When it comes to managing migraines, it can be tempting to focus on avoiding just one trigger. We also have a tendency to pin all our hopes on that one thing which will keep us migraine free – such as a new medication or one single diet.
The reality is that reducing migraines is about finding the balance between avoiding a whole heap of triggers, while working on incorporating as many strategies as we can to manage migraines. And, the triggers and treatments are unique to each migraine sufferer.
In Dr Josh Turknett’s book, The Migraine Miracle, the analogy of balloons and weights are used to describe the balance we need to aim for to reduce migraines.
Imagine that you are in a basket, to which you can attach balloons to lift up into the air. When in the air, you have a “safe zone” to float about in – but if you elevate too high past your safe threshold, then you will come into migraine territory.
The balloons are your triggers. Some are big balloons, and some are smaller. You can attach a certain number of balloons and still stay in the safe zone. But add one balloon too many, and you will fly up past the threshold and – bam! You have a migraine.
You also have weights to attach to your basket to keep you within the safe zone. Yep – you guessed it - the weights are the strategies you use to manage your migraine – such as diet, medications, supplements and lifestyle.
For example, here are my balloons:
• Change in weather
• Irregular sleep
• Irregular blood sugar levels
• Caffeine and alcohol
• Heavy exercise
• Exposure to chemicals including scents
I can experience a few of these things, and still be OK. But add in one too many, and sure enough, I’ll develop a migraine about 4pm that day.
The weights I use to help keep me safe are:
• Supplements or medication
• Herbal medicine to manage stress, keep liver healthy and balance hormones
• Regular sleep
• Nutrition and diet
• Avoiding caffeine and alcohol
• Gentle exercise and movement every day
• Stress management techniques
• Using natural products
• Modified lighting
• I’m afraid I can’t change the weather, but managing all the other factors can mean barometric pressure changes don’t affect me as much as they once did.
Over time, the balloons and weights can change. For example changes in hormonal profile, digestive health, work situation and so many other factors can influence how we need to manage migraines.
A good place to start to manage your own migraines is to write down all your balloons and weights. Check in each day whether you are still in the safe threshold and whether you might need to check you have enough weights to keep you in the safe zone.
And if you would like some support to help you work out the cause/s of your migraines, or come up with treatment strategies, why not book in for an online consultation and we can figure it out together.
Managing sleep is a vital, yet complicated, aspect of migraine treatment which is often overlooked.
Too little sleep can trigger a migraine attack. Too much sleep can also trigger a migraine attack. Sometimes a sleep (particularly in the early stages of an attack) can treat a migraine. Getting good quality restful sleep can help prevent migraines. Yet migraine sufferers often have difficulty obtaining good quality restful sleep.
Yep! It sure is complicated.
Let’s unpack a few things here.
Firstly, people living with migraine (according to the American Migraine Foundation), are between 2 and 8 times more likely to experience sleep disorders, compared with the general public.
This insomnia can stem from conditions which are often associated with migraine – such as anxiety and depression, stress, pain, teeth grinding and sleep apnoea.
And yet - and this is really not fair - not getting enough sleep can increase the number of migraine attacks, creating a cycle of sleep problems – which leads to more migraines – which leads to more sleep problems.
This is why addressing those factors which impact on sleep is often a priority in the natural treatment of migraine.
Too much sleep – such as sleeping late on holidays and weekends, or afternoon naps - can also trigger a migraine.
So, the key is to work on balance and consistency when it comes to sleep:
• Keep a consistent bedtime and wake time every day – even on weekends. The best number of hours varies from person to person – but aim for 7-8 hours. If you are a young person, you may need more sleep than this. If aged 50 or older, you may need less sleep.
• Create a calming bedtime routine. Avoid technology at least one to two hours before going to bed, try a warm shower or warm bath with Epsom salts, diffuse lavender oil, turn down the lights.
• Avoid naps. If you have a migraine attack and or need extra sleep that day, try aiming for an earlier bed time in the evening instead of an afternoon nap.
• Keep the bedroom for sleep. Don’t watch TV, scroll, talk or text on your phone, study or eat in the bedroom. Keep clutter out of the bedroom and use natural bed materials. Consider an air purifier or Himalayan salt lamp.
• Try a sound machine or sound app – I like Sleep Stream.
• If you find yourself awake during the night, don’t watch the clock – it will make you anxious and more frustrated if you can’t sleep. Get up for a little bit, have something to eat (often migraine sufferers get low blood sugar during the night), try a guided meditation or deep slow breathing.
• Avoid caffeine and alcohol.
• Spend some time outside during the day in natural light. Morning sun on your face is particularly good for helping to regulate sleep patterns. If you can exercise gently in the sunlight in the morning, even better.
As a naturopath, I also often prescribe specific sleep supplements to help establish a sound sleep routine, or improve the quality of sleep.
Are you looking to reduce the severity and frequency of your migraines, reduce or avoid pharmaceutical treatments or support overall health? Supplements may deserve a place in your migraine management strategy.
Many supplement ingredients researched have evidence that supports their use as a preventative treatment - although not so much for an active migraine. The exception to this is ginger, which can help settle nausea during a migraine, and perhaps even stop a developing migraine if taken early enough.
Diving into research papers and clinical trials, these supplements have proven to be effective in reducing the frequency and severity of migraines, when taken regularly:
- Butterbur herb (not readily available in Australia)
- Magnesium (particularly magnesium diglycinate)
- Riboflavin (vitamin B2)
- and possibly Feverfew herb*
With migraine, it is important to remember that what works for one person, will not work for another. For example, some forms of magnesium will actually trigger a migraine for me, but will work well for other people.
As a practitioner, I also take a personalised approach and look at the overall health picture and possible drivers of migraine in each individual. So, I might consider which herbs and nutrients would work together to address imbalances in the following areas:
Just like our fingerprints, the supplement regime prescribed is different for every single individual - I’m fairly certain I’ve never given the same prescription twice. (This is why after an initial consultation i spend at least an hour preparing just one client treatment plan as each case is complex, with many factors to consider.)
And, as I always say when talking about supplements, it is important to consult with a qualified practitioner who really knows their stuff - such as a naturopath (trained in both nutrition and herbal medicine), herbalist (trained in herbal medicine) or nutritionist (trained in nutrition). Please don’t take a supplement based on internet articles or because a friend “swears by it”. Supplements vary greatly in quality, potency, effectiveness and safety, and it is important to work with a qualified practitioner to get the best results and avoid possible side effects. Never buy supplements from overseas sites as they may bypass strict Australian quality controls.
Take care and feel free to reach out if you would like a consultation to consider which supplements may work for you.
*Feverfew herb is a traditional herbal medicine for migraine. Some studies show it is effective, while other studies have failed to show this. In clinical practice, I find it does tend to enhance the action of other supplements and herbs, and you will often find it in a combination remedy. (In fact, this is often the case for many herbal medicines - herbs seem to work best in synergy with other herbs, which is why herbal medicine formulas are highly prized in both Western and Eastern herbalist practices. Herbal medicine truly is both an art and a science!)
1. Change the lighting
Light actually hurts during a migraine. It’s known as photophobia. You can help by turning off bright (especially fluorescent) lights and closing the curtains. If a little light is needed, then soft or low lamps are better than ceiling lights.
2. Be mindful of perfumes and strong-smelling foods.
Strong smells can nauseate a migraine sufferer, who are thought to also has a heightened sense of smell. Which smells and odours cause problems can differ for individuals – check which ones affect the migraine sufferer in your life.
3. Keep it quiet.
The migraine sufferer is very sensitive to noise. Just like it is believed they have a super sense of smell, they also can seem to hear sounds that others can’t. What sounds quiet (or even normal level) for you can be deafening to someone who has a migraine. Speak softly and gently, and avoid any unnecessary sounds such as television, music and loud conversations.
4. Send a text. Don’t phone.
Talking can be difficult for a migraine sufferer on many levels. Firstly, their speech can be affected or they have trouble finding the right words or following a conversation. And secondly, the sound of talking can hurt. Also understand that it might be a few days before they feel up to returning your call.
5. Understand when they cancel social or work commitments.
As a migraine sufferer myself, I’ve had to cancel so many plans which results in feelings of guilt. Plan another event or outing with them in the future to show that you understand and are still there for them, no matter what. Check in on what is fun for your migraine sufferer.
6. Ask how you can help.
Offers to babysit, cover a work project, pick up a prescription or supplement, tidy up or help around the house, drive to appointments or pass on messages on a migraine sufferer’s behalf will be gratefully received.
7. Be supportive of their self-care.
Whether it is a change to diet or a need for quiet time, help them by not tempting them with foods or alcohol they are trying to avoid or crowding in on their downtime.
8. Understand that migraine is not just a bad headache.
Migraine is a whole collection of often debilitating symptoms which makes it difficult to function and think straight. Migraines can strike anytime, and some people get them weekly (or even daily).
Take the time to understand their symptoms, triggers and early warning signs that a migraine is on the way.
Treating and preventing migraine naturally is a special interest of mine. Book in a call or consultation if you would be interested in a naturopathic consultation to help you, or someone you know with migraine.
For many chronic migraine sufferers, particularly where migraines are inherited and experienced by many family members, migraines and headaches are simply “a fact of life”. Something to be put up with.
If you do regularly get migraines and headaches, you might have not stopped to consider the impact they can have on every area of your life.
The Migraine Disability Assessment Test
The MIDAS (Migraine Disability Assessment) is used by healthcare to help measure the impact of headache on your life, and find the best treatment for you.
Please answer the following questions about ALL of the headaches you have had over the last 3 months.
Select your answer in the box next to each question. Select zero if you did not have the activity in the last 3 months.
You can take the completed form to your healthcare professional.
1. On how many days in the last 3 months did you miss work or school because of your headaches? ___________
2. How many days in the last 3 months was your productivity at work or school reduced by half or more because of your headaches? (Do not include days you counted in question 1 where you missed work or school.) ___________
3. On how many days in the last 3 months did you not do household work (such as housework, home repairs and maintenance, shopping, caring for children and relatives) because of your headaches? ___________
4. How many days in the last 3 months was your productivity in household work reduced by half of more because of your headaches? (Do not include days you counted in question 3 where you did not do household work.) ___________
5. On how many days in the last 3 months did you miss family, social or leisure activities because of your headaches? ___________
Scoring: After you have filled out this questionnaire, add the total number of days from questions 1-5. Total _______________ (Questions 1-5)
MIDAS Grade Definition MIDAS Score
• Little or No Disability 0-5
• Mild Disability 6-10
• Moderate Disability 11-20
• Severe Disability 21+
If Your MIDAS Score is 6 or more, please discuss this with your practitioner.
What your healthcare practitioner will also need to know about your headache:
A. On how many days in the last 3 months did you have a headache? (If a headache lasted more than 1 day, count each day.)
B. On a scale of 0 - 10, on average how painful were these headaches? (where 0=no pain at all, and 10= pain as bad as it can be.)
You can also download the questionnaire as a PDF here.
(Adapted from Innovative Medical Research, 1997 © 2019)
Anyone who experiences migraines (or is close to someone that does) knows that migraine is so much more than a headache. We all know about nausea and vomiting, and sensitivity to light, noise and smell – but there are many, many other migraine symptoms which are often overlooked.
For example, my partner used to be able to tell I had a migraine on the way when one of my eyes would water, or the eye would become smaller. If I have trouble talking or finding the right word, then I take that as a sign to put into place my migraine-avoiding strategies.
Migraine.com asked their Facebook community for their “strangest” migraine symptoms:
As we all experience migraines very differently, it can be useful to start keeping a diary of your own migraines, and write down as many symptoms that you notice before, during and after a migraine. Understanding your early symptoms and treating your migraine as soon as you notice them, is your best chance of avoiding a full-blown migraine.
Naturopath, Nutritionist and Herbalist