Source: LE (Life Extension) Magazine, February 2004
By Romy Fox
Almost everyone gets a headache once in a while, and for most people an aspirin or two is usually enough to make it go away.
But for 45 million Americans, the headaches keep coming back—monthly, weekly, and even daily. By the numbers, the problem of recurrent headaches is quite serious. Every year, headache-driven absenteeism and medical expenses cost the US some $50 billion. Americans spend more than $4 billion a year just on over-the-counter headache pain relievers.(1)
A Headache “Sampler”
Tension headaches account for about three-quarters or more of all headaches. “Tension-type” headaches produce mild-to-moderate pain on both sides of the head. The pain is steady and comes gradually rather than all at once, and later fades away. Tension headaches are commonly associated with stress, but also may be linked to emotional problems such as depression. Most tension headaches respond to standard over-the-counter painkillers.
Cluster headaches arrive in groups. For days, weeks, or even months on end, they strike one or more times a day. Each headache may be relatively brief, lasting perhaps 30 to 90 minutes. The pain begins mildly, but quickly becomes unbearable. One side of the face at a time is typically affected, with the pain centering around the eye on the affected side. Some 1 million Americans suffer from cluster headaches, which typically attack men; 90% of victims are male, with most in their twenties, thirties, and forties.
Exertion headaches are linked to physical activities such as exercise, sex, laughing, and coughing. They often strike during or just after strenuous activity. While not considered dangerous per se, exertion headaches may indicate a stroke or other problem and therefore should be brought to the attention of a physician immediately.
Organic headaches are messengers telling you that something is amiss, and that could be anything from elevated blood pressure to a brain tumor. The headache pain may be accompanied by fever, neck stiffness, confusion, difficulty in speaking or moving, or other symptoms. The pain tends to grow worse, either increasing with each headache or striking more frequently. Organic headaches account for fewer than 1% of all headaches.
Other kinds of headaches, such as those associated with hangovers, constipation, and low blood sugar, often can be cured by attacking their underlying causes.
Because headaches can signal a serious underlying illness, it is best not to self-diagnose them. If you experience unexplained, unusual, or particularly severe headaches, if they strike more often or in different ways than in the past, or if your headaches are associated with any other symptoms, you should consult your physician immediately.
Magnesium helps support the muscles, including those surrounding arteries, to relax, and this may be why a deficiency of this mineral is linked to headaches. Researchers have learned that some of the same things that deplete the body’s supply of magnesium—including stress, alcohol, and pregnancy—can trigger headaches in susceptible people.
In 1993, two different studies were performed at the New York Headache Center by Alexander Mauskop, MD, one of the nation’s leading authorities on migraines and author of What Your Doctor May Not Tell You About Migraines.(5,6) Mauskop and his team found that people in the throes of a migraine had lower levels of free magnesium in their blood.
Their next step was to determine whether replacing the missing magnesium would stop the headaches. In 1995, Mauskop and his colleagues gave intravenous injections of magnesium to patients who were in the throes of a migraine and also had low levels of free magnesium.(7) The magnesium injections brought the migraines to a halt, sometimes in as little as 15 minutes. Mauskop found that the lower the initial level of free magnesium in migraine sufferers, the more substantial and long lasting was the relief offered by the injections. The following year, Mauskop published a study reporting equally good results among 40 people suffering from several types of severe headaches, not just migraines.(8)
After learning that an intravenous infusion of magnesium could halt a migraine in progress, researchers wondered whether taking daily magnesium supplements could keep migraines from striking in the first place. German researchers addressed that question in a study of 81 migraineurs.9 The volunteers in this randomized, double-blind, placebo-controlled study suffered an average of 3.6 migraines each month. For 12 weeks, half of the patients were given 600 mg of magnesium daily, while the other half received a placebo. The results were encouraging: among those taking the magnesium, the number of migraines, days lost to migraines, and anti-migraine medications required all dropped significantly. An earlier Italian study, performed exclusively on women suffering from menstrual migraines, also found that magnesium supplementation could prevent migraines from striking.(10)
Dr. Mauskop agreed that magnesium supplements could indeed make migraines less frequent, noting, “a trial of oral magnesium supplementation can be recommended to a majority of migraine sufferers.”(4)
Minor deficiencies of magnesium are widespread, and 15-20% of Americans suffer from chronic magnesium deficiency.(11) Even minor magnesium deficiencies may be enough to trigger migraines in susceptible people.
Riboflavin, also known as vitamin B2, has a variety of functions, from aiding in the manufacture of red blood cells to assisting in the extraction of energy from carbohydrates, protein, and fat.
Riboflavin may be related to migraines via tiny “energy factories” in the brain cells called mitochondria. Low mitochondrial energy production in migraineurs may trigger headaches, and having additional supplies of the vitamin on hand may help increase cellular energy production and reduce migraine risk.
In 1994, researchers from Belgium’s University of Liege studied 49 migraineurs.(12) The volunteers were given 400 mg of riboflavin with breakfast every day for at least three months. By the end of the study period, participants reported an average of 67% fewer migraine attacks, as well as less-severe attacks.
Four years later, the same researchers conducted a second study in which 55 migraineurs were given either riboflavin or a placebo for three months.(13) Those taking the vitamin saw a decrease in the frequency of attacks and number of days lost to migraines compared to those who received the placebo.
Researchers have noted that for a large percentage of the population, riboflavin intake is either substandard or barely adequate, with elderly people and the poor especially likely to be deficient.(14)
Other Intriguing Therapies
While physicians continue to explore how magnesium, riboflavin, feverfew, and butterbur work to counteract migraines, several other therapies also are under study.
Glucosamine. Doctors at Canada’s Brampton Pain Clinic studied 10 people. All suffered migraines or migraine-like headaches and none had been helped by previous standard treatments.23 After they took glucosamine for 4-6 weeks, the volunteers reported a drop in the number and intensity of migraines. The researchers theorize that glucosamine works through white blood cells called mast cells to boost the production of heparin, which helps to reduce blood clotting, thus reducing nerve-mediated inflammation and pain. How much glucosamine is required to prevent migraines is unknown, but the therapeutic dose may be similar to that used to treat osteoarthritis (approximately 1,800 mg per day).
Coenzyme Q10 (CoQ10). This vitamin-like substance may aid migraineurs by stimulating the mitochondria to produce more energy. A 2002 study published in the journal Cephalgia reported on 32 migraine patients treated with a daily dose of 150 mg of CoQ10 for four months.24 By the study’s end, the average number of migraine attacks per month fell from 4.85 to 2.81, and CoQ10 did not trigger any reported side effects. If the results of this preliminary study are confirmed by double-blind studies, 150 mg per day of CoQ10 may become the recommended dose.
Melatonin. Secreted by the pineal gland at night to aid in sleep, this hormone also may play a role in the genesis of migraines. French researchers noted abnormal melatonin levels in the blood of four of six women who suffer from migraines (compared to nine healthy people serving as controls).25 The scientists theorized that problems with the pineal gland may be responsible for migraines in some people, thus explaining why melatonin may help reduce the incidence of migraines.
According to the American Migraine Study II conducted by the National Headache Foundation, migraine headaches are underdiagnosed and undertreat-ed.(26) Despite new understanding of the disease and new “medications designed specifically for the treatment of migraine, many patients continue to experience needless pain and disability,” the study reported.
Some 28 million Americans suffer migraines, which means you can find a migraineur in one of every four households. While standard medications are helpful, millions may find additional relief in natural, readily available substances such as magnesium, riboflavin, feverfew, butterbur, glucosamine, CoQ10, and melatonin.
1. Educational Resources: NHF Headache Fact Sheet page. National Headache Foundation web site. Available at: http://www.headaches. org/consumer/generalinfo/factsheet.html. Accessed November 25, 2003.
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3. Khosh F. Natural approach to migraine headaches. Townsend Letter for Doctors and Patients, Aug-Sep 2002.
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5. Mauskop A, Altura BT, Cracco RQ, Altura BM. Serum ionized magnesium levels in patients with tension-type headaches. Olesen J and Schoenen J, eds. In: Tension- type Headache: Classification, Mechanisms, and Treatment. New York: Raven Press; 1993: 137-40.
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7. Mauskop A, Altura BT, Cracco RQ, Altura BM. Intravenous magnesium sulphate relives migraine attacks in patients with low serium ionized magnesium levels: a pilot study. Clin Sci (Lond) 1995 Dec;89(6):633-6.
8. Mauskop A, Altura BT, Cracco RQ, Altura BM. Intravenous magnesium sulfate rapidly alleviates headaches of various types. Headache 1996(Mar);36(3):154-60.
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16. Murphy JJ, Heptinstall S, Nitchell JR. Randomized double-blind placebo-con- trolled trial of feverfew in migraine preven- tion. Lancet 1988 Jul 23;2(8604):189-92.
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23. Russell AL, McCarty MF. Glucosamine for migraine prophylaxis? Med Hypotheses 2000 Sep;55(3):195-8.
24. Rozen TD, Oshinsky ML, Gebeline CA, et al. Open label trial of coenzyme Q10 as a migraine preventive. Cephalagia 2002 Mar;22(2):137-41.
25. Claustrat B, Brun J, Geoffriau M, Zaidan R, Mallo C, Chazot G. Nocturnal plasma mela- tonin profile and melatonin kinetics during infusion in status migrainosus. Cephalagia 1997 Jun;17(4):511-7.
26. New Results Available from the American Migraine Study II [press release]. Chicago: National Headache Foundation, February 22, 2000.