By Dr. Mercola
Headaches affect virtually everyone at one time or another. Wouldn't it be nice to have a simple, natural drug-free solution? "America's Pharmacist," Suzy Cohen, shares a number of alternatives in this interview.
She's been a guest on a number of TV shows, including Dr. Oz, The View, and The Doctors. She's also authored seven books, including the #1 Amazon hit, Headache Free: Relieve Migraines, Tension, Cluster, Menstrual, and Lyme Headaches, which is the focus of this article. You can get a free copy of one of the chapters on her site.
Most pharmacists are deeply rooted in conventional medicine since they're using the primary tool that most doctors use–drugs. Suzy is different in that regard, since her primary focus is on natural approaches not pharmaceuticals.
Part of what ignited her interest in learning more about complementary medicine was the side effects people were experiencing from their prescribed drug therapies.
"How is that happening? That isn't right. I gave them medicine... and these people are sicker with side effects than what they came in for," she says. "While this is all ruminating in my head, my husband was at home, and he wasn't feeling well. He wasn't responding to conventional medicine.
I really started to think outside the pill, if you will, looking at Mother Nature's medicine cabinet and thinking, 'There has to be something that can help my husband... and my patients at the pharmacy that has less toxicity than what I've been taught in pharmacy school.'"
She ended up joining an organization called The Institute for Functional Medicine, ultimately graduating as a functional medicine practitioner. Over the years, she learned how to evaluate the body as a whole system, opposed to treating individual symptoms.
"A person with six symptoms could be reactive to one food, for example. It could be tied to the increase in one inflammatory cytokine, say, histamine, which is a big one with headaches," she explains.
Common Migraine Symptoms
The term "headache" includes a wide variety of head pain, from tension headaches to migraines and cluster headaches. The latter two are clearly the worst. An estimated 13 percent of Americans suffer from migraines. Cluster headaches are far less common, affecting maybe five percent of people, or less.
Unfortunately, despite its prevalence, migraines are still one of the most poorly understood medical disorders of our time. Part of the problem has been that the experiences of those suffering from migraines vary greatly.
Aside from throbbing, searing pain, which may or may not be one-sided, some experience "auras" prior to onset, while others do not. There may also be nausea, vomiting, visual disturbances, auditory disturbances, sweating, shortness of breath and/or sensitivity to light, sound, and smells.
Those who have never had a migraine before can be quite frightened by the neurological symptoms, which mimic a mild stroke or seizure. The visual disturbances are most disconcerting because at times, one may experience, short term visual loss (especially if you're dehydrated), visual snow, and/or seeing spots or wavy lines. Neuropathy may occur such as numbness or, tingling in your fingers, arm or leg.
What Causes Migraines?
According to Suzy, certain foods are among the most common triggers for headaches and migraines. She refers to some of the main culprits, as "migrenades," and they include:
Gluten (proteins in wheat) Soy Corn and high fructose corn syrup (HFCS) Artificial sweeteners Casein (dairy) Eggs Monosodium glutamate (MSG) Caffeine
The pharmaceutical answer to migraines is a class of drugs called "triptans," sold under brand names such as Axert, Zomig, Imitrex, Maxalt, Amerge, and several others. These drugs act as "serotonin receptor agonists" meaning they enhance serotonin levels, which constricts the blood vessels around your brain.
The idea is that by reducing blood flow around your brain, the pain is lessened in severity. The fast-acting dosage forms such as nasal sprays or injectable can sometimes be used to abort a migraine if you take them in time.
The drawback is that these drugs come with significant side effects. They're also very expensive. Clearly, if you suffer from recurrent migraines, you'd be well advised to find and treat the underlying cause. According to Suzy:
"[H]eadaches, especially migraines, are caused by mitochondrial dysfunction. If you can fix the mitochondria, you can relieve migraines and headaches. If not cure them, you can certainly reduce the frequency of them. A mitochondria is an organelle inside your cell. You have trillions of them, and they generate your cellular energy [called] adenosine triphosphate (ATP). It's like a battery or a generator in every single cell.
When your mitochondria are sick, dying, or they're oxidized – because of excessive free radical damage—then your frequency for headaches goes up. This has been shown in a lot of research, which I cover in Headache Free.
What happens is this toxic pathway gets upregulated – nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kappaB) – and it starts spitting out pro-inflammatory cytokines such as interleukin-6 (IL-6), interleukin-1 beta (IL-1β), and tumor necrosis factor-alpha (TNF-α). The point is that your body is on fire, and your head is going to hurt."
How to Address Migraines Without Drugs
To successfully treat the underlying cause of your migraines, you need to "regenerate your cellular batteries," the mitochondria, and one way to do that is by taking coenzyme Q10 (CoQ10). The reduced form, ubiquinol, tends to work best for most people.
"CoQ10 is fantastic," Suzy says. "It's an antioxidant that's both lipophilic and hydrophilic, meaning, it loves water and loves fatty parts of the cell. It goes into every single cell all over your body, especially your brain and your heart. You know if you're CoQ10-deficient because you're more prone to headaches. Plus, a prolonged deficiency of CoQ10 can cause significant muscle pain as well as headaches. Now, here's the thing: people are seriously deficient in CoQ10 because there are so many drugs that deplete this nutrient, including the birth control pill, hormone replacements, antacids, diabetes drugs, and statins. These drugs deplete CoQ10."
Other supplements that can improve migraines include:
- Magnesium. According to Suzy, about 50 percent of those with recurrent headaches are deficient in magnesium. As with CoQ10, a number of drugs rob your body of magnesium, including birth control pills, diuretics, antacids, and acid blockers, in particular the proton-pump inhibitors (PPIs) such as omeprazole, esomeprazole. These medications can wipe out magnesium so severely that it can affect your heart.
Suzy recommends taking 400-600 milligrams (mg) of magnesium per day. Also increase your consumption of green leafy vegetables, which are rich in bioavailable magnesium. Spirulina is another good source. Avoid magnesium oxide supplements, as they tend to cause diarrhea. This is the form commonly sold in pharmacies and it will say "magnesium oxide" on the label. Again, this can cause gastrointestinal upset.
My favorite is magnesium threonate, which is a newer, emerging type of magnesium supplement that appears promising, primarily due to its superior ability to penetrate the mitochondrial membrane. You can also improve your magnesium status by taking regular Epsom salt baths or foot baths. Epsom salt is a magnesium sulfate that can absorb into your body through your skin. Magnesium oil (from magnesium chloride) can also be used for topical application and absorption.
- Riboflavin (vitamin B2). Riboflavin will make your urine bright yellow, which will interfere with your ability to determine if you're drinking enough water. So when taking a B2 supplement, avoid using the color of your urine as an indicator of how much water you need. Use your thirst instead. Suzy recommends taking 200-400 milligrams or B2 per day, which can be divided up by taking half in the morning and the other half in the afternoon. That's well over 100 times the recommended daily allowance (RDA), so you're essentially using riboflavin as a drug in this case; but it's a relatively safe drug with virtually no side effects. Ideally, you'll want to balance riboflavin with the other Bs by taking a "B complex" with it.
Dietary and Lifestyle Considerations
Diet is another important component, not only for migraines and headaches, but health in general. In Suzy's experience, a gluten-free diet tends to support both brain and gut health, thereby reducing headaches.
"By gluten-free, I mean eliminating foods with gluten. I don't mean substituting them and getting gluten-free muffins and gluten-free bars, because they're laden with all kinds of things. I just mean avoiding the bread, wheat, and pasta. Just completely taking it out of your diet and going to a more hunter-gatherer type of diet like the Paleo diet."
Another simple intervention is to eliminate aspartame and other artificial sweeteners from your diet. Ditto for artificial colorants and other artificial additives. This means avoiding most if not all processed foods, and preparing home-cooked meals using fresh, whole ingredients instead. Stress, cortisol, and thyroid hormone also play a role in headaches and migraines, making stress relief and addressing your thyroid function essential components of a more comprehensive plan. Selenium and Ashwagandha are two helpful supplements as they both support thyroid function.
If you frequently suffer headaches in combination with insomnia, Suzy recommends trying one to two grams of glycine at night. Glycine increases levels of gamma-aminobutyric acid (GABA), which is an inhibitory neurotransmitter that calms and helps you sleep. Tryptophan or 5-hydroxytryptophan, sold as 5-HTP, can also be helpful.
"For some people, [5-HTP] will work. But for other people, they'll convert it down a different pathway, and it'll excite them. If you try tryptophan or 5-HTP and you get stimulated, I would either back down on the dose, take it earlier in the day, or just stop it altogether. You may be one of those people with the pathway issue that's driving it to the excitatory side."
If dietary interventions don't seem to be working, you may need to dig even deeper. In some cases, frequent headaches can be caused by an undiagnosed disease. Such was the case with Suzy's husband, whose headaches were eventually traced back to Lyme disease, a tick-born infection. Once the Lyme disease was treated, the chronic headaches stopped.
How to Address Tension and Cluster Headaches
Tension headaches are by far the most common type of headache. As Suzy notes, if you haven't had a tension headache yet, you will eventually. As the name implies, they're caused by stress and tension. While all of us experience stress and tension, the main difference is how we cope with it. Having an effective coping strategy is essential here. My favorite, as it has a very high success rate, is an energy psychology method known as the Emotional Freedom Technique (EFT).
"Usually, it's because people are holding tension in their traps (trapezius muscle), or in the back of their head or neck," Suzy notes. "You can still address it with nutrients. One of the best things you can do is take magnesium, because it relaxes your body. It relaxes muscle pain. If you're tight and irritable, magnesium will reverse that.
[The Russian herb] Rhodiola is helpful for someone with a tension headache, because it increases levels of serotonin; it makes you feel good. It helps you adapt—it's a plant adaptogen. It knows what your body needs. It knows how to raise certain hormones. In particular, it can help raise serotonin and reduce cortisol. Massage would also be great. It's known to reduce cortisol. It takes you away from your work and your computer. If you can just try to relax into that, that would be helpful for the long-term fix.
There's study after study that show natural supplements in high-quality forms can help reduce our risk for headaches. The only time I ever think maybe it's not going to help you that much is possibly with cluster headaches. These are the types of headaches that are also dubbed 'alarm clock headaches.' They're also dubbed 'suicide headaches.' They feel like someone's stuck an ice pick in your eye. I'm not kidding. They come at the same time at night usually around 1:00 or 2:00 in the morning. It'll wake the person up with a jolt."
The real key for treating cluster headaches is to reduce histamine-containing foods (refer to the listing at the beginning of this article). Suzy also recommends keeping an oxygen tank at hand, and begin breathing on it when a cluster headache strikes. In terms of supplements, Suzy claims the only supplement that might help with cluster headaches is high dose melatonin, about 4 to 6 milligrams before bedtime and not indefinitely… just until the cluster episode passes. Since too much melatonin can suppress your morning cortisol levels, you're advised to discuss this with your doctor before trying this route. Symptoms of too much melatonin include morning fatigue and/or feeling like you have a hangover, as well as anxiety, irritability and confusion.
The Solution for Migraines and Headaches Is Rooted in Your Diet
As you can see, your diet is really the foundational core for any long-term solution for headaches and migraines. It's also foundational for optimal health in general. You don't have to "get used to" living with headaches. There are answers, but you need to think differently. As Suzy says:
"Traditional medicine has basically told people that they need to take medications to relieve the pain or to temporarily constrict the blood vessels around the brain to stop the blood flow that is causing your head pain. That is how the most commonly prescribed drug like the triptans work.
I'm here to say that that is not my answer! You can live headache-free if you determine the underlying cause of your headaches. By that, I mean find out what your migrenade is. It could be a food additive. It could be a type of food that you're eating. It could be histamine. It could be artificial sweeteners. Find the migrenade. Get rid of it! That will help you and you should also improve your diet.
And then support the batteries in your cell – the mitochondria. Support them with cell-loving nutrients such as CoQ10 or ubiquinol and acetyl-l-carnitine. You can also use natural minerals to support them, like magnesium. Selenium could be very helpful because it supports thyroid function. Another great one is Ashwagandha... When your thyroid is low, you're more prone to headaches... Also you can consider natural plant-based adaptogens such as rhodiola."