allergies

15 September 2016

Migraine: Is it really “Brain Hives”? (part 2)

Earlier this week we looked at the history of a strange term for migraine – brain hives. In the past, doctors have sometimes thought of migraine as an allergy, partly because of the way that certain things tend to trigger an attack.

Although this view may be thought of as overly simplistic, we also saw that more recent research has actually shown a connection between allergy and migraine.

But, brain hives? (By the way, here’s a blogger who used the term brain hives a few years ago – wondering if they made “brain scratchers” to relieve symptoms!)

Brain hives and migraine — Photo courtesy John Benson

What about the connection to hives? What exactly is hives?

Like migraine, much of the time we don’t know what triggers an attack of hives.

Also known as urticaria, hives may be triggered by eating a certain food, by an insect bite, or by contact with some other irritant.

Histamine is released, and the capillaries in the body leak fluid. As the fluid accumulates, a rash appears on the skin. The skin swells, and itchy pink or red round or oval “wheals” or welts appear.

Some cases may last for a few hours, other cases can last for weeks, or even become chronic, although we’re not sure why. Read more here: What are hives?

Earlier this year at the Migraine Summit, respected migraine researcher clinician Dr. Stephen Silberstein was discussing the migraine chain reaction. Interestingly enough, he brought up the term “brain hives”. Listen to what he said:

We still don’t know exactly what triggers the migraine attack, where the pain comes from. Some people believe, with a lot of good evidence, that in many ways, migraine is like brain hives. What are hives? Chemicals are released from nerves on the skin, we get swelling and itching.

We think in many ways, migraine may be like that, chemicals are released from nerves lining the surface of the brain. They produce a chemical reaction, swelling, leakage end up perhaps to pain of migraine. Very simple analogy to think that migraine is brain hives.

Dr. Silberstein’s main point was not that migraine is an allergy – I want to be careful not to misrepresent him. However, his point was that there are similarities between the migraine chain-reaction and the hives chain-reaction.

As the authors of “Managing Your Headaches” pointed out, “allergy shots will not protect you against migraine.” It’s easy to jump to a simplistic answer – just give me an allergy test and a pill. It doesn’t work that way for migraine (and sometimes not for hives either!).

Their thoughts were:

A great number of foods have been implicated in triggering migraine. It is important to understand that when we talk about these food triggers we are not implying that are you are “allergic” to the particular food involved. Allergies imply an immunologically mediated trigger. When foods trigger migraine, they generally do so by influencing the head pain pathways that we have discussed previously. Allergy shots will not rid you of migraine or your susceptibility to your migraine triggers.

But doctors have been so quick to point out the differences, that they’ve sometimes missed the connection. If a migraine patient is generally more “sensitive” to triggers, wouldn’t it make sense that an allergy – even a mild intolerance – could be a part of the story?

Maybe doctors of past generations had a point. There may be a closer relationship to allergies and migraine than we usually think.

The link between food and contaminants and migraine is also controversial. Just how much should patients focus on avoiding triggers? How much does it help? Can you over do it?

But the fact remains that patients are often helped dramatically when they avoid a food or change hairspray. And some have even been able to discover the connection through allergy testing.

So let the research continue – not just in the labs, but maybe in your own home.

12 September 2016

Migraine: Is it really “Brain Hives”?

James Information 0

Strangely enough, the term “brain hives” has a history to it, when it comes to migraine. And I just heard the term again this year.

Almost a century ago, Dr. Ray M. Balyeat was a big name in migraine research in the United States. Dr. Balyeat made some very modern observations about migraine, which would hold up well today.

But Dr. Balyeat’s specialty was actually allergies. In fact, he had a successful clinic for patients with allergy and asthma.

So what did he see? Of course he began to notice similarities between migraine and allergic reactions. He saw incredible improvement in patients who simply avoided certain food triggers.

Now it’s easy to jump to the conclusion that just because a food triggers migraine attacks, that you’re “allergic”. It doesn’t seem to be that simple.

However, researchers continue to notice the connection between allergies and migraine.

We do know that, for example, migraine patients who are tested for common allergies seem to improve when they eliminate the offending foods from their diet (see Migraine and Food Allergy? New Study…). Food intolerance or “delayed” allergies are also an interesting field of research. These are problems that would not show up in a typical allergy test.

Migraine is indeed connected in some way to hay fever. People suffering from rhinitis, allergic and otherwise, do tend to have more problems with migraine (see What Most People Donâ€™t Know About Migraine and Allergies (Hay Fever)).

The connection between migraine and histamine also provides another possible clue.

Hives on the brain — Dr. Marshall Mandell, featured in the Reno Gazette-Journal, 17 April 1978.

A generation later, another allergist from the USA was promoting a “controversial discipline” known as clinical ecology – that is, finding the contaminants that are causing an illness.

Dr. Marshall Mandell believed that most migraine attacks were in fact caused by “cerebral allergies”, such as chemical hypersensitivities (hypersensitivity – certainly a popular word in migraine research today!).

Though some of Dr. Mandell’s ideas would be dismissed today as they were then, he did take patients seriously when other doctors wrote off their headaches as “all in your head”. He used vitamin B, still commonly used in migraine treatment. And he recognized many environmental triggers that research has continued to bring to light.

All of this takes us into a world that is much more complicated than obvious allergic reactions causing migraine. But there’s no doubt that there is some kind of a connection. Were these doctors from the past really on to something?

Later this week we’ll take a closer look at hives, and migraine, and see what connections we can find.

21 December 2015

Asthma, Migraine, and the Asthma Headache

James Discoveries & Stats, Information 1

Yes, there is a connection between asthma and migraine. But what is the connection, and will it help us treat both?

Anyone who has had an asthma headache already suspects that there may be some kind of non-coincidental relationship between the asthma symptoms they’re most familiar with and the headache. And the connection between migraine and asthma is actually quite well known.

Migraine and Asthma For example, we know that people with migraine are at a higher risk to have asthma as well. A child of a mother with migraine is more likely to develop asthma.

In short, asthma is considered to be comorbid with migraine – in other words, the two diseases tend to go together more often than would be the case if it was all random.

But why is this the case? We do have some clues. For example, both migraine and asthma are genetic. They both have triggers – often similar triggers, such as allergens and irritants in the air. People who get hay fever are more likely to have more migraine attacks. Both asthma and migraine have been connected to histamine levels, and inflammation.

A study last month upped the stakes again – it seems that pre-existing asthma increases your chances of developing chronic migraine (see Beware, asthma sufferers: Migraines may worsen). In fact, asthma may increase your risk even more than another comorbid condition often mentioned by researchers – depression.

Research definitely seems to be telling us that the link between asthma and migraine is no longer something we can ignore.

Headache specialist Dr. Roger K. Cady (founder of the Headache Care Center) offers some helpful thoughts on the connection (see Could Your Migraines Signal Uncontrolled Asthma?). In his own practice he has noticed the connection between allergies, migraine and asthma in both adults and children. He suggests that there may be inherited hypersensitivities that are involved in both conditions, or neurotransmitters which are released during an attack. His advice would be to discuss the connection with your doctor and make sure you’re treating both conditions.

For example, a beta agonist medication for asthma may actually trigger migraine, while beta blockers for migraine may actually worsen the asthma.

The good news is that if you can avoid these pitfalls, treating one condition is likely to improve the other.

To investigate the connection further, check out some of the topics below:

15 January 2014

Does the Smell of an Onion Trigger Migraine?

James Discoveries & Stats, Treatments 6

Could the smell of an onion – or garlic – actually trigger a migraine attack? If so, what can we do to keep it from happening?

There’s no doubt that certain smells bother people who are having a migraine attack, even in the early stages before there’s a headache. And many people have reported that smells actually trigger attacks – perfumes and household cleaners are common culprits. It has been estimated that odours can trigger attacks in 70% of migraineurs.

Does smelling onions trigger a migraine attack?

We also know that eating onion can trigger migraine attacks in some people.

In the spring, in the journal Headache, a report was published on a woman who experienced some pretty significant symptoms after just smelling raw onion.

She first had some allergy-type symptoms in her late 20s after eating an onion dip. Over the next few years she started experiencing a variety of symptoms after just smelling an onion – severe headache, visual symptoms, sore throat, feeling faint, and so on.

The woman was testing for allergies, and in this case the test was positive for garlic and onion. It’s nice to get a positive result in an allergy test – many migraineurs will test normal for their triggers.

Obviously this was a bit of a severe case, more of an allergic response than just a trigger. However, to varying degrees many migraineurs do experience symptoms after exposure to odours including cigarette smoke, car air fresheners, aerosols, and even the smell of foods cooking (particularly fatty foods).

The treatment that this woman was given actually worked. In her case, medication was tried first without success.

The treatment was two-fold. First, a nose plug (she had been covering her nose and mouth when going out previously). Next, “counter-stimulation” using peppermint. These two simple solutions kept the headaches from coming.

Are there certain smells that trigger migraine attacks for you? Have you ever tried a nose plug, or a counter-smell such as peppermint oil?

For more information:

Alliaceous Migraines (Study abstract. “Alliaceous” refers to the plant-group that onions are a part of.)
The smells that can give you a migraine

10 December 2013

What Most People Don’t Know About Migraine and Allergies (Hay Fever)

James Discoveries & Stats, Information, Tips 0

Just how is migraine related to allergies – specifically, allergic rhinitis? There’s a growing amount of science out there to answer the question, but many people still don’t understand the connection, and therefore they have trouble finding good treatments.

First, a quick definition. There are a lot of different terms that are thrown around – hay fever, seasonal allergies, rhinitis, mixed rhinitis… In this post we’re going to talk about allergic rhinitis and mixed rhinitis.

Sneezing? Stuffy Nose? How is Migraine related?

Allergic rhinitis involves some very familiar symptoms generally centred around the nose. Think itchiness, runny nose, and watery eyes, for example. The symptoms are typically triggered when you’re exposed to something that your body sees as a threat – pollens, cigarette smoke, cats, or perfumes.

Allergic rhinitis refers more to things like pollens, animals, and molds. Mixed rhinitis can include these things, but also weather changes, gasoline, perfumes, cigarette smoke, and so on.

The Migraine and Rhinitis Connection

Research into the 2008 American Migraine Prevalence and Prevention (AMPP) Study, reported on last month, confirmed that people with rhinitis (allergic and mixed) had more frequent migraine attacks – and more disabling attacks. The connection with mixed rhinitis was the strongest.

This is no surprise, really. Way back in 2006 we talked about the fact that people with hay fever seemed far more likely to have migraine.

But the researchers are cautious with these results. Vincent Martin, MD, lead author of the study, says this:

We are not sure whether the rhinitis causes the increased frequency of headaches or whether the migraine attacks themselves produce symptoms of rhinitis in these patients. What we can say is if you have these symptoms, you are more likely to have more frequent and disabling headaches.

The authors are right to be cautious. The questionnaire that the study is based on had a low response rate, and there are serious limitations to questionnaires like this in the first place.

Although it’s hard to know exactly how much allergies impact migraine and vice versa, thanks to this and many other studies we can make some pretty good guesses about how migraine is connected to rhinitis.

Could rhinitis make you more susceptible to migraine attacks? Absolutely. Any changes in the body could cause problems for someone with migraine. But some studies suggest that the raised histamines in someone with an allergy could contribute. (Don’t miss the two-parter – Migraine and Histamine: Part 1 and Migraine and Histamine: Part 2)

Could migraine attacks make you more susceptible to rhinitis? Well, there’s no doubt that migraine attacks can cause rhinitis symptoms. Runny nose, congestion, watery eyes – these are common migraine symptoms. In fact, you could be confusing rhinitis with migraine. You might not be allergic at all.

Could something be causing both migraine and rhinitis? For sure. This is especially true when it comes to mixed rhinitis. Changes in weather, lightning, perfumes – these are all things that could very well trigger rhinitis as well as migraine.

What to do about it

Your first response should not be to run out and take anti-histamines, or and antibiotic (please no!). You need to do a bit of research on this one, but the rewards are great.

If you suffer from a lot of rhinitis symptoms, and migraine attacks, here’s what you need to do:

Keep a detailed headache diary. Include rhinitis symptoms as well as actual headache.
Now that you have more information, take it to your doctor and discuss it with her.
Avoid allergens. This is always your first priority, especially if you see a clear connection (but even if you don’t). An excellent source of ideas for the migraineur is What Your Doctor May Not Tell You About: Migraines. It’s an older book, but when it comes to quick tips about things like this, it’s still worth having a copy. Check out chapter 7 – Eliminating Environmental and Other Triggers
Consider starting with migraine treatment. In many cases, your main problem is going to be migraine, not rhinitis. Treating the migraine may solve both problems. This is especially the case if you have a less-clear case of rhinitis, but you certainly have migraine. You may need to find a migraine specialist.
Cautiously treat rhinitis. Treatment of rhinitis may help with migraine as well. If you clearly have rhinitis, especially allergic rhinitis, you’ll want to take it a little more seriously. A specialist may be useful here as well. Do not just rush out and get an antihistamine – treatment will depend on you and your medical history and symptoms.

Doctors are slowly starting to take this connection seriously. However, if you’ve read through this post, you may still be ahead of most doctors. Keeping track of your symptoms and doing your own research will help your doctor get you better treatment faster.

To read more (in addition to the links above):