Curing Migraines: What causes them and medical treatment available.

Migraines: Causes and triggers

Migraines are headaches that cause severe, throbbing pain, along with nausea, vomiting, and sensitivity to light or sound. Migraine headaches usually last for between four (4) and seventy-two (72) hours. Many people experience symptoms, called "auras," before their migraine starts that signal one is coming on.


What causes a migraine?
Though tests are inconclusive most researchers believe that migraines are due to an imbalance of hormones and chemicals produced in the brain. When the levels of these hormones or chemicals increase they lead to inflammation. This inflammation then causes the blood vessels in the brain to swell and press on nearby nerves, causing pain. Persons with migraines can usually tell when when an attack is coming on and can identify what is called triggers that cause migraine pain.


What are migraine triggers?
A migraine trigger is anything that causes the onset of migraine symptoms which include headaches, nausea, etc.

Some migraine triggers:

• Stress  - When stressed the human body produces a surge of hormones. These hormones temporarily increase your blood pressure by causing your heart to beat faster and your blood vessels to narrow. Headaches due to high blood pressure affect both sides of the head. The headache pain tends to pulsate and often gets worse with physical activity. Studies reveal high blood pressure can cause headaches because it affects the blood-brain barrier. How? Hypertension results in excess pressure on the brain, which can possibly cause blood to leak from the blood vessels into the brain. What is called an edema (swelling) occurs which causes the brain to swell and because it is contained in the skull, its hard bone casing, there is no space for the brain to expand and this leads to a build up of pressure. This causes edema, or swelling, which is problematic because the brain sits within the skull and has no space to expand. This symptoms of this are a headache, dizziness, nausea, confusion, weakness, seizures, and blurred vision. Symptoms that are usually associated with a migraine.

• Hunger - Fasting, eating high-sugar foods, dieting too rigorously, and skipping meals can all potentially cause a headache or migraine. Irregular eating hours affects the body and brain causing a drop blood-glucose (low blood sugar). Headaches produced from going without food are often quite severe and accompanied by mild nausea. Sound familiar? There is also similar symptoms of missing a meal and the early warning signs (auras) of a migraine attack, such as: yawning, sweating, headache, a craving for sweet things, and mood changes.

• Alcohol, especially red wine - Red wine contains a group of flavanoids known as tannins. These substances gives red wine its drying quality. The more tannins a wine has, the more it will dry out your mouth after you sip it. Some studies show that tannins may boost production of the brain chemical serotonin, and the sharp increase of this hormone triggers migraines in persons who suffer from them.  

• Fermented foods, citrus and nuts - These foods contain two (2) substances called tyramine and phenylethylamine. They are hormones which can be found naturally in foods and belong to a group of enzymes called monoamines also known as monoamine oxidase (MAO). They usually appear in fermented foods such as: 
• Aged cheese (blue cheese, brie, moldy cheese)
• Smoked fish
• Cured meats (Also note that most cured meats contain nitrates or nitrites, examples of cured meats are pepperoni, salami, sausages, lunch meats, and hot dogs
• Chocolate
• Vinegar (white and red)
• Soy food products

How does Tyramine and Phenylethamine cause headaches:

1. Tyramine - it causes nerve cells in your brain to release the chemical norepinephrine. Having higher levels of tyramine in your system along with an unusual level of brain chemicals can cause changes in the brain that lead to headaches.
2. Phenylethylamine - It functions as a neurotransmitter that gives you heightened focus, attention, goal-directed behavior, and task-completion. Combined with its mood elevating effects, these attributes are why supplementation with PEA can bring about increased get-up-and-go, enhanced sense of well-being, and optimal cognitive performance. Moreover, PEA amplifies the actions of other key brain chemicals – serotonin, dopamine, norepinephrine, and acetylcholine. As such, PEA is thought to slow down the rate at which your brain and body age, extend health span, and increase longevity. Unfortunately there are many persons whose bodies are not able to deal with this substance in their system. Phenylethylamine can initiate migraine-type headaches in susceptible individuals. Migraine sufferers have a reduced ability to properly break down all monoamines (so that nutrients can be absorbed), but particularly phenylethylamine. Phenylethylamine readily crosses the blood-brain barrier and thus could be a mediator of the cerebrovascular disturbances seen in migraine attacks.

• Foods that have monosodium glutamate - MSG is a key ingredient in certain seasonings, baking mixes, bouillon, stuffing mixes, Chinese food, frozen foods, processed meats, prepared soups, and condiments.

• Birth control pills or estrogen replacement therapy - Migraines are more common in women than in men, especially during the reproductive years of a woman's life. The main reason for this is the role of the female sex hormone, oestrogen, therefore a woman's menstrual cycle can be a significant migraine trigger. Oestrogen and progesterone (fertility hormones), and the physical and chemical processes that go towards producing them, all have a widespread effect on the body and as the contraceptive pill is made up of similar hormones there will be correlating effect on your migraines.

Medical Treatments

There are various studies that recommend various methods of treating migraines. Some doctors investigate whether or not this illness is hereditary. You may have a family history of migraines. It may be wise to find out if there are members of your family who suffer from it. The doctor may need to know this information to help determine treatment that may be able to help you.

Find out from the affected family member: 

1. When the migraine's first appeared (e.g. childhood or adulthood)?
2. What triggers their headaches?
3. How severe are the symptoms?
4. Have they sought treatment?
5. What treatments have been effective or provided relief of symptoms?

If you have been diagnosed with migraines medical options that can be prescribed for you. They fall into two (2) major categories:

1. Pain-relievers or pain-killers
2. Preventative medications

Pain-relievers (pain-killers)

These are taken to stop symptoms of the migraine during an attack. Drugs such as Aspirin, Ibuprofen (Advil, etc), and Acetaminophen are usually taken for mild migraines. There is also the Excedrin Migraine, a drug which is a combination of caffeine, acetaminophen and aspirin, which is specifically designed for your migraine but only if the headache is moderate. 

While each of these drugs are effective in their own way they cannot alleviate severe migraine headaches, and best used in the short term. All drugs (including Advil) pose additional problems if taken over a longer period of time. Over-exposure to these drugs can cause:

• ulcers
• gastrointestinal bleeding
• medication-overuse headaches

Other Pain-killers

Triptans - These drugs, often used to treat migraines cause the blood vessels to constrict, therefore blocking the pain pathways in the brain. Triptans do provide temporary pain relief for headaches. They are available in pill form, nasal spray and injections. Unfortunately, persons taking Triptans may also experience side-effects such as nausea, dizziness, drowsiness and muscle weakness. Triptans are not safe for persons who are at risk of strokes and heart attacks.

Opioids - These drugs contain narcotics such as codeine, so though effective in treating migraine are highly addictive, and are only used if other medications fail to provide relief.

Glucocorticoids (prednisone, dexamethasone) - These drugs are used in tandem with other medication to help relieve pain, but doses are restricted to prevent side-effects.

Preventative medications

Preventative meds are used for persons who experience more severe, debilitating pain:

• that last longer than 12 hours
• occur four (4) or more times a month
• regular pain-killers can't help
• migraines include longer aura or numbness and weakness

Beta-blockers - Though commonly used to treat high-blood pressure and heart disease, these drugs have been noted to have an effect on migraines, reducing the frequency and severity of the attacks.

Antidepressants - Drugs such as Tricyclic Antidepressants  may prevent migraine by affecting the level of serotonin in the brain and has been proven to be effective against the onset of migraine attacks. Now don't go rushing off to your doctor demanding that he or she gives you antidepressants for your migraines. Amitriptyline is the only tricyclic proven to effectively prevent migraines and even then, they are called antidepressants for a reason. Please note you may experience side-effects such as:

• sleepiness
• dry mouth
• weight gain;
• and even constipation

Some antidepressants such as SSRIs may even worsen or trigger headaches in some patients.

So far we have explored the medical approach to dealing with migraine headaches. Have you noticed anything? No? Well let us break it down for you. These drugs, though used for treating migraines, only provide temporary relief. They do not cure you of your migraines. You should also note that the drugs only treat the symptoms or release chemicals that inhibit or prevent symptoms before they begin but neither the pain-killers or preventive meds cure you of the illness, once you stop taking the drugs, there is a strong possibility the symptoms will return. Most significant however, is the fact that when taken for a long period of time, they will probably produce side-effects that are just as or even more devastating on your health than the migraines themselves!

Talk to your doctor about symptoms and how you can get them under control. Thanks for reading this article. God bless!

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References

WebMD. What are Migraines? https://www.webmd.com/migraines-headaches/qa/what-are-migraines
WebMD. Migraine headaches: what are the characteristics of migraine triggers? https://www.webmd.com/migraines-headaches/qa/what-are-the-characteristics-of-migraine-triggers
WebMD. Tyramine and migraines. https://www.webmd.com/migraines-headaches/tyramine-and-migraines
Integrative Psychiatry. The many health benefits of PEA (Beta-Phenylethamine) - Your brain's natural stimulant. https://www.integrativepsychiatry.net/blog/the-many-health-benefits-of-phenylethylamine-pea-your-brains-natural-stimulant/
McCulloch J, Harper AM. Integrated Psychiatry. "Phenylethylamine and cerebral blood flow. Possible involvement of phenylethylamine in migraine." 1977 Sep;27(9):817-21. https://www.integrativepsychiatry.net/blog/the-many-health-benefits-of-phenylethylamine-pea-your-brains-natural-stimulant/
Mayo Clinic. Stress and high blood pressure: What's the connection?https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/stress-and-high-blood-pressure/art-20044190
Nall, Rachell. Medical News Today. "Can high blood pressure lead to headaches?". https://www.medicalnewstoday.com/articles/322451.php
The Migraine Trust. Hypoglycaemia. https://www.migrainetrust.org/about-migraine/trigger-factors/hypoglycaemia/
Web MD. Some kinds of Red Wine may not trigger migraines. https://www.webmd.com/migraines-headaches/news/20120620/some-kinds-red-wine-may-not-trigger-migraines
The Migraine Trust. Migraine and the contraceptive pill. https://www.migrainetrust.org/living-with-migraine/coping-managing/contraceptive-pill/
Office of Women's Health. Migraine. https://www.womenshealth.gov/a-z-topics/migraine
Mayo Clinic. Migraine- Diagnosis and treatment. www.mayoclinic.org/diseases-conditions/migraine-headache/diagnosis-treatment/drc-20360207