Treatment of migraine with targeted nutrition focused on improved assimilation and elimination

Alternative Medicine Review, Oct, 2001 by James Sensenig, Jeffrey Marrongelle, Mark Johnson, Thomas Staverosky

Abstract

This study was undertaken to assess the impact of three months of targeted nutritional therapy for migraine on health-related quality of life. The study is also intended to lend support to a theory that migraine is caused by an underlying dysfunction involving assimilation or elimination mechanisms. Forty people were selected from approximately 120 applications. Fourteen participants were selected from among those applicants within the authors' practices and 26 from applicants solicited via the Internet. Participants were required to complete the Medical Outcomes Trust Migraine Specific Quality of Life (MSQ) Questionnaire. Eighty percent of the study participants experienced significant and sustained improvements in quality of life during the 90 days of the study. The study instrument is specifically designed to measure quality of life improvement and thus does not solicit responses relative to number of migraine attacks or duration of each migraine. However, it should be noted that improvement in quality of life is likely due to a reduction in the duration and frequency of migraine attacks. (Altern Med Rev 2001;6(5):488-494)

Introduction

Migraine prevalence studies have indicated that the condition is suffered by more than 17 percent of the female and six percent of the male population in the United States. (1) In addition to the debilitating effect of a migraine attack, sufferers report a significant impact on their quality of life between attacks. Many migraine patients report that the fear of getting a headache totally disrupts their ability to plan social events, vacations, and other family activities. (2,3) The debility associated with migraine has substantial economic impact, with estimates of the direct cost of migraine treatment and indirect migraine-associated costs due to lost productivity in the workplace as high as $17.2 billion annually in the United States. (4) Studies have shown that most people who have migraine headaches are never diagnosed by a physician or treated with prescription medicine, (1,5) and those who do receive care are often dissatisfied with the results. (6)

Available research on the treatment of migraine is focused in acute treatment and prophylactic medications. Advances in acute treatment are well documented. Sumatriptan, a serotonin-1 agonist, administered subcutaneously, orally, or intranasally, is effective in alleviating the pain and associated symptoms of the acute migraine attack. Moderate or severe pre-dose pain is reduced to mild or no pain within two hours of dosing in approximately 80 percent of patients treated with the subcutaneous form and 63 percent of patients treated with the nasal form, and within four hours of dosing in 65-78 percent of patients treated with the oral form. (7-10) The use of sumatriptan has also been shown to have a positive impact on the quality of life of migraine sufferers. (11)

In contrast there has been limited progress in the prophylactic treatment of migraine. Although current preventive pharmaceuticals can be expected to reduce the duration and frequency of migraine attacks, the treatment guidelines suggest almost all patients will still require symptomatic or acute treatment. (12) Indeed a good response to prophylactic treatment is defined as a 50-percent reduction in the frequency or severity of migraine attacks. (12) Few studies have compared the response to particular migraine preventive drugs, leaving physicians with little guidance for choosing among various agents. (13) The medications used include beta blockers, calcium channel blockers, tricyclic antidepressants, anticonvulsants, serotonin antagonists, NSAIDS, and MAO inhibitors.

Botanical and nutritional approaches to migraine prevention have shown some promise. For example, riboflavin proved superior to placebo in reducing frequency and length of migraines. (14) On average, magnesium levels are lower in people with migraines. (15) It has been shown that intravenous magnesium can relieve some migraines in minutes. (16) Double-blind research indicates daily supplemental magnesium reduces premenstrual migraines. (17) Studies have shown the continuous use of botanicals, including Tanacetum parthenium (feverfew) (18-20) and Petasites hybridus (butterbur) (21) can result in a reduction in the duration, frequency, and severity of migraine attacks.

The approach utilized in this study is based on classic naturopathic medical philosophy; i.e., disease is the deterioration of normal function in one of two areas -- either the body is not getting what it needs due to faulty assimilation or the body is unable to remove wastes and toxins due to poor elimination, or both. Naturopathic philosophy also suggests that genetics determine underlying susceptibility to disease or dysfunction, but not actual disease manifestation. The goal is to remove obstacles to cure by focusing on improving assimilation and elimination, allowing the body's inherent abilities of repair and recovery to function properly.