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Prevention of Migraine Headaches

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By Anna Spoelhof, FNP

Laurie Birkholz, MD, and Associates | Ms.Medicine

Holland and Douglas, Michigan

Today, I’d like to shed some light on a very common and sometimes debilitating disorder, migraine headaches. Did you know that migraine headaches affect approximately 17% of women? There are several classifications, but migraine is the most common diagnosis in patients presenting to primary care providers with a headache. Often, patients describe their migraine as a pulsating or throbbing headache, typically on one side. Sometimes, it is accompanied by nausea, vomiting and/or light sensitivity. Dealing with chronic migraine headaches is difficult and can take a negative toll on your physical and emotional health. Studies show that migraineurs often experience emotional problems, reduced vitality, increased disability and difficulties with work. Migraines can be triggered by a multitude of things, including stress, physical exertion, fatigue, lack of sleep, odor, chemicals and certain medications. In women, migraines can be triggered by the normal decrease in estrogen right before the menstrual period each month, which are referred to as menstrual migraines.

So, how do we prevent such terrible headaches? Well, before we talk treatment, let’s talk about preventative therapy. The main goals of preventive therapy are to: 

  • Reduce attack frequency, severity, and duration
  • Improve responsiveness to treatment of acute attacks
  • Improve function and reduce disability
  • Prevent progression of episodic migraine to chronic migraine

Prophylactic medications are often used successfully to help prevent migraines in the future. Such treatment is typically recommended for people who have frequent, long-lasting, or very severe migraines. If you experience menstrual migraines, hormone-based intervention may be indicated. In some cases, both acute treatment (medicine you take to relieve pain immediately) and preventive treatment are necessary to adequately control migraines.

In addition to medical treatment, lifestyle measures can be very beneficial for keeping migraines at bay. Lifestyle changes include: 

  • Practicing good “sleep hygiene” (set consistent bedtimes and wake times; sleep only as long as you need to feel rested; avoid caffeine, alcohol, and smoking before bed; do not look at your phone or other devices right before bed).
  • Eating nutritious meals around the same time each day
  • Get regular exercise
  • Avoiding things that may trigger a migraine (keep a headache diary to help determine triggers)
  • Assessing tension in your neck and shoulders
  • Initiating mind/body approaches
  • Exploring Mindfulness-Based Stress Reduction
  • Practicing breathing exercises
  • Considering guided imagery                     

There are also some well-studied supplements that may help. They are as follows:

  • Vitamin B2 (Riboflavin). 400 mg qd
  • Magnesium. 600 mg qd
  • Feverfew. 25 mg bid
  • CoEnzyme Q-10. 150 mg a day, for adults; 1-3 mg/kg/day for children.
  • Fish oil/olive oil. Fish oil: 756 mg qd EPA; 498 mg qd DHA and olive oil 1,382 mg oleic acid daily
  • Butterbur (Petasites). Petadolex 50-100 mg bid

Migraines can be awfully burdensome and can affect your quality of life. So, speak up and ask your health care provider if you think you may be experiencing migraine headaches. There are many efficacious treatment plans, including preventive and abortive therapies. As always, consult your health care provider before trying any supplements or other over the counter medications!

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