Saturday, 24 March 2012

Why Does My Head Still Hurt--Part II

Alright, now for Part II of my migraine series, I’m going to get really sciency.    
So, according to conventional science, what is a migraine and why do they occur?

This is a "normal" brain scan

Migraines are typically thought to be caused by vasodilatation (swelling or widening of the blood vessels).  First, something occurs to cause injury (a “trigger”), and this injury/trigger causes swelling of the blood vessels which allows increased blood flow to the injury site (where healing compounds leach out of the vessels in an attempt to repair damage), which unfortunately allows further swelling to occur.  
Medicinenet ( describes migraines this way:
“Migraine headache is caused by vasodilatation (enlargement of blood vessels) that causes the release of chemicals from nerve fibres that coil around the large arteries of the brain. Enlargement of these blood vessels stretches the nerves that coil around them and causes the nerves to release chemicals. The chemicals cause inflammation, pain, and further enlargement of the artery. The increasing enlargement of the arteries magnifies the pain.
“Migraine attacks commonly activate the sympathetic nervous system in the body. The sympathetic nervous system is often thought of as the part of the nervous system that controls primitive responses to stress and pain, ..., and this activation causes many of the symptoms associated with migraine attacks; for example, the increased sympathetic nervous activity in the intestine causes nausea, vomiting, and diarrhea. Sympathetic activity also delays emptying of the stomach into the small intestine and thereby prevents oral medications from entering the intestine and being absorbed. The impaired absorption of oral medications is a common reason for the ineffectiveness of medications taken to treat migraine headaches.The increased sympathetic activity also contributes to the sensitivity to light and sound sensitivity as well as blurred vision.

Brain scan during a migraine--see all the extra activity? 

Wow, now that’s a whole chain of unfortunate events.  You begin to see the conundrum felt by migraine sufferers.  In a nutshell, migraines are inflammation in the brain. 
So what is inflammation, really?  There’s a really good, short article about inflammation in MDA.  If you want to read it, go here: .  Unless you’re really new to this Paleo thing, you’ve heard all about inflammation and why it’s bad for you. To summarise the article, some of the inflammation triggers Mark lists include; toxic diets high in sugar, processed carbs, high gluten intake, too little sleep, being too sedentary, chronic stress, and poor gut health.  So that’s inflammation triggers.
Now what about migraine triggers?  Back to Medicinenet where they list; sleep disturbances, fasting, hormones, MSG, nitrates, chocolate, aged cheese and alcohol (aged and fermented food contain tyramine which can cause blood vessels to constrict and then expand, imitating the effects of barometric pressure which also causes migraines), aspartame and caffeine.  They also note that declining estrogen in women at a certain time of month can be a trigger.  But the truth is, a migraine can be caused by any or all of these triggers and the reaction could take days to occur, making it hard to pinpoint the exact cause at that time.
Now, I see some similarities here.  Lack of sleep.  Stress.  Poor diet.  Unfortunately, we can’t control barometric pressure.  But my point is, inflammation and migraine are very similar, if not the same.
More importantly, I see how just eating a paleo diet (and vicariously, an anti-inflammatory diet) can help reduce if not eliminate migraines altogether because we paleo advocates should already be avoiding MSG, aspartame and nitrates, alcohol (or at least consuming in moderation) and cheese (or at least moderating it).  And fasting?  Well, we know it can cause headaches sometimes.  Particularly if you’re eating a SAD because you’re going to have a sugar crash (though I recommend avoiding fasting if you do have migraine problems, or at least, pick a time when a migraine is least likely to occur).  There’s even science suggesting that reducing inflammation will help regulate hormones.  Huh. 
So, if migraines and inflammation are similar, if not the same, then an anti-inflammatory diet should offer relief, if not a cure. According to Dr Vincent Pedre, the 10 most inflammatory foods are:
  1.  Gluten
  2. Corn
  3. Beef/pork
  4. Shellfish
  5. Soy
  6. Oranges
  7. Peanuts
  8. Refined sugars
  9. Dairy products (all types)
  10. Eggs
Dr Pedre is known for his unique approach to medicine, combining western medicine with more holistic practises and has appeared on several prominent tv and radio shows and runs several blogs.  He wrote a great blog about a case study he did on a woman suffering frequent migraines where he treated her with an anti-inflammatory diet which you can read here
So, since Paleo avoids gluten, corn, soy, peanuts, refined sugars, and dairy, I should be pretty home-safe, right?  Maybe, maybe not.

Lets be honest—despite being lactose intolerant I continue to consume dairy.  Despite discovering that I have gluten intolerance, I still have “cheats” that include wheat.  I know I am allergic to citrus fruit, but I eat it anyways (too much causes headaches, rash, mouth sores and upset stomach).  I have to say that just looking at this list tells me the worst offenders for me are going to be gluten, dairy, and citrus.  I already know this and despite all the red flags my body was giving me, I have never paid it any attention. 
Why would I completely ignore something so obvious?  Can I blame it on akrasia, like Mark over at MDA suggests?  ( read this article at ).   Or is that just being lazy?
We all have cheat meals, meals that are completely un-paleo where we make mistakes, we gorge, then we regret it and get right back on that paleo-horse.  My biggest cheats are hakka (Chinese/Indian fusion food laden with MSG, salt, wheat and soy oils), and ice cream (dairy and refined sugar).  Maybe my occasional food cheats are more than just a gut-bomb.  Maybe I’m laying the framework for a whopping migraine that may come that day, the next, or even a week later.  And here I thought I was just messing up my stomach and bowels.  It can take up to two weeks for a stomach to heal after consuming grains and causing inflammation of the guts.  So why can’t it also take 2 weeks for a brain to heal from inflammatory triggers?
Right about now, if you read part 1 in my blog ( ), you heard a lot of prattle about ketosis and are probably wondering what the heck it has to do with any of this.  Since fasting can cause migraines, then it should be assumed that ketosis can, too.  So how can ketosis help migraine sufferers?  Robb Wolf has some very strong opinions on this, and some strong science, too.  This is what I’m trying to figure out.  But that’s going to have to go in another sciency blog, aka part III of my migraine series.
Until then, I’m going to have to take a much more hard-nosed approach to paleo/primal eating.  I will be giving up hakka completely, I will avoid grains even on my “cheats” and I’m going to give up dairy once again.  Of course, I will also be avoiding oranges.  We’ll see how that goes as I try to sort this new thought on ketosis out.
Meantime, have you suffered from migraines?  Has just “eating paleo” helped?  What are your triggers, and are they the obvious ones I’ve names here, or are your triggers entirely different?

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