Is Stevia giving me a Migraine Attack?

Some people have reported that stevia, or a sweetener made from stevia, have given them headaches and migraine symptoms.  Is this a rare problem?  Or is it something we should all be concerned about?

Let’s get one thing straight.  Researching stevia will drive you crazy.  It’s a political football, an economic hot potato, and a constant source of controversy for health nuts, diet gurus and medical professionals.

Buzzwords and catch phrases abound.  Let’s get a few out of the way right now:

  • “Natural”:  It’s time we all realized that the word natural on a label means almost nothing.  Are all the ingredients natural?  Is a genetically modified plant “natural”?  Is a chemical derived from a plant natural even though it’s been highly processed?  Does “natural” mean safe?  Seriously, ignore the word “natural”.  A walk in the forest might be natural, but it’s highly suspect on a package in the supermarket.
  • “Used for centuries”:  You’ll hear it over and over – stevia has been used worldwide for centuries.  That’s nice.  Did people of ancient times use the same manufacturing and packaging techniques?  Did they eat it along with the drugs I take?  Did they eat the same amount, along with the same diet I’m on?  And what clinic trials were done with these ancient peoples to see how they’re health changed when they stopped using stevia?  Yes, I’m glad nations weren’t wiped out in the past by stevia use.  But I’m really not sure how much this proves about that ingredient in my diet drink.
  • “generally recognized as safe”:  The GRAS phrase is used by the FDA, but it does not tell us that certain people will not have side effects from eating it.  Lots of ingredients are GRAS but cause problems for migraineurs.

Now none of this tells us that stevia is dangerous.  It does show that a lot of the hype that we’ve heard and will continue to hear does not necessarily prove that stevia is perfectly safe for everyone.

What is Stevia?

Stevia - migraine trigger?
Stevia – all natural if eaten like this.  Maybe.  (Photo courtesy of hardworkinghippy)

Stevia is a plant.  But you might actually be asking, what is this artificial sweetener I’ve heard about that people call “stevia”?

Unfortunately, we run into our first problem here.  Stevia is not one thing.  Various products are made from stevia, and some are more processed than others.  They use various substances.  There is no one stevia.

And there’s another problem.  Stevia sweeteners often come with “fillers”, and some of those are safer than others.

Are Stevia Sweeteners Safe?

Which ones?  Frankly, we could do research into every product that contains a derivative of stevia – except that there is limited research out there.  Most researchers seem to agree that stevia derivatives themselves are generally safe in small quantities for short term use.

But what about the other ingredients?

A search online will turn up a number of possible side effects of stevia – but again, stevia in which form?  How much per day?  Once you start trying to connect the studies with the product on the shelf, things get a little more tricky.

Now there are some people who may have an allergy to stevia products.  Some people have found that hay fever translates into a bad reaction to stevia.

The biggest concerns when it comes to stevia are related to sweeteners in general.  Again, research specifically on stevia is pretty limited compared to the tidal wave of stevia products that are in the pipeline.

However, there are growing concerns that artificial sweeteners may cause obesity (in some cases even more than sugar itself), and may lead to other imbalances in the body, especially if used regularly.

Stevia and Migraine

At this point, stevia does not seem to be high on the list of migraine triggers.  However, migraine affects everyone differently, and it is possible that stevia could, in some cases, trigger migraine symptoms.

But before we blame stevia derivatives, if you suspect it may be a trigger, ask yourself some questions:

  • What stevia am I talking about?  Which product am I actually using?
  • Unless I’m just chewing an organically grown stevia leaf, what “fillers” or other ingredients could be responsible for the migraine symptoms?
  • What other changes have I made in my diet that could be causing problems?  (including eating less sugar, and any sudden changes, even if you consider them to be good changes)

There are some concerns about stevia and low blood pressure.  Stevia may interact with calcium channel blockers and anti-inflammatory medication.

So take a close look at any changes in your symptoms, and talk to your doctor if you have any concerns.

Conclusion?

This is a bit of an unusual introduction to a possible migraine trigger.  The reason is that there really is so little research on how a specific derivative of stevia may affect someone with a specific condition, such as migraine.  And stevia is not like a drug, where you would give patients 30mg a day to see how they react.  It’s eaten in combination with other things, and it has the potential to drastically change your diet in a short period of time.

Typical advice for migraine patients is best repeated here.  Avoid fast, drastic changes.  Watch your symptoms carefully.  Read labels.  Do your own research.

When it comes to stevia, there is good reason to be skeptical of both the “for” and “against” sides of the argument.  But for most of us, a little sugar or honey in moderation seems to outshine most other sweeteners.

If you feel that stevia has increased your migraine symptoms, leave a comment.  Let’s keep the conversation going.

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Imagine Life without Migraine

Most of us go through those cycles.  There’s the feeling of hopelessness – that no treatment will ever work and that migraine will destroy my life.  There are those days when you’re ready to “fight back” and get serious about living life in spite of migraine, or finding a better treatment.  There are those days when you’re just feeling down and don’t really care.

And once in a while … once in a while … there’s this wild hope that migraine will be conquered.

Well, let’s have a day of hope.  Some recent posts and articles I’ve been reading have simply been a reminder to hope.

For example, take a look at a recent post from Kerrie Smyres of The Daily Headache.  Actually, as I write this Kerrie is having one of those down times.  But in her post a few days ago, she makes some excellent points.

There are actually a lot of good reasons to hope.  Not only are there excellent treatments available, there are more treatments on the way, and more doctors who are wanting to help migraine patients.  Check out her post here:  Full of Hope About the Future of Migraine Treatment

The Migraine Trust published an interview with Victoria Saxton of Migraine Monologues.  Victoria is also filled with hope after seeing a real reduction in her migraine attacks.  Check out My migraine journey – a marathon not a sprint.

Your turn…

Maybe you’re still thinking of years of trying and suffering and getting nowhere.  But why not take a moment to imagine what life would be life without migraine.  And don’t imagine with bitterness – let yourself hope, just a little, that your pain will lessen, the attacks will be less frequent, and you’ll start to steal your life back.

Migraine Heads

And here’s how.  The Migraine Trust has started a campaign that you can be involved in, called “Migraine Heads”.

It’s very simple, really.  Two head outlines.  In one you describe/show life with migraine.  In the second you describe/imagine your life without migraine.  Finally, you send it back via post, Facebook, or Twitter.  Oh, and don’t forget to tell us about it too!

To get started, visit Migraine free future and download the simple template.

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Migraine Surgery – Should it be Banned?

The debate about migraine surgery is nothing new, but it shows no signs of going away.  Researchers in Germany recently fired a shot at migraine surgeries, using strong words starting with the title of their editorial, published in the journal Cephalalgia, Surgical treatment for migraine: Time to fight against the knife.

Migraine Surgery - cut it out?!

Their article, which you can read for yourself, doesn’t hold back in criticizing treatments and studies that involve surgical intervention for migraine patients.  They mention the dreaded word “placebo”, doubt if “treatment-refractory” migraine patients even exist (patients who don’t respond to treatment), conjure up images of Europeans gazing in horror at American websites about migraine treatments, and talk about the horrible effects that surgery can have.

Even if the authors of the article manage to offend just about everybody, their article should not be quickly ignored.

Sadly, there is an impression that when “all else fails” at least there’s a way to deal with the problem through surgery.  Sure, it may be serious, but so is my pain.

But it’s not that simple.  Surgery is no guaranteed cure for migraine (well, it’s not a cure at all – but there’s no guarantee that it will take the symptoms away), and surgery itself can cause more problems.  And yes, those problems can be serious.

Authors Hans-Christoph Diener and Ulrike Bingel are right about one thing – the evidence for many – most migraine surgeries is not strong.  Doctors are right to put surgery way at the bottom of the list of treatments to try for migraine.

There’s no doubt that many patients do not respond well to some migraine treatments.  It takes many people many years to find a good treatment, if they find one at all.

But we can’t automatically assume that surgery is always out there, waiting to solve our problems once we’ve tried x number of medications.

Should we continue to study surgery as a migraine treatment?  Many researchers think so, just as we should continue studying many migraine treatments.  And no one that I know of is calling for a ban.

But we do need to take a closer look at the evidence before we recommend surgery to any patient.  That means understanding the clinical trials, but also understanding the medical history of the patient, and taking time to understand which treatments have the best chance of working.

That’s what we all want, isn’t it?

Meanwhile, if you’re considering surgery for migraine, it’s worth your while taking a look at Diener and Bingel’s thoughts.

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Football Helmets and Sports Concussion

The debate about concussion in sports continues to heat up.  Recently FIFA’s medical committee chairman, Michel D’Hooghe, recommended that games be stopped for three minutes so that players could be properly assessed for brain injury (that is, concussion).  Meanwhile, Will Smith and Gugu Mbatha-Raw are set to star in a new movie about concussion in the NFL.

Schutt Football Helmet

The controversy about football helmets isn’t over either.  On the one hand, some studies seem to show that helmets can protect players from concussion to some extent, while some experts claim that the protection is minimal to none.

Virginia Tech has come up with a five star rating system for helmets, based on testing both on the field and in the lab.  Certain helmets, such as the Schutt AiR XP Pro VTD and Riddell 360, for example, far out-performed the Schutt Air XP Ultralite and Riddell Revolution IQ.

To see the ratings, visit Adult Football Helmet Ratings – May 2014.

Although ratings are helpful, players need to know one thing above all the controversy and hype.  If you’re playing a contact sport, especially sports like American football, hockey or rugby but including sports like football/soccer and basketball, you’re in danger of brain injury.  Even if you buy the best protection, it won’t protect you anywhere close to 100% from concussion.

Does that mean don’t play the sport?  Not necessarily, but it does mean that you can’t keep your brain from banging against the side of your skull using a helmet.  That’s why there is a call for proper assessment of injuries, the need to visit a doctor or specialist, the need to get out of the game when there is an injury, and to think carefully before you put yourself in danger again.

There are also movements for better training on how to tackle, and better rules to protect players.  (See the ideas from one specialist here)

The bottom line?  Get the best helmet you can, but don’t trust it to protect you from concussion, a brain injury which can have consequences for years ahead.

For more thoughts, see this recent news report (video and article):  High school football helmets tested for concussion risk  See also this article on Head sports trauma

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Is it Concussion or Migraine?

If you’re dealing with headache symptoms, and you suspect you may have had a concussion, it’s natural to ask – is it concussion or migraine?

First, some important background.  Many people don’t realize that concussion is a brain injury.  It’s important to start here, because there are still those who think that concussion is a minor, temporary injury.

Although some injuries are certainly worse than others, a single concussion can lead to long term problems.  For more see Is it a Concussion or a Brain Injury?

Concussion or Migraine?

So back to our question.  Concussion can lead to something known as post-concussion syndrome (PCS).  In PCS, although the concussion (read: mild brain injury) may have happened several days or even weeks ago, you start developing symptoms such as dizziness, fatigue, headache, anxiety, and insomnia.  (More about post concussion syndrome symptoms here)

Now PCS can indeed look a lot like migraine, and sometimes it is difficult to know the difference.  In fact, some might say that PCS is triggering actual migraine attacks.

But more likely when you ask if it is concussion or migraine, you’re asking if the concussion is at the root of the problem, and if you should be looking for treatment that is different from typical migraine treatment.

How to tell if you have PCS:  Here are some important clues.  First, in order to be diagnosed with PCS, your symptoms must be new.  These symptoms usually appear between a few days and four weeks of the concussion.  So if you’re having the same symptoms as before, you probably won’t be blaming them on the concussion.

If, however, you had struggled with headaches before the concussion, but your symptoms have changed, you may have PCS.  You should see a doctor without delay.

After you have confirmed that your symptoms are new, or that they have changed, your doctor will want to know more about they symptoms you’re experiencing, when they started, how severe they are, and so on.

If you decide after speaking with your doctor that you don’t have PCS, you still need a proper diagnosis for your symptoms.  There are various types of headache, and even various kinds of migraine.  Getting a specific diagnosis will help you find treatment that will be effective.

For more information, see Post Concussion Syndrome – causes and treatment

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