Migraines are debilitating for so many people and natural prevention and/or reduction of symptoms is most desirable.
There are many factors involved in the processes that cause migraines, and there can be a large genetic component. Natural remedies can help the body to heal itself, as in any holistic approach. Factors include:
Nervous system dysfunction
Migraine is now believed to be primarily nervous in origin via dysfunction processing of sensory inputs to the central nervous system
Vascular issues
It is no longer believed that the major underlying cause of migraine is due to dysfunctional dilation and constriction of blood vessels, but this is nevertheless a factor to be considered even though it may not be the underlying cause. Pain may be caused by dilated blood vessels and sensitised by pain-producing chemicals and inflammation.
Cortical spreading depression
This refers to local self-spreading wave of electrical activity in the cortex of the brain (an awareness of this can be the ‘aura’ experienced by some migraine sufferers) and is associated with tissue hypoxia (lack of oxygen), inflammation and nerve swelling, with subsequent damage to nerve cells. It ahs been found that increasing oxygen shortens the duration of cortical spreading depression (Takano et al., 2007). Migraines can be associated with low blood pressure, which may cause reduced oxygen supply to the brain.
Sex hormones
Sex hormones may affect migraines. In menstruating women, after ovulation, bloodflow to the brain may be compromised by a relative diversion to the uterus, contributing to pre-menstrual migraines. Premenstrual migraine may also be exaccerbated by reduced oxygen that happens premenstrually and blood sugar changes around that time
Sympathetic nervous system dysfunction
This may be a factor in that migraine may be associated with sympathetic nervous system dysfunction including neurotransmitters such as noradrenaline and dopamine, with associated inflammation and pain. Often migraine attacks will happen when a person relaxes and reduces the need for such sympathetic nervous system involvement. Other neurotransmitters that are involved are include serotonin.
Other factors
It may be necessary to address blood sugar regulation as insulin and blood glucose balance can be a factor in migraine. This is best addressed through a glucose-balancing diet, although herbs can help as well, for example Siberian ginseng and cinnamon. Migraines are also more likely if a person is stressed, both physically or emotionally.
A general approach
In general, in addressing migraines, the chronic imbalances must be addressed as well as the attacks and will take into account:
- Inflammation (e.g. turmeric, hawthorn, white willow, liquorice),
- Circulation (ginger, gingko, rosemary),
- Vascular smooth muscle function (magnesium supplementation (magnesium citrate), cramp bark),
- Blood glucose and insulin (avoiding refined carbohydrates),
- Hormonal balance (e.g sage, linseed, fermented soya, wild yam),
- Pain
- Hypotension
- Stress and neurotransmitter imbalances (adaptogens like Siberian ginseng that help the body cope with stress and relaxing herbs like lemon balm to reduce anxiety).
- Health of neurons (Gingko, bacopa)
Recent Trials
In terms of clinical studies that have been carried out on herbs and migraines, there have been several which have found that ginger or a combination of ginger and feverfew, taken sublingually, is effective in reducing migraine symptoms when taken at first onset of warning symptoms (Mehdi et al., 2012; Cady et al., 2011). Both herbs are great anti-inflammatories and ginger is also used traditionally for peripheral circulation. A preliminary 2006 study found white willow and feverfew effective in reducing frequency, pain and duration of migraine in 12 patients (Shrivastava et al., 2006). Another recent preliminary trial showed an extract of gingko to be useful in reducing the pre-migraine aura. A 2002 study showed phytoestrogens to reduce frequency of pre-menstrual migraine attacks (Burke et al., 2002)
References
Allais G, D’Andrea G, Maggio M, Benedetto C. 2013 The efficacy of ginkgolide B in the acute treatment of migraine aura: an open preliminary trial. Neurol Sci. May;34 Suppl 1:S161-3. doi: 10.1007/s10072-013-1413-x.
Burke BE, Olson RD, Cusack BJ. 2002 Randomized, controlled trial of phytoestrogen in the prophylactic treatment of menstrual migraine. Biomed Pharmacother. Aug;56(6):283-8.
Cady RK, Goldstein J, Nett R, Mitchell R, Beach ME, Browning R. 2011 A double-blindplacebo-controlled pilot study of sublingual feverfew and ginger (LipiGesic™ M) in the treatment of migraine. Headache. Jul-Aug;51(7):1078-86. doi: 10.1111/j.1526-4610.2011.01910.x. Epub 2011 Jun 1.
Mehdi M, Farhad G, Alireza ME, Mehran Y. 2013 Comparison Between the Efficacy of Ginger and Sumatriptan in the Ablative Treatment of the Common Migraine. Phytother Res. May 9. doi: 10.1002/ptr.4996. [Epub ahead of print]
Shrivastava R, Pechadre JC, John GW. 2006 Tanacetum parthenium and Salix alba (Mig-RL) combination in migraine prophylaxis: a prospective, open-label study. Clin Drug Investig.;26(5):287-96.
Takano T, Tian GF, Peng W, Lou N, Lovatt D, Hansen AJ, Kasischke KA, Nedergaard M. 2007 Cortical spreading depression causes and coincides with tissue hypoxia. Nat Neurosci. Jun;10(6):754-62. Epub 2007 Apr 29.
