artificial sweeteners

14 November 2019

How To Quit Sugar (1)

Quite often I find myself disagreeing with the prevailing views and popular articles when it comes to “quitting sugar”. I think part of the reason is because our motives tend to be quite different from the motives of other people.

Sure, lots of people want to lose weight – maybe you do, too. Or be healthier in general. Or attain to some kind of athletic achievement. But for someone with chronic headaches, the motivation is something called “PAIN”. We would like to get rid of it, along with the other horrible symptoms that tend to come with it.

So keeping in mind that – sure, we would like to be a healthy weight. We want to be healthy in general. But we really do have a more immediate goal. And that often changes the way in which we do things.

So for those who want to cut down on their migraine/headache attacks, I would like to share a few thoughts about quitting sugar, just for you.

Where are we going?

What exactly is our goal here? To never let another sugar granule enter our bodies forever? Well, not necessarily. But let’s face it, there is an increasing amount of evidence that…

Most people are simply eating way too much sugar.
Refined sugar is not doing you much good, but it is doing a lot of bad.
Artificial sweeteners by and large are also often unhealthy, they also go hand in hand with sugar as migraine triggers.

So I suggest that our goal should be this – cut out virtually all sugar and sweeteners for a significant amount of time (several months). Beyond this time of experimentation (what’s happening to my symptoms?) and adjustment (it will take your body time to adjust – this is a significant change), you may want to introduce very small amounts of sweeteners (including sugar) into your life on rare occasions.

Some people will tell you it’s just impossible or unreasonable to completely cut sugar and sweeteners. It’s not. It’s a challenge that you need to prepare for, yes. But it can be done, and for many it may completely transform your life.

“Cutting down” is one of the great banes of diets. “I don’t each much of that…” “But today is a cheat day…” And the truth is, you are either trying to measure everything (frustrating!) or you really have no idea how much “bad food” you’re eating. Because you think you’re “cutting down” you feel a little better about yourself (until you cheat), but you really don’t get any results.

So, commit yourself to a drastic change. This is not a diet. You’re going to change how you eat. But this is not necessarily a forever commitment. How about 6 months? Then you can evaluate how you’re doing and how things have changed.

Prepare…

It does help to prepare before you jump in. Here are a few tips.

Cut out the sugary drinks. This is a simply step you can take ahead of time to help your body start to adjust before you go all in. You know your doctor will agree that sugary drinks are the easiest and fastest way to get a whole lot of unhealthy sugar into your body. And guess what? This is not just soda pop – this is juice too. Try the wonderful invention of water. Or get some fancy teas or coffees. Just get rid of the drinks with sugar.
Make it fun. You’re going to do some cooking, let’s face it. How can you make it easier, or more fun? How about a new kitchen appliance, like an Instant Pot? Or a good meat thermometer? A spiralizer (seriously, everyone needs a spirilizer to make healthy food fun!)? Treat yourself as you start on this new adventure!
Find a buddy. It will help a lot if you have a friend or family member who will do this with you. Even if their motivations are different, they still might be excited to join you!
Observe, and start to think about what you will eat. Actually, we’ll talk more about this next time. But it’s time to start thinking about how you’re going to eat in the future. First, observe – you’ll start reading labels, or noticing how often you add sugar to food, or how often you eat sauces with lots of sugar in them (one is commonly called “ketchup”). Then you’ll start thinking – if I don’t eat that sugary cereal for breakfast, what will I eat? What, no double mocha coffee espresso late? What about that snack I always get at 2pm? at 10pm?

Many people are getting angry enough with migraine to turn away from drugs, and instead start making serious changes. And as I’ve said for many years, diet is one of the most powerful tools you have.

We’ll look more at this topic soon as we seriously investigate the option of quitting sugar.

11 November 2019

Caffeine Pills for Headache?

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Many people have noticed that a quick shot of caffeine – be it in a cup of coffee or tea, or a cola, or even in a painkiller – may keep a headache at bay. But some people also specifically use caffeine pills to fight headache. But is it a good idea?

Caffeinated drink - a good option to fight migraine?

Migraine experts have traditionally had a love-hate relationship with caffeine. For those that have few attacks and find that it helps, many doctors do suggest some strong coffee or a Coke to stop a headache. And some patients recognize that there are some benefits to taking a pill instead. For example,

It’s convenient. You can keep a pill or two on you at all times, and take it when needed.
Don’t like coffee? No problem – take a pill.
Pills are less likely to cause heartburn (although they still might).
You get a predictable, exact amount of caffeine.
Although you may lose some benefits of tea or coffee, you also cut out some bad ingredients – and added ingredients, such as sugar or artificial sweeteners.

(Here’s an overview of caffeine pills, discussing some of the general pros and cons, from MedicalNewsToday: What to know about caffeine pills.)

Although coffee and tea have benefits, I think that the best advice has always been to keep your caffeine intake low and consistent, and avoid the sweeteners. Drinking coffee every day at the office and then skipping it (or drinking it later) on weekends has always been a prime suspect when it comes to weekend headache.

Now few people would want to take a caffeine pill a day – if you don’t, your caffeine is not consistent. If you feel you do, for headaches, you have a significant problem.

The typical advice you’ll hear is that if you’re taking a pill with caffeine (even a combination drug, such as aspirin+caffeine), you shouldn’t take it more than twice a week. If you do, you’re running into a serious risk of “rebound headache” – in other words, headache symptoms increase and become more frequent not in spite of but because of the caffeine pills.

However, others argue that rebound headache is more of a continuum. In other words, every time you take a pill with caffeine for a headache, you’re increasing your chances of a future headache to some degree. And don’t just count your “migraine attacks” in this – if you have a constant low-level headache, or frequent “tension headaches”, these may also become worse or more frequent.

(This article from the American Headache Foundation uses the “two days a week” line, but also points to some fascinating studies and statistics about caffeine, that should at least make you think twice before considering this to be a good solution to your headache issues. See Caffeine and Migraine.)

So look at it this way. If a couple times a year a strong coffee or a caffeine pill stops a headache, you probably have nothing to worry about. Especially if you rarely have headaches or migraine attacks. But let’s face it, most people like that aren’t reading this article.

If you do feel you need the pills with you, or you’re often reaching for a pill or an energy drink or a coffee to stop a headache – even if it’s a fairly “mild” headache – you can probably find better solutions. First consider gradually lowering your caffeine intake. Next, if your headaches are a regular issue, be sure you’ve talked to a doctor, and if possible a headache specialist. You can find better solutions, and probably avoid worse symptoms in the future.

To give you a little more motivation – in one of our online polls, about 1 in 10 people had tried cutting caffeine out of their diet, and found that it helped with their migraine or headache. So it’s worth trying – but remember, you’re best to lower amounts slowly, and keep them as consistent as possible.

3 July 2015

Dysautonomia and Migraine

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Yesterday we took a quick look at dysautonomia symptoms and the relationship between dysautonomia and migraine. Today we’re going to talk a little about what you can expect, and what you can do, if you have both migraine and a dysautonomia disorder.

Migraine and Dysautonomia Your prognosis will vary drastically depending on what type of dysautonomia you have been diagnosed with. As we mentioned yesterday, some types of dysautonomia are progressive, and can shorten your life. Other types are chronic, and never go away completely. Some resolve on their own. Some are severely disabling (limiting your ability to get out of bed), while others are mild.

So it is very important to get a specific diagnosis, and to talk to a specialist who can guide you. There is help available, but you will need patience to find what works and to improve your quality of life.

Lifestyle Changes

In general, you will fight dysautonomia symptoms with changes in lifestyle. Diet changes can be key – drinking plenty of water, increasing your salt intake, avoiding sugar, artificial sweeteners, alcohol, and caffeine, and eating several small meals during the day, for example.

Exercise is important, but can be very challenging for patients with dysautonomia. A gradual increase in moderate exercise is usually planned.

As with migraine, an overall healthy lifestyle will go a long way. But there are some specific changes you may need to make depending on your specific diagnosis.

Other (non-drug) Treatments

Other treatments may include wearing compression stockings and elevating the head of your bed. Sometimes supplements are recommended.

Drugs: A Balancing Act

Sometimes drugs are used for dysautonomia as well, but this can be a very challenging balancing act.

For one thing, some drugs that you may be familiar with can actually lead to dysautonomia, such as some drugs taken for high blood pressure or depression – and yes, drugs for migraine. You may need to take a medication which will contribute to your symptoms, but hopefully you can find something that will have only a small impact (I’m talking about changing to a different but similar medication). Your doctor will need to monitor you carefully. Watch your symptoms, but don’t expect them to go away completely.

If you have a dysautonomia from another disorder, such as diabetes, your treatment will likely focus on the “primary” condition. In some cases, you may take medications for both, but again, it’s a difficult balancing act.

Some medications that may be used in some cases include fludrocortisone, midodrine, and ephedrine. Medications will require monitoring and adjustment over time.

You may need to adjust your migraine medication, because it could be making your symptoms worse. This is another reason why it is helpful to speak to a specialist.

Selected Sources and Resources

Here are some of the key sources I’ve used in these two articles, as well as resources you can use to learn more:

What is Dysautonomia? (A brief summary from the National Institute of Neurological Disorders and Stroke)
Dysautonomia Youth Network of America, Inc. (a wealth of information on dysautonomias – don’t miss their pdf brochures)
Clinical Evidence of Dysautonomia (a technical article from Clinical Methods: The History, Physical, and Laboratory Examinations.)
Dysautonomia (summary and a list of organizations from the Cleveland Clinic)
Dysautonomia Links (from the American Dysautonomia Institute)
Postural orthostatic tachycardia syndrome (from the US National Library of Medicine)
Dysautonomia: Invisible, Often Misdiagnosed (experiences from someone with a form of dysautonomia. Remember, every type is very different.)

22 September 2014

Is Stevia giving me a Migraine Attack?

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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 – 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.

17 March 2014

Pop, Soda, Soft Drinks – the Headache Connection

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So – does drinking soft drinks cause headaches?

Well – cause? Probably not. Trigger? Maybe. Make things worse long term? Possibly.

The relationship between pop/soda/soft drinks and headache or migraine is complex. There’s a lot of information online, but unfortunately a lot is incomplete, overblown, or simply incorrect. More and better studies need to be done.

When people talk about the headache connection it usually is a conversation about caffeine. But there are a number of concerns even in non-caffeinated beverages.

We need to be clear that a moderate amount of fizzy drink isn’t going to cause problems (at least, not immediate, visible problems) for many people. But here are a few things to think about if you’re wondering if your soft drinks are making your headaches worse…

Caffeine: Yes, caffeine is a factor. The best advice when it comes to caffeine seems to be – keep your caffeine intake low, and constant. Don’t have a litre of cola one day, none the next, and a can the next. For more on caffeine, particularly in common beverages, check out A Coffee Headache? Caffeine and Headaches
Sugar: It’s not unusual for a soft drink to contain the equivalent of 1/4 cup of sugar. That’s a lot of sugar, and it won’t break down slowly. That means sugar spikes. That alone could trigger an attack. There could also be a cumulative effect (too much sugar over and over for several days). There’s also a more complex relationship with glucose, insulin, and nitric oxide. The longer term issues could include things like diabetes and obesity, both closely related to migraine. More about sugar and migraine here.
Artificial sweeteners: Aspartame, sucralose (Splenda), acesulfame potassium, saccharin, cyclamates – these are examples of artificial sweeteners that you may find in your soft drink. Good evidence suggests that these “diet” drinks may lead to the same or more weight gain than sugar drinks. But that’s only the beginning. Each of these chemical formulations has its own problems, including migraine attacks and joint pain. Some people find an obvious, direct relationship (drink diet soda = headache). Others find that the effect over time leads to more or more severe headache symptoms.
Phosphoric Acid: There are increasing concerns about phosphoric acid because it upsets the balance of calcium in the body. It may upset magnesium balance, which is tends to be a major factor in migraine in particular.
Acidity: The acidity in your soft drink comes mostly from the phosphoric acid and carbonation. Because headache conditions are often related to issues in the gut, the added acidity from many soft drinks may trigger certain symptoms, in the short term or in the long term. Although there is great debate over how much of a problem acidity is in the general population, it does seem to irritate some conditions.
Artificial colours: Again, these chemicals will vary from drink to drink, and the effects from person to person. But some people believe that this often-overlooked set of ingredients may be one of the biggest problems for people with headache conditions. Colour additives are regularly pulled from the market because of health concerns – is the one in your soda the next to go?
Sodium: The amount of sodium in soft drinks is low enough that it should not cause any problems on its own. However, large amounts of sodium in your diet may trigger some headache conditions.

Each of these items deserves an article of its own. Meanwhile, don’t let anyone tell you that avoiding caffeine or sugar is enough. It may be – for some people. But for others, the extra hidden ingredients could be a real pain.