A pounding headache afflicts most people at some time in their lives. It interferes with daily activities and keeps us from functioning at our best. Doctors offer powerful medications that may or may not help and have side effects of their own. What are the main types of headaches? What causes them? And how can we get rid of them without making ourselves sicker?
In her book No More Headaches, No More Migraines, Dr. Zuzana Bic has some of the answers. Dr. Bic is a lecturer for the Public Health Program in the College of Health Sciences at University of California at Irvine, and is in private practice. In her research and work using integrative lifestyle medicine in the prevention of chronic diseases, she has been able to identify headache “triggers.” There are many things that trigger headaches. If we know what they are, we can avoid them and cut down on headaches without pain medications. She describes changes we can make in our day-to-day lives to make headaches a thing of the past.
“Where my research is unique,” says Dr. Bic, “is in trying to identify the common denominator for all the lifestyle factors. I have a group I call diet-related triggers. In this group belongs all food that is high in fat, high in refined sugar, most processed or refined food, and food that is low in complex carbohydrates. A related group is obesity, which is connected to not eating properly, and also hypoinsulinemia or insulin resistance, one of the first signs of diabetes. Hypoglycemia, which means low levels of sugar, is another trigger for headaches. Prolonged hunger and dehydration can cause headache, as can alcohol and caffeine intake.”
What is the common factor? “This is the question I have addressed in my studies,” Dr. Bic says. “What I have found I try to explain to the patients. As you know, the cells in the blood—platelets, red blood cells, and white blood cells all coexist in the blood vessels. A high level of fat in the blood will crowd up the vessels, similar to a crowded freeway with one car bumping into another car. A process like platelet congregation occurs and there is a little bit of damage to the platelet, causing it to release serotonin. The body acts to excrete this excess serotonin and thus you have lower levels of serotonin. Serotonin is a very important neurotransmitter, and its lack is an important factor in triggering headache.”
Other lifestyle triggers include smoking, a sedentary lifestyle, and exhausting physical exertion. “Some patients who suffer from anorexia nervosa or bulimia exercise excessively, and this is the type that can result in headache,” Dr. Bic says, adding that “stress, oral contraceptives, or hormone replacement also trigger headaches.”
Dr. Bic identifies imbalanced diet as one of the main headache triggers. She found it effective to put her patients on a low-fat diet with a lot of fruit, vegetables, grains, beans, and a higher amount of fiber. She also recommends increasing the daily intake of water. “They think they drink enough water, but if they monitor it in their food diaries, they find that there is not enough water. They are always surprised.
“I also recommend starting an exercise program or increasing the level of physical activity. Start walking ten minutes in the morning and ten minutes in the evening. Or park the car as far away as possible and walk to the office. To cut down on stress, I recommend meditation or one-minute relaxation techniques such as breathing exercises or changing how they perceive situations to a more objective point of view.”
In her research, Dr. Bic also elucidates the timing of the trigger and the headache. “Some of my patients are more sensitive and can have a headache immediately, one hour after the trigger. For others it can be seventy-two hours after the trigger. I think it is the accumulation of unbalanced lifestyle factors. It is possible for a person to be sedentary, eat a high-fat diet, have a very stressful situation, and not be drinking enough water. All these things accumulate and they can have that headache from three hours to seventy-two hours.”
Dr. Bic points out that some types of headaches are not caused by triggers and therefore are unaffected by lifestyle changes. These include headaches resulting from trauma, infection or tumors in the brain, or problems with eyes or ears.
There are several types of common headaches. For information on migraines, see chapter 45.
Tension Headaches: Tension headaches are characterized by a dull, aching pain that radiates throughout the entire head. Some sufferers describe the feeling as having a tight band wrapped around their head. Tension headaches can start in the shoulders and neck and move upward to the back of the head. Stress, arguments, repressed anger, poor posture, depression, social problems, or major life changes can induce tension headaches. Tension headaches may also be a symptom of depression, especially in the elderly who have experienced a potentially traumatic or stressful event, such as retirement, forced relocation, reduced mobility or independence, or a serious illness.
Cluster Headaches: Cluster headaches come in groups. They can last for extended periods of time for days, weeks, or even months. Sufferers usually experience one or more headaches per day. Each headache may be relatively brief, lasting for thirty to ninety minutes, and may escalate in intensity during that time. In general, cluster headaches affect one side of the head, and the pain is centralized in the eye area on the affected side.
Exertion Headaches: Exertion headaches are connected to physical activities such as exercise, sex, laughing, and coughing. They generally occur during or just after the activity. In and of themselves they are not dangerous, but frequent exertion headaches may indicate an underlying physical state conducive to stroke or another serious condition.
Organic Headaches: Headaches that are the symptoms of a serious underlying physical condition, such as high blood pressure or brain tumors, are considered organic headaches. In addition to the headache pain, the sufferer may have fever, confusion, and/or trouble speaking or moving. The pain tends to grow worse, increasing with each headache or striking more frequently.
Hypnic Headaches: This newly described type of headache, which occurs in elderly patients, is easy to recognize. Hypnic headaches—so called because they arise out of sleep—present as bilateral pain that lasts for thirty to sixty minutes, awakening patients from sleep one or two times each night. Hypnic headaches occur primarily in individuals over age sixty-five and respond well to treatment with medication (most often lithium, taken at bedtime).
Keeping a daily journal of headache occurrences may help you and your doctor to understand what is causing your headaches. A number of medications, many of which are commonly prescribed as we grow older, may cause headaches. If you are worried about your headaches, or if they are disruptive to your daily functioning, you should consult with your health care provider. If your headaches follow a recent head injury; are associated with seizures; are so severe they prevent you from doing activities you want to do, wake you from sleep, cause blurred vision, eyespots, or other visual changes; or are associated with fever, vomiting, stiff neck, or tooth, jaw, or sinus pain, you should consult with your doctor immediately. Chronic headaches, or headaches that change in character or suddenly develop in an older person, should be carefully evaluated. They may be the result of a drug interaction or carbon monoxide poisoning. Headaches may also be the symptom of a more serious condition, such as giant cell arteritis (a condition of the arteries of the optic nerves that can result in blindness), brain tumors, spinal degeneration, lung disease, or even a warning sign of stroke.
Lifestyle and nutrition play important roles in headache prevention and treatment. Other alternative therapies include homeopathy, acupuncture, bodywork, and aromatherapy.
Attention to specific areas of your lifestyle can be crucial in preventing headache. Any behavior that promotes a healthful lifestyle, such as regular sleeping schedules, managing stress, practicing relaxation techniques, and staying physically fit, can reduce the frequency and intensity of headaches. When the pain is in your brain, the importance of the mind–body connection becomes paramount.
Studies have shown that moderate exercise can release endorphins and natural cortisol, which act to elevate mood and reduce stress. Aerobic exercise, such as dancing, walking, biking, or swimming, can help reduce the frequency of tension headaches. Gentle exercises, such as stretching, yoga, or even walking, can reduce discomfort while releasing stress. Exercise is also beneficial in normalizing sleep patterns and enhancing self-confidence. To ensure that you stay on a regular exercise regimen, I suggest that you choose a pleasurable activity and stick with it.
Meditation acts to calm the mind and relieve stress. Twenty minutes, twice a day, of mindful meditation is recommended to prevent and reduce tension and stress. Engaging in breathing exercises and being generally aware of your breathing patterns throughout the day can be beneficial in eliminating headaches. Focusing on the positive aspects of life and nurturing an optimistic outlook will reduce the effects of stress on the body and aid in coping with headaches.
It may sound simple, and it is. Standing and sitting correctly can keep your muscles from tensing and triggering a tension headache. Good posture supports and protects all of your body, allowing you to move efficiently and with less fatigue. When standing, make sure your weight is evenly distributed on both feet, hold your shoulders back, and tuck in your chin. Pull in your abdomen and buttocks. When sitting, make sure your thighs are parallel to the ground and your head is not slumped forward. Try to avoid standing or sitting in one position for long periods of time. Take frequent breaks to move around and stretch. Make sure your shoes fit correctly, and do not make a habit of wearing high heels regularly.
Studies indicate that a poor diet may be a significant factor in triggering headaches. One of the most important steps is the elimination of caffeine from your diet. Caffeine and caffeinelike substances found in coffee, tea, and many soft drinks can cause symptoms of anxiety, such as nervousness, fear, heart palpitations, nausea, restlessness, and tremors. Caffeine overstimulates the adrenal system and can deplete your body of important B-complex and C vitamins. It can cause stress and anxiety reactions in users. One study shows that patients with anxiety experienced a degree of anxiety that directly correlated with their consumption of caffeine. Even more astonishing, this report suggested that the persons most at risk for suffering from anxiety effects have a heightened sensitivity to the effects of just one cup of coffee.
Ironically, the process of eliminating caffeine from your diet may cause with-drawal headaches, as your body compensates for the lack of caffeine by producing more adenosine, a neurotransmitter that helps to regulate the diameter of the arteries in your head. As adenosine levels increase, your arteries dilate, and the excessive blood flow can then cause a throbbing headache. Once your body begins to regulate adenosine levels, however, the withdrawal headache will cease and you should remain headache-free.
Hypoglycemia (lowered blood glucose levels) is also directly correlated to headache and its related symptoms. To compensate for lowered glucose levels, your body releases insulin, a hormone that encourages glucose to move from the bloodstream into the cells. A sudden drop in blood sugar may cause the arteries in your brain to constrict, contributing to high blood pressure and headache. Maintaining proper blood sugar levels by avoiding refined carbohydrates is essential to controlling headaches.
Another common trigger for headaches is sensitivity to certain chemicals in foods. These chemicals include monosodium glutamate (MSG), a common flavor enhancer found in many processed foods; artificial sweeteners found in diet foods and diet soft drinks; nitrites, preservatives found in processed meats and some cheeses; and amines, a common compound found in a wide range of foods, including spinach, tomato, potato, tuna, liver, dark chocolate, and alcohol.
Headache sufferers should be conscious of the foods they eat. Choose organic, chemical-free foods and eat regular meals to avoid hypoglycemic reactions. Keep a food journal that lets you see if there are food-related patterns to your headaches. When a headache occurs, review the foods you ate in the seventytwo hours prior to its onset to see whether you can identify any trends. If you suspect a particular food may cause headaches, try eating that specific food for a week and see whether it triggers a headache. If it does, avoid it in the future.
The following remedies may be used for both temporary and acute cases of headache. When dealing with a chronic condition, homeopathic remedies must be used in conjunction with other therapies, as prescribed by a qualified health professional. Consult with your health care provider before taking any homeopathic remedy, and follow your provider’s recommendation for the appropriate dosage. Always inform your medical practitioner of any homeopathic remedies you may be taking.
Acupuncture may provide relief from chronic headache pain. By listening to your symptoms and examining your appearance and pulse, acupuncturists can diagnose and impact headaches. Acupuncture releases tension in the muscles. It causes a relaxation response in the body, resulting in lowered blood pressure and heart rate. Acupuncture increases the flow of blood, lymph, and nerve impulses to affected areas and decreases stress while promoting feelings of well-being and energy.
A variety of treatments involve the transfer of energy from the practitioner to the patient, which can help relieve pain and anxiety. In one study, massage reduced anxiety and lowered saliva cortisol levels (a key measurement of stress). Massage can be very effective at removing tension from the muscles and may provide relief from headache pain.
Reiki employs a powerful, hands-on healing technique in which the universal life force energy is channeled through the practitioner and transferred to the patient. Chronic stress and anxiety can deplete the energy in our bodies. Reiki is used to support the body’s natural ability to heal itself. It releases spiritual and emotional blocks and brings a feeling of harmony and vitality.
Massage can enhance general relaxation and provide an outlet for stress and tension. Massage therapy can reduce feelings of anxiety, promote better sleep patterns, and increase feelings of well-being.
Shiatsu combines traditional Chinese medical theory and various Japanese massage techniques. The therapist uses direct pressure with hands and fingers to redirect the flow of energy throughout the body. Shiatsu treatment is deeply relaxing and can be beneficial in both chronic and acute conditions.
Many people who experience tension headaches also grind their teeth during sleep—a practice called bruxism. A device called an NTItension suppression system (NTItss) is created and fit by a dentist and is worn while sleeping as a guard against tooth grinding and jaw clenching.
Craniosacral therapy is a hands-on healing technique that manipulates the soft tissues and bones of the head (cranium), the spine down to its tail (sacrum), and the pelvis, as well as the membranes and cerebrospinal fluid that surround these areas. The practitioner uses an extremely light touch to palpate, or feel, areas to detect a fluctuation in the cerebrospinal fluid, and then manipulates the area to clear blockages and correct the flow. This therapy is beneficial in reducing stress, improving the quality of sleep, and enhancing the general functioning of the body’s organs.
Essential oils can be used in baths or inhaled to provide rebalancing effects. Do not apply essential oils directly to the skin; they must be mixed with carrier oils. Some of the scents that may be effective in easing headache pain include eucalyptus, ginger, lavender, peppermint, rosemary, sandalwood, and wintergreen.
The alcohol hangover is an old problem. It’s even referred to in the Bible: “Woe unto them that rise up early in the morning, that they may follow strong drink” (Isaiah 5:11). The doctors call it by a fancy name: veisalgia, meaning “uneasiness following debauchery” and “pain.” The symptoms are headache, nausea, diarrhea, and fatigue, combined with decreased cognitive and visual-spatial skills and work loss.
Alcohol in high doses can be toxic. It can dehydrate the body and have effects on the heart. It also negatively impacts the brain, liver, and kidneys. Anyone who drives a car or has to operate machinery is going to have a problem when they have a hangover. Anyone who has to run a meeting or get the chores done is going to have a problem the next day. These people are going to feel lousy even after the alcohol is gone from their bodies. The alcohol leaves behind its toxic effects when you drink too much.
We know it has something to do with what’s in the alcohol. Dark-colored liquors, like brandy, wine, and whiskey, produce a bad hangover. Vodka, gin, or other clear liquors do not cause the worst symptoms. Sulfites found especially in dark wines can make you sicker. Alcohol causes a diuresis, or excessive fluid excretion.
Are there any ways to prevent hangover? In one study, an herbal preparation called Liv.52 from the Himalaya Drug Co. in Bombay decreased hangover symptoms. How did it work? The investigators thought it might be because the herb blocked the conversion of ethanol to acetaldehyde. Acetaldehyde is created from the by-products of ethanol (which is alcohol) in our stomachs. It can act like a poison in some people. Women are more susceptible to this because they have lower levels of the enzyme needed to convert alcohol to something less toxic.
In another study, vitamin B6 was given before, during, and after parties where the participants drank enough to get intoxicated. Those who took the vitamin reduced the number of hangover symptoms by 50 percent.
One thing everybody agrees on is to drink lots of fluids before, during, and after drinking alcohol. It helps to dilute the alcohol in the first place and replaces the fluids that are excreted by the kidneys.
The following chart summarizes the supplements I recommend adding to the protocol for overall brain health found in chapter 16. This protocol is designed for individuals who suffer from, or are specifically concerned about, headache. If you are concerned about conditions discussed in other chapters, consult with a health professional about how you can safely impact multiple conditions.
If you are taking medications—whether prescription or over-the-counter—or have any food restrictions, consult with your doctor before beginning any supplement program. Your health care provider should always be up-to-date on all vitamins, supplements, and herbal or homeopathic remedies you are taking. Supplement overdoses are rare, but possible, and certain combinations may affect individuals adversely.
| SUPPLEMENT | DOSAGE | CAUTIONS |
|---|---|---|
| 5-HTP (5-hydroxytryptophan) |
50–100 mg three times daily | Several months of treatment may be needed for maximum benefit. Nausea is the main side effect, but if it occurs, it usually dissipates within several days. Do not combine with prescription antidepressants. If you are taking prescription medication for depression, you should consult your doctor before taking 5-HTP. Excess levels of serotonin in the blood can be dangerous in case of coronary artery disease. |
| magnesium | Up to 1,000 mg | May take six weeks or more for effects to be felt. |
| melatonin | 300 mcg–1 mg two to three nights per week | Tolerance may develop with regular use. Long-term effects of nightly use are unknown. |
| vitaminB2 (riboflavin) | Increase daily dosage from 50 mg to 150 mg. Do not exceed a daily supplement of 150 mg. | Must build up to a therapeutic level. May not show results for several months. |
| vitaminB3 (niacin) | At the onset of migraine aura, take 100–150 mg. | High doses of niacin may cause a “hot flash” sensation. Some varieties are advertised as “flash free” and prevent this effect. |
| fever few | As directed | |
| black cumin seed oil | 1 tsp | |
| cayenne pepper capsules | As directed |