Treatments

18 February 2009

Triptans and NSAIDs: 1 better than 2?

It’s become very common to use NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen (ie Advil) or naproxen (ie Aleve, Naprosyn) along with other medications. But, as a recent study points out, sometimes more is less.

This study from Merk & Co. surveyed 8440 oral triptan users. The idea of the study was to find out what combinations were being used, and how effective they were.

Patients were put into 6 categories – some took NSAIDs first, then triptans. Others took them both at the same time, and so on.

The patients who seemed to get the most relief were those taking only triptans, triptans and NSAIDs together, or NSAIDs first, then triptans.

But one interesting outcome was that, not only were those taking only triptans comparatively satisfied with their treatment, they also had less nausea than any other groups. In other words, at times it seems that triptans by themselves are better than triptans with NSAIDs.

Though common wisdom would say that attacking your migraine on two fronts will be more effective, we certainly don’t want to take more medication than we need to. If you’re frequently using these medications, you may find that cutting out the NSAID won’t hurt. It will also avoid the dangers of long term use, such as significant gastrointestinal problems.

Talk to your doctor, and try simplifying your therapy. You might find that your symptoms even improve over time.

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!

21 January 2009

Christian Body Migraine Defense (now Tuliv Migraine Defense)

James Treatments 7

People are still looking for and asking about a supplement for migraine known as Christian Body Migraine Defense. Also called CB Migraine Defense, the name was changed to Tuliv Migraine Defense in 2007.

Christian Body Migraine Defense actually came under the most fire because of its name. Both Christians and non-Christians alike were uncomfortable with the use of "Christian" in the name of a product like this.

In defence (pardon the pun) of the name, it actually came from the original name of the company – which was Christian Body. The company focused on the Christian community, encouraging them to take better care of their bodies. Their early focus was on vitamin supplements, and Christian Body Migraine Defense was added later on. I tend to agree that it was a good move to change the name! 🙂

Ingredients

So what is in Tuliv Migraine Defense? Let’s take a quick look at the ingredients:

Borage Oil Powder: Borage is traditionally used as a cooling and calming herb, and is said to improve circulation and decrease inflammation. It’s also been popular in use for the hormonal system, to treat symptoms of PMS and menopause.
Dong Quai Extract: Used as a hormone regulator and a mild laxative. Also may thin the blood. (Note: Dong Quai is considered dangerous during pregnancy)
Vitex Agnus: Also known as chasteberry, and believed to reduce prolactin (a hormone) in higher doses. It’s used to treat both male and female reproductive systems, and there is some evidence it’s beneficial for treating symptoms of PMS.
Black Cohosh: Very popular these days for symptoms of PMS and menopause. There is increasing interest in using it to treat osteoporosis. There are some concerns about black cohosh increasing and prolonging blood flow during menses, and some researchers caution against taking it for long periods of time. It also contains tannins, and has been known to cause headache.
Cramp Bark: Popularly used to treat menstrual cramps, but is also used for all kinds of muscle pains.
Wild Yam Extract: Another one used for PMS and menopause. Has also been used with Vitex agnus to treat morning sickness.
Vitamin B6: Works on the metabolism, among other things. Helps in the creation of serotonin in the body. It’s also used for morning sickness, and to treat hangover. B6 is a mild diuretic.
Folic Acid: A form of vitamin B9. Many of you are familiar with folic acid because it’s taken by women who want to become pregnant. It has a number of benefits in the body, and it’s been a suggested ingredient to fight heart disease, stroke and depression.

Please note – that wasn’t supposed to be a comprehensive overview of these ingredients, just a brief informal summary. I know there is much more that could be said!

The theory behind the supplement

You’ll notice many of these herbs are often used by women for PMS and menopause. However, the creators of Christian Body Migraine Defense believe that migraine is related to hormones in both men and women. The claim is that this supplement treats the hormonal problem and so gets to the very root of migraine. The site says:

Over 90% of all migraines occurring in men and women are caused by the body’s inability to properly manage specific hormones which causes the release of neurochemicals that upon reaching the trigeminal-vascular system in your head generates a painful migraine headache.

The problem with the money

The former Christian Body Migraine Defense, now Tuliv Migraine Defense, suffers from the same problem of a lot of smaller companies. They’re not going to have the money for massive clinical trials like the big companies. The need to rely on research (often one or two people) and a lot of luck.

That’s not necessarily a strike against them. We urgently need researchers coming from new angles with new ideas. There is so much information to go through, it is entirely possible that a small company or even an individual anywhere in the world may make the breakthrough that leads to much better migraine treatment. Besides, even the research of the big companies can be misused and misunderstood.

However, it’s obvious that the lack of research can be a strike against as well. With so many things to try, the fact that Tuliv Migraine Defense is different may be one of the few reasons why people will order.

Christian Body Migraine Defense vs Other Supplements

Also a little puzzling is the way the company speaks out against other migraine treatments. Although they admit their supplement won’t work for anyone, they also downplay other supplements that have a great deal of evidence to back them up. On their home page they say,"Migraine Defense does not contain hormones, feverfew, butterbur, magnesium, amino acids, or any other such non-productive ingredients."

They need to take a look at the clinical evidence behind some of those "non-productive" ingredients.

Later they say: Migraine Defense is not a "folk lore remedy" and does not contain such notions as butterbur, feverfew, or magnesium as do many of the “soup pot” migraine potions sold today.

There is increasing clinical evidence for all three of those in the treatment of migraine, and calling them "potions" isn’t contributing to the scientific research in my opinion. (More on butterbur, feverfew and magnesium for migraine)

I’ve also learnt to be cautious about companies claiming to know the cause of migraine, as their main page says about the developer of Christian Body Migraine Defense: …he did more than discover the true biological cause of migraines; he went on to develop the first anti-migraine nutraceutical formula that completely stopped and eliminated forevermore migraines for his wife Eileen.

In summary, I don’t want to write off smaller companies making contributions to migraine treatment. Often they indeed to a better job than the larger companies. However, I would approach each one with caution.

Remember, herbs can have side effects, and can interact with other herbs and drugs. Do your research, and talk to a doctor who knows your medical history and knows what other herbs, supplements and drugs you’re taking.

And remember, there are a lot of good options out there – the best thing is to find a good specialist who is willing to help you through the maze.

2 January 2009

Doctors and Alternative Therapy for Migraine (video)

James Treatments 1

This video comes from the NBC, and it’s just a little discussion of some of the more common "alternative" treatments for migraine.

It’s good to see more and more doctors recommending something other than drugs. There is such a wide variety of treatments available that the doctor who offers a couple of painkillers and then gives up is (thankfully) becoming more and more rare.

The video talks about a number of things we’ve talked about before, such as butterbur, magnesium, botox, coenzyme q10 and biofeedback.

Click below to go to the video:

Thanks to Diana Lee for passing this video on.

10 December 2008

Reflexology for Migraine?

James Treatments 3

Reflexology continues to be a matter of debate, and reflexology for migraine is no exception. For example, in the USA there is a drastic difference from state to state regarding the qualifications required to practise. For example, some states require that you be a massage therapist, others do not.

The idea behind reflexology is that stimulation on various parts of the body (usually feet or hands) can improve the functioning of various parts of the body – various organs, for example. Pressure is applied to specific areas in order to improve the health of each body part.

Recently I’ve been reading over the literature on reflexology for migraine and headache, and I’m afraid I’ve come away unimpressed. I really want to like reflexology. I strongly believe, in fact, that massage of the feet and hands can have a positive impact on migraineurs, and can be a viable treatment.

But reflexology claims to be more than massage. And studies comparing reflexology to massage are often uninspiring. Positive studies are often too vague to be helpful.

With so many treatments out there, we need to ask which are the best ones, which ones are actually worth the cost. So far, the research on reflexology has not convinced me that it should be anywhere near the top of the list for treatment.

As regulations for reflexology have been relaxed, many more practitioners have appeared on the scene. People even want reflexology for their pets. If reflexologists want to offer reflexology for migraine, I suggest they offer larger and more scientific studies showing that it’s worth our money.