Follow Sharron on Twitter

Sharron's book is now available at Amazon www.amazon.com, Barnes and Noble www.barnesandnoble.com, and wherever books are sold. The book can be purchased in print form or ebook format.

Conari Press, an imprint of Red Wheel/Weiser, LLC  is the publisher of Sharron's book, Migraine: Identify Your Triggers, Break your Dependence on Medication, Take Back Your Life -  An Integrative Self-Care Plan for Wellness," released June, 2013. Follow Sharron on Twitter @murraysharron, and her page Sharron Murray, MS, RN on Facebook, for tips to help you battle your migraines and achieve wellness.

 

Sunday
Mar162014

EFFECTIVE SUPPLEMENTS FOR MIGRAINE RELIEF

 

In general, our nutritional needs should be met through a healthy diet. However, for many of us with migraine, maintaining a healthy diet that meets our nutritional needs is a challenge. Food and beverage triggers, food cravings, nausea and vomiting, and comorbid diseases with diet restrictions of their own can limit our selection of items and absorption of nutrients.

You might want to ask your doctor for a referral to a nutritionist to help plan your diet and recommend appropriate supplements to avoid nutritional deficiencies if you

  • Find the task of selecting items suitable for your needs overwhelming
  • Have a number of comorbid diseases, and/or
  • Have poor renal or liver function.

That said, many of us seek help for migraine and headache relief through supplements, along with herbs and other complementary therapies, for additional reasons, including 

  • Dissatisfaction with our conventional medical treatment,
  • Unpleasant side effects from medications, and
  • The expense of medications.  

The most common supplements (nutraceutical options) we use to prevent and treat our migraine attacks are

  • Magnesium,*
  • Riboflavin (Vitamin B2),*
  • Coenzyme Q10 (CoQ10),* and
  • Fish oil.  

Keep in mind, while evidence for the effectiveness (efficacy) of some of these supplements is increasing, more research is necessary to establish evidence-based guidelines for others. That said, let's take a closer look at each of them.

Magnesium

Magnesium is a mineral in our bodies that is important for a number of functions, including

  • Protein synthesis,
  • Neuromuscular function,
  • Regulation of nerve cells (calms our nervous system)
  • Regulation of blood sugar
  • Maintenance of vessel tone (keeps our blood vessels from going into spasm), and
  • Regulation of the neurotransmitter, serotonin.

A number of studies have shown that people with migraine have low levels of brain magnesium during attacks. As well, many sources report that we may have lower levels of serum magnesium than others. Additional reasons that may be associated with magnesium deficiency are

  • A diet lacking in magnesium (foods high in magnesium include whole, unprocessed foods such as green, leafy vegetables, nuts, wheat germ, bananas, soy products, milk, and unrefined grains),
  • Alcohol intake as may deplete magnesium from the body,
  • Caffeine intake as may deplete magnesium from the body,
  • Menstruation as levels drop right before onset, and
  • Comorbidities that may also exhibit magnesium deficiency such as mitral valve prolapse, anxiety disorders, and epilepsy.

Symptoms of magnesium deficiency include irritability, agitation, anxiety,confusion, insomnia, restless leg syndrome, muscle spasms, twitching, seizures, weakness, poor coordination, nausea and vomiting, irregular heart rate and rapid heart rate.

Although the most common side effect of magnesium replacement is diarrhea, you should be aware that too much magnesium can lead to toxicity. Symptoms may include hypotension, flushing, slow heart rate, lethargy, drowsiness, respiratory paralysis and death.

As well, you need to know that many medications can interfere with blood levels of magnesium such as diuretics, some antibiotics, calcium channel blockers and other blood pressure medications, chemotherapy drugs, steroids, hormone replacement therapy, and digoxin. In addition, if you have poor renal function you must be careful with magnesium intake as you are unable to excrete excessive amounts via your kidneys. 

Riboflavin (Vitamin B2)

Riboflavin is a water-soluble vitamin that is important for a number of functions in our body, including

  • The breakdown of proteins, fats, and carbohydrates, and
  • Maintenance of the body's energy supply.

It is thought that mitochondrial dysfunction (mitochondria generate the energy for other cells to do their jobs, including those in the brain) and impairment of energy production, may play a role in migraine pathophysiology (Sun-Edelstein and Mauskop, 2011). Some studies have shown that riboflavin, through enhancing mitochondrial function, may help decrease the frequency and severity of migraine attacks. 

Foods high in riboflavin include milk, cheese, eggs, nuts, enriched breads and cereals, whole grains, mushrooms, sweet potatoes, and leafy green vegetables.

Side effects of riboflavin replacement are thought to be minimal. Apart from bright yellow urine, diarrhea may occur.

Coenzyme Q10 (CoQ10)

Coenzyme Q10 is a vitamin-like substance found throughout the body that is thought to

  • Provide energy to cells, and
  • Have antioxidant effects.

Because of its role in mitochondrial function and energy generation, it is believed to work against migraine in much the same way as riboflavin.

Mild side effects of CoQ10 replacement may include loss of appetite, nausea, vomiting, diarrhea, and rash.

Because some sources report that CoQ10 may decrease blood pressure, you should discuss the use of this supplement with your doctor if you are taking

  • High blood pressure (antihypertensives) medications like captopril, diltiazem, and many others.
  • Preventive medications for migraine like beta blockers and calcium channel blockers that may affect your blood pressure.

Because some sources indicate CoQ10 may  increase the risk of bleeding when taken with drugs that increase bleeding, you should discuss this supplement with your doctor if you are taking drugs like advil, ibuprofen, and naproxen. As well, you should discuss this supplement with your doctor if you are taking Coumadin, which is used to slow blood clotting, since CoQ10 may interfere with the effectiveness.

Fish Oil (Omega-3)

Fish oils come from fatty fish. Fatty fish are believed to contain omega-3 (Eicosapentaenoic acid). EPA is thought to

  • Reduce inflammation and swelling,
  • Relax blood vessels, and
  • Inhibit platelet clumping (blood clotting).

Fish richest in EPA are those that inhabit deep, cold water such as tuna, salmon, trout, sardines, herring, and mackeral.

Some studies have suggested that omega-3 may help to decrease the frequency and severity of migraine attacks by affecting prostaglandin levels and serotonin activity.

Because EPA is thought to inhibit platelet clumping, it should not be taken with other blood thinning herbs and medications without your doctors approval. As well, it should be discontinued one-two weeks prior to surgery, or other invasive procedures that may cause bleeding. Please check with your doctor for specific directions.

*You should know that the evidence-based guidelines for NDAIDS and other complementary treatments for episodic migraine prevention in adults have been retired by the AAN Board of Directors on September 16, 2015, due to serious concerns with a preventive treatment butterbur, recommended by this guideline.  Retired guidelines are no longer considered valid and are not supported by the AAN. Retired guidelines remain on their website for reference use only.

Note:

This article is part of the series "Bridging The Gap Between East and West: Principle II: Herbs, Supplements, and Medications For Maintaining and Restoring Optimal Health With Migraine." 

Sharron :).

References:

Murray, S., M.S., R.N. Migraine:Identify Your Triggers, Break Your Dependence on Medication, Take Back Your Life. San Francisco: Conari Presss, 2013.

NIH  National Institute of Health. (2011, October 21). Co-enzyme Q-10: MedlinePlus Supplements. Retrieved March 18, 2014 from http://www.nlm.nih.gov/medlineplus/druginfo/natural/938.html.

Sun-Edelstein, C., M.D., & Mauskop, A., M.D. (2009). "Foods and Supplements in the Management of Migraine Headaches". Clin J Pain. Volume 25, Number 5. pp 446-452. Retrieved from www.clinicalpain.com.

Sun-Edelstein, C., M.D., & Mauskop, A. M.D. (2011). "Alternative Headache Treatments: Nutraceuticals, Behavioral and Physical Treatments". Headache. March, 2011. pp 469-483.

Sharron is a health and wellness author. A person with migraine herself, her most recent book is "Migraine (see references)".

Follow Sharron on twitter @murraysharron, her Facebook page: Sharron Murray, MS, RN and her website www.sharronmurray.com.

This article is not intended as a substitute for medical advice. If you have specific concerns about your health or nutrition, please consult a qulaified health professional.

Updated February, 8th, 2016

Copyright 2014, Sharron E. Murray 

Sunday
Mar092014

EFFECTIVE HERBS FOR MIGRAINE RELIEF

 

"Attack is often a word associated with migraine, and for good reason. If you suffer from headaches or know someone who does, you are well aware of its crippling nature" (Ahn and Goadsby, 2013).

It is this "crippling nature" of the headache phase of the migraine attack, which may or may not respond to medications, or as in my case cause us to take too much medication, that drives several of us to seek out complementary therapies like herbs and supplements. Because many of us use herbs and supplements in combination with medications, we need to be aware of interactions between the three and how to use them safely and effectively. 

Keep in mind, that while studies about the benefits of a number of herbs and supplements for migraine treatment and prevention are increasing, information about herb-supplement-drug interactions is limited. If you are pregnant or breast-feeding, have comorbid diseases or chronic conditions, and/or are taking over-the-counter (OTC) or prescription medications, you should always consult with your doctor before augmenting your migraine treatment program. As well, you need to be aware that any herbs or supplements that affect blood clotting should be discontinued at least one-two weeks prior to surgery or other invasive procedures that may cause bleeding, such as extensive dental work. Please check with your doctor for specific directions. For more information about how to use herbs safely, please see "Herbal supplements: What to know before you buy".

As well, remember that herbs, supplements and medications are only one part of an effective treatment plan for migraine. Many sources indicate that the foundation of any approach to migraine management, holistic or otherwise, should include trigger management, a healthy diet and nutrition, exercise, and healthy lifestyle habits to be successful. Perhaps Dr. Steven Herzog, M.D., member of the American Academy of Neurology (AAN) and medical director of the Headache Insitute at Texas Neurology in Dallas says it best when speaking about the migraine management puzzle. In an article in Neurolgy Now (Shaw, 2012) he is quoted as saying, "Lifestyle modifications such as exercise, good nutrition, and avoiding triggers-along with complementary therapies such as certain vitamins and supplements all have their place."

HERBS

Herbal medicine has been practiced for centuries in numerous cultures throughout the world. Today, there are a number of herbal preparations available OTC as tablets, capsules, gels, sprays, ointments, tinctures, elixirs (essential oils) and teas that are used to prevent and treat migraine attacks. Some of the more common ones, include:

Butterbur (Petasites hybridus)*

  • Thought to have anti-inflammatory properties
  • Believed to have an effect on vessel spasm and blood flow to the brain.
  • Side effects may include headache, indigestion, fatigue, nausea and vomiting, constipation or diarrhea.
  • Should not be used if you have kidney or liver disease, without your doctor's approval (butterbur plant contains pyrrolizidine alkaloids, which are carcinogenic and hepatotoxic so best to use products that are certified and labeled "PA-free").

Feverfew (Tancetum parthenium)*

  • Believed to have anti-inflammatory properties. 
  • Thought to inhibit platelet clumping (blood clotting), influence serotonin levels, and affect vessel tone.
  • Side effects may include abdominal pain, gas, nausea and vomiting, diarrhea, and nervousness.
  • May increase bleeding times so should not be taken with other blood thinning herbs and medications such as aspirin and Coumadin, without your doctor's approval.

Ginkgo Biloba

  • Thought to inhibit platelet clumping and affect blood flow to the brain.
  • May also have ant-inflammatory properties.
  • Side effects may include dizziness, upset stomach, diarrhea, mouth sores, or irritation around the mouth.
  • May affect insulin and blood sugar levels so should not be taken if you are diabetic, without your doctor's approval.
  • Like feverfew, it should not be taken with other blood thinning herbs and medications, without your doctor's approval.

White willow bark (Salix alba)

  • An analgesic with anti-inflammatory properties similar to aspirin.
  • Side effects are similar to aspirin and include stomach upset, ulcers, bleeding, ringing in the ears, and inflammation of the kidney.
  • Should not be taken with other analgesics or nonsteroidal anti-inflammatory drugs (NSAIDs), without your doctor's approval.
  • Should not be taken with other drugs or herbs with blood thinning properties, without your doctor's approval.
  • May make beta blockers and diuretics less effective.
  • May increase blood levels of phenytoin (Dilantin).
  • Should not be taken if you are allergic to aspirin.
  • Should not be given to children as they may develop Reye's syndrome (a disorder that damages the liver and the brain).

Turmeric (Circuma longa)

  • Thought to have anti-inflammatory properties.
  • Thought to inhibit platelet clumping and affect blood flow to the brain.
  • Should not be taken with any other blood thinning herbs and medications without your doctor's approval. 

Ginger (Gan Jiang)

  • Is a calming herb with ant-inflammatory properties like aspirin.
  • May inhibit platelet clumping and affect blood flow to the brain.
  • Thought to help with nausea.
  • Should not be taken with other blood thinning herbs and medications, without your doctor's approval. 

Cayenne (Capsicum frutescens)

  • The main ingredient, capsaicin, is believed to have anti-inflammatory properties that may interfere with sustance P  (a neuropeptide thought to be involved in the pathophysiology of migraine).
  • Thought to affect blood flow to the brain.
  • Should not be taken with other blood thinning  herbs and medications, without your doctor's approval.

 Peppermint (Mentha piperita)

  • Is a calming herb with anti-inflammatory properties.
  • Is also a nasal decongestant and may relieve the sinus congestion associated with migraine.
  • May help with nausea and vomiting.

Lemon balm (Melissa officinalis), Valerian (Valeriana officinalis), and Skull cap (Scutellaria lateriflora)

  • Thought to help with muscle relaxation and sedation.
  • Should not be taken with opioids (narcotic), combination drugs that contain opiods and/or barbiturates, muscle relaxants, or other CNS depressants without your doctor's permission as can increase your risk for respiratory depression, hypotension, coma, and accidental overdose.

*You should know that the "Evidence-based guidelines update: NSAIDs and other complementary treatments for episodic migraine prevention in adults" have been retired by the AAN Board of Directors on September16, 2015, due to safety concerns with a preventive treatment, butterbur, recommended by this guideline. Retired guidelines are considered to be no longer valid and no longer supported by the AAN. Retired guidelines will remain available on their website for reference only. 

Chinese Herbs

Chinese herbs are classified as balancing, cleansing, or regenerating tonics, medicinal herbs, and potent medicinal herbs. Tonic herbs are used to support organ network functioning and prevent imbalances. Medicinal herbs are used to correct organ network imbalances and alleviate illnesses. Potent medicinal herbs are powerful healing agents used by licensed practitioners to treat more serious illnesses.

Herbs that may be used by a licensed practitioner to treat migraine may include chrysanthemum, angelica sinensis (Don Quai), gardenia, skullcap, motherwort, abalone shell, gamber vine, gastrodia, and China root. It is important for you to know that a variety of herbs are often combined into formulas unique to the individual. Therefore, they should not be transferred from one person to another as a combination that does not match your individual diagnosis and symptoms can be harmful. As well, to avoid interactions, your doctor should be aware of all the prescribed herbs you are taking and your practitioner should have a list of your medications.

Sharron:).

Note:

This article is part of the series "Bridging The Gap Between East and West: Priciniple II: Herbs, Supplements, and Medications For Maintaining and Restoring Optimal Health With Migraine". 

References:

Ahn, A.,H., M.D., PhD. & Goadsby, M.D., Ph.D. (2013). "Migraine and Sleep: New Connections." Cerebrum. Nov-Dec; 2013: 15 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3997296/ 

Bravo, T.P., & Vargas, B.B. (2015). "Migraine Preventative Has Safety concerns" Neurology Times". January 28th.  http://www.neurologytimes.com/headache-and-migraine/migraine-preventative-butterbur-has-safety-concerns 

Murray, S.,M.S., R.N. Migraine: Identify Your Triggers, Break Your Dependence on Medication, Take Back Your Life. San Francisco: Conari Press, 2013.

Shaw, G. (2012). "Heading Off Migraine: What's the evidence for non-pharmaceutical approaches?" Neurology Now, Volume 8 -Issue3 - p 23-30. doi: 10.1097/01.NNN.0000415690.22156.f6 from http://journals.lww.com/neurologynow/Fulltext/2012/08030/Heading_Off_Migraine__What_s_the_evidence_for.17.aspx

Sharron is a health and wellness author. A person with migraines, her most recent book, "Migraine: Identify Your Triggers, Break Your Dependence on Medication, Take Back Your Life-An integrative Self-Care Plan For Wellness" (2013), is a Conari Press publication.

Follow Sharron on twitter @murraysharron, her Facebook page: Sharron Murray, MS, RN and her website: www.sharronmurray.com.

This article is not intended as a aubstitute for medical advice. If you have specific concerns about your health or nutrition, please see a qualified health care professional.

Updated February 8th, 2016

Copyright 2014, Sharron E. Murray

 

 


 

 

 

 

 

 

Friday
Nov222013

AHA/ACC DIETARY GUIDELINES TO REDUCE CARDIOVASCULAR RISK: APPENDIX FOR PRINCIPLE I -DIET AND NUTRITION FOR OPTIMAL HEALTH WITH MIGRAINE

 

"Let food be thy medicine and medicine be thy food." Hippocrates 

November 12, 2013, the American College of Cardiology/American Task Force on Practice Guidelines published the AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk. These guidelines include lifestyle recommendations for diet.

Because recent studies have shown a correlation between migraine, cardiovascular disease, and hypertension, along with an increased risk of stroke, these guidelines are important for us to know. But, before we get to them, let's refresh our knowledge and take a brief look at the definitions of cardiovascular disease and hypertension.

CARDIOVASCULAR DISEASE (CVD)

The American Heart Association (AHA) defines cardiovascular disease as heart and blood vessel disease. Also called heart disease, many of the disorders involved are related to atherosclerosis. Atherosclerosis develops when plaque builds up in our arterial walls. Plaque consists of fat, cholesterol, calcium and other substances found in our blood. Accumulation of plaque is believed to narrow our arteries and make it difficult for blood to flow through. Eventually, an area of plaque can rupture and cause a blood clot to form. If the clot is large enough, it blocks the flow of blood.

Heart Attack

When a clot forms and blocks a blood vessel in the heart, it is called a heart attack. If the clot completely blocks off a vessel, the portion of heart muscle supplied by that artery starts to die. A large amount of damage to the heart muscle can affect the pumping action of the heart. This can lead to heart failure. Without treatment, the bodys' need for oxygen and nutrients may be compromised.   

Stroke

If blood flow to the brain is blocked, an ischemic stroke can occur. In this case, the portion of the brain supplied by the vessel involved will begin to die. A hemorrhagic stroke happens when a blood vessel in the brain breaks (ruptures). According to the National Stoke Association, hypertension is the most important risk factor for stroke.

It is important to know that although brain cells that die from lack of oxygen cannot be replaced, injured brain cells can be repaired with rehabilitation. In this way, functions like speech, memory and motor power can improve.

Hypertension

To understand hypertension, we need to take a brief look at the physiology of blood pressure. Blood pressure is the force of blood pushing against our arterial walls. For a person over 18, an optimal blood pressure is considered to be 120/80 or lower. The top, or systolic, number is a measurement of the force our blood exerts on our arterial walls when our heart pumps. The bottom, or diastolic, number is the force our blood exerts on our arterial walls when it rests between beats.

Hypertension, or high blood pressure (stage one hypertension) is a measurement of 140/90 or higher. High blood pressure makes our hearts work harder to pump blood through our bodies. This can cause our blood vessel walls to thicken and deteriorate. Besides stroke, it can lead to a number of other problems like heart attack, heart failure, and kidney failure.

Relationship between cardiovascular disease, hypertension and migraine

Although more research is necessary, endothelial dysfunction and hypercoagualability, as well as pathological reactivity, have been reported as important findings in people with migraine. We should know that endothelial cells form the inner lining of our blood vessels and provide an anticoagulant barrier between our vessel walls and our blood. In addition, these cells react with physical and chemical stimuli in our circulation and help regulate homeostasis, vasomotor tone, and immune and inflammatory responses. Injury of these cells results in many pathologic states including atherosclerosis, loss of membrane function and clot formation.

Dietary Recommendations to Reduce Cardiovascular Risk

Keeping all of these things in mind, let's take a look at the dietary recommendations to reduce cardiovascular risk. Overall, dietary patterns, rather than individual dietary components, are emphasized as foods are typically consumed in combinations rather than individually. Two dietary patterns, along with their relationship to health outcomes, that have been identified based on expert evidence are the DASH (Dietary approaches to stop hypertension) and Mediterranean (Med)  patterns

That said, let's examine the diet recommendations for lowering low-density lipoprotein (LDL) cholesterol, and the diet recommendations to lower blood pressure.

Diet recommendations for lowering (LDL) cholesterol are:

  • Consume a dietary pattern that emphasizes intake of vegetables, fruits, and whole grains; includes low-fat dairy products, poultry, fish, legumes, nontropical vegetable oils and nuts; and limits intake of sweets, sugar-sweetened beverages, and red meats.
  • Adapt this dietary pattern to appropriate calorie requirements, personal and cultural food preferences, and nutrition therapy for other conditions including diabetes mellitus (type 2 diabetes). *For those of us with migraine, we would add migraine disease here.
  • Achieve this pattern by following plans such as the DASH* dietary pattern, the USDA* (US Department of Agriculture)) Food Pattern, or the AHA* (American Heart Association) Diet.

 *The DASH diet is high in vegetables, fruits, low-fat dairy products, whole grains, poultry, fish, and nuts; and low in sweets, sugar-sweetened beverages, and red meats. It is also low in saturated fat, total fat, and cholesterol and rich in potassium, magnesium, calcium, protein, and fiber.

*The USDA diet suggests choosing a variety of foods from the five major groups: grains, vegetables, fruits, protein foods, and dairy products and limiting oils, solid fats, and added sugars.

*The AHA diet suggests an overall healthy dietary pattern that includes a variety of fruits and vegetables, whole-grain products, low-fat dairy products, skinless poultry and fish, nuts and legumes, and nontropical vegetable oils. As well, saturated fat, trans fat, sodium, red meat (the leanest cuts possible), sweets and sugar-sweetened beverages should be limited.

Diet recommendations for lowering BP are the same as those for lowering LDL cholesterol with the addition of lower sodium intake:

  • Choose foods with less sodium and prepare foods with little or no salt.
  • Consume no more than 2,400 mg/day of sodium.
  • Further reduction of sodium intake to 1,500 mg/day is desirable since it is associated with an even greater reduction in BP.
  • If you can't meet these goals at the moment, reducing sodium intake by at least 100 mg/day can lower BP.

*Most of the sodium we consume is in processed foods. Therefore, it seems best to avoid them.

Maintaining a healthy diet is one of the most difficult, but important, things we can do to help decrease the frequency of our migraine attacks and reduce our risk for the development of cardiovascular disease, hypertension, and stroke (if we have a family history of these disorders, our risk is even greater). If you find the task of selecting foods suitable for your needs overwhelming, have a number of comorbid diseases, or have poor renal or liver function, you might want to ask your doctor for a referral to a nutritionist to help plan your diet and recommend appropriate supplements to avoid nutritional deficiencies and further organ damage. 

References:

American Heart Association. (2011)."What is Cardiovascular Disease?" https://www.heart.org/HEARTORG/Caregiver/Resources/WhatisCardiovascularDisease/What-is-Cardiovacular-Disease_UCM_301852_Article.jsp#.VrOTUr 

Eckel, H.,E., et al. (2013, November 12). "2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk: a Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". Circulation.  http://circ.ahajournals.org/

National Stroke Association. (2013). "High Blood Pressure (Hypertension)". http://www.stroke.org/

Mancia, G., et al (2011). "Hypertension and migraine comorbidity: prevalence and risk of cerebrovascular events: evidence from a large, multicenter, cross-sectional survey in Italy (MIRACLES study)." Journal of Hypertension, Vol 29, No 2. Lippincott Williams & Wilkins. DOI:10.1097/HJH.0b013e3283410404  

Schurks, M., S., et al. (2009). "Migraine and cardiovascular disease: systematic review and meta-analysis."  BMJ. 2009;339:b3914.  http://www.bmj.com/content/339/bmj.b3914.long

Sumpio, B., E., Riley, J.,T., and Dardik A. (2002). " Cells in focus:endothelial cell." Int. J. Biochem Cell Biol. Dec;34(12): 1508-12. http://www.ncbi.nlm.nih.gov/pubmed/12379270 

Sharron is a health and wellness author. A person with migraines herself, her most recent book is "Migraine: Identify Your Triggers, Break Your Dependence On Medication, Take Back Your Life-an integrative self-care plan for wellness: San Francisco: Conari Press, 2013

Follow Sharron on twitter @murraysharron her Facebook page: Sharron Murray MS, RN and her website www.sharronmurray.com 

This article is not intended as a substitute for medical advice. If you have any specific concerns about your health or nutrition, please consult a qualified health care professional.

Updated February 4th, 2016

Copyright 2013, Sharron E. Murray

 

 

 

 

Monday
Oct142013

BRIDGING THE GAP BETWEEN EAST AND WEST: PRINCIPLE I - DIET AND NUTRITION FOR MAINTAINING AND RESTORING OPTIMAL HEALTH WITH MIGRAINE

 

EASTERN MEDICINE

In Eastern medicine, what we eat is thought to affect our health more than anything else. For example, along with natural healing properties and nourishment, foods are believed to influence the balance of energy in our bodies:

  • warming foods like meat, poultry and dairy are thought to have a stimulating effect, 
  • cooling foods such as fruits, vegetables, and liquids are thought to have a calming effect, and  
  • neutral foods like fish, whole grains, nuts, legumes, beans and seeds can be eaten anytime.

The selection of foods is based on the individual's needs to bring about an optimal state of wellness. For example, if you're tired, sluggish or depressed and tend to get chilled easily, the consumption of warm foods may increase your energy. On the other hand, if you tend to be hyperactive and get overheated, cooling foods may be more appropriate for you. 

Other guidelines to foster wellness include:

  • favor whole, organic and seasonal foods, with the larger portion to include a variety of fruits, vegetables, fish and whole grains.  
  • minimize the intake of dairy, meat, foods high in saturated or trans fats, and those full of sugar, salt and cholesterol, along with caffeine and alcohol.
  • avoid processed foods and those with additives, chemicals, preservatives, pesticides, and artificial colors and sweeteners.

WESTERN MEDICINE

In Western medicine, what we eat tends to focus on the amount of calories, carbohydrates, protein, fats, vitamins, and minerals in a given food. Even though the current food guidelines include fruits, vegetables, grains and proteins, with the larger portions being vegetables and grains, our diet often revolves around our lifestyle and can include:

  • fast foods,
  • junk food,
  • sugar and sweets,
  • salty foods,
  • fatty, greasy and fried foods, and
  • processed and packaged foods that contain additives, chemicals, preservatives and artificial sweeteners.

Comorbidities

The foods we consume are often associated with diseases and disorders like diabetes, hypertension, stroke, heart attack, gastric reflux, gastritis, irritable bowel syndrome, pancreatitis, cirrhosis, gallstones, celiac disease, hemorrhoids, allergies, inflammatory responses, cancers, and obesity. Some of these diseases and disorders may be comorbid for many of us with migraine.

In particular, we are believed to be at risk for development of disorders like hypertension, heart disease, stroke, and obesity. If we have fat around our belly (large waistline or "apple shape"), our risk for cardiovascular disease increases. As well, although migraine may not be directly linked to diabetes, we need to be aware that increased fat around our belly can lead to insulin resistance, an elevation in our blood glucose levels, and diabetes. In addition, if we have a family history of these diseases, our risk is intensified.

Food and beverage triggers

Along with the dietary issues that may be associated with our individual comorbidities, our diet and nutrition may be complicated by food and beverage triggers, which may precipitate our migraine attacks. Although numerous, subjective (often without scientific evidence), and unique to the individual, some of the more common ones are believed to include:

  • chemicals in the foods and beverages we ingest and/or the chemicals, additives, preservatives, pesticides, and artificial colors and sweeteners that are added to the product. Examples include: tyramine (cheeses, bananas, avocados, nuts, peanut butter, canned soups, soy sauce), alcohol, caffeine, phenylethylamine (chocolate), sulfites (fermented beverages and wines), nitrites (bacon, ham), and aspartame.  
  • gluten, a type of protein found in wheat, barley, rye and to a lesser degree oats. It may be added to a number of processed foods as a stabilizer, emulsifier, thickener, starch or hydrolyzed protein. Examples include: salad dressings, sauces, seasoned rice mixes and snack foods, beer, self-basting poultry, vegetables in sauce, soups, and pasta.
  • MSG, a sodium salt derived from glutamic acid. It may be added to a number of foods like sauces, gravies, processed meats, packaged foods, and canned soups and vegetables to enhance flavor. 

Food cravings

Even if we do not have food and beverage triggers, food cravings, especially for simple carbohydrates that may contain fat and salt, as well as sugar, may add to the complexity of dietary management and increase our risk for hypertension, stroke, heart attack, obesity and diabetes. These may be related to:

  • low serotonin levels that occur with alterations of this neurotransmitter during our migraine attacks.
  • fluctuations in our hormone levels with our menstrual cycle and other hormonal changes (serotonin levels increase with estrogen levels and drop with estrogen levels).
  • fluctuations in blood glucose levels that may occur late in the day or early evening, or with fasting or skipped meals.
  • low magnesium levels that may be associated with triggers like alcohol and caffeine (deplete magnesium from the body); a drop in magnesium levels right before the onset of menstruation; and some studies have shown that, along with low brain magnesium during attacks, we may have low systemic magnesium levels.

Examples of foods and beverages that we may crave include: starches and sugars like pasta, potato chips, chocolate, candies, ice cream, cakes, cookies, and sodas. When we reach for these foods and beverages to satisfy our cravings, we can exacerbate the fluctuations in serotonin and magnesium levels, and the dips and peaks in our blood glucose levels.

EAST MEETS WEST -EAT TO BE WELL

Keeping in mind the dietary issues I have shared with you and how they impact those of us with migraine, here are some guidelines that have helped me achieve optimal health with migraine and that you might want to take into consideration:*  

1. Avoid your known personal triggers. I have found that by following the remaining guidelines, some of the unknowns were taken care of for me.

2. Avoid processed and packaged foods and those with additives, chemicals, preservatives, pesticides, and artificial colors and sweeteners.

  • In Eastern medicine, it is thought that what isn't excreted from the body as waste can accumulate as toxins and lead to disease. 
  • In Western medicine, many of these packaged and processed foods contain possible triggers like sulfites, nitrites, MSG, gluten, and aspartame. As well, although debatable in the literature, some of these ingredients are thought to be neurotoxins and carcinogens. In addition, although more studies are necessary, with frequent consumption artificial sweeteners are thought to be associated with weight gain, metabolic syndrome (3 or more of: blood pressure >135/80 mmHg; fasting blood glucose >100 mg/dl; large waist circumference -men>102cm, women >89cm; low high density lipoprotein or HDL cholesterol -men <40mg/dl, women <50 mg/dl; triglycerides >150mg/dl), type 2 diabetes, and cardiovascular disease.

3. Avoid fast food; junk food; refined foods and sweets with white four and sugar; rich and creamy sauces; greasy and fatty foods; high fructose corn syrup; hydrogenated oils; fermented foods and beverages; sodas; and, hot and spicy foods. Minimize intake of dairy products and red meat.

  • In Eastern medicine, many of these are thought to lead to a sluggish digestive system and the accumulation of damp phlegm (mucus); and/or, cause an excess of liver fire to accumulate and rise to our heads. 
  • In Western medicine, apart from being migraine triggers for many of us, a number of these foods contain fat, salt, and sugar that can contribute to fluctuations in our serotonin levels, weight gain, hypertension, and increased total cholesterol, triglyceride and blood glucose levels. 

4. Avoid or minimize consumption of caffeine and products that contain caffeine such as coffee, tea, sodas, diet sodas, and chocolate.

  • In Eastern medicine, stimulants are thought to create imbalance and disharmony in our body, mind, and spirit. 
  • In Western medicine, apart from being triggers and stimulants for many of us and interfering with our sleep, some of these products can contain fat and sugar. This can contribute to fluctuations in our serotonin levels; weight gain; and, increased total cholesterol, triglyceride, and blood glucose levels. In addition, it is thought that caffeine can deplete magnesium from our bodes.
  • Caffeine (including caffeine in medications) withdrawal can contribute to morning migraines. If you are sensitive it is best to avoid after 2 pm.  

5. Avoid or minimize alcohol intake.

  • In Eastern medicine, alcohol consumption is thought to contribute to imbalance and disharmony in our body, mind, and spirit.
  • In Western medicine, although alcohol is a CNS depressant, some studies show that it has both stimulating and depressant effects in humans. Increased heart rate and aggression are associated with stimulation and, for some people, stimulating effects appear to be more rewarding than sedative effects. As well, alcohol is thought to contribute to fluctuations in serotonin levels, can deplete magnesium from our bodies, and may interfere with sleep.

6. Eat wholesome organic foods with no antibiotics, growth hormones, pesticides, additives, preservatives, artificial colors, or flavors.

  • If organic fruits and vegetables are too expensive or difficult for you to obtain, whenever possible substitute natural foods and beverages that are minimally processed and have no artificial ingredients, added colors, chemicals, or preservatives. 
  • Thoroughly wash non-organic fruits and vegetables in salt water or a fruit and vegetable wash to remove chemicals and pesticides.

7. Eat a variety of fresh fruits, vegetables, whole grains (breads and cereals), beans, legumes, fish, and poultry to help prevent fluctuations in your serotonin levels and curb food cravings (caution as beans and some fruits and vegetables like strawberries, tomatoes, and spinach may be a trigger for you).

8. Eat whole, unprocessed foods such as green leafy vegetables, avocados, bananas, dried fruit, nuts, fish (halibut), low-fat dairy (yogurt), wheat germ, peanut butter, rice, sunflower seeds and unrefined grains to maintain magnesium intake (caution as avocados, bananas, yogurt, dried fruits, nuts, peanut butter, and sunflower seeds may be triggers for you).

  • Chocolate (which may explain why we crave it) is also high in magnesium but it is also high in fat. If chocolate isn't a trigger for you (we may experience chocolate craving as a premonitory factor and may not be a trigger), try to have a small piece of high quality, anti-oxidant rich dark chocolate rather than milk chocolate, which may have more calories and fat.

9. Favor fiber-rich foods such as leafy green vegetables, parsley, onions, brown rice, bran, carrots, celery, asparagus, papaya, pineapple, cherries, grapes, prunes, and fresh herbs and spices such as ginger, oregano, rosemary, cilantro, dill, sage, mint, and turmeric to help with digestion and elimination (caution as onions, papaya, pineapple, and prunes may be triggers for you).

10. If necessary, eat small, regular meals (5-6 times a day) to prevent food cravings, and dips and peaks in blood glucose levels, from getting out of control (hypoglycemia can trigger a migraine attack).

  • Include protein at every meal or snack to help slow digestion and moderate fluctuations.

11. Eat your breakfast before 9 a.m., lunch before 1 p.m., and dinner before 7 p.m.

12. Avoid fasting and skipped meals to avoid fluctuations in blood glucose levels and hypoglycemia.

13. Stay hydrated with water as dehydration can trigger a migraine attack (8-10, 8 ounce glasses a day is suggested but you may need more with heat and exercise).

Maintaining a healthy diet is one of the most difficult, but important, things we can do to help decrease the frequency of our migraine attacks and reduce our risk for development of diseases and disorders like hypertension, stoke, heart disease, obesity, and diabetes. If you find the task of selecting foods suitable for your needs overwhelming, have a number of comorbid diseases, or have poor renal or liver function, you might want to ask your doctor for a referral to a nutritionist or dietitian to help you plan your diet and recommend appropriate supplements avoid nutritional deficiencies and further organ damage. 

 *from "Migraine: Identify Your Triggers, Break Your Dependence On Medication, Take Back Your Life -An Integrative Self-Care Plan For Wellness"

Sharron :).

Updated, December 3, 2015

References:

Reubin, A. et al. (2013). "Stimulant and Sedative Effects of Alcohol." Current Topics in Behavioral Neurosciences, Volume 13, pp 489-509.

Swithers, S., E., (2013). "Artificial sweeteners produce the counterintuitive effect of inducing metabolic derangements." Trends in Endocrinology and Metabolism xx, from http://dx.doi.org/10.1016/j.tem.2013.05.005.

Sharron is a health and wellness author. A person with migraines herself, her most recent book, "Migraine: Identify Your Triggers, Break Your Dependence on Medication, Take Back Your Life -An Integrative Self-Care Plan For Wellness" (2013), is a Conari Press publication.

Follow Sharron on twitter @murraysharron, her Facebook page: Sharron Murray, MS, RN and her website www.sharronmurray.com.

This article is not intended as a substitute for medical advice. If you have specific concerns about your health or nutrition, please consult a qualified health care professional.

Copyright 2013, Sharron E. Murray

 

 

 

 

 

 

 

Tuesday
Sep242013

BRIDGING THE GAP BETWEEN EAST AND WEST: FIVE PRINCIPLES FOR MAINTAINING AND RESTORING OPTIMAL HEALTH WITH MIGRAINE

 

Eastern medicine is a naturalistic philosophy of health and medicine that looks at the interrelationship of our body, mind, and spirit. Every human being is considered unique. The patient and the doctor work together to maintain and sustain good health. The focus of the relationship is on the prevention of disease and the concept of wellness. This requires an individual to take responsibility for his/her own health and to maintain a healthy lifestyle that includes diet, exercise, and practices such as meditation to reduce the effects of stress and balance the energy centers in his/her body.

In his book "Secrets of Self-Healing" (Avery, 2008), Dr. Ni lists five principles for self-healing and wellness that provide powerful tools for maintaining and restoring optimal health. These five principles are:

  • diet and nutrition
  • herbs and supplements
  • exercise and acupressure
  • lifestyle and environment
  • mind and spirit. 

Today, in Western medicine, along with the diagnosis, treatment, and prevention of symptoms and diseases, most physicians and health care personnel acknowledge the relationship between an individual's diet, lifestyle, exercise and level of stress to his/her health. Besides medications, medical procedures, and surgeries, a variety of relaxation and behavioral treatments and therapies are part of treatment plans for a number of illnesses to promote, maintain and restore good health.

In her article "Migraine Research", Dr. Dawn C. Buse reports that people with migraine can live healthy, productive lives with an effective treatment plan that includes a proper diagnosis, medical care, and

  • acute and preventive pharmacological therapies 
  • non-pharmacological therapies such as biofeedback, relaxation training, cognitive behavioral therapy, meditation, guided visual imagery, and yoga 
  • a healthy diet
  • healthy lifestyle habits like regular sleep/wake schedules and exercise, adequate hydration, no smoking, moderate caffeine intake, and
  • trigger management.

Given this information, let's take a closer look at these principles and concepts and, from a perspective of Eastern and Western medicine, apply them to migraine disease. Keep in mind that we are individuals, who are unique in our triggers, symptoms, comorbities, and risk factors for the progression of episodic to chronic migraine, as well as risk factors for the development of numerous other diseases and disorders.

That said, there are five principles that have helped me revert from chronic migraine and medication overuse headaches (MOH) to infrequent episodic migraine. In addition, these five principles have been instrumental in maintaining and restoring my optimal overall health. They are:

  1. Diet and nutrition
  2. Herbs, supplements and medications
  3. Exercise
  4. Lifestyle habits
  5. Mind and spirit

In subsequent articles, I share each of these principles with you in more detail, along with research studies that support scientific efficacy. 

Sharron is a health and wellness author. A migraine sufferer herself, her most recent book, "Migraine Identify Your Triggers, Break Your Dependence on Medication, Take Back Your Life -An Integrative Self-Care Plan For Wellness", (2013), is a Conari Press publication.

Folow Sharron on twitter @murraysharron, her Facebook page: Sharron Murray, MS, RN, and her website www.sharronmurray.com.

This article is not intended as as a substitute for medical advice. If you have specific concerns about your health or nutrition, please consult a qualified professional.

Updated, February 1, 2016

Copyright 2013, Sharron E. Murray