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By Daniel Miller, D.C., M.D.
Causes of migraines Updated August 2011
The first issue I explore with the patient who has migraines is that of diet, and specifically, food sensitivities. Estimates of food allergy and sensitivity as a trigger for migraines have been as high as 70%1. Wheat and dairy seem to be the most notable culprits, as they are in many other food- related conditions, and withdrawing both at once seems to be easier than doing one at a time, since many of our common foods (bagel and cream cheese, cereal and milk, pizza, pasta with cheese, etc.) I ask the patient to completely withdraw wheat and dairy foods for a three week minimum, and I provide dietary sheets with alternatives. I then have the patient "challenge" with a wheat or dairy meal, warning them that a migraine might be initiated. I have also noticed that aspartame (NutrisweetT) and various preservatives and additives can effect a migraine history, and I ask the patient to withdraw those, and the common migraine-associated foods (chocolate, red wine, etc.) as well. The second piece to look for is a structural component. The large majority of my patients with a diagnosis of migraine have a superimposed musculoskeletal component which effects the duration and intensity of the migraine. I palpate along the occipital ridge, frequently finding tight muscles and tender points. I then palpate down the posterior strap muscles of the neck, the sternocleidomastoid muscles, and the trapezius muscle.Trigger point maps, developed by Dr. Janet Travel, show points in these muscles which refer pain to the top of the head and to the temples. I measure rotation and lateral Bend of the neck to each side. I also assess jaw motion. Although migraine is thought to be a vascular phenomenon, it is surprising how much the problem can be modified by good body work, chiropractic and/or osteopathic adjustments. The next area I investigate is whether there is a hormonal variation. Quite commonly, I have a female patient whose migraines appear at ovulation and at the beginning of menses, or premenstrually. This can be accompanied by other symptoms suggesting a relative estrogen/progesterone imbalance.Documenting this imbalance can be difficult since standard blood tests give only a single snapshot of the hormones. Recently, salivary assays have been developed to measure estrogen and progesterone over the course of a monthly cycle. In my experience, it is usually progesterone which is relatively deficient. I sometimes treat this with topical progesterone cream, but until there are more studies of the absorption and release from adipose tissues of progesterone delivered in this manner, I more commonly give oral progesterone. For relative estrogen deficiency I might use black cohosh extract, soy-based phytoestrogens, or (if other symptoms co-exist) triple estrogen preparations Two herbs I have found to be effective are feverfew and ginger.Although we are providing a lots of free information we have to keep some information back. The reason is that we have to make a living and to keep the site active. These information shall be provided to the clients that are paying for consultation service and purchasing our products. It is in your interest that if you let us to choose for you Online consultation for alternative treatments. Please do not forget to bookmark the site. Free telephone consultation with Ben Ash 011-312 3393. Consultation in office would cost about R 300 including supplements.
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