Finding Your Migraine’s Window Of Vulnerability
The FDA is currently reviewing a new migraine drug called Trexima, which combines the migraine drug Imitrex and naproxen sodium contained in Aleve and other over-the-counter medications. The triptan prevents blood vessels from dilating. This dilating leads to migraine pain the anti-inflammatory drug prevents release of an inflammation-triggering enzyme, according to product developers.
Also in the pipeline: A drug that shows promise as both in preventing migraines and in stopping a migraine once one starts, says George R. Nissan, DO, director of research for the Diamond Headache Clinic in Chicago. The drug works by inhibiting a protein released during inflammation, called calcitonin gene-related peptide . CGRP is found in high levels in migraine patients.
“We’re looking for migraine drugs that don’t have the limitations or side effects of antiseizure or blood-pressure-lowering drugs,” Nissan tells WebMD. “CGRP doesn’t cause constriction of blood vessels, so there would be fewer worries for patients with heart disease, and fewer limitations on its use. However, it may take years until we see it FDA-approved.”
Stephen Silberstein, MD, professor of neurology and director of the Thomas Jefferson University Headache Center in Philadelphia, has led pioneering studies into this “window of vulnerability” during a migraine headache.
How To Treat Migraines Caused By A Vitamin Deficiency
Consulting with a doctor is the best way to treat a migraine caused by a vitamin deficiency. A doctor may prescribe migraine medications to treat migraine pain and offer tips and recommendations to prevent a single migraine from becoming a recurring problem.
For those who are dealing with ongoing migraines related to a vitamin deficiency, a consultation with a neurologist may be required. A neurologist can provide a chronic migraine diagnosis, and he or she may also prescribe migraine medications.
If a chronic migraine patient finds his or her current migraine medications are ineffective or cause intolerable side effects, Dr. Jonathan Cabin of The Migraine Institute can help. Dr. Cabin is a head and neck surgeon with dual-subspecialty training in facial plastic and reconstructive surgery, and his unique expertise enables him to offer personalized chronic migraine treatments. To learn more about how Dr. Cabin helps patients dealing with chronic migraine pain, please contact us today at 310.461.0303.
A Deficiency In Vitamin B2 Has Been Linked To Migraine Headaches
Although all of the B vitamins play a role in protecting you from headaches, vitamin B2 seems to stand out the most.
“Eating foods high in vitamin B2 or supplementing with a quality vitamin may help improve mitochondrial energy metabolism and therefore, decrease the incidence of migraine headaches,” she explained.
The recommended intake of B2, according to the NIH, is 1.3mg for males and 1.1mg for females ages 19 and up. If you’re pregnant or breastfeeding, the recommended daily allowance is 1.4mg for pregnancy and 1.6mg for lactation. You can find B2 in foods like eggs, kidney, liver, lean meats, milk, green vegetables, and fortified grains and cereals. Higher doses may be recommended if you suffer from migraine headaches.
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Finding Relief For Migraines
For the estimated 10% of the population who suffer from migraines, there is good news. A growing body of research suggests that certain supplements may be as effective as-or even superior to-conventional medicine in the prevention and treatment of these debilitating headaches.
B Vitamins And Headaches
Many people take multivitamins containing several of the B vitamins. This is also known as a B complex supplement, which usually contains eight B vitamins in one serving. There are many health benefits of B vitamins, but too much may have side effects.
Excessive vitamin B3 consumption commonly causes skin flushing and headaches. People with vitamin B12 deficiency may be prescribed a high dosage as treatment, though this may yield headaches as a side effect.
Ironically, B vitamin deficiencies are also associated with chronic headaches. According to a June 2018 study published in Neurological Sciences, researchers found a correlation between vitamin B12 deficiency and tension headaches in children. To avoid B vitamin headaches, aim for the recommended dietary allowance of 2.6 micrograms.
- Stomach pain
- Gastrointestinal problems
One of the most common symptoms of taking vitamins in any dose is nausea or upset stomach. This can often be attributed to taking vitamins on an empty stomach. In cases where vitamins cause nausea, Cleveland Clinic recommends taking vitamins with food, lowering your dose, getting vitamins from food sources and opting for an easy-to-digest formula.
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Ways To Get Vitamins Into Your Diet
Eating a varied diet will most likely provide many of the vitamins a person needs. Good sources of many different vitamins include:1-5
- Fruit, especially bananas, strawberries, and oranges
- Green, leafy vegetables
- Lean meats like chicken
- Healthy fats, like avocados, vegetable oils, and fatty fish
This is not a complete list of all foods that contain vitamins. In many cases, foods in the United States are fortified. This means foods that normally do not contain vitamins have vitamins added. Cereals, grains, and milk are commonly fortified foods.1-5
Outside of our diet, vitamins can also be taken as supplements. Vitamin supplements usually come in pill form. They can be purchased over the counter at a pharmacy or grocery store.1-5
Vitamin B12 Deficiency Symptoms
Signs of vitamin B12 deficiencies take about two years or more before they are noticed. The symptoms listed below may start a bit sooner.
The causes of this can be due to anemias, chronic alcoholism, gastric bypass surgery, and lack of intrinsic factor. Lack of intrinsic factor is perhaps the most common cause. This may be eitheran inheirited problem, or it can be the result of drugs such as H2 blockers and proton pump inhibitors. These are medications that reduce stomach acid which is needed forintrinsic factor to bind to B12 in food sources and carry it across the gut to the rest of the body.
An additional medication that could cause B12 deficiency can be metformin which is a common medication used in diabetes. At the present time, studies have indicatedthat 10-30% of diabetics who take metformin are at risk for vitamin B12 deficiency symptoms. A good way to counter act this effect is to take sublingual vitamin B12.
The following are vitamin b12 deficiency symptoms:
- Confusion or change in mental status
- Tingling in hands and feet
- Unexplained worsening of neuropathies, such as carpel tunnel syndrome
- improved mood
- less neuropathic pain
- less tingling
Another benefit may be reducing the pain that MS patients feel from nerve damage caused by MS. Many of these people have pain in theirarms and legs in addition to weakness. This is because there are different nerve fibers for sensation than there are for muscle strength.
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Who Should Not Take Vitamins
Most people benefit from eating a diet that contains many vitamins. However, some vitamins, especially when taken as supplements, can interfere with prescription drugs. Telling your doctor about any vitamins or supplements you take before starting a new drug can help determine if they are safe for you. Before taking vitamins, tell your doctor about all your health conditions.
Do not take vitamins if you are pregnant or breastfeeding without talking to your doctor first.
Vitamins B6 B12 And Folic Acid
Studies showed that vitamins B6, B12, and folic acid, taken over six months, had visibly reduced the frequency of Migraine attacks
Experts recommend an average of 400 milligrams of B complex a day. Vitamin B2 or riboflavin is also essential for the body, as it provides energy, through the metabolism of fats. Deficiency of this vitamin can hinder the normal functioning of the body, and may even trigger a Migraine attack.
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Side Effects Of Vitamins
Most of the side effects of vitamins come from having too much or too little of them. Some vitamins are water-soluble. This means they are not stored and are removed from the body quickly through our urine. Others are fat-soluble, including vitamins D and E. These can be stored up and reach high levels in the body.1-5
It is hard to get too much of a specific vitamin from diet alone. However, taking large doses of vitamins can lead to side effects, such as:1-5
These are not all the possible side effects of taking too much of a vitamin. Talk to your doctor about what to expect or if you experience any changes that concern you while taking vitamins. You should also stop taking any vitamins until your doctor tells you it is safe to have them again.
A Magnesium Deficiency Can Contribute To Headaches
Magnesium helps the body regulate nerve and muscle function, maintain blood sugar levels, and regulate blood pressure. Dr. Sara Crystal, MD, Neurologist and Headache Specialist, andCove medical advisor, told INSIDER there is good evidence that magnesium deficiency can contribute to migraines. That’s why she said many people find magnesium supplements helpful in treating these symptoms.
Since magnesium is considered a natural “relaxer” of the muscle and nervous system, Morrison said it’s not surprising that a lack of this mineral causes muscle tension, cramps, insomnia and widespread pain, including headaches. Good food sources include legumes, nuts, seeds, green leafy vegetables, fortified foods like breakfast cereal, milk, and yogurt.
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Vitamins For Migraines And Headaches
When you have a headache caused by vitamins, you may want to see a doctor and discontinue use. However, there are cases where people take vitamins for migraines and headaches.
Magnesium and coenzyme Q10 supplements are often recommended to reduce the frequency and severity of headaches as well as prevent migraines. Some herbal supplements, such as feverfew, have also been known to treat headaches.
Some people have chronic migraines while others may experience headaches as a result of nutrient deficiencies. Headaches and migraines are a reported sign of deficiencies in vitamin B12, vitamin D, magnesium and iron.
Taking vitamins for migraines and discontinuing use of vitamins to prevent headaches may put you at a standstill. To avoid headaches altogether, try to drink plenty of water, eat a balanced diet and exercise regularly. Consult with a medical professional about any vitamins you choose to take.
Other Vitamin Deficiencies Associated With Migraines
In addition to the aforementioned vitamin deficiencies, people who lack sufficient amounts of folate and coenzyme Q10 may be more prone than others to migraine attacks.
Folate is a B-vitamin used to produce red and white blood cells in bone marrow, RNA and DNA, as well as transform carbohydrates into energy. Folate-deficiency anemia may develop in individuals who lack folic acid, a synthesized version of folate, in the blood. In this instance, an individual may experience migraines, along with a lack of energy, decreased appetite, pale skin and other physical symptoms.
A recent study published in The Journal of Headache and Pain highlighted the use of folic acid to treat migraine symptoms. The study revealed migraine patients who were given 2 mg of folic acid in conjunction with vitamins B12 and B6 achieved greater success in reducing their migraine symptoms than patients who received 1 mg of folic acid in combination with vitamins B12 and B6.
Coenzyme Q10 is a vitamin-like substance found in cells. Roughly one out of every 100,000 people are coenzyme Q10-deficient, the U.S. National Library of Medicine notes. Furthermore, a coenzyme Q10 deficiency may put a person at risk for migraines, heart disease and other medical issues.
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Nutraceuticals And Migraine Treatment
Studies have shown that 80% of people with headache disorders have used some form of alternative medicine, including nutraceuticals, for headache treatment, said Dr. Chua. And there is some value to moving forward with this option. Multiple studies have been conducted evaluating non-pharmacological treatments for their efficacy and safety. The most common are:
- Magnesiuma mineral used to prevent migraine attacks
- Riboflavina vitamin also known as B2, which in high doses has been shown to prevent migraine attack
- Co-enzyme Q10 an antioxidant that, when taken regularly for migraine prevention, has been shown to reduce frequency and intensity of migraine
Feverfewa plant that can be used as a preventive treatment for migraineis another commonly used nutraceutical, but its effectiveness has not been well-proven in studies.
Other alternatives often cited for migraine treatment include butterbur, tree bark, lavender, peppermint, and ginkgo biloba, and there are tons and tons of others out there, Dr. Chua said, but there is less evidence available that supports their efficacy.
Vitamins B6 B9 And B12
The flavoenzyme 5,10-methylenetetrahydrofolate reductase regulates the flow of folate between the production of nucleotides and the supply of methyl groups during methionine synthesis and has major effects on the distribution of intracellular folate . MTHFR also plays a pivotal role in the pathogenesis of migraine and hyperhomocysteinemia. The MTHFR enzyme encoded by MTHFR catalyzes the reduction of 5,10-methylenetetrahydrofolate to 5-methyltetrahydrofolate, an ethyl group donor to the intermediary metabolite homocysteine during its metabolism to methionine. Methionine is used in the synthesis of the universal methyl donor S-adenosylmethionine. Upon donation of the methyl group, S-adenosylmethionine is converted to S-adenosylhomocysteine, which is subsequently hydrolyzed to homocysteine and adenosine .
Hyperhomocysteinemia is caused by abnormal methionine biosynthesis due to deficiencies in folate, vitamin B12, and vitamin B6 . Folate is also needed to drive the methionine synthesis pathway, as a lack of dietary folate and/or reduced MTHFR enzymatic activity can result in increased homocysteine levels in blood plasma . This relationship makes homocysteine a key intermediate in one-carbon metabolism and further clarifies the involvement of B vitamins in transferring one-carbon units and their relation to the plasma concentrations of total homocysteine .
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Finding The Window Of Vulnerability
In another approach to the goal of preventing migraine headaches, Silberstein and other researchers have looked at “drug timing.” This involves finding the window of vulnerability, a critical time period for migraine headache sufferers. If patients can take their drugs just at this point instead of ongoing, some side effects can be offset. They’ll also take less medication, cutting out-of-pocket costs.
Two recent studies of menstrual-related migraines produced the first scientific evidence for a pattern of vulnerability in migraine headaches. Researchers say their findings could apply to other types of migraines, not just menstrual headaches.
It’s an exciting finding. If altitude changes are your nemesis, then taking a long-acting triptan drug twice a day on the day before you go skiing in Utah and continuing it for a week may nip your migraine from starting at all.
New migraine drugs are also on the horizon. “A lot of drugs are coming down the pipeline, drugs that work by different mechanisms,” says Silberstein. One is a class of enzyme-blocker drugs, such as Aricept, currently prescribed to treat mild to moderate confusion related to Alzheimer’s. This drug is a contender for migraine prevention, he tells WebMD.
Can Vitamin Deficiency Cause Migraines
It seems like such a simple answer, but its what researchers suggested when they presented their data to the 58th Annual Scientific of the American Headache Society. They have proposed that vitamin supplements might be the secret to preventing and treating migraines.
To support their theory, researchers drew from nutrient measurements taken from the blood of young adults, teens, and children seeking treatment for headaches. Researchers looked at four key nutrients: vitamin D, riboflavin , folate , and CoQ10, an antioxidant that is vital to cell function.
Researchers found that nutrient deficiencies were common for those with migraines. They discovered that all four vitamins showed deficiencies. More than two-thirds of those tested showed low vitamin D. About 15% of teens had riboflavin levels below the recommended, and 40% were at levels where doctors recommend supplementation. Nearly two-thirds tested low for folate, and 30% tested below the lower reference limit for CoQ10.
Although these may seem like promising connections, there are many reasons why we wouldnt want to take this research too seriously yet.
Prevention: The Future Of Migraine Therapy
Stopping a migraine headache before it ever begins is the new focus of treatments.
Until a few decades ago, people had little more than aspirin to fight the throbbing, debilitating pain of a migraine headache. Then, in the 1980s, researchers developed strong drugs to halt migraine pain once it begins. But those drugs have serious side effects. Some people cannot take them if they are at risk for heart disease or other conditions. Also, if the drugs are not taken within the first hour of migraine headache pain, they don’t help much.
These older drugs are still prescribed. But more recently, the approach to taming this lion has made a 360-degree turn. Now, prevention is the focus. It involves disabling a migraine headachebefore the pain ever begins. One method is to take non-migraine drugs daily to help prevent a migraine from starting. The drugs affect brain chemicals or blood vessel inflammation that lead to migraines.
Another is to fine-tune treatment for each patient. The goal is to take fewer drugs, avoid many side effects, and have better control of the beast. For example, you become aware of your pattern of getting a migraine headache, learn what triggers it, and take certain drugs during your own window of vulnerability – that is, the brief window of time you can most benefit from a drug.