may, in act, be caused by

a combination o actors genetic, chemical, neurobiological,

personality, environmental, and psychosocial stress actors.

Migraines are most likely caused by an abnormal trigger o

chemicals that cause blood vessels to dilate or constrict. But,

which chemicals are responsible? What triggers these chemical

abnormalities? And most importantly, how can these conditions

be conquered, thereby eliminating migraine?

First, lets take a look at some known causes

Neurological and Chemical Caue

Bra Chca: Nurorar

Migraine is believed to result rom changes in brain chemistry

involving, specically, the neurotransmitters. Neurotransmitters

act as chemical messengers that send messages in the orm o

an electrical signal rom one nerve cell to another, acilitating

communication between the brain and the rest o the body.

The neurotransmitter serotonin may hold the key to what

goes wrong in a brain in migraine. Serotonin uctuations alter

the pH balance in the brain and cause blood vessel dilation and

constriction. Lets say that your nervous system responds to an

external trigger (e.g., a certain ood), creating a spasm in the

nerve-rich arteries at the base o the brain. This spasm closes

down or constricts arteries that supply blood to the brain, thusreducing blood ow to the brain. Simultaneously, platelets are

clumping together to release serotonin. In act, unusually high

levels o serotonin have been detected in the brain beore a mi-

graine episode. But during a migraine attack, serotonin levels

dip very low, which causes the blood vessels to dilate or en-

large; this vasodilation causes the throbbing headache, distort-

ed vision and other symptoms.


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Serotonin and its neural receptor -HT (-hydroxytryptamine)

are the ocus o much o the current migraine research (speci-

cally, the -HT, -HT, and -HT receptor subtypes especially

-HT are believed to be responsible or most migraine activi-ty). As migraine symptoms worsen, -HT levels decrease. Intrac-

ranial blood vessels dilate, resulting in a decrease in blood ow.

Generating more -HT (specically, -HT) may stop an attack

and hasten recovery.

Gamma-aminobutyric acid (GABA) is another neurotransmit-

ter thought to play a role in migraine attacks. GABA, working in

tandem with serotonin, acts as an inhibitory neurotransmitterthat quiets the bodys stress response when were experiencing

physical or emotional stress. Imbalances in these neurotrans-

mitters trigger more stress, undermine your immune sys-

tem and can trigger conditions such as anxiety and depression,

which, in turn, create more stressand more migraines.

Glutatmate, an excitatory transmitter, has been linked to mi-

graine, as well as other orms o chronic pain, including neuro-

pathic pain, muscle spasticity and rigidity secondary to spinal

cord trauma, stroke, and multiple sclerosis. Around percent

o people have a genetic abnormality that prevents them rom

being able to adequately break down glutamate (as in Monosodi-

um Glutamate (MSG)) into glutamine. (You can see why MSG is

a headache trigger or some migraineurs.)

An increase in the neurotransmitter dopamine may help trigger

and maintain a migraine attack since this dopamine is involved in

controlling cerebral blood ow, nausea, vomiting, and gastric ac-

tions. Some research suggests that migraine syndrome symptoms

may be related to dopamine activation, including prodromal symp-

toms (mood changes, yawning, drowsiness, ood craving), head-

ache-accompanying symptoms (nausea, vomiting, hypotension) and

postdromal symptoms (mood changes, drowsiness, tiredness).


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the science

Horoa Trggr

In one way or another, hormones control just about every as-

pect o human physiology, and most hormones are involved in

multiple aspects o our unctioning. Thats why hormonal imbal-

ances and deciencies can inuence many dierent aspects o

our physical and emotional well-being.

Stress Hormone Cortisol. Stress, which triggers high levels o

cortisol and adrenaline, plays a role in triggering migraines.

People with chronic migraine have elevated cortisol levels, in-

cluding notoriously elevated evening cortisone levels.

Cortisol is a stress hormone produced by the adrenal glands.

While cortisol is a major culprit behind migraine, its important

to understand that cortisol is not inherently bad. Its neces-

sary or survival. Your body produces cortisol as a natural re-

sponse to stress, both physical and emotional. Its part o our

ght-or-ight response.

Cortisol is a glucocorticoid, which means that part o its job is

to increase the ow o glucose (as well as protein and at) outo your tissues and into your bloodstream, an act that torques

energy and physical readiness to better prepare you or han-

dling a stressor.

In general, short-term elevations o cortisol in the blood-

stream are good theyre simply part o our adaptive response

to stress. Short-term stress actually revs up the immune sys-

tem an adaptive response that prepares our bodies or ght-ing injury or inection. But long-term elevations o cortisol

weakens the immune system and triggers migraine and depres-

sion. Chronic stress causes too much wear and tear and the

system breaks down.

Hr how coro aack h u y

Every cell in our bodies contains a tiny clock called a telomere,

which shortens each time the cell divides. Short telomeres have


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been linked to diseases such as HIV, osteoporosis, heart disease

and aging. The telomerase enzyme within each cell keeps im-

mune cells young by preserving their telomere length that is,

their ability to keep dividing. Cortisol suppresses immune cellsability to activate telomerase, thus gradually weakening the im-

mune system.

Perhaps evolution made a tradeo. When the emergency

stress response is triggered, the body quickly mobilizes its re-

sources or action. Functions that are not on the emergency

team temporarily shut down. When hormones are raging pre-

paring or battle energy-consuming components o the im-mune system, such as white blood cell (T-cell) production, are

temporarily suppressed.

Excessive cortisol can also lead to a decrease in insulin sen-

sitivity, increased insulin resistance, reduced kidney unction,

hypertension, suppressed immune unction, reduced growth

hormone levels, and reduced connective tissue strength. High

cortisol levels have also been linked to the storage o body at,

especially visceral abdominal body at (intra-abdominal at).

Visceral at is stored deeper in the abdominal cavity and around

the internal organs, whereas regular at is stored below the

skin (subcutaneous at). Visceral at is dangerous because it puts

us at risk or heart disease and diabetes.

Now, cortisol is not the mechanism that makes you at. (We

make ourselves at!) In act, one o cortisols jobs is to increase

the breakdown o stored adipose (atty) tissue into glycerol and

atty acids so that they can be converted to energy. But cortisol

does contribute to storing abdominal at. Chronically elevated

cortisol levels keep our bodies in a state o ght-or-ight, which

consumes oxygen and burns energy that the body could be using

or the process o breaking down at and building muscle.

Chronically elevated cortisol levels can also cause muscle tis-

sue loss by triggering the process o converting lean tissue into


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glucose. High cortisol levels can increase muscle protein break-

down and inhibit protein synthesis (building up muscle proteins).

Thus, chronically elevated cortisol can prevent you rom building

muscle and decrease your physical strength.

The goal is to maintain a healthy, normal level o cortisol.

We have many hormones in our bodies, which, in the proper

amounts, maintain good health, but when excessive or decient,

have negative eects on our health.

For example, Cushings syndrome is associated with high corti-

sol levels, while Addisons disease is associated with low cortisol

levels.TIP: Want to nd out i your cortisol levels are high? Blood,

saliva and urine tests can provide the answer. They uctuate

throughout a 24-hour period, so tests must account or the time

o day. What is a normal level o cortisol? Cortisol concentrations

are generally highest in the early morning rom to a.m. and

lowest around midnight. (According to Medline Encyclopedia,

- mcg/dl is a normal level o cortisol in the bloodstream at

a.m..) Cortisol is also temporarily elevated ollowing exercise;

this is a normal bodily response to exercise or stress.

Mao.

Migraine suers typically have lower than normal melatonin

concentrations, as well as delayed nighttime melatonin peaks.

Melatonin is an antioxidant hormone thats naturally secreted by

the pineal gland in the brain, especially at night. (For more onmelatonin, see Chapter 7.)

Puary Gad.

The pituitary gland, located - inches behind the bridge o

your nose, was once reerred to as the master gland because

it directs all hormone secretion in the body, including, or exam-

ple, insulin, cortisol and adrenaline three notorious migraine

culprits.


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the science

High levels o estrogen and progesterone can deplete the body

o the mineral magnesium. Magnesium aects serotonin recep-

tors and has been ound to help regulate neuronal excitability,

as well as other migraine-related chemicals, such as nitric oxide.Thus, magnesium mitigates PMS symptoms as well as migraine

headaches.

Whats interesting about several o the oods that are triggers

or many migraineurs (e.g., chocolate, red wine, cheeses, pro-

cessed meats, MSG) is that each o them has a special detoxica-

tion pathway in the liver; a pathway that can easily be disrupted

by nutritional deciencies and gene abnormalities. For instance,

craving chocolate is oten linked to a zinc or magnesium de-

ciency, the two minerals that are most critical or proper DNA

replication via enzyme activation. I enzymes do not perorm as

designed, the results are mutated DNA strands and the eventual

expression o bad genes.

Cheeses oten contain molds. Mold toxins (known as mycotox-

ins) are directly linked to poor DNA replication and add a signi-

cant stress load on the liver. Processed meats contain sulphites,as do wines. Many people do not have adequate nutrients to aid

in the detoxication o sulphites. Molybdenum, a trace mineral

needed in only small amounts, can oten help this particular de-

toxication pathway.

To stop a migraine, each o these disrupted patterns must

be corrected Chemicals must be detoxied; genetic expres-

sion must be overcome with enzymatic co-actors (e.g., zinc and

magnesium); stress must be reduced; and insulin must be man-

aged with a hypoglycemic diet and proper nutrients.

I h Mdcao Curg h Hadachor Caug ?

Sometimes in the world o migraine, the treatment actually

makes the condition worse. Perhaps the most notable example

o this vicious cycle is Medication Overuse Headache (MOH), a

disorder caused by requent use o migraine medications.


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0 the science

You may know MOH by another name: the rebound headache.

How is overuse dened? More than - days per week, week

ater week, month ater month.

MOH creates a headache-worsening pattern more severe

headaches occurring more requently which, in a touch o

cruel irony, results in the need to take more medicine. Not only

is the pattern itsel harmul, but during this vicious cycle, oth-

er eective treatments are less likely to work. MOH is believed

to aect to percent o the general population, and is widely

considered to be the most common culprit behind the progres-

sion rom episodic migraine to chronic migraine.

While the mechanisms underlying MOH remain unknown, we

do know that opiates and triptans are associated with the de-

velopment o MOH. But thats not allover-the-counter medica-

tions can also cause MOH.

Research suggests that opiates and triptans may be triggering

neural adaptations in peripheral sensory bers (in acial regions,

or example) that innervate dura (brous membrane covering

the brain and spinal cord) that contribute to the increased re-quency and occurrence o migraine headaches. In other words,

overuse o these meds is actually causing neurons to change

over time, and worse, these neuroadaptive changes persist or

long periods o time and can continue to cause unpleasant e-

ects, long ater the medication is discontinued. These medica-

tions have also been shown to inuence gene-related peptides

(compounds o two or more amino acids) that regulate acial

trigeminal nerve cells. (, 9)

A large-scale Albert Einstein College o Medicine study o

migraine suerers showed that overusing medications contain-

ing narcotics (e.g., acetaminophen with codeine or Percocet) or

barbiturates (e.g., Fiorinal, Fioricet and Esgic) actually makes mi-

graine worse. Overuse o these medications is also associated

with an increased risk o transormed migraine (TM) headaches,

which are characterized by teen or more days o headache per


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month. NSAIDs (e.g., ibuproen and naproxen sodium) appear

to actually be protective against transition to TM or those su-

ering less than headache days per month, but create an in-

creased risk o transition to TM or those o us with high levelso monthly headache days (, 9).

Th Bg Pcur

I being migraine-ree is not enough reason or you to take

steps to improve your overall health and wellness, you should be

aware that several serious health problems have been strongly

linked to migraine.

Overweight people between the ages o 2 to 55 are1.

at higher risk or migraine attacks. Excess belly at

is thought to be a higher risk actor than abdominal

at. (Arca Acady o Nuroogy, 2)

While migraine without aura has been associated with some2.

increased risk or cardiovascular disease (CVD), migraine

with aura more than doubles the risk o heart attack and

CVD, increases the risk o angina by 1 percent, and morethan doubles the risk o death rom ischaemic stroke,

particularly or emales ages 45 or younger who smoke and

use contraceptives containing estrogen.

Women who have weekly migraine are signicantly more

likely to suer a stroke than those with ewer migraines or

no migraine at all. (Arca Acady o Nuroogy, 2),

(Its important to be note, however, that you can dramaticallylower cardiovascular risk actors by preventing hypertension,

hyperlipidemia [high cholesterol], and not smoking).

People with migraines may be more likely to develop3.

blood clots, a condition known as venous thrombosis

or thromboembolism. Blood clots limit blood ow and

cause swelling and pain. I they dislodge rom the vein

and travel to the heart and lungs, they can be atal.

Interestingly though, people with migraine have not been


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ound to be more likely to have hardening or narrowing

o the arteries (ahrocro) (, 2),

Depression, bipolar disorder, generalized anxiety, social4.

anxiety and panic attacks are highly comorbid with migraine,across all populations and age groups.

For example, studies show that teens who have migraine

are at greater risk or suicide; twenty percent were at

high risk o suicide. Nearly 5 percent o teen migraineurs

had one or more psychiatric disorders 21 percent

had Major Depression, 1 percent had panic disorder.

Teens who have migraine with aura were even more

likely to have psychiatric disorders and were six times

more likely to be at high suicide risk than those without

migraine (Arca Acady o Nuroogy, 2).

Now, Im not trying to scare you. But I do want to help you be-

come aware o the consequences o not nding the right treat-

ment or migraine. The simple reality is that symptoms, let

untreated, tend to escalate. Over time, they last longer and be-

come more severe. A person who might currently be subclinicalor migraine (i.e., doesnt meet the ull diagnostic criteria or mi-

graine) is at risk or developing ull-blown migraine attacks. As

symptoms progress and worsen, they become more difcult to

treat, which means that you will suer more and recovery will

take longer.

I o ak a cor ook a your ovra hah ad ?

I you ignore your migraine symptoms, or treat them solely

with medication (which can lead to rebound), your lie and your

health may become unmanageable. The key to migraine pre-

vention is pinpointing and treating the causes and triggers, rath-

er than simply continuing to treat the symptoms. As youll learn in

upcoming chapters, the rst step o migraine prevention is discov-

ering and understanding the unique physiology o your own body,

and learning to listen to what its trying to tell you.


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. I It All in the Gene?


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the science

in response to stimuli rom the outside world, such as environ-

mental inuences and how we treat our bodies.

Scientists have actually identied specic genes and pathways

that are aected by liestyle and geography. Environmental ac-

tors can play a huge role in turning genes on or o; so or ex-

ample, people who share the same genetic makeup but live in

dierent environments and treat their bodies dierently may

express genes dierently. We even have epigenetic genes that

control other genes; in other words, they can alter gene expres-

sion by silencing and regulating other genes (e.g., the KRAB-ZFP

amily o genes).The bottom line is that genes are never totally to blame or

our ortunes, good or bad. And we all have the capacity through

our thoughts and behaviors to alter gene expression. That

means you have plenty o opportunity to inuence your own

health and well-being. This is absolutely true o migraine.

Migraine genetics help explain why some people develop mi-

graine and some dont. Is there a single primary migraine gene?Possibly, but so ar, research suggests that migraine heritability

is multiactorial; in other words, we all inherit a mixture o sev-

eral gene variations, which can combine with external actors,

such as stress or toxic substances, to breed migraine.

Several emerging patterns in migraine genetics are beginning

to erase some o the mystery surrounding why some people

suer migraines and others dont. To illustrate how genes play

a role in causing migraine and other co-occurring disorders,

heres a sampling o what migraine research is teaching us

to percent o migraine suerers have a amily history o mi-

graines. (National Headache Foundation (NHF))

People with migraine oten have a parental history1.

o early heart attack and an increased risk o

high cholesterol and high blood pressure.

Studies show that teenagers rom low income households2.


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the science

with no amily history o migraine are more likely

to suer migraine than children rom upper income

amilies, a actor which may be explained by actors that

are associated with low socioeconomic status, such asstress, poor diet or limited access to medical care and

psychotherapy. In amilies with a history o migraine, the

rate o migraine among adolescents was nearly the same

between both high- and low- income groups, suggesting

that in those with a genetic or amilial history o migraine,

the biological predisposition dominates socioeconomic

actors (American Academy o Neurology, 2).The Cacnl1a gene has been strongly linked to both migraine3.

and epilepsy, which helps explain why epilepsy oten co-

occurs with migraine. This gene aects the movement

o calcium into and out o specic brain cells. Calcium

movement regulates the release o neurotransmitters

and plays a role in growth and regulation o cells.

The ion channels in the membrane o the migraineurs4.

neurons are ar more permeable and excitable than

the non-migraineurs. (Youll recall that migraine is a

state o neuron hyperexcitability.) One study o 4

migraineurs in Finland and Australia led to the discovery

o a mutation in a brain calcium-channel gene (1q23), a

gene with particularly strong links to emale migraineurs.

Several studies o this gene also showed that pulsating

and unilateral migraine pain may be directly linked

to specic genetic loci (locations). In other words,

there may be a genetic explanation or why pain is

unilateral in some suerers and pulsating in others.

Familial hemiplegic migraine type-3 (FHM3), a rare and5.

severe orm o migraine with aura that oten includes

a weakness or paralysis o one side o the body, is

caused by mutations in a sodium channel gene, SCN1A,


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which has also been linked to epilepsy. The calcium

channels o people with FHM3 have also been ound to

be hyperexcitable by even weak stimuli, which explains

their increased susceptibility to cortical spreadingdepression (CSD). (Vanderbilt University Medical Center)

A 2 University o Iowa study ound that an excess.

o a small protein called RAMP1 appears to turn up

the volume o a nerve cell receptors response to the

neuropeptide CGRP (calcitonin gene-related peptide),

which is elevated during migraine and long believed to be

involved in causing migraines. Researchers investigatedCGRP receptors in the trigeminal nerve (responsible or

relaying almost all sensory perception), including pain

and touch or the ront o the head, and ound that

migraineurs may have subtle genetic dierences in the

RAMP1 gene that increase levels o RAMP1 protein.

Around 3 percent o patients with migraine with.

aura have a patent oramen ovale (PFO), a deect in

the wall between the two upper (atrial) chambers

o the heart that is present in everyone beore birth

but seals shut in about percent o people.

Can you nd out i you have any o these genetic propensities?

Sure. You can have your personal genome mapped or between

$ to $.

But beore you get out your checkbook, you might want to

ask yoursel this: Do I really want to know everything I could be

at risk or? Even i you understand that genes are not destiny,

knowing that you are at high risk or a debilitating illness could

conceivably cheat you out o a quality lie. And gene scans can-

not tell you with certainty whether or not you will develop a

particular illness because scientists dont yet know all the pos-

sible gene variations which may contribute to (or, on the ip


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8 the science

side, protect us rom) a particular illness. Also, its difcult to

measure the degree to which other actors (e.g., liestyle ac-

tors) will contribute to or prevent that illness.

Can We Alter Gene Expreion?

Gene research is beginning to ocus on epigenetics. Epige-

netics reers to a change in gene expression that is caused by

something other than a change in the underlying DNA code.

The epigenome sits on top o the genome. These epigenetic

marks tell your genes to switch on or o, to express them-

selves strongly or weakly. It is through epigenetic marks thatenvironmental actors such as liestyle and stress can make an

imprint on genes that will be passed rom one generation to the

next.

Were beginning to identiy genes that actually have epige-

netic unctions. For example, the KRAB-ZFP amily o genes is

involved in regulating the expression o other genes and ulti-

mately, helping us deal with stressors. The KRAB-ZFP genes,which are believed to have appeared airly recently on the evo-

lutionary scale, serve as epigenetic censors, selectively silencing

the expression o other genes (Trono, 9).

Oten, several dierent genes may be involved in slightly in-

creasing or decreasing risk o developing a particular illness.

It is believed that these repressor genes make up about

percent o our genetic material, and vary rom person to per-

son. This variability in the KRAB amily o regulators, or exam-

ple, helps explain why some people are predisposed to anxiety

or depression and some are not, or why some people might be

predisposed to migraine and others arent.

Epigenetic alterations are oten long-lasting or even perma-

nent, so your personal history can have a lasting impact on

your genetic expression either positively or negatively, and

that epigenetic alteration can be passed along to subsequent


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generations. For example, some studies show that liestyle

choices like smoking and overeating can change epigenetic

marks in a manner that causes the genes or obesity to express

themselves too strongly and the genes or longevity to expressthemselves too weakly. So bad liestyle choices not only shorten

your lie, they may also predispose your current and uture chil-

dren to disease and shorter lives.

Epigenetic changes are biological responses to environmental

pressure stressors. I the environmental pressure is removed,

the epigenetic marks will eventually ade and those genes will

revert to their original expression. For better or worse, yourliestyle and environment will have an impact on how your

genes express themselves.


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The Therapie

PART

. Landing on the Chiropractor

Table


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the therapies

Ill admit, I was skeptical about chiropractic. I viewed it as a

rather strange proession, unknown (to me) and unconvention-

al. For the most part, I had always viewed my health, ailments

and treatments, in conventional terms. I went to see conven-tional doctors, I ate conventional oods and I hoped that con-

ventional treatments would help me.

Pain drove me to the chiropractors ofce. Pain drove me to

open my eyes and mind to possible treatments beyond conven-

tional medicine. I went because I had to.

My back was killing me no matter what position I arranged

mysel in and I had to eel better ast. Working in the ast-paced mortgage industry, at the end o the most recent hous-

ing boom, I had closings to manage, phone calls to juggle. I had

to be able to hold mysel erect at a desk or -9 hours straight.

Waiting or the pain to go away on its own was not an option.

And I simply did not want to take another drug. I knew over-

the-counter painkillers wouldnt do the trick, and I did not want

yet-another prescription drug.

A riend suggested I see a chiropractor. In his opinion, those

physicians were more skilled at interpreting X-rays than pri-

mary healthcare practitioners; I wouldnt have to see an end-

less string o specialists just to have a good set o diagnostic

X-rays explained to me. I would save time and could be back at

my desk aster. And when youre in pain, you absolutely want to

save time.

It was then that another riend recalled a chiropractor reliev-

ing her back pain, but also shared how a ew visits resulted in

her not getting any more hangovers. Upon hearing her obser-

vation, I stopped in my tracks. I had already known or a while

that the physiological mechanisms or a migraine and a hang-

over were similar. Well, normal people have to really overdo

the imbibing to get a hangover. For me, one glass o wine was

oten all it took to land me in bed, nauseated, suering


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the therapies

a throbbing migraine. Now, you may laugh, but I actually ound

mysel clinging hopeully to the notion o cured hangovers.

Perhaps a chiropractor could cure my migraines!

I wasnt exactly expecting a shaman when I came in, but I

took mental notes. My rst visit didnt eel like a typical visit

to the doctors ofce. It stood in stark contrast to my usual -

minute consultation with a medical doctor who ew in with his

laptop, barely even glancing at me as I detailed my symptoms.

What Ive since learned is that many people preer chiropractic

physicians to medical doctors because chiropractors are oten

perceived as more sensitive and responsive to their needs.Patients report that chiropractors they see are less hurried,

more sympathetic, more communicative, and are more likely to

treat them as equals. (, 97)

These humanitarian considerations are important in all as-

pects o patient care in every physician-patient relationship, but

theyre especially crucial or migraineurs. Theres oten little

objective inormation to report in their cases and the subjective

actors are critical to accurate diagnosis and treatment. Phy-

sician studies o dissatised patients show that those patients

usually want more diagnostic tests but do not want to see the

same doctor again. Why? Because the doctor had ailed to pro-

vide an adequate explanation o their problem the rst time.

( , 96)

Th pa do ru hr docor. Prhap you cara?

My chiropractor inspired trust on my rst visit. As he treat-

ed my lower back, in acute pain at the time, and then adjust-

ed my cervical (neck) vertebrae, he inquired i I had questions

and then spent time with me, answering them. I learned that

my body was aging, and that my lumbar spine was in the ear-

ly stages o degenerative disk disease. I was also told that my


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the therapies

neck muscles were ropy. But I was oered hope and encour-

agement, instead o another drug prescription.

My chiropractor stressed the importance o regular exercise

and a healthy diet. I was given exercises or strengthening and

stretching the tight muscles around my neck, upper back and

below the skull and encouraged to incorporate regular physical

activity into my liestyle.

Upon leaving the chiropractors ofce, I had to demonstrate

that I knew exactly what my proper posture should look like.

The goal was to retrain my body; specically to re-train my

cervical spine musculature and lower back muscles to betterserve me during normal bodily movements. The goal was to re-

duce biomechanical stress on my spine. For example, contract-

ing your lower back muscles with the technique o abdominal

bracing will help stabilize your lumbar spine. I you have weak-

nesses in your lumbar spine, like I do, its worth exploring.

These were my rst attempts at changing bad habits I had ac-

quired over the years.

The word wellness popped up in the conversations a ew

times. The idea o ocusing on wellness, on health rather than

illness, was an entirely new concept to me. And what did well-

ness actually mean? Im not sure I knew at the time. But what

I instinctively elt was that it had been many years since Id ex-

perienced it. And those ropy neck muscles Was it possible that

they could have anything to do with the headaches Ive experi-

enced since my teenage years? Could there be a connection?

There was an obvious link, I understand now, that no other doc-

tor had ever pointed out to me beore. No book I ever read on

headache recommended spinal manipulation.

Ater a ew visits to the chiropractor, I resolved to quit the an-

tidepressant medication, prescribed to me or the treatment o

migraines. It was not my chiropractic physicians advice. I sim-

ply had to see or mysel - and I had a new hope to hang onto.


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the therapies

What Can Chiropractic Do For Headache?

Chiropractic care relieves mechanical and unctional stress o

the bodys muscular and skeletal systems. In conjunction with

dietary changes, regular exercise, and your personal commit-

ment, chiropractic care can dramatically improve your overall

health.

Mechanical and unctional stressors can play a role in migra-

nous symptoms, thus, chiropractic treatment, especially when

supplemented with massage therapy, may eectively treat

these symptoms, as well as pain related to cervicogenic and

tension headaches. Chiropractic has been proven to decreasethe intensity, duration, and requency o migraine syndrome.

Both peripheral and central nervous systems are susceptible

to noxious mechanical and chemical stimulation. But what does

that mean to the migraine suerer, and how can chiropractic

help?

Lets say that your body is under chronic postural strain you

might even be totally unaware o it, like I was. The result is thatyour muscles grow increasingly tighter, and that tightening im-

pacts vascular and mechanical systems in your neck and head.

All our bodily systems are closely intertwined, and imbalance in

one inevitably inuences the others.

Migraines always have a vascular component headaches oc-

cur when blood vessels in your head become inamed. My head,

or example, was slightly turned to the right or years, and

I started experiencing severe migraines, always in the let hemi-

sphere o my head.

Migraine is also the disruption o normal neurological unc-

tioning. There is one trigeminal and two upper cervical nerves

on each side o your head and neck. These nerves supply ar-

eas o the skin along the base o the skull and behind the ear

and join with other nerves outside the skull to orm a continu-

ous net. Typically, the upper cervical nerves ollow a curving


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course that passes through various muscles in the upper back,

neck and head; in many, these nerves pass through the cervi-

cal spine musculature. When the migraine mechanism becomes

activated, pain impulses travel via the trigeminal and/or up-per cervical nerves. Since theres one o these nerves supplying

each side o your head, your migraine may be unilateral or one-

sided.

Another actor is nutrition, which well discuss more thor-

oughly in PART III. Pro-inammatory diets have also been known

to produce migraine symptoms. Nociceptors are sensory nerve

bers which, once irritated by noxious mechanical or chemi-cal stimuli, can cause headaches that either are, or can mim-

ic, classic migraine headaches. The medical term used or this

phenomenon is sensitization. Typically, nociceptors have a high

threshold or nerve impulse activity; in other words, a signi-

cant aggravating stimulus is required or these nerve bers to

re or respond. Under normal physiological conditions, they re-

main relatively silent.

Pro-inammatory diets change the composition o your body

chemistry with increased production o arachidonic acid and

prostaglandins both powerul drivers o inammation. Persis-

tent production o these chemicals can sensitize nociceptors

by lowering the nerves ring threshold. Thus, normal unc-

tional daily activities that are not typically painul may become

increasingly difcult to perorm because o this painul sensiti-

zation phenomenon.

I you nd that your migraines are consistently diet-driven like

mine were, what it means is that your body is (consistently) try-

ing to communicate a message to you.

For any given migraine headache, the cause may be musculo-

skeletal or dietary or both. Thats why chiropractors use a ho-

listic treatment approach, and thus improve your overall health.

And what they most certainly dont do is merely treat your


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symptoms with a drug. Its not enough to temporarily allevi-

ate the symptom. The goal is to pinpoint and treat the primary

cause o any imbalance(s) and help your body restore itsel to

better health.

What the Science Say

Several clinical trials have shown that spinal manipulation is

eective in treating migraine. In one study o people with mi-

graines, percent o those who received chiropractic manipu-

lation reported a greater than 9 percent reduction o attacks

and 9 percent reported a signicant reduction o the inten-

sity o each migraine. In another study, people with migraine

were randomly assigned to receive spinal manipulation, a daily

medication Elavil (amitriptyline), or a combination o both. Spi-

nal manipulation, interestingly, was as eective as Elavil in re-

ducing migraines. And in nine other studies these researchers

reviewed, chiropractic was as eective as medications in pre-

venting migraine headaches. (, )A recent clinical trial at Australias Macquarie University indi-

cated that 7 percent o migraine suerers experienced either

substantial or noticeable improvement ater a period o chiro-

practic treatment. Around percent o these patients showed

noticeable improvement either lower requency o migraines,

shorter duration, or a signicant reduction in the use o medi-

cations. (This last result is important because some migraine

medications have serious side eects and can even trigger re-

bound headaches.)

Around percent showed substantial improvement (more than

6 percent o their symptoms were reduced during the course o

chiropractic treatment). Whats most impressive about this result

is that this was a chronic group. Eighteen years was the average

length o time theyd had migraines. A change o this magnitude

in chronic migraineurs is quite amazing.


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Despite impressive clinical trial results like these, however,

some medical practitioners still dispute the ability o chiroprac-

tic care to help migraine suerers. Be orewarned: Youre going

to bump into this. Youll probably nd that most medical doc-tors are not likely to reer you to a chiropractor, no matter how

loudly your symptoms scream that you might need a spinal ad-

justment. Unortunately, many medical doctors have a long-held

bias against chiropractic. And organizations like the American

Medical Association (AMA) only uel that controversy. Doctors o

chiropractic, ater all, are not among dues-paying members o

the AMA.Some medical doctors simply dont have a ull picture o what

chiropractic can do. But a proessional discussion between a

doctor o chiropractic and your medical doctor regarding the

clinical ndings and treatment plan, may help your medical doc-

tor eel better about making that reerral.

There is great diversity among chiropractors.

The chiropractic proession includes specialties, such as:

Diagnosis and Internal Disorders (Chiropractic Internist; the

chiropractic equivalent o a primary care physician)

Orthopedics

Neurology

Chiropractic Physiological Therapeutics and Rehabilitation

Chiropractic Acupuncture

Diagnostic Imaging (Radiology)

Nutrition

Occupational Health

Sports Physician

Chiropractic Pediatrics

Its important to take the time to nd a chiropractor youre

comortable with, and get results rom.


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Wha o Expc Fro a Chropracc Evauao or Mgra

The chiropractor will use his/her hands, X-ray or other ad-

vanced diagnostic imaging modalities to analyze your spine and

determine i you have any unctional musculoskeletal problems.

Since migraineurs experience dierent symptoms, a chiropractor

will need to evaluate several aspects o your health. In order

to determine the right course o treatment to help relieve your

specic migraine syndrome, chiropractors should assess the

ollowing:

Investigating the history o your present1.

illness, as well as your amily history

Determining whether the headaches are part o a2.

migraine syndrome or another type o headache

Evaluating the type and source o pain; or example,3.

a neuromuscular evaluation, as well as liestyle or

environmentally-related causes, such as diet, exercise,

sleep, nutrition, personal or proessional stress

Musculoskeletal triggers, such as head-neck posture4.

(this is an issue that plagues many, including me),

prolonged static positions and requent repetitions

(e.g., car mechanics or data entry operators)

Evaluating untreated visual acuity problems,5.

such as myopia (nearsightedness)

Assessing whether head pain is a symptom o a more.

ominous problem, such as brain tumor, intracraniallesion, astrocytoma, vascular bleed, or concussion

Assessing whether temporomandibular joint (TMJ).

disorder may explain some migraine-like symptoms.

TMJ syndrome is a painul, acute or chronic

inammation o the temporomandibular joint,

which connects the mandible (jaw) to the skull.


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What to Expect From Treatment

Your chiropractor is likely to rst address any mechanical

or neuromuscular dysunction o cervical and upper thoracic

vertebrae, such as:

Range o motion

Muscle spasm

Joint dysunction

Postural stress

Correcting unbalanced structure takes tremendous stress o

the body. Using special mechanical techniques, your chiroprac-

tor will perorm a chiropractic spinal adjustment to correct any

spinal mechanical dysunction that may be necessary, which

helps to restore joint unction, relax musculature, and loosen

tight ligaments, moving you one step arther rom migraines

crazy neural ree-or-all.

A standard chiropractic treatment approach might include:

Mobilization

Manipulation

Traction

Stretching and exercise

Correcting unhealthy posture

Eliminating aggravating activities

Passive modalities such as ice, heat,

topical ointments, ultrasound

Obviously, youll have to rely on the chiropractor or ma-

nipulation. But notice that many o these treatments are sel-

treatments, and a good chiropractor can advise you on how to

sel-treat or maximum eect; or example, stretching, exercise,

posture sel-correction and eliminating pain-inducers can be e-

ective. Sometimes, the simplest tactic creates amazing results.

It is not suggested here that chiropractic will cure every


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migraineurs headaches. For many migraine suerers, chiro-

practic is only one piece o the cure puzzle, not be the be-all,

end all migraine treatment. Chiropractic might not necessar-

ily cure your migraines orever, especially i you have severe,chronic migraine symptoms. But or a signicant percentage o

migraineurs, the neck region is a contributing actor, and or

those people, chiropractic treatment can be essential. The odds

are pretty good that competent chiropractic will oer some lev-

el o relie. And something else: Theres very little to lose.

Chiropractic generally has no side eects and treatment is

considered extremely sae; however, your chiropractor shouldcertainly exercise caution in treating the cervical spine. A thor-

ough history, examination, and imaging, as indicated, are neces-

sary prior to treatment.

Most likely, the worst that could happen is that you might

be a little sore or a ew hours, depending on the rigorousness

o the treatment, and how severe your problem is going into

treatment.


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. In Morpheu Arm (Sleep)


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Eventually, the news Id been dreading came: I was laid o

rom my job, sent home with a couple months severance pay.

But little did I know that the layo would be a blessing in

disguise.

It was an emotionally turbulent time in my lie. I was too de-

pressed to actually enjoy my time o rom work. Some days,

I didnt even eel like getting out o bed. But I took advantage

o my predicament. I had time on my hands, so I rested. I read

a lot. I did some research. I hadnt had the luxury o ree time

since high school. All those years, Id never even taken a realvacation. As an immigrant to the US, I was always ocused on

making it here, getting ahead.

But guess what? My body started responding almost immedi-

ately to getting lots o rest. I had ewer headaches... yet, I still

didnt make the connection between sleep and migraine right

away.

While the stress o the workweek wore o by Friday night,I sometimes couldnt even enjoy the weekends because they

were spent in the grip o a weekend migraine. The stress

might go away on Friday night, but the migraines would come

back with a vengeance on Saturday.

Part o the solution was changing my sleep schedule. Instead

o staying up late and sleeping in late, keeping a regular sleep

schedule helped deeat the headaches.

Looking back on my lie now, its clear that Id been sleep-de-

prived since high school. Some people seem to get by with less

sleep (though, arguably, no one really gets by with it), but

not a migraine suerer. Migraineurs never get away with sleep

deprivation.

Getting adequate sleep and quality sleep is one simple

step that everyone can take today to start beating migraine.


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I you were a girae, youd only need hours sleep. (Wouldnt

that be great?) Pythons, on the other hand, need hours sleep

per day. How much sleep do humans need? Adults need 7-

hours; adolescents, 9- hours; and babies, 6- hours.

Contrary to popular myth, we do not adapt to getting less

sleep than our bodies actually need. And worse, the amount o

sleep we need increases when weve been deprived o sleep.

What Doe Sleep Actually Do For You?

Quality sleep improves the brains ability to learn, remember

inormation, maintain emotional stability and make decisions;

thus, sleep deprivation impairs learning, memory and thought

processes. Sleep has a tremendous impact on our ability to

properly assess a situation and make wise decisions. Sleep de-

privation can be particularly dangerous when you have to make

high-stakes decisions, which, in a twist o irony, are the very

decisions that tend to keep us awake at night!

Sleep consolidates memory. Fresh impressions o daily events

are rst stored as short-term memories in the brains hip-

pocampus, then moved within hours (or days) usually during

deep, dreamless sleep into the an area in the cerebral cortex

known as the neocortex, or new bark, where they are stored

in long-term memory. Sleep also strengthens and reinorces our

procedural or how to memories (e.g., learning musical compo-

sitions), as well as declarative or what memory (e.g., learningnew words or concepts).

Sleep deprivation is a notorious migraine trigger and it eeds

mental health problems such as depression and anxiety, which

can urther exacerbate stress, and ultimately trigger more re-

quent and more intense migraines.

Youre probably already aware that sleep has a dramatic im-

pact on mood. Insufcient sleep makes you irritable and tired

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and more likely to have trouble with relationships. Chronic in-

somnia makes us more vulnerable to depression (and depression

makes us more vulnerable to insomnia). Sleep deprivation can

make you seem and eel depressed (e.g., irritable, moody,apathetic, at) and rachet up anxiety levels. Why?

Because youre less mentally and physically capable o cop-

ing with daily stressors. And sleep deprivation inuences over-

all neurotransmitter imbalances and uctuations, including the

eel-good neurotransmitter serotonin that is responsible or

eelings o well-being, calmness, personal security, relaxation,

condence and concentration.Some o the brains serotonin is converted in the pineal gland

to melatonin, an antioxidant hormone that regulates sleep pat-

terns and helps you get a good nights sleep. Frequently called

the hormone o darkness, melatonin regulates our circadian

rhythm (sleeping and waking) patterns: It tells the body when

its time to sleep. The bodys natural levels are high during the

evening and low during the day.

Melatonins antioxidant properties help ght the damage

wreaked on us by ree radicals; or example, melatonin can help

stop wear-and-tear damage to DNA.

Melatonin has been shown to decrease headache requency

and intensity and help reduce analgesic and triptan consump-

tion. In addition to what the body produces naturally, some mi-

graineurs take melatonin supplements to ght jet lag, mitigate

seasonal aective disorder and regulate nighttime dementia.

But its important to be aware that melatonin supplementa-

tion is not without its share o controversy. Recent research

suggests that excess melatonin may actually be hurting you at

night. Memories o the days events are consolidated during

sleep, and melatonin directly inhibits memory ormation. And

one recent study by Louisiana State University chemists sug-

gests that melatonin reacts with ree radical chemicals in the

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body to orm unhealthy metabolite compounds that can contrib-

ute to disorders such as depression. LSU researchers claim that

the antioxidant properties o melatonin are modest at best and

that metabolizing excess melatonin may cause more harm thangood.

A in all thing, balance i the key!

Sleep deprivation also increases

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Cure Your Migraines the Natural Way