Migraines

There are a range of conventional and natural products available that might help migraine. For safe use of over-the-counter medicines, herbal remedies and supplements, consult a qualified person (such as a pharmacist) before buying or taking any medicine, remedy or supplement:
– if you have a serious medical condition
– if you are breast-feeding, pregnant or planning to become pregnant
– if you suffer from allergies

Registered herbal medicines (bearing the THR logo) will have a package insert. Read this before taking the product.

Avoid taking the product if you think you may be allergic to any of the ingredients.

Do not combine over-the-counter medicines, remedies or supplements with prescribed medicines unless you have first checked with your prescriber or a pharmacist.

Seek advice from your doctor or pharmacist:
– If your symptoms do not get better
– if your symptoms get worse
– if you get new symptoms or have a side effect

The information here, including dosages, only applies to adults (over 16 years). Keep all medicines out of the reach of children.

Many modern drugs started as medicinal plants and people have been using herbs to treat illnesses for thousand of years. Some of these remedies have been tested against the toughest health conditions, and plants with the strongest reputations across many cultures deserve a close look.

From the way they have been described in old texts, and from what we now know of the action of many plant constituents, it is possible favourite plant remedies work particularly by nudging better function in digestion, circulation, and eliminatory processes: helping the body help itself rather than directly attack a disease. Women also favoured plants in managing their health and childrearing needs.

Researchers are now discovering that many herbal medicines have useful benefits for the body, including in healing and repair, in stabilising hormonal responses (including stress hormones, insulin and sex hormones), and in reducing long-term inflammation.

Summary
B vitamins are a traditional remedy for stress-related problems, so perhaps that’s why some people feel they prevent their migraines. We could not find much evidence for this. However, Australian researchers recently found that a B-vitamin combination reduced the amount of homocysteine in the blood. Homocysteine is thought to irritate the blood vessel lining in some people, and can therefore trigger migraine.

Evidence
In one study, 52 migraine sufferers were given B vitamins for six months and the results showed that they experienced half the number of migraine attacks.

Safety
B vitamins are generally safe but large doses can turn your urine bright yellow. Don’t be alarmed if this happens.

Cost
B vitamins are very inexpensive.

Summary
The leaves and roots of butterbur have long been used as a remedy for headaches and inflammation. Researchers have discovered that extracts of butterbur contain active ingredients that can prevent migraine.

Evidence
Several studies have shown that butterbur may be effective in preventing migraine. It is not clear what dose gives the best preventive effect, but at least 75 mg is needed. The best source of such reliable products are prescription medicines in some European countries.

Safety
There are real concerns about the lack of controls on the supply of this herb. Butterbur extracts may contain harmful components called pyrrolizidine alkaloids that are potentially harmful to the liver. The extracts need careful preparation to remove these elements – and this does need to be clearly declared on the product information.

Cost
Costs vary from the suspiciously cheap to the astronomically expensive. The more reliable products will cost up to £20 per month.

Summary
Co-enzyme Q10 is a health-promoting substance that is naturally produced in the body, but production falls as we get older. It is also found in certain foods, particularly beef, spinach, sardines, tuna and peanuts, but cooking and processing tends to destroy it. 

Evidence
Some recent research suggests that taking co-enzyme Q10 might help prevent migraines.

Safety
Co-enzyme Q10 is essentially a safe nutrient. If you are taking warfarin or any other blood-thinning medication, consult your doctor first.

Cost
Available from healthfood shops and online as capsules  at up to £15 per month.

Summary
Feverfew is a traditional medicinal herb found in many old gardens, and is also occasionally grown for ornament. It has citrus-scented leaves with daisy-like flowers. It is a widely used herbal remedy for migraine.

Evidence
Several studies have shown that feverfew may be effective in preventing migraine. Other studies have shown no effects. Lack of consistency in sourcing the correct plant and other quality problems may be one reason.

Safety
Feverfew may cause allergic reactions in people who are allergic to chrysanthemums, daisies, marigolds, or other members of the Compositae family, including ragweed. There have been many reports of allergic skin rashes after contact with feverfew. But few side-effects have been reported and they are usually mild and reversible. The main concern is that the product is of adequate quality – there have been know substitutions by other members of the chrysanthemum family. Do not buy cheap products, and be suspicious of those that are too expensive. Look for well-recognised manufacturers with a reputation to maintain.

Cost
Approximate costs will be no more than £15 per month.

Summary
Our bodies need the mineral magnesium for all sorts of reasons. For instance, it strengthens our blood vessels and it’s good for nerve and muscle function. The richest food sources of magnesium are green leafy vegetables (such as spinach) and nuts. Other good sources include wholemeal bread, fish, meat and dairy foods, kelp (a type of seaweed), wheat bran, almonds, cashews, blackstrap molasses and brewer’s yeast. 

Evidence
It is not clear whether magnesium supplements help with migraines. Some studies say yes, others no. But it is worth making sure that you are getting enough magnesium in your diet.

Safety
Magnesium is a safe mineral supplement. Large doses can give you diarrhoea.

Cost
Magnesium supplements should not be expensive.

Summary
In some people, migraine headache can be accompanied by nausea and vomiting. If applies to you, an anti-sickness (anti-emetic) drug, with or without painkillers, can be useful. Both painkillers and anti-sickness medicines are more effective if you take them as soon as you feel the attack beginning. 

Evidence
Research shows that simple painkillers such as aspirin and ibuprofen are effective in treating migraines if you take them as soon as the headache starts to develop. Paracetamol is not as effective but it can be helpful in mild headaches, and has fewer side-effects.

Safety
If used in the correct dose, painkillers are generally safe, but taking them (whether prescription or over-the-counter) every day can cause headaches. Anti-inflammatory painkillers, such as aspirin and ibuprofen, can irritate the stomach, liver and kidneys. Ibuprofen can cause indigestion, and even stomach ulcers or bleeding. Stop taking them if you start getting indigestion or stomach pain, and tell your GP or pharmacist. Around 15% of people taking oral anti-inflammatory medication experience this type of reaction. Paracetamol can be dangerous in doses of more than 4g a day (2 tablets, 4 times per day.

Cost
Painkillers can be bought from pharmacies for low cost.

Summary
Sumatriptan relieves migraines by stimulating serotonin receptors in the brain. This makes the muscles in the brain contract and narrow the blood vessels. At the same time, it reduces pain signals in the nerves that go to the brain. It will be more effective if you take it as soon as you feel the attack beginning. 

Evidence
Sumatriptan (sold over the counter as Imigran Recovery) is effective for people who have migraines that have not been helped by painkillers such as aspirin and ibuprofen.

Safety
If used correctly, according to the prescribed dose, this medication is generally safe. But an overdose can be dangerous, and requires immediate medical attention.

Cost
These types of medication are generally fairly inexpensive.

Summary
Migraines were traditionally seen as more catastrophic symptoms than usual headaches. Measures that would calm volatile reactions in the body were generally looked for.

An old trick used by physicians in earlier times was to ask the questions: “Does the pain improve if you apply a hot pack, or a cold pack? Which would you prefer?” The implication was that there were two categories of migraine (more if one takes into account those who have no preference). Most sufferers prefer heat. This could be interpreted as their having more vasoconstriction (narrowed blood vessels) where heat opens up the circulation. However around a third of sufferers prefer a cold pack: here there could be more vasodilatation, and the cold pack would relieve by narrowing the blood vessels.

The difference was reflected in traditional treatment approaches. For those preferring heat, warming vasodilating remedies would be prescribed. These might include kitchen spices like ginger and cinnamon, and warming culinary herbs like rosemary. Feverfew, reviewed separately here, is also in this category.

For those who preferred cold packs a completely different approach would be used. Traditional ‘cooling’ remedies were also used for liver and digestive problems, and this is where the (toxic) origin of these migraines was assumed. Liver remedies usually taste bitter. Gentle examples are dandelion root (Taraxacum officinale), artichoke leaf (Cynara scolymus). Stronger examples include gentian root (Gentiana lutea), wormwood (Artemisia absinthium) and others not recommended for self care. All these bitter cooling remedies could usefully be combined with peppermint (Mentha x piperita).

Safety
All the remedies above are all likely to be safe to take as home remedies, usually as teas. The best principle is to try the ones that seem to suit your needs best; first at a low dose and then scaling up if there is any hint of benefit.

The main risk with any migrainous condition is that a remedy may make the condition temporarily worse. This risk will be minimised for the traditional approaches above if you first decide which approach fits your migraine: the wrong one is more likely to upset you.

It is also advisable not to buy herbs online unless from suppliers with prominent reputation (they will be concerned to protect this by ensuring quality for their products). Unfortunately there are few controls on herbal sales and many cases of adulterated or wrong products.

A good approach in choosing traditional herbal approaches for migraine is to see a qualified herbal practitioner. They can choose from a wide list of herbs, from a number of traditions that have good reputations for helping diffuse migraine volatilities but are not so accessible to the wider public. You will find well trained practitioners from a number of traditions from the website of the main umbrella body the European Herbal and Traditional Practitioners Association. This will entail extra costs but will allow you to have herbs you might not find elsewhere, and tailored to your needs.

Cost
Most herbs should be inexpensive and can be bought from specialist suppliers. Seeing a practitioner may cost around £50 for a first visit.