Discoveries & Stats

2 February 2009

Menstrual Migraine: Back to Vitamin E

Menstrual migraine is debilitating and difficult to treat. The best treatment to stop a menstrual migraine in its tracks seem to be the triptan drugs, though different triptans work better for different people.

A recent study (released on January 15th) entitled The effect of vitamin E on the treatment of menstrual migraine studied just that – is vitamin E useful in treating menstrual migraine?

This was the plan of attack: Try vitamin E softgels (400IU) two days before and three days after menstruation. Did it help?

Yes, it helped some. Particularly with certain symptoms, such as sensitivity to light and noise, and nausea.

We also recently talked about vitamin E as an antioxidant, when we discussed the link between migraine and the mitochondria. Vitamin E might just be a rising star in migraine treatment.

Though this probably won’t replace medications in most patients, it may be just what you need to get some of the worst symptoms down to a manageable level. It’s an inexpensive supplement. Talk to your doctor about trying Vitamin E along with your current migraine-fighting strategy.

Read more about menstrual migraine here. Nature’s Way has quality vitamin E sotfgels like the ones used in the study.

26 January 2009

Fight Migraine: Be nice to your Mitochondria

James Discoveries & Stats, Tips, Treatments 3

Links between related diseases, such as migraine and irritable bowel syndrome (IBS) are important for more than one reason. First, they get us closer to finding the common cause, which could lead to future treatments of both diseases.

But learning about links can be important to you right now. They can give you new insight into how to prioritize your treatment, and what lifestyle changes you can make that can give you more "healthy days" to enjoy your life.

That’s why I was interested in the report put out by researchers at the Mayo Clinic earlier this month. The report had the typically long name Mitochondrial DNA, Gastrointestinal Motor and Sensory Functions in Health and Functional Gastrointestinal Disorders. Let me break it down quickly for you.

Simplified diagram of a mitochondrion

Researchers of various diseases, not just what are technically called mitochondrial diseases, are very interested in mitochondrial DNA (mtDNA), and something called nucleotide polymorphisms (SNPs). These are variations in the mtDNA that might be related to diseases such as stroke, migraine, and irritable bowel syndrome.

To get to the key point – these researchers believe that certain variations – SNPs – may be associated with gastric emptying, and even pain. The same variations are related to migraine, and childhood cyclic vomiting syndrome (which in many cases is probably abdominal migraine).

Developing treatments

Treatments are being investigated to treat diseases related to mtDNA. This includes diet and supplement treatments, exercise training, and more direct DNA therapy, such as artificially manufactured enzymes. One of the big jobs of the mitochondria is energy production, so a lot of today’s therapy is based around reducing energy "leaks" (ie excessive stress), and keeping a steady source of energy (snacks with complex carbohydrates, eating regularly, supplements, etc).

Can this research benefit me Now?

This research actually supports much of what we’ve talked about before. For example, we just talked about gastric stasis and the benefit of migraine nasal sprays. Gastric stasis may be linked to migraine through these SNPs, or variations (which may explain why many migraineurs have gastric stasis all the time).

Much of the common treatment for mitochondrial disease makes sense for migraineurs. Ever had an attack because you skipped a meal? Or slept in (and so went longer without eating)? Here are some key treatments and lifestyle changes which have even more credibility when looking at the link between migraine and the mitochondria:

B complex vitamins: Very common in migraine treatment, and a key ingredient in Migreleif, a well researched supplement.
Antioxidents: such as vitamin E. Magnesium is also key in the cleansing of the body (also a key ingredient in Migrelief). (this also means avoiding toxins, like cigarette smoke, alcohol, and MSG). Magnesium and antioxidant superfoods include beans and spinach.
Eating regularly: Be careful not to skip meals. Try healthy snacks thoughout the day, including complex carbohydrates which will keep a steady supply of energy in your body.
Coenzyme Q10: A key supplement for migraine which we have discussed before in HeadWay. CoQ10 is also an antioxidant. But the key factor may be the way it "jump starts" the energy production in your cells. I am personally taking CoQ10 now, in the 300mg softgels (3 month supply of softgels). For migraine, between 150mg and 300mg is recommended, but check with your doctor for the amount right for you (CoQ10 at Vitacost).

You may find that following these suggestions not only cut down your migraine attacks, but also related mitochondrial symptoms such as depression, muscle fatigue and IBS. Fighting gastric stasis will also make your medication more effective when you need to take it. There are a suprising number of benefits to treating your mitochondria right!

5 January 2009

Anti-seizure meds and Suicide

James Discoveries & Stats, Medications 10

Anti seizure meds are back in the news after the The US Food and Drug Administration (FDA) reported on its analysis of almost 200 studies on various drugs. The question was – are people on antiseizure medication at more risk of suicidal thoughts?

This is an important question particularly for migraine sufferers, for a couple of reasons. First, many migraineurs are on these drugs as a treatment for migraine. They include drugs like Depakote (divalproex sodium), Neurontin (gabapentin), Lamictal (lamotrigine), Keppra (levetiracetam), and of course Topamax (topiramate).

To add to the issue, depression is comorbid with migraine, meaning that people often have both issues at the same time.

Suicide warnings on antiseizure medication

The FDA finally concluded that there was a risk of increased suicidal thoughts for people taking these and related medications (21 medications in all). They decided that a new warning label will be required for these medications. That decision was followed in Europe, and the data is currently under review in Canada.

The decision to change warning labels has been controversial. It’s natural that there would be controversy where money is involved. Seizure medication sold to the tune of $10 billion in the United States alone in 2007.

But money isn’t the only issue. Doctors are concerned that the news is confusing patients, and they’re afraid some patients will stop taking their medication.

The risk for suicide is really very small, they say, compared to the risks of not having the medication at all.

These labels are often so arbitrary. For example, in 2007 psychiatrists convinced the FDA to scale back language on labels of antidepressants, because some patients got worried and stopped taking the medication.

What’s the answer? What you’re doing right now – we as patients need to be educated on the issues.

There’s almost no chance that taking antiseizure medication alone will cause you to commit suicide. The warning in the US will be that "about 1 in 500 patients face an increased risk of suicidal thoughts and behavior".

However, if you do suffer from depression, be aware that the drug could, in rare cases, make it worse. Discuss this with your doctor, and be sure she knows your medical history.

Do not just stop taking your medication without talking it over with your doctor.

Medications have helped many with migraine. But we need to use them knowledgeably, with caution, and with the counsel of a doctor.

For more, read U.S. orders suicidal action warning on epilepsy drugs from the UK, and FDA adds suicide warning to epilepsy drugs

20 December 2008

Is High Blood Pressure Causing My Headache?

James Discoveries & Stats, Medications, News 13

It seems intuitive that high blood pressure, or hypertension, would cause headache. After all, we often associate headaches with our blood vessels, especially headaches with pounding pain.

High blood pressure is just what it sounds like – your blood is moving through your blood vessels at a higher pressure than normal. Of course, your blood pressure is constantly changing due to a variety of factors, but we’re talking about a higher pressure than is normal under the circumstances, or generally higher than normal.

In 1913 Dr. Theodore C. Janeway suggested a link between high blood pressure and headache. Many of Janeway’s theories are still generally accepted today – but the hypertension headache connection is under suspicion.

I should put it this way – it’s generally accepted that hypertension in most cases doesn’t cause headache. In fact, it’s more likely to be the other way around.

In fact, this past spring a study in Norway (published in the 15 April edition of Neurology) suggested that high blood pressure is linked to fewer headaches, and even migraine attacks!

It seems more clear that headaches could cause high blood pressure. First, pain itself can cause temporary high blood pressure. That’s usually not considered dangerous, and it goes away (in other words, chronic pain is not likely to cause long-term high blood pressure).

Second, many medications taken for headache can cause high blood pressure. Long term use of anti-inflammatory drugs can cause hypertension. This would include ibuprofen (ie Advil) and naproxen (Naprosyn).

But wait – aren’t some drugs for hypertension also used to treat migraine? Yes, there are preventative drugs for migraine that are also used for hypertension, such as calcium channel blockers and beta blockers (such as Atenolol (Tenormin)). However, the reason these work for migraine is not the same reason they work for high blood pressure.

In 2005, British researchers fought back and suggested that hypertension does cause headache. This was a meta-study, studying the data from other studies. However, there are reasons why this probably isn’t the last word.

For example, the study showed that people on medication for hypertension had fewer headaches. That shouldn’t be a surprise, but it’s a long way from proving that hypertension is causing headache. Also, these weren’t studies designed to find out if high blood pressure causes headache – they were focused on other things. Studies focused on the question are still inconclusive after almost 100 years. (more on this study)

Drs Young and Silberstein sum it up well in their book Migraine and Other Headaches:

In order for high blood pressure to cause a headache, it has to be so high that it overcomes the normal protective reflex of the brain’s blood vessels … Blood pressure so high that it causes a headache is a medical emergency. Some people may have high, but not immediately dangerous, blood pressure due to pain caused by a headache.

Is high blood pressure causing my headache? Probably not. But do be cautious of taking medications that could increase blood pressure, especially if your doctor is already concerned about your blood pressure.

4 December 2008

Doxycycline for daily headache?

James Discoveries & Stats, Medications 17

So how would you feel about taking an antibiotic for your headache? If you’d be uncomfortable with that, you’re not alone, and I’m proud of you. 🙂

But that’s no reason to ignore the small study that was done by Dr. Todd D. Rozen of the Michigan Headache and Neurological Institute. In the study he used Doxycycline to treat new daily persistent headache. Before we get to the results, a quick overview of Doxycycline itself.

Doxycycline is the generic ingredient in a whole host of brand name antibiotics, such as Adoxa, Doryx, Monodox, Periostat, and Vibramycin. These types of antibiotics work by interrupting the life cycle of the bacteria. It’s used for a number of different bacterial infections.

New daily persistent headache (NDPH) is one of the most treatment-resistant types of headache. In fact, the patients in this trial had already tried (unsuccessfully) 5 different preventive treatments. Interestingly, many patients get NDPH after an infection. And one theory is that a certain type of inflammation is behind NDPH.

That inflammation chain-reaction can also be stopped by Doxycycline, making it a candidate for treatment.

Only 4 patients were in the trial, but 2 became 100% pain free, 1 had an 80% improvement in daily pain intensity, and the last person had a slight improvement in pain intensity and a more than 50% decrease in severe pain episodes. On average, patients improved after 3 months (2 daily dosages of Doxycycline, 100mg). There was only one notable side effect – one patient got a severe sunburn (you have to be careful about your time in the sun when you’re on Doxycycline). These are very good results for something so difficult to treat!

So the results are pretty positive, and it probably wasn’t because of the antibiotic properties of Doxycycline at all. If these findings are confirmed by larger studies, it may show that our understanding of NDPH is on target. And it may open the door to better treatments.

Doxycycline itself may or may not be a good treatment. Obviously, we need to be cautious about taking antibiotics. Also, many medications, supplements and foods can decrease its effectiveness, so it needs to be taken properly under the care of a doctor.

This study was brought to my attention by the Headache News Blog.