Treatments

2 March 2017

Vitamin B2 (riboflavin) for Migraine

Vitamin B2, otherwise known as riboflavin, has long been a recommended supplement for migraine. Over the past couple of years, studies have continued to show the benefits of B2 for adults, although there has been less evidence for its use in children (see also Supplements as Preventatives for Children – what works?).

Some studies have even found that its comparable to certain common drug treatments (see this study comparing riboflavin to sodium valproate, leading some researchers to recommend it as a safer option as compared to more mainstream migraine medications.

But vitamin B2 still seems to shine most when used in conjunction with other complimentary and traditional treatments. Hence the popularity of combo supplements such as MigreLief. See also some of our visitors comments in Magnesium for Migraine 2 – Combos?

A common recommendation for migraine patients is 400mg of B2 daily. It’s wise to check with your doctor before trying any new treatments.

Recently, ConsumerLab.com did a test of various vitamin B supplements. They tested only two brands with B2, but they both passed quality tests. They were the PipingRock.com brand, and Nature’s Way. The PipingRock.com version was at time of writing less expensive, while according to ConsumerLab.com the Nature’s Way version had the advantage of being gluten free and avoiding other common allergens such as soy and dairy. Both come in 100mg capsules.

Check out this randomized controlled trial, which found patients taking riboflavin had 50% fewer migraine attacks than those taking the placebo: Effectiveness of high-dose riboflavin in migraine prophylaxis.

20 February 2017

Migraine Experts Remain Skeptical of Acupuncture

James News, Treatments 1

A report last year suggesting that the benefits from acupuncture “persist” long term has led to some interesting discussion among migraine experts. An interesting theme of their comments – they might recommend acupuncture, but they’re still skeptical.

Acupuncture: Experts Skeptical Many migraine clinics and professionals seem reluctant to speak out against acupuncture. Part of the reason is that they see few or no side effects, which is a good start. But acupuncture is also very heavily promoted, and many patients swear by it and would not appreciate hearing anything against it.

The study released in October (The persistence of the effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain.) drew on earlier studies. However, as has been noted again and again, these studies are not as reliable as many of the medical trials we’re familiar with.

Dr. Richard Lipton pointed out once again that “blinding” is difficult – in other words, how do you make someone “think” they’re receiving acupuncture when they’re not (an important part of blind clinical trials). One of the most often cited trials showing benefit from acupuncture for migraine did use “fake” acupuncture, but concluded that Treatment outcomes for migraine do not differ between patients treated with sham acupuncture, verum acupuncture, or standard therapy. In other words, just stick the needles anywhere.

Long term studies of acupuncture for migraine remain nonexistent. Dr. Dawn C. Buse notes that some studies may simply reflect that patients who apparently benefit from acupuncture are actually more self sufficient and willing to try new treatments – in other words, it’s not the acupuncture, it’s the overall way of life.

But if some studies seem to show that acupuncture may compare to more traditional treatment, why doesn’t everyone use it?

Some of the reasons include:

Poor clinical trials (as mentioned above), or trials with mixed results, and therefore a lack of confidence in the results.
Emphasis on a combination of treatments. Most specialists are positive about complimentary treatments, but most of these treatments work best along with more traditional treatments. Acupuncture isn’t the cure.
Many other good options. Although acupuncture tends to get a lot of press, there are many, many non-traditional and complimentary treatments available. Many specialists simply put acupuncture further down the list, feeling that there are better options.
Expense and time commitment. Even Dr. Alexander Mauskop, who is a licensed acupuncturist, admits to treating very few patients with acupuncture. For one thing, acupuncture is not likely to be covered by insurance. And it takes time – one of the cited studies, for example, had patients in for acupuncture 5 times a week. If you need to go 5 times a week, to actually get a benefit, would you do it?

Between studies with mixed results, time and expense, and many other and often better options, many specialist would agree with Dr. Deborah I. Friedman: “In general, I don’t discourage it, but I rarely suggest it …”

2 January 2017

5 Ways to Maximize Your Omega-3 Supplements

James Discoveries & Stats, Treatments 2

Omega-3 supplements are recommended by many doctors, not just for general help but also to help fight migraine.

But it’s easy to spend your money on something that really won’t be a big help. So here are some tips to help you get the most out of your omega-3 supplement.

Take your supplement with food. In fact, a fatty meal is your best bet to make sure the oil is absorbed. Good fats, of course. Whatever that looks like for you. But just be aware that you will absorb the oil far better with a hearty bacon and eggs breakfast than with a glass of skim milk.
If possible, use fish oil. If you’re a vegan, you won’t want to go this route. But if you can do it, this is probably your best bet.
Take with a healthy, balanced diet. It’s best to get your nutrients from food. Supplements are “supplements”, not “replacements”. Eat a healthy diet low in processed foods and high in fruits and vegetables. For omega-3 foods, try omega-3 fortified eggs, fish, ground flax seed, chia seed, and hemp seed.
Choose the right brand. Consumer Lab recently tested many different brands for accuracy on the label, freshness, etc. See below for some of the recommended brands.
Watch for EPA + DHA. These amounts should be on the label. 1000mg of fish oil is not the same as 1000 of the EPA/DHA combination. For plant based supplements, look for the ALA amount.

People with migraine often opt for the higher concentration omega-3 supplements. Consumer Lab recommends Viva Naturals Omega-3 Fish Oil. Viva Naturals is tested to avoid contamination (mercury, PCBs, etc) (and Consumer Lab confirmed this), is fresh, and is also the lowest-cost approved fish oil in its category.

Although not certified gluten-free, this supplement is made gluten free in a dedicated gluten free facility.

This brand also received an “A” ranking from Labdoor (the brand was then “Viva Labs”, but according to the company the product hasn’t changed).

For certified gluten-free versions, try OmegaVia Pharma-Grade Omega-3, which is also enteric coated (which should help with absorption), or GNC Triple Strength Fish Oil, also enteric coated. As with the Viva Naturals brand, they were tested for contaminants and freshness.

The OmegaVia brand also made the top 5 in the Labdoor rankings.

Some brands that were not approved included Kirkland Signature, NutriGold, and Vitacost brands, because they contained less EPA/DHA than it said on the label, and/or they contained contaminants.

If you’re going to take omega-3 supplements this year, save your money and get the most out of what you buy. Following the above instructions can result in getting several times better absorption – much more benefit for your money!

12 December 2016

Laser Therapy (LLLT) for Migraine

James Information, Treatments 1

Yes, there is current interest in using lasers to treat migraine. In this case, low level laser therapy, otherwise known as LLLT.

The idea of adding more light and heat to migraine may not sound appealing at first. But LLLT is a non-invasive and non-painful therapy that has been used for a number of pain conditions including headache disorders. There are specific laser treatment devices that are used for certain conditions.

In the case of LLLT, the lasers are set at a lower level than what is used for surgeries. This is not a cutting treatment. Instead, it stimulates your cells in certain ways that may promote healing.

The trials of this type of laser therapy for various conditions have not always had spectacular results. However, since the therapy seems to be side effect free and non-invasive, there is some interest in further researching the treatment.

So that brings us to migraine. Currently, The San Francisco Clinical Research Center is putting together a sham-controlled, single attack study to test the effectiveness of LLLT for migraine. Now, this is a very specific and small study, but it might be a place to start.

The LLLT needs to have a target. In this case, it’s the sphenopalatine ganglion (SPG). The SPG, a nerve cluster behind the nose, is already the focus of migraine treatment (and cluster headache treatment). Injections to this site have shown great promise in migraine treatment – could laser therapy do the same thing?

This study won’t give us all the answers, because it will not be a series of treatments (which may be what is needed) but only a single treatment.

However, if this treatment can help with a single attack, it could be another situation where a migraine patient could have a hand-held device at home that would allow them to treat themselves.

If you’re interested, you can talk to a migraine specialist about this treatment. If they have had success with their patients, it might be something to pursue.

Meanwhile, we’ll look forward to hearing about future research.

For more information:

An example of a laser therapy device: K-Laser
Laser Therapy overview
A Skeptical Look at Low Level Laser Therapy
Study of Low-level Laser Therapy in the Acute Treatment of Migraine – the clinical trial mentioned above
Cold Laser Treatment: Uses, Benefits, and Effects specifically for headache

8 December 2016

Beta Blockers: Migraine

James Medications, Treatments 0

This information on beta blockers: migraine is a step back to some of the basics regarding migraine treatment. Just what are beta blockers, and why are they used for migraine?

Beta blockers, also called beta-adrenergic blocking agents, are medications used for both migraine and blood pressure issues. They work by blocking certain neurotransmitters (norephinephrine and epinephrine) so that they won’t bind to certain beta receptors on nerves.

In this way the drugs reduce your heart rate and reduce blood pressure by dilating blood vessels. Different beta blockers have a slightly different effect on your cardiovascular system.

Beta blockers for migraine are given as preventatives. Some of the most effective beta blockers for migraine are metoprolol, propranolol, and timolol.
beta-blockers-migraine In 1966, a patient using beta blockers for a heart condition experienced a dramatic improvement in migraine symptoms. In the 1970s, beta blockers started to be tested and used for migraine on a regular basis.

It’s easy to jump to the conclusion that the effect of beta blockers on the cardiovascular system is the direct reason why they prevent migraine. After all, we’re very familiar with that pounding, pulsing pain – why wouldn’t relaxing of the blood vessels help?

But of course it’s not that simple. Believe it or not, that pounding is not directly related to your heart beat. So today, migraine experts are not certain about just why some beta blockers help some patients.

Before taking beta blockers for migraine, your doctor will need to know your medical history. People with certain heart conditions, lung conditions, or those taking certain other medications, may not be able to take beta blockers. There are also other migraine treatments that you may want to try first.

Today, there are various beta blockers you can take for migraine, and there are various ways you can take them. If one doesn’t work, another might.

One of the most interesting recent discoveries is that beta blocker eye drops may even be effective abortive migraine-fighters! See $5 Eye Drops to Stop Migraine Attacks?

Common side effects of beta blockers include fatigue, weight gain, trouble sleeping, nausea, sexual dysfunction, and shortness of breath. Some of these will depend on the dosage and the type of beta blocker. Your doctor can help you choose what to try first.

For more information, see: