Why You Need to Know About Niacin B3 for Migraine

The hunt for B vitamins that don’t trigger migraine

Earlier last year, in my ongoing hunt for a Folk Medicine solution to easily, safely, and affordably abort migraine headaches, I got distracted by a long and circuitous diversion when I found myself studying B vitamins.  I wanted to understand why some people with migraine who clearly need B vitamins so much can’t tolerate them. I had personally been triggered by methylated B vitamins myself and had heard stories from clients reacting poorly to them.

In the process of discovering which B vitamins may be causing the most havoc for those with migraine, I also discovered that niacin worked beautifully to abort migraine.  But the irony is that it is niacin – aka nicotinic acid or B3 – that I was initially the most skeptical of.  I wrote about my concerns that niacin might be triggering migraine in this blog post:  (“Does Niacin B3 Contribute to Migraine and Histamine Intolerance?”). Please read that blog post for a primer on Niacin.

I was suspicious of niacin as a potential trigger because niacin is a “methyl sponge” – ie, it mops up methyl.  It is generally known that high histamine is associated with undermethylation.  I had tied my own migraines to histamine intolerance and helped many with migraine to eliminate their migraine symptoms through a low histamine diet while rebuilding gut health using my SimplyWell Protocol, with excellent results.

If it is true that those with high histamine are undermethylated already, wouldn’t lowering their methylation with niacin deepen the histamine load and add to migraines? This was my concern. Surely the few anecdotal reports of people I had found online who had had success with niacin to abort migraine were not really suffering from true migraine then – or were they?

While niacin does mop up methyl, it turns out it is actually required for the breakdown of histamine:

“Alcohol Dehydrogenase (ADH) is the final step in histamine breakdown. This is the same enzyme that breaks down alcoholic beverages. This explains why some individuals flush when they drink. It is also a good reason to perhaps skip cocktails, beer, and wine during hay fever season. This enzyme actually has four different cofactors including zinc, vitamin C, thiamine (B1) and nicotinamide adenine dinucleotide (NAD—a niacin-based flavoprotein).” (Source)

Folic acid and folate trigger migraine because they contribute to glutamate load – and niacin reduces folate.

It appears there is more to migraine than histamine or methylation. I’m beginning to wonder if in fact the low histamine diet and gut healing in the SimplyWell Protocol is successful because it also raises niacin (by way of feeding gut bacteria that produce it), and lowers glutamate.  Maybe glutamate toxicity is playing an even bigger role in migraine outcomes than histamine or methylation status.  Not so incidentally, it seems that folic acid and folate supplementation is the biggest culprit in triggering migraine (even methylated folate) – and niacin reduces folate.

“Folates are comprised of numerous glutamic acids conjugates. The higher the dose of folates, the greater the propensity towards an increase in the pool of free glutamate. Hence, the “excitatory” and neurological types of adverse effects of folate in certain individuals.” (Source)

According to Dr. Albert Mensah, those who are undermethylated have low brain serotonin and also

“. . . have a genetic tendency to be very depressed in calcium, magnesium, methionine, and Vitamin B-6 and may have excessive levels of folic acid in nuclei of brain cells.” (Source)

I make a point to eat a lot of vegetables to get naturally-occuring folate since I choose not to supplement with synthetic  folic acid or folate, for reasons stated above. One concern I had with taking niacin (eventhough I take mine in my own hand-blended B complex with other Bs but without folic acid or folate) was that it might deplete folate, since niacin-derived NAD is a necessary co-factor for the enzymes dihydrofolate reductase in the folate/tetrahydrobiopterin cycles and S-adenosylhomocysteine hydrolase in the methionine cycle (Source).

A recent blood test showed no folate deficiency even while supplementing with 80mg of niacin a day (and sometimes more when I aborted a headache) for three months. It seems my concerns about taking niacin depleting folate and folic acid may be unfounded – perhaps because undermethylators are high in folic acid.

Luckily, the B-complex B-Minus by Seeking Health contains no folic acid or folate (or methyl b12).  It also contains some niacin B3, whereas many other B blends contain niacinamide or non-flushing B3, which does not have the same benefits as niacin as nicotinic acid does.

Why niacin sufficiency is so important for those with migraine

Because migraine is a chronic systemic inflammatory condition affecting the whole body, there are many angles from which to view migraine causality.  One perspective worth recognizing is that migraine is a metabolic disease caused by inefficiencies in enzymatic processes.  Because vitamins, minerals, and amino acids are all needed for enzymes to work, it makes sense to ask to what extent nutritional deficiency is playing a role in migraine.  This is especially important in the case of niacin, which is used in more biochemical reactions than any other vitamin-derived cofactor once it is converted to the enzyme NAD.

 “. .Your body uses NAD (with a hydrogen it is NADH) in over 450 biochemical reactions, most of which are involved in anabolic and catabolic reactions. Most people tend to associate NAD with glycolosis (sugar breakdown) and ATP (energy production). However, NAD is involved in many other reactions as a cofactor, including either the synthesis (anabolism) or the breakdown (catabolism) of just about every molecule our cells make: steroids, prostaglandins, and enzymes. NAD is involved in cell signalling and assists in ongoing repair of your DNA.” (Source: Niacin, the Real Story)

Technically, niacin is the third B vitamin discovered (although because it can be made from tryptophan in the body it actually should be classed as an amino acid). Niacin deficiencies in the general population but also in those with migraine may be more widespread than realized because testing for niacin deficiency is not a common practice.

Niacin B3 is vitally important, especially for those with migraine because it:

  • raises blood sugar (good for migraineurs with low blood sugar)
  • breaks down glutamates (often the cause of that migraine that starts at 4am)
  • it helps synthesizes sex hormones like estrogen and progesterone (low estrogen and progesterone lead to migraine)
  • helps heal leaky gut
  • helps metabolize excess ammonia (cause of leaky gut and also brain inflammation)
  • increases serotonin
  • removes heavy metals
  • cleans out the lymphatic system
  • helps to break down beta-amyloid lesions in the brain (common in migraineurs)
  • thins the blood – ie, has an “anti-sludging effect” (migraineurs have sticky blood)
  • mops up adrenaline, thus reducing anxiety
  • improves sleep

Causes of niacin deficiency and pellagra

Compromised gut flora due to the use of antibiotics, consumption of high-carb diets, estrogen dominance, and stress all contribute to niacin deficiency. A diet high in the amino acid leucine may also contribute because it interferes with the conversion of tryptophan to niacin. Leucine is high in whey and soy protein concentrates and is also known as the food additive  E641 as a flavor enhancer (Source). Niacin deficiency can also be caused by Hartnup’s disease, where there is a block in the tryptophan-nicotinic acid pathway. Consumption of polyunsaturated fats DHA, EPA, and linoleic acid also play a role because they activate the conversion of tryptophan to quinolinic acid, and inhibit the formation of niacin (Source).

Problems caused by niacin deficiency can range from mild to fatal, as in the case of severe pellagra. Mild niacin deficiency is characterized by mental fatigue, irritability, weakness, indigestion, and skin irritations, while mild to advanced pellagra involves headaches, insomnia, loss of strength, light sensitivity, nausea, indigestion, and hypersensitivity to smells (Source). In acute niacin deficiency, an encephalopathy is found which closely resembles Wernicke’s syndrome – a thiamine B1 deficiency disease usually found in alcoholics and discovered post-mortem.

Prior to the discovery that pellagra was caused by niacin deficiency (and subsequent fortification of flour with niacin in 1940), it was thought to be an infectious disease.  Three million pellagra cases and 100,000 deaths resulted from niacin deficiency in the US in the first half of the 20th century – with 30,000 of those deaths occurring in 1930 following the Great Depression (Source: “Niacin, the Real Story”).

Given that migraine headache is experienced by a disproportionate amount of women compared to men, it’s really interesting to make note of the fact that:

“Pellagra occurs about twice as often in women as in men, and this is because estrogen activates an enzyme that alters metabolism of tryptophan, blocking the formation of niacin . . . Progesterone inhibits the activity of that enzyme. Progesterone also . . . decreases the excitatory carcinogens and increases the formation of niacin.” (Source)

Niacin is a known – but obscured – migraine solution

From my research it appears that the benefits of niacin for migraine are known but not widely shared, realized, or emphasized.  A few websites mention niacin as being helpful along with a long slew of other substances, most notably riboflavin (B2), feverfew, butterbur, ginger, magnesium, etc etc.  With niacin mentioned in passing along with this long list of other contenders, it is easily overlooked and does not stand out as a legitimate solution. The majority of the websites I saw didn’t mention that niacin could abort a migraine outright, or how to do it, they just said it was supportive of migraine.

The two sites I did find that said migraine could be aborted with niacin didn’t mention that it could also be used to prevent migraine, or why it worked.  The authors of the book “Niacin, the Real Story” (by Hoffer, Saul, Foster) only had a very small section on the topic sharing a single report from the Scottsdale Mayo Clinic in which a patient had responded to sustained-release niacin.  They also mention that a 2005 review of nine articles investigating niacin therapy for migraine stated:

“Intravenous and oral niacin has been employed in the treatment of acute and chronic migraine and tension-type headaches, but its use has not become part of contemporary medicine, nor have there been randomized controlled trials further assessing this novel treatment . . . Although niacin’s mechanisms of action have not been substantiated from controlled clinical trials, this agent may have beneficial effects upon migraine and tension-type headaches.” (Source)

Clearly, there is benefit in the use of niacin for migraine, but for some reason these benefits have become obscured, forgotten, ignored, buried, unrealized, or just not very rigorously studied. I want to bring niacin back into the limelight.

Going off the Protocol to experiment with niacin

A nagging voice of intuition kept asking me why there would be anecdotal reports and some support from studies that niacin helped migraine if it actually exacerbated it. I’m glad I got over my initial caution with niacin so I could discover its benefits.

I’ve learned I have to stay on my SimplyWell Protocol to be completely free from migraines. But I still go off of the Protocol form time to time to test the extent to which the underlying root causes of my migraine have been healed (or not), and to experiment with new approaches to migraine.  After three weeks off the Protocol, the telltale migraines do come back. Last time I went off the Protocol, I used this as an opportunity to try out niacin. The niacin worked beautifully (usually at a dose of 500mg) to dissolve both headaches and a few migraines.  I then went back on the Protocol.  Each time I get off of it, I’m reminded that preventing migraine with the Protocol is much easier and more desirable than having to rely on a pill to abort migraine.

Now that I’m back on my beloved SimplyWell Protocol, and am migraine free again, I still continue to utilize niacin in my B complex that I make myself.  I love niacin, because it clearly stabilizes my mood, improves my sleep quality, has completely eliminated any brain fog I used to wake up with in the morning (which usually went away after an hour), and has given me more resilience in being able to eat very high histamine foods without even a glimmer of brain fog.  I take it daily, and truly appreciate it’s value for improving my quality of life. I try not to share anything with my migraine clients that I have not personally tried or use regularly myself.

Feedback from clients on niacin

I’ve received feedback from a number of clients who have used niacin for migraine, with mixed results. As with all things, diversity in response, approach, and interest is the name of the game.  That includes people who just don’t like the idea of taking a synthetic supplement, even while they rely on synthetic pharmaceuticals to abort migraine.

A few of my clients have had great success aborting migraine with niacin – these are the people who don’t mind the flush. One client even said that the flush of niacin felt almost identical to the flush she gets from her Imitrex shots. Some people, myself included, enjoy the flush.

Another client was encouraged by the research I shared but chose to do a lot more research herself and after doing so, decided to take time-release niacin before bed.  She no longer wakes up with migraine in the morning like she used to, and she has replaced her nightly triptans with niacin. Personally, I am not in favor of time-release niacin due to its potential challenges it poses for the liver to process it, but my client has done her research and made her own conclusions.

Others can’t tolerate the flush and some even find the experience downright awful (itching, burning, prickling, shivers, nausea).  From the people I’ve worked with taking niacin, I’ve observed that it is generally those who have had migraine for a longer time period, who eat a normal diet including high histamine foods, and who also take medications for migraine that have the most unpleasant reactions.  For these people niacin may not be a viable option for aborting migraine, though they may benefit from getting smaller doses in a B complex taken with food to avoid such reactions.  On the other hand I also had a client who had migraines for a long period and took medications while eating high-histamine food who felt fine with the flush and used niacin to get off her meds.

Some people don’t even get a flush even on very high doses of niacin, and also aren’t able to abort a migraine with niacin without a flush – while other people can abort a migraine with niacin even in the absence of a flush. So responses are all over the board.

Flushing from niacin usually indicates a high level of histamine (since niacin empties the mast cells of histamine), while a lack of flushing from niacin usually indicates a very high threshold for niacin and potentially a very deep deficiency and/or an excess stress manifested as adrenaline in the body.

“When an individual is stressed, their requirements for vitamin B3 will need to increase, due to increased amounts of adrenalin (epinephrine) being released from the adrenal medulla, creating more oxidized adrenalin. To convert the increased oxidized adrenalin back to original adrenalin, the reducing ability of NAD is necessary, and thus the need for more vitamin B3. Perhaps the lack of or reduced flushing among these patients was due to an increased metabolic need for vitamin B3 (i.e., a more rapid conversion of vitamin B3 to NAD within the body), necessitated by heightened periods of stress.” (Source)

Most people can abort a migraine with 250mg of niacin on an empty stomach or with only a small amount of food if the migraine is caught early on.  If it is not taken until the migraine is advanced, more may be needed for it to work.  Generally 250-500mg is sufficient to abort a migraine for most people, but individual tolerances for niacin vary widely.

Follow the money

In 2017, the global market for drugs used to treat migraine is $3 billion and rapidly growing. The money spent to pay expert practitioners to (often unsuccessfully) treat migraine is surely even more. Niacin costs about .06 cents per capsule.  Triptans cost about $28 per pill. The new CGRP receptor antagonist drugs, which use recombinant DNA, will probably cost tens of thousands of dollars per shot, and may not be covered by insurance.  The fact that niacin is available in most every drug store or grocery store and is not widely known about for use with migraine is amazing when you consider how incredibly important, supportive, and effective it is at addressing some of the root causes of migraine.

I find it inexcusable that so many people are suffering so much with migraine headache – fully 1/3 of them caused by medications themselves – even while such simple, effective, and affordable solutions such as niacin exist. The good news is that niacin is only one of many natural approaches to aborting migraine.

Want to learn more about niacin for migraine?

This blog post is an excerpt from a new e-book I am writing that includes more information on niacin, including:
  • Why not just get niacin from food?
  • Niacin, Tryptophan, and Serotonin
  • Gut flora imbalances and their effects on niacin
  • Niacin and hormones
  • How niacin works with riboflavin
  • Is niacin a replacement for the SimplyWell Protocol?
  • How to abort a migraine with niacin
  • How to prevent migraine with niacin
  • Cautions, contraindications, and safety concerns with niacin
The good news is that for those who have sensitive stomachs or cannot tolerate the niacin flush, I’ve discovered another even gentler and more effective way to abort migraine using an essential amino acid that is virtually unknown as a solution for migraine.
I have searched for over a year to find alternatives to NSAID’s or pharmaceuticals that are effective, and I’m so excited to have found them. The ability to get rid of headaches and migraines using natural supplements can be a huge leverage point during the first few months on the SimplWell Protocol because these supplements are supportive and nutritional rather than suppressive and toxic.
Stay tuned – this e-book will be available in the coming months.

Two Years on the SimplyWell Migraine Relief Protocol

How Did Migraine Become My Life?

A year into my chronic migraine saga post c-section I was bewildered to realize that my life was still completely dominated by pain, indigestion, brain fog, poor sleep, and the host of problems that stem from that.  It never occurred to me that at such a relatively young age (34) I would find myself chronically ill with migraines. That was something that happened to other people, right?

Two years after the c-section, I was still sick as a dog.  I spent all of my time researching and experimenting, trying to find my way out of the maize of hell I was in. Occasionally the magnitude of the problem and the fact that my migraines still persisted despite my best efforts became totally overwhelming.  Apparently, this was now my life. I was married to an amazing man and had the sweetest son – a son who needed my attention and energy.  But my full love of life, my full energy, and my sense of self had been very eroded.  I was a shadow of my former self.

Discovering the SimplyWell Protocol

I did not know when or if I would ever have a breakthrough, but I did. I’ve called my breakthrough The SimplyWell Protocol.  I call it this because two of the most important aspects of the Protocol (carrots and potatoes) are very simple, seemingly mediocre foods – and as such, easily overlooked.  I had not expected that my relief would come from such a humble and unexpected place, especially after all I had tried and the doctors I had seen. (I’ve considered rebranding my name because many people don’t find lifestyle change simple.  What they mean is that it’s not easy.  Simple and easy are not the same thing).

I discovered the SimplyWell Protocol in January of 2015. I still had indigestion, mild headaches, and a fair amount of brain fog, but the migraines were gone and, because I was so relieved to have a break from them and to have found a solution, I was very diligent in following the Protocol.

Refining the SimplyWell Protocol

By the time summer 2015 came around, I had decided to refine the protocol by diversifying the sources of prebiotics beyond resistant starch in an attempt to increase the diversity of flora in my gut microbiome.  That step, combined with all of the vitamin D I was getting from the summer sunlight, meant that my brain fog largely dissipated and I started to feel strangely normal.

The discovery of the six steps that I now call the SimplyWell Protocol allowed me to hold a job.  By following the lifestyle changes outlined in my Protocol, I was able to continue my life with a chronic debilitating condition while exhibiting very few of the symptoms of chronic migraine, and without the use of any pharmaceutical or over-the-counter pain meds of any kind.

Eventually, after feeling great and migraine free for six months, I started to slack off on the Protocol. I also wanted to find out what would happen if I went off it. I learned that the underlying cause of my chronic migraines was and is not CURED by my Protocol.  I had to – and still have to – stay on the Protocol to maintain a state of being symptom free.  I’m grateful for this state of normalcy while on the Protocol. (My belief is that the pathogenic and histamine-producing microbial populations which seeded my gut in the hospital post c-section got the prime real-estate of the inner gut lining and that this population remains difficult to uproot even while the Protocol helps to shift the overall biofilm towards healthier bacteria).

This is the liberty and resilience that the Protocol offers, but it is also risky. The danger of relapse inevitably arises once people start to feel good on the Protocol. They feel so good they stop taking the steps necessary to maintain resilience in the face of eating high histamine foods, getting triggered by a stressful life event, or just being overworked and too busy like most of us moderns are to properly take care of themselves.

On and Off the Protocol Over the Past Two Years

All told, I’ve taken about six months off of the Protocol in the past two years.  Four of those six months were a deliberate experiment that I took to see if I could reset my gut flora using B vitamins and vitamin D, as outlined by Dr. Stasha Gominak.  The other two months off of the Protocol represent the total amount of time that I’m estimating I went off the protocol through accident, negligence, or laziness.  These bouts of slipping off the protocol usually lasted about two weeks each. The migraines do come back after about two weeks off of the Protocol.  Currently I am on another break from the Protocol as I experiment with exploring the underlying emotional basis for migraine.  You can learn more about that here.

I have had a handful of migraines in the past two years, as compared to about 8-10 migraines a month prior to discovering the Protocol.  I will outline the causes of the migraines I have had below.  But I think it’s also important to point out that one very big difference in my life is that not only are migraines very scarce and I always know why they crop up when they do, but also the overall quality of my life is greatly improved because I have a clear head without other headaches or brain fog the rest of the time.  My quality of life and ability to function as a mother has drastically improved, and my brain and gut health continue to get better as I learn more about sleep hygiene and nutrition, especially the importance of B vitamins (all of these topics will be explored in my comprehensive online course).  This has been an amazing journey.

Over the past two years, I’ve had migraines from the following triggers:

  • Extreme stress + sleep deprivation
    The sleep deprivation has been ongoing for 7 months now that I have a second child and am breastfeeding every night.  This makes me less resilient to stress. With sleep deprivation, melatonin levels get disrupted.  Melatonin is known to inhibit CGRP, the vasoactive peptide responsible for causing migraine.  It is very hard to heal migraine with disrupted sleep.  Parenting small kids is very stressfull in general.  Stress management is a hugely important aspect of healing migraines, and it’s one that I am still learning.
  • Going off the Protocol accidentally or through negligence while eating high histamine foods
    These migraines were no mystery.  One day I woke up with a migraine and realized that in addition to being off the Protocol for almost two weeks, I had eaten nothing but high-histamine foods the day before: yogurt, pizza, dried fruit, chocolate, kombucha, spinach salad, and a bone broth soup with cayenne pepper. Ooops!  While eating high histamine foods becomes less and less of a problem while on the Protocol, eating only high histamine foods while off the Protocol very predictably leads to migraines.  No surprises there.
  • Experiment with arginine
    One disadvantage of not getting migraines often is not being able to experiment with potential solutions anymore. I’m a little embarrassed to admit that I actually tried to induce a headache with salami and cheese to see if calcium pyruvate and arginine would clear it up.  When it did, I decided to take more arginine – which gave me a migraine.  What I did find out from this, however, is that small doses of arginine with pyruvate may work very well to help the body eliminate glutamates, whereas larger doses dilate the blood vessels too much.  Valuable information, paid for dearly.  (Don’t tell my husband that that migraine was self-induced, K? And if you’re reading this babe, sorry for making you stay home with the kids on that day and missing work).
  • B12 supplementation
    This was a migraine from a single dose of methylated B12 that I took early on after discovering the Protocol.  I have since read that B12 can potentially be toxic if taken when glutathione levels are low. (Folate and folic acid are also huge migraine triggers, even moreso than B12 is).

I’ve also had a few strong headaches that were caused by viral infections.  These headaches were different in characteristics than migraine – pain was in a different place (more at the base of the skull/occiput rather than deep behind the eye).  I was still pleasantly surprised to see that these two viral headaches I had responded well to the cabbage compress.

Full Disclosure

It was never my intention to have a c-section, or to get chronic migraines, or to become a migraine relief coach (at least, it was not my ego’s intention, even while it clearly is part of my soul’s path).  Given the unintentional way that I ended up in the position I am in, I have nothing to offer but honesty and transparency in my process of healing myself.

The Protocol is quite young, and what I offer migraine clients is always evolving as I research migraine. I continue to find more solutions to migraine headache above and beyond the Protocol, but to date, the Protocol remains the best way that I’ve found to relieve migraine without meds for myself and those that I coach.

It would be nice if there was a natural silver bullet out there that acted as effectively as pharmaceuticals without the side-effects. The protocol is not a silver bullet.  It is only a tool. If there is any silver bullet, it is each individual person to the extent that they recognize that healing happens through consistent dietary and lifestyle change, accomplished through an inner motivation to live a better life.

It has been a great joy not only to empower myself to take better care of myself so as to be free from migraines, but to help others do so.  The pleasure of my work comes not just from feeling the satisfaction in knowing that low-tech, simple foods can so radically help us, but also from seeing people find the power in themseves to transform their lives.  Plants and information are only healing to the extent that people apply the information and use the plants.  The only thing that ever heals people is themselves.

 

 

Emotional Healing for Migraine with Dr. Sarno’s TMS Concept (Video)

In this video I explore my own recent reflections on healing migraine as TMS pain.  TMS, or Tension Myoneural Syndrome is a concept originated by Dr. Sarno, and reviewed by Steve Ozanich in his book “The Great Pain Deception.”

Dr. Sarno’s basic premise is that chronic pain is a clever way that the body uses to express deep-seated emotions that we as children learned to repress because we believed that expressing emotions our parent’s disapproved of would lead to use being abandoned/cut off from our source of life.

It is not a new idea to me that the body takes on the stress of unexpressed emotions, or that repressed emotions can manifest as disease. It is also not a new idea that the body actually IS our subconscious. What is new is the idea that pain is an actual diversion tactic that the mind uses to avoid unconscious rage.

I’m compelled by this idea. So I decided to go off the Protocol to see if this will really work. After all, I’d rather not have to eat potato starch every day for the rest of my life. I am happy to find a better solution to the Protocol if one exists.

Find out more about what I’ve learned in the two weeks I’ve been off the protocol as I reflect on and experiment with Dr. Sarno’s ideas in the video below.  Enjoy!

 

Here’s Part 2

7 Common Blind Spots in the Management of Migraines

Over the course of my time coaching people to alleviate migraines, it’s become clear over and over again that some doctors and naturopaths may inadvertently be causing MORE headaches and migraines through the recommendations they make – especially when it comes to management of migraines caused by digestive problems and subsequent histamine intolerance.

I’m actually very grateful that a naturopath I was seeing early on for my migraines (prior to developing the SimplyWell Protocol) prescribed an herbal remedy that contained cinnamon as its first ingredient.  I was experiencing peripheral neuropathy along with the migraines and, rightly so, she thought the increased circulation boost offered by the cinnamon would help alleviate that (actually, it was my lymph that was congested).  When the remedy made me even sicker, I took a close look at the ingredient list and through doing some online research, realized that cinnamon is a major trigger for those with histamine intolerance.  This was the clue that I needed which sent me down the path of investigating migraine through the lense of histamine intolerance, which probably wouldn’t have happened had she not suggested I take cinnamon.

This was a good lesson in realizing that all reactions to medications whether positive or negative are telling us something: even bad reactions may be helpful if we can use them as a clue to better understand what’s going on in our bodies.  Conversely, sometimes the substances that we’re taking don’t manifest as obvious problematic symptoms that we can link to them, so we may inadvertently be using supplements or eating foods that are actually causing harm without knowing it. And then there’s the problem which is all too common of taking so many supplements and medications that it is nearly impossible to know which is causing what effects, for better or worse.

Below is a rundown of the most common ways to manage migraine, usually at the advice of a holistic or conventional professional health care provider, which may be exacerbating rather than mitigating your migraines.  It helps to be mindful about these blind spots so that you can interface with your health care professional in a more educated way.  Be forewarned that many health care practitioners may not be aware of what histamine intolerance is, since it is not a formal diagnosis.  I have heard of many cases of doctors undermining or questioning the existence of histamine intolerance.  Other practitioners may be aware of histamine overload but don’t link it to migraine.  Luckily, more and more more practitioners are learning about histamine intolerance and its causes.

Blind Spot #1: Fermented Foods & Probiotics

As people wake up to the importance of good gut health and its role in basically everything, many are getting on board the fermented food bandwagon. After all, it makes sense that if your gut flora have been depleted by antibiotics and meds (which most of ours have), that replenishing them with more good flora by way of fermented foods and probiotic supplements would be beneficial.  But this is not always the case.

One of my pet peeves is to see how widespread the fervent belief in the value of fermented foods is.  Fermented foods are the holy grail of gut health right now – except that they actually make a lot of us sick. As I have explained here in this blog post on histamine intolerance, fermented foods (yes, even the beloved home-made sauerkraut, kimchi, or kombucha) become problematic for those of us who are low in the enzyme, DAO (diamine oxidase), which helps to break down histamine.  Most fermented foods as well as probiotic supplements contain a mixture of histamine-producing, histamine-neutral, and histamine-degrading bacteria. (If you do feel you need a PRObiotic, choose only those strains that are histamine-degrading, like l. plantarum, l. rhamnosus, or b. infantis).

As a result of this DAO enzyme deficiency, those with the deficiency who eat fermented foods will not be able to break the food down properly, so by the time it reaches the colon, it will start to ferment even more.  Opportunistic bacteria in the colon, many of them also histamine-producing, will also try to lend a hand in the breakdown of the food.  By this point, your serum levels of histamine are probably quite high, and symptoms of bloating, brain fog, and migraine may appear.

Let’s be clear that I am not demonizing fermented food.  Fermented foods are beneficial if you can break down histamine.  The problem is not histamine-rich foods, but the nutritional and mineral deficiencies that make it impossible for the body to produce enough enzymes.  B vitamins, in particular, are building blocks for enzymes, and many B vitamins are normally provided by our gut flora.  However, if our gut flora are depleted, we won’t have these building blocks in place.

Luckily, we have extra help from PREbiotics, which also increase healthy gut flora but are much more supportive for those with migraine. Prebiotics and probiotics are normally complimentary, so once we have stabilized with the SimplyWell Migraine Relief Protocol, we’ll find we can gradually reintroduce the wonderful and otherwise beneficial fermented foods like sauerkraut that used to give us problems.

Blind Spot #2: Bone Broth & Collagen

Bone broth and collagen are usually recommended as a means to improve the integrity of the gut lining.  Full of minerals, healthy fats, and most importantly chock full of important amino acids, bone broth and collagen at first glance appear to be really good for building gut health.  And they are – IF you have the nutritional building blocks for the enzymes needed to properly convert glutamic acid (one of the most abundant amino acids in bone broth). 

The problem is similar to that of histamine overload exacerbated by low diamine oxidase enzyme – it means that an otherwise beneficial substance becomes toxic when it is unable to be transformed or broken down due to enzyme deficiencies.  The problem is also a cyclic, chicken-and-egg problem: how do you build gut health and enzyme function if your gut health is so poor that you can’t properly absorb or assimilate the nutrients needed to make the enzymes needed for good gut health?  Because healthy gut flora normally produce many of the B vitamins that are essential for enzymatic function, consistent B vitamin and mineral supplementation is usually crucial here.

But until then, bone broth and collagen may pose some problems for those with migraine, because the glutamine and glutamic acid in it has a molecular structure very similar to monosodium glutamate (MSG) – a known migraine trigger. Despite the fact that glutamic acid is used by the body for the creation of glutathione (which is generally low in those with migraine), some caution is still in order here.  Migraineurs also have high levels of glutamate in certain parts of the brain, which leads to excitotoxicity.  Glutamine and glutamic acid are converted into glutamate.  Therefore migraineurs are best supported by avoiding substances that contribute to excessive glutamate load.

Kaayla T. Daniel, PhD, coauthor of the highly acclaimed book Nourishing Broth: An Old Fashioned Remedy for the Modern World, points out that:

The glutamine content of broth increases with cooking time as do the levels of all other amino acids. Thus long-cooked bone broth is more nutrient rich and preferable for all who can tolerate it. . Appropriate supplementation and detoxification may also help sensitive people handle glutamine. People with severe MSG sensitivity are often low in vitamin B6 or unable to convert it to the active form of pyridoxal-5-phosphate (p5p). Becoming replete in B6 and the other B vitamins may help. Glutamine sensitivity can also come from lead toxicity, widespread today due to lead contamination of our food and environment.

A separate issue in consuming bone broth or collagen if you have migraines is that of freshness and quality.  Bone broth must be made and consumed fresh because – just like any other food – bacteria start to break down broth the longer it has been around – making packaged or leftover bone broth much more of a trigger than fresh homemade bone broth.

And, as is true of all animal products we eat, any bone broth consumed must be 100% organic.  Dr. Stephanie Seneff explains how the herbicide roundup (generic name glyphosate) can contaminate many products made with gelatin:

Once you think of glyphosate insinuating itself into collagen, it’s an easy step to imagine that glyphosate would be a major contaminant in gelatin, a very common food additive and the main constituent of gelatin-based deserts. Gelatin is routinely added to marshmallows, pudding, gummy bears, yogurts, margarine, frosting, cream cheese, sour cream, non-dairy creamers and fat-reduced foods. Gelatin is typically derived from the bones joints and skin of pigs and cows. These animals are fed high doses of glyphosate in their GMO Roundup Ready corn and soy feed. The glyphosate that makes its way into their joints ends up in your gelatin dessert.

Gelatin is also the main constituent of gel caps, which have become a standard way of packaging both pharmaceutical drugs and nutritional supplements such as fish oil. I would predict that any nutritional supplement housed in a gel capsule is going to cause you much more harm than good, because whatever benefit the contents provides is more than offset by the damaging effects of the glyphosate. This also means, of course, that bone broth, a highly nutritious food, must be made from grass-fed beef rather than from the large confined animal feeding operations (CAFOs). One solution is to be sure that your supplements use vegan gel caps, which are made from cellulose, a plant-derived polysaccharide that would probably be much less at risk of glyphosate contamination. (Source)

Bummer.  Major bummer. And if that weren’t enough of a bummer, glyphosate also interferes with how the body is able to utilize glyceine, one of the other amino acids that bone broth supplies.

Takehome: if you only get migraines once in awhile, bone broth and collagen may be supportive of your healing (only if it is 100% organic due to the glyphosate contamination issue).  But if you have chronic migraines and very high histamine, and are easily triggered by food, it may be best to opt out of consuming a lot of bone broth, or only eating occasional bone broth you make yourself that has been made with short cooking times. Be absolutely sure not to buy packaged broths, and opt for supplements made with vegetable, rather than gelatin, caps.

Blind Spot #3: Methylated B vitamins

These days taking methylated forms of B12 and folate is all the rage. As more and more people do genetic testing and find they have the MTHFR gene mutation, they and their doctors may believe they need methylated B vitamins.

I was always suspicious of methyl B12 as a stand-alone supplement, because I’ve personally experienced migraines triggered by B12.  Multiple clients of mine have repeatedly mentioned that they also get migraines from methylcobalamin. I have come across some evidence that B12 can be toxic in the presence of glutathione depletion.  Glutathione is our most powerful and abundant antioxidant in the body, and migraineurs are generally low in it. (As it turns out, triptans – the most popular drug for the treatment of migraine – also cause oxidative stress in the liver and thereby deplete glutathione, at least in rats).

Not only folic acid, but also methylated forms of folate can be problematic also because they may increase glutamate and lower serotonin levels. Folic acid and folate supplementation also lower riboflavin levels – not good for those with migraine. Consider this:

The potential limitations of administering a restricted range of B vitamins are illustrated by evidence showing that approximately a third of supplementation studies to date have involved the administration of folic acid alone. . . . [F]olate and vitamin B12 are intimately interlinked within the folate/methionine cycles, and increasing the level of folate can mask the accrual of permanent neurological damage associated with a specific vitamin B12 deficiency. A striking illustration of this was provided by an epidemiological study by Morris et al. who reported that high folate status was associated with protected cognitive function, but only in those with normal vitamin B12 status, with this relationship reversed in participants with low vitamin B12 status. For this group, high folate status exacerbated the detrimental effect of vitamin B12 deficiency, increasing the risk of cognitive impairment and anaemia by a factor of five, compared to those with normal vitamin status. A further study also demonstrated that low vitamin B12 status was associated with a significantly increased decline in cognitive performance over the subsequent eight years, with this effect exacerbated in those having high levels of folate, or those taking folic acid supplements. Alongside these observations it is interesting to note that in one study supplementation with folic acid also significantly increased the proportion of participants with riboflavin deficiency. (Source)

Why not just try to get all of your b vitamins through food?  Because b vitamins from food have always been a supplemental source to begin with – adding to the b vitamins that our gut flora would normally produce for us.  That is precisely the problem: evolutionarily, we have never relied on food alone for our b vitamins.

While supplementation with methylfolate may initially give some positive results, it can also quickly backfire, especially for those with migraine.  Luckily, there are alternative ways to methylate – through the use of choline or thrimethylglycine for example.

Methylation is an extremely complex topic (one that I certainly don’t have a full grasp on) – and around which there is much confusion and many diverse perspectives even among experts. Below are a few perspectives worth considering from some of the experts on the benefit of being cautious when it comes to supplementing with methylfolate:

Chris Masterjohn:

This is not – NOT NOT NOT NOT NOT NOT all about getting methylfolate. . . . You can’t restore the normal flux of methylfolate no matter how much you eat. The RDA for folate is 400 mcg depending on your sex and life stage, and that assumes you’re going to absorb 200mcg of folate. Each molecule of folate you consume is recycled 18,00 times per day. If you consume a molecule of methylfolate the methyl group on that folate is available once, and then it has to be recycled 17,999 times. Where does that recycling come from? The carbons come from serine or glycine, but the part that MTHFR is catalyzing, the part that’s defective in someone with an MTHFR mutation, they’re coming from glucose. . . One glucose molecule, if you’re burning it for energy, supplies enough NADPH to recycle one molecule of folate one time. You’re going to need 3,00 to 6,000 molecules of glucose for every molecule of folate to get your daily methyl flux out of it. . . . But if you wanted to make up for that process by adding individual methyl groups . . . . from methylfolate that you got out of a capsule, in order to make up for that process you would have to consume an incomprehensible amount of folate: 4.5 grams of folate. You would have to consume 18,000 times the RDA of folate. I have no idea what happens to folate when you consume 18,000 times the RDA for it, I just don’t know. My guess is a lot of it winds up in your poop. But I do know that I would never advise anyone to eat 4.5 grams of folate. And that if anyone thinks that by eating super high doses of folate like several milligrams that they’re getting anywhere near inching their way towards making up for the normal flux of methyl groups through that pathway, that’s delusional. (Source).

Dr. Ben Lynch

If you know or suspect that you may be deficient in various minerals or vitamins, then it is important that you replenish many of them prior to supporting with methylfolate or methylcobalamin. Why? Because if you support with these two powerful methyl donor nutrients, it can cause a ‘clog’ in your biochemistry. This ‘clog’ may occur in how your brain chemicals (neurotransmitters) get formed and/or eliminated. Obviously, this can cause some significant issues. (Source)
Dr. Carolyn Ledowsky

A lot of information available from a variety of sources says that for those patients who have MTHFR mutations (especially the C677T MTHFR mutation) methylfolate is critical to take. And yes, for some patients, gentle supplementation via methylfolate may be all that is needed if they are otherwise healthy and have few health conditions they need to address. However for anyone dealing with allergies, inflammation, poor detoxification, hormonal imbalances or mood/ neurotransmitter imbalances – methyfolate could amplify these issues if they have not been addressed prior to engaging the methylation cycle once more. (Source)

Dr. Albert Mensah

Much discussion surrounding methylated folate comes from genetic testing and the MTHFR paradigm, which is neither an accurate assessment nor an appropriate guide for true methylation disorders. MTHFR testing is very significant in the realm of autism and in multiple sclerosis, however, in the area of mental health it is strikingly inconsistent and dubious at best.  The proof is in the pudding. People who are truly undermethylated do not do well on methylated folate after two to three months. In fact, on quite the contrary, many people report worsening of symptoms. (Source)

Marlene Merritt, LAc, DOM, MS Nutrition

Methyl groups have effects on many, many different areas of the body, INCLUDING TURNING ON AND TURNING OFF GENES and this includes tumor suppressor genes. To prevent abnormal methylation, there are seven checkpoints to prevent hypermethylation, since hypermethylation often causes cancer. So this is another reason that you not want to take large amounts folate (or any other methyl donor (ex: methyl-B12, SAMe), because you also do not want too much methylation to occur.

So then why in the world would you want to take a nutraceutical like methylfolate/5-MTHF? . . .

[L]ong term supplementation of methylfolate causes a list of side effects that rival a pharmaceutical drug: anxiety, irritability, insomnia (from changes in neurotransmitters), sore muscles and achy joints (from reduction in glutathione production), headaches and migraines (from increased nitric oxide production), nausea, palpitations, rashes and suicide, in addition to exacerbating B6 and B12 deficiencies, along with magnesium, zinc, copper, manganese and other mineral deficiencies. . . .

In preparing this article, I interviewed five biochemistry and nutrition PhD’s, all of whom categorically said that they would not take methyl folate as a supplement and considered the amounts typically prescribed as unsafe. (Source)

Blind Spot #4: Excessive Vitamin D Supplementation

Another pet peeve of mine: excessive vitamin D supplementation.  Don’t get me wrong – it appears that vitamin D3 supplementation is pretty valuable (though this may need to be reconsidered – see below).  Most people, whether they have migraine or not, are low in vitamin D.  But taking huge amounts of vitamin D is also dangerous – especially to migraineurs, since vitamin D requires magnesium for absorption.

Dr. Carolyn Dean explains:

Here’s what happens. You feel great on your magnesium and then you begin to have more magnesium deficiency symptoms after adding a high-dose Vitamin D supplement. Magnesium is required to transform Vitamin D from its storage form to its active form and for many other aspects of Vitamin D metabolism. That means if you take the extremely high doses that allopathic doctors are now recommending you can plummet into magnesium deficiency and not know what the heck is happening. In general, I don’t recommend more than 1,000-2,000 IU of Vitamin D daily for this reason. And never take Vitamin D without magnesium. (Source)

Excessive vitamin D can also deplete vitamin K stores, which are essential for helping calcium build bone.  With vitamin D excess and K depletion, calcium ends up in the wrong places. Sufficient vitamin A is also crucial if you are supplementing with vitamin D.  According to Nora Gedgaudas in her book “Primal Body, Primal Mind”, insufficient Vitamin A can lead to vitamin D toxicity.

Chris Masterjohn explains his hypothesis:

[V]itamin D increases the expression of proteins whose activation depends on vitamin K-mediated carboxylation; as the demand for carboxylation increases, the pool of vitamin K is depleted. Since vitamin K is essential to the nervous system and plays important roles in protecting against bone loss and calcification of the peripheral soft tissues, its deficiency results in the symptoms associated with hypervitaminosis D. This hypothesis is circumstantially supported by the observation that animals deficient in vitamin K or vitamin K-dependent proteins exhibit remarkable similarities to animals fed toxic doses of vitamin D, and the observation that vitamin D and the vitamin K-inhibitor Warfarin have similar toxicity profiles and exert toxicity synergistically when combined. The hypothesis further proposes that vitamin A protects against the toxicity of vitamin D by decreasing the expression of vitamin K-dependent proteins and thereby exerting a vitamin K-sparing effect. If animal experiments can confirm this hypothesis, the models by which the maximum safe dose is determined would need to be revised. Physicians and other health care practitioners would be able to treat patients with doses of vitamin D that possess greater therapeutic value than those currently being used while avoiding the risk of adverse effects by administering vitamin D together with vitamins A and K. (Source)

It’s well established that overly-high vitamin D levels are associated with frequent urination, constipation or diarrhea, hypercalcemia, headaches, increased risk of heart attack or stroke, kidney failure, and tiredness, among other things – and it is recommended that those with headaches and thyroid disorders (ie, migraineurs) supplement with vitamin D cautiously (Source).  Levels as high as 100 are above the suggested 50-80ng/ml range, and levels of 150 ng/ml and above are considered toxic.

It appears that what is often not realized by many health care practitioners is that elevated levels of vitamin D have ALSO been associated with headache and migraines.  Dr. Stasha Gominak, a neurologist specializing in alleviating migraine, improving gut health, and re-establishing sleep hygiene, believes that vitamin D supplementation contributes to B5 deficiency (and we need it for enzymatic function!).  She has put forth the hypothesis that our gut flora do not produce sufficient B vitamins in the presence of vitamin D depletion. She suggests that vitamin D should be in the range of 60-80ng/ml.

Other experts differ in their view, including Chris Kesser and Chris Masterjohn, and Amy Proal. Chris Kesser summarizes the evidence as follows:

The U.S. laboratory reference range for adequate 25(OH)D is 30 to 74 ng/mL, while the Vitamin D Council suggests a higher range of 40 to 80 ng/mL, with a target of 50 ng/mL (17).

But a large body of evidence in the medical literature strongly suggests that optimal vitamin D levels might be lower than these figures. There is little to no evidence showing benefit to 25(OH)D levels above 50 ng/mL, and increasing evidence to suggest that levels of this magnitude may cause harm. . .  Based on an exhaustive review of over 1,000 studies in 2011, the Institute of Medicine recommends a much more conservative range of 20 to 50 ng/mL. . . .

What about optimal vitamin D range from an evolutionary perspective? A study on traditionally living hunter–gatherer populations in East Africa found that the Masai and Hadzabe tribes had average 25(OH)D concentrations of 48 ng/mL and 44 ng/mL, respectively (35). These indigenous populations get a great deal of sun exposure but also have very high intakes of vitamins A and K, suggesting that these levels are probably towards the higher end of the optimal range for most people in the modern world.(Source).

And here is another very important consideration from Amy Proal explaining the cause of low vitamin D levels:

Vitamin D supplementation is routinely justified based on a plethora of studies that report low concentrations of 25-D in the blood of patients with a wide variety of inflammatory conditions. Thus far, the consensus on these findings has been to assume that the low concentrations of 25-D are driving or contributing to the pathogenesis of these diseases. However, the low concentrations of 25-D often detected in patients with inflammatory conditions may be a result of the inflammatory disease process rather than the cause of the inflammation. . . Indeed, our data suggest that under conditions of microbiome and interactome dysregulation, the body uses multiple mechanisms to naturally downregulate intracellular production of 25-D. (Source)

You can read more about alternative viewpoints and potential problems with vitamin D supplementation in the following articles: “Vitamin D: More is Not Better”, “The Evolution of Diverse D Requirements”, and “The Concept of Vitamin D Deficiency is Flawed”, “Harm from Vitamin D is Supported by High Quality Studies”, and “Vitamin D Supplements are Immunosuppressive”.

After considering these views, I no longer supplement with vitamin D.  I am currently looking into purchasing a vitamin D lamp, since I live in the Pacific Northwest. I make sure to get plenty of vitamin A from butter and beef liver pate. Getting just 15 minutes of sunlight a day should be sufficient for most people.  Sunlight is converted into vitamin D by the presence of cholesterol in skin and vitamin E.  As it turns out, vitamin E is best absorbed topically, so I like to use a sesame oil for my skin with some essential oils added as one way to boost my vitamin D production when I go out into the sun

Blind Spot #5: Insufficient or Wrong Kind of Magnesium

Magnesium is nature’s natural calcium channel blocker.  When magnesium levels are low, the voltage gated calcium channels that allow nutrients and oxygen into the cell don’t work properly.  Due to the imbalances in the ratios of our most important electryolytes – calcium, magnesium, sodium, and potassium, these channels may not be able to open and close in a balanced way.  When these channels are open, calcium floods into the cell, causing cell death (important side note: EMF – electromagnetic frequencies also cause damage by the exact same mechanism).  In order to maintain the integrity of the cell, we need the proper ratios of magnesium to calcium, potassium, and sodium.  As I pointed out above, less magnesium will be available for cellular health if it is being used up by excessive vitamin D supplementation.

One thing that I see consistently with clients is that some of them give up on magnesium if it doesn’t provide immediate or obvious benefit in alleviating their migraines.  I did this myself early on, and actually noticed a more positive immediate benefit from potassium.  Potassium deficiency, however, is usually tied to an underlying magnesium deficiency.

Magnesium supplementation can actually cause initial cleansing reactions and headaches.  A blood test for magnesium is not reflective of actual tissue concentrations of magnesium.  Therefore it is important to supplement with sufficient quantities of magnesium for the long-term.  It takes up to 4-6 months of continual supplementation to reach the right tissue concentration levels.

It is important to not only get enough magnesium (your body requires 300 mg just to maintain daily functions even without a deficiency), but to get the right kind.  Just the other day I discovered that one of my clients had been taking magnesium aspartate.  While some early studies did show magnesium aspartate to be beneficial for those with fibromyalgia, and aspartate is part of the citric acid or Krebs cycle, nevertheless it is also a neurotoxin at certain levels and when the person taking it doesn’t have the proper enzymes to convert it to a form the body can handle.  The same goes for magnesium glutamate.

Both magnesium aspartate and magnesium glutamate are often hidden in products labeled “magnesium chelate.” Dr. Russel Blaylock, a neuroscientist, explains this at length in his book Excitotoxins: The Taste that Kills.  Because those with migraines already have very high levels of inflammatory neurotoxins including glutamate and CGRP, and are already sensitive to glutamate-containing foods and supplements, it’s crucial to avoid magnesium glutamate, as well as aspartate, for optimal brain health.

Those who are constipated or who have oxalate sensitivity issues may benefit from magnesium citrate, as this form helps to flush out oxalates from the body (and may cause some cleansing reactions).  Magnesium citrate also supports the citric acid or Krebs cycle, which brings oxygen into the cell to create ATP, or cellular energy.  Magnesium malate is also supportive of the citric acid cycle and generally doesn’t cause loose stools as the citrate form does.

Those who already have loose stool should avoid the citrate form.  The glycinate form is great because not only is it well tolerated, but it also lends a glyceine amino acid, the smallest and most versatile amino acid.  (The receptor sites on cells often get blocked for this amino acid, incidentally, by the presence of glyphosate, or roundup contamination in food – which seriously messes up enzymatic function).

Magnesium chloride can be easily absorbed as bath salts or through the skin, though magnesium oil is sometimes very itchy.  This form of magnesium is mined in ancient deposits, so sourcing is important.  The benefit of magnesium chloride is that the chloride portion of this molecule can be used by the body to produce stomach acid for those low in stomach acid.  Chloride is also important for the cellular receptor sites for diamine oxidase (DAO), meaning that it helps to metabolize histamine.

I always take a minimum of 800 mg total of magnesium daily. I like to use a combination of magnesium chloride (the kind sold as “magnesium oil” in my water, along with other minerals I add to my filtered water), and a magnesium glycinate as well as magnesium malate supplement.

Blind Spot #6: Ingestion of Cinnamon

Cinnamon is without a doubt an incredible healing plant ally.  It is warming, pungent, and therefore dispersing of stagnation, which is one reason why cinnamon may be suggested by holistic health care practitioners to improve circulation.  Cinnamon especially is also a powerful antiviral and antibiotic as well as a mast cell stabilizer.

It is not totally clear why cinnamon triggers migraine, but it has been observed repeatedly that it does in those with histamine overload.  Cinnamon does contain histamine, but most likely, histamine triggers caused by cinnamon are due to the fact that sodium benzoate (NaB) produced by cinnamon is a DAO inhibitor and will therefore impair histamine degradation. 

It must also be noted that there are different kinds of cinnamon, and the coumarin in cinnamon may be the culprit, as it is hard for the liver to process (and could therefore trigger migraine in someone who already had compromised liver detoxification).

There are big differences between the main forms of cinnamon, cassia, and Ceylon. If you ingest cinnamon as a spice or take it in supplement form, you want to make sure that it is produced from Ceylon cinnamon. Both forms of cinnamon contain coumarin, which is a natural blood-thinning agent but is hepatotoxic. Ceylon cinnamon contains minute amounts of coumarin compared to cassia cinnamon. Coumarin detoxification requires proper liver function and activation of the cytochrome P450 gene CYP2A6. If you have a polymorphism in CYP2A6, you need to avoid cassia cinnamon if all possible. Proper detoxification of coumarin will be lessened, and increased risk of liver damage may occur. (Source)”

Side note: I’ve made an analgesic salve available in my shop that does contain cinnamon along with cayenne for rubbing on the temples and intranasally to dissolve migraine – but, as explained above, topical application has very different effects than ingesting it does!

Blind Spot #7: Ingestion of Cayenne or Chili

As for chili, it can definitely add to your overall histamine load.  Cayenne as well as most spicy chilis, especially their seeds, contain a powerful compound called capsaicin.

How capsaicin is administered makes a difference in its therapeutic effects (or lack thereof).  Because cayenne (and capsaicin) thins mucous, consumption of cayenne may be more applicable for those with sinus headaches than with migraines caused by digestive upset and histamine overload. This mechanism makes sense when you consider that those who experience relief from capsaicin get it when they take capsaicin in a drink (where it gets exposed to the nasal sinus) but don’t when they take it in capsule form.

Capsaicin has been shown to inhibit CGRP (Calcitonin Gene Related Peptide), a potent vasodilator implicated in migraine. However, again, in this study the capsaicin was administered through the nose (Source). Intranasal exposure to capsaisin numbs and desensitizes the cranial nerves. Note that Lundberg and coworkers found that CGRP was inhibited (in guinea pig lung) only when small concentrations of capsaicin were used, but not when high concentrations were (Source). Capsaicin seem to contribute to migraine by way of neurogenic inflammation on a cellular level caused by a sudden influx of calcium into the cell followed by cell death (Source).

For those with histamine intolerance, ingesting cayenne must be avoided, because capsaicin not only contains histamine but also is a potent vasodilator itself (source).  It is a very potent trigger. If you’re going to take it, take it up the nose.  Otherwise – avoid!

Side note: I’ve made an analgesic salve available in my shop that does contain capsaisin in cayenne for rubbing on the temples and intranasally to dissolve migraine – but, as explained above, topical application has very different effects than ingesting it does!

A Final Note About “Triggers”

I just want to briefly point out that when we speak about histamine intolerance and its associated food “triggers”, that it is the amount of pre-existing histamine in the body that determines whether a food with more histamine will act as a trigger or not.  This makes it a little tricky because it means that depending on the person’s histamine level at the time, they will get different responses from the same kind of food and may therefore think that something like chili, sauerkraut, or chocolate isn’t an issue because it doesn’t cause a migraine every time it is consumed.  Again, histamine intolerance is an issue of histamine overload, not an immediate, anaphylactic allergic response.  So the word trigger may be misleading.  What we are talking about here is problematic foods that increase histamine and add to the overall load, which will sometime mean that that food acts as the trigger because the histamine bucket “tipped over” into migraine.

 

 

 

Bitters for Migraine Prevention and Liver Health

Over the course of my research into health, wellness, and optimal digestion, I’ve frequently been reminded of the value of consuming bitter foods to stimulate the liver and produce more bile.  We evolved eating many more bitter-tasting foods than your average person eats today, with the primary and sometimes only bitter food consumed by most westerners in a given day now being coffee.

Most digestive bitters marketed for medicinal purposes are supplied in the form of a tincture of herbs in alcohol.  This is one reason that I’ve avoided bitters for the most part in my healing journey, along with many other tinctured medicines.  While grain alcohol does not contain the same level of histamine-triggering compounds as other alcohols like wine or beer, in my worst times of histamine overload I felt it was still better to avoid tinctures along with other fermented foods.  I knew that I could simply stimulate my liver health by consuming dandelion greens or adding some aloe vera to a smoothie or onto my tongue.  Yet I never got into a regular practice of consuming bitters until now.

Guido Masé

Recently I’ve been reading over an excellent book by master herbalist Guido Masé called “The Wild Medicine Solution: Healing with Aromatic, Bitter, and Tonic Plants.”  Guido Masése is the chief herbalist at Urban Moonshine, a Vermont-based company that sells bitters and other exquisite herbal concoctions.  Guido is also a clinician at the Burlington Herb Clinic and teaches herbal medicine at the Vermont Center for Integrative Herbalism and the University of Vermont.  As I discovered in the course of reading his book, he’s also a historian, expertly weaving together herbal lore, mythologies and historical context with his cutting-edge scientific understanding of plant properties. You can visit his blog, A Radicle, here.

How can bitters help those of us with migraine?

Because migraine is a chemical sensitivity issue, we need to not only reduce the number of chemicals we are exposed to but also support our body’s ability to manage, neutralize, and excrete environmental toxins (especially herbicides, pesticides, and chemical treatments sprayed on our food) and metabolic waste products via improved liver function and bile flow.  Bitters help us to do that. As Guido explains:

Let’s take a moment to examine the ‘detector’ our physiology uses to assess the degree of metabolic challenge that our food contains.  The bitter taste receptor is part of a family of proteins known as TRs (taste receptors).  There seem to be six different types of TRs and some degree of variation within each different type.  For example, the receptor for sweet flavor is one type of protein, coded for by three genes, and able to detect sugars.  The receptor for umami is similarly simple and detects amino acids (protein). Sour taste is mediated through two different receptor subtypes, able to detect hydrogen ions (responsible for acidity). We have a receptor for fats and another for salt (sodium). . . . But the bitter taste receptor family, known as the T2R receptor family, is made of over twenty different subtypes, coded for by some thirty-four genes, and able to detect over one hundred often completely unrelated chemical compounds. . . . Stimulating T2Rs has profound implications throughtout the digestive system and in the liver . . . For now, suffice it to say that getting the signal of bitterness on the tongue increases the antioxidant enzyme and bile secretions in the liver through the combined action of the hormones, such as cholecystokinin, and nerves, such as the vagus nerve.  . . . Interestingly, T2R receptors are found in many other tissues of the body, indicating that their chemosensory ability is not limited to the tongue.  . . . Researchers have discovered these bitter taste receptors in the airways of the lungs, and even in brain cells. (Source: “The Wild Medicine Solution: Healing with Aromatic, Bitter, and Tonic Plants.”, Masé)

The liver is the central hub where most of our detoxification pathways are carried out – and picks up the slack from the detoxification that would normally be provided by an intact gut microbiome.  When our gut flora are out of balance and the bacteria that help us to detoxify are wiped out by antibiotics, medications, and environmental assaults, our liver has to work extra hard.  When the liver is overloaded, bile flow is affected (and with it, our ability to emulsify fats and absorb fat-soluble vitamins crucial for health).  Reduced bile flow in turns can potentially lead to gallbladder attacks or stones.  (Conversely, one of the best ways to support the liver and gallbladder is to heal your gut – as outlined in the SimplyWell Migraine Relief Protocol). Guido describes below how liver cells need stimulation and chemical challenge in order to function (unlike other kinds of cells, which simply need nutrition):

If we are talking about processing chemicals, we have to talk about the liver.  While many tissues in the body have the ability to produce enzymes and antioxidants that help to neutralize toxins, none compare to the four-pound sponge located no our right upper abdomen, halfway hidden behind the ribcage.  It is a tireless metabolic workhorse – but, curiously enough, if left alone it does very little.  Isolated liver tissue and isolated liver cells do not seem to do much of anything, neither synthesizing bile nor producing high levels of metabolic enzymes.  Researchers attempting to study how liver cells behave have learned that, in order to better replicate the conditions found in living beings, the cells have to be bathed not only in nutrients, but also in a cocktail of chemicals.  It is only then that they begin to act like their true selves. (Source: “The Wild Medicine Solution: Healing with Aromatic, Bitter, and Tonic Plants.”, Masé)

What role does the liver play in histamine intolerance and overload?

Alison Vickery addressed this in a blog post on that exact topic (“What if This Was About the Liver?“).  In this post, she describes her recovery in terms of the following steps 1) address any gut dysbiosis, 2) Reduce toxin exposure, 3) eat a high protien, nutrient-rich, anti-inflammatory diet, 4) rebuild with specific foods and herbs, and 5) consume liver protective and regenerative supplements.

I have dramatically improved my histamine tolerance, and put my mast-cell activation type symptoms into remission, and dropped by 2/3rds my inflammation markers, by supporting my liver. And it makes sense that the liver plays a role in histamine intolerance. Histamine is not just disassembled in the gut by diamine oxidase (DAO). It is also disassembled in the liver by histamine N-methyltransferase (HNMT or HMT) where it is in high concentrations. Why would HNMT be in the liver? The liver disassembles ALL inflammatory material including histamine released from mast-cells, along with a long list of chemicals manufactured by the body and those ingested. (Source)

Bitters: The Poison Antidote

The development of bitters came from the idea that if the body is regularly stimulated with a bitter or poison challenge, it will be better able and more used to processing an unexpected or unwanted poisonous assault. Historically, the creation of bitters is credited to Mithridates Eupator of Pontus, who reigned over what is now Turkey from 120 – 53 BC.

Mithridates. Photo Credit: https://commons.wikimedia.org/w/index.php?curid=408281

Mithridates had an urgent incentive in developing them as an attempt to prevent himself from being poisoned by his feuding and murderous family.  At age 14, his father was poisoned to death and his mother took control of the kingdom, sparking his interest in discovering a poison antidote. As Guido Masé describes it,

The young prince hit upon an interesting idea: perhaps, if full doses of poison could kill, then smaller doses might strengthen him against death.  Simply employing plants that tasted like poison but were not toxic themselves (like the root of high mountain gentian) might do the trick.  Mithridates retreated from palace life for a period and apparently delved deeply into venom brewing and antidote crafting, because when he returned, both his mother and his brother were poisoned and died.  The prince became king, married his sister, and set about building an army – all the while looking over his shoulder, fearing the murder in his evening meal, but confident that the regular use of his antidotes would keep him alive. (Source: “The Wild Medicine Solution: Healing with Aromatic, Bitter, and Tonic Plants.”, Masé)

Mithridates’ poison antidote concoction likely involved a mixture of bitter and aromatic plants.  He experimented extensively with monkshood and nightshade, gentian, calamus, iris, parsley, carrot seed, and various resins, gums, and tree saps mixed with aromatic plants such as ginger, cardamom, and rose in smaller portions. He tried his concoctions on himself in order to discover proper dosages and build up a tolerance.  His primary aim was to create an antidote so powerful that it could reverse the effects of a poison administered by a scheming relative and save his life.  To help him with his task, he consulted with herbalists, shamans, and professional poisoners, where he learned to extract venom from vipers and use poisons from fly agaric mushrooms. (Incidentally, both venoms and magic mushrooms have been used successfully to combat chronic headache).

We Used to Eat More Bitters

During the Industrial Revolution, when many people moved from the countryside to cities to work in factories, the diversity of plants in the average person’s diet began to drop:

This change was slow at first, with many folks still connected to the country and the wild, bitter botanicals such a life offered.  Inevitably, after a few generations, however, families picked fewer dandelion greens in the spring, relying less on foraging for supplementing their meals.  Instead, for most people, the supplement became an extra helping of carbohydrate.  And while we blame so much of our modern public health concerns on the rise of sweet in the Western diet, we can’t forget that at the same time we handily eliminated much of what was bitter and wild in our food. . . we have decided that our diet should be free of uncomfortable foods, foods, that are wild, bitter, fibrous, weedy, or otherwise challenging. (Source: “The Wild Medicine Solution: Healing with Aromatic, Bitter, and Tonic Plants.”, Masé)

The impacts of this change not only to consumption of sweeter foods but also less consumption of bitter foods had profound implications not only for the health of our bodies, but also the health of the land.  With more fields dedicated to the production of carbohydrates, we have seen a huge addition of chemical additives to the ecosystem.

Corn farmers applied 57 million pounds of glyphosate (Roundup), more than 51 million pounds of atrazine, and some 20 million pounds of other herbicides in 2010.  By comparison, all the herbicide applied to potatoes amounted to about 4 million pounds, of which more than half was actually fungicide. (Source: “The Wild Medicine Solution: Healing with Aromatic, Bitter, and Tonic Plants.”, Masé)

The sweet flavor does very little to activate the gut (instead, it activates reward circuitry in the brain). This wasn’t as much of an issue in the past as it is now, since many sweeter foods were usually consumed in whole plant form along with the other bitter elements in the rind or peel and their respective benefits. However, our current penchant for sweet processed foods and lack of consumption of bitters is wreaking havoc not only on our digestive tracts but also on our environment in the form of Big Ag.

My Personal Use of Bitters

Currently my practice of ingesting bitters involves small amounts of neem powder placed on the tongue a few times throughout the day (the lovely neem plant is featured at the top of this page). Some traditional herbs for migraine, like feverfew, owe some of their effectiveness to their very bitter flavor. Since I am breastfeeding, I have opted out of taking larger quantities of neem or any other bitter plant, as it reduces milk supply.  However, simple stimulation of the taste buds with even very small amounts of bitter plants is a sufficient prompt to get the liver primed to detoxify other substances that enter our bodies via food, water, air, and pharmaceutical medications.

So, while we and our livers are currently inundated with no shortage of chemical assaults, most of them are foreign substances compared to the toxins that our liver evolved to process (which included toxins from bacteria, the bites of venomous insects and animals, or directly from poisonous roots, barks, leaves, seeds, and berries).  Perhaps by using the bitter plants which our liver is more evolutionarily designed to be stimulated by, we can help it to process the new chemicals that are relatively new to our environment. (Source: “The Wild Medicine Solution: Healing with Aromatic, Bitter, and Tonic Plants.”, Masé)

Like Mithridates, we do need to be vigilant in order to avoid being overwhelmed by our big bully family members – corporate polluters who care more about power and profit than the health of the whole.  Regular intake of bitters can help us to be more resilient to the world we live in.

Best Practices in the Kitchen to Prevent Migraine

As a general rule, eating to prevent migraine involves avoiding fermented and high histamine and foods in favor of freshly prepared, PREbiotic, and mineral-rich foods – as outlined in the SimplyWell Migraine Relief Protocol.

I want this article to be about what you can eat, not what you can’t.  But because migraine is essentially an issue of lymphatic congestion caused by compromised gut flora and environmental toxicity exposures that our bodies are too overwhelmed to handle, the issue of food sourcing and food quality is also important to mention – so please pay attention to the last two sections of this article to stay mindful of ways to avoid adding to the chemical overload.

Please note that the practices outlined below do not take into consideration every single food sensitivity that every migraineur may have (that diet would be breatharianism).  The list below emphasizes healing foods that support gut health and electrolyte balance and generally prevent histamine overload.  Sensitivities to oxalates, salycylates, sulfites, benzoates, etc. are not addressed here.

Prebiotic Foods

I’ve written about prebiotic foods and why I adore them so much already, but want to do another quick overview here.  Prebiotic foods are foods that contain soluble fiber which is resistant to breakdown in the small intestine and preferentially feeds the healthy bacteria in our guts. They are very different from probiotic foods and priobiotic supplements in that they support the growth of healthy bacterial populations already present rather than trying to introduce new bacteria.  Many strains of PRObiotics are histamine-producing (which is why kim-chi can give you a migraine), whereas PREbiotics contain no histamine and reduce histamine load.  There are different types of prebiotics, including arabinogalactans, resistant starch, inulin, galacto-oligosacharides, pectins, and gums.

It’s essential we eat a lot of these foods to maintain a diverse microbiome.  Many people are averse to foods high in prebiotic fibers because they can initially cause gas and bloating.  In many cases this is just a temporary discomfort – and a sign that the pathogenic bacteria are being replaced with healthy bacteria.  Gas and bloating is an expected “side-effect” that occurs as your body’s gut flora recalibrate.  However you do want to go slow on introducing prebiotic foods into your diet (as outlined in the SimplyWell Protocol). I have many prebiotic-rich recipes in my recipe section.  The easiest foods to incorporate into your diet to get sufficient prebiotics are:

  • raw carrots
  • cold bean dips like hummus
  • potato salad (with lemon juice instead of vinegar!)
  • raw jicama (use it in salads or drizzled with lime juice)
  • raw radishes (eaten alone or in salads)
  • cold rice (I make a lovely tabouleh using rice instead of bulgur wheat)
  • anything made with fresh or dried shredded coconut
  • cold lentil salads or Dosa wraps

Cautions: those with SIBO (small intestine bacterial overgrowth will not do well on prebiotics and will need to address SIBO first.

Selenium-rich Foods

Selenium is needed to make glutathione, the body’s most important antioxidant (which is usually low in those with migraine, because the high inflammation levels mean that this antioxidant is in constant demand and therefore depleted.  Interestingly, triptan medications used to treat migraine also deplete glutathione).  Selenium is also essential for thyroid health.

It is commonly said that Brazil nuts contain the most selenium of any food. But according to Chris Masterjohn, PhD, the amount of selenium in Brazil nuts is highly variable, and entirely dependent on quantities of selenium in the soil the trees are growing in (since Brazil nut trees do not utilize selenium for their own needs).  Due to this, you may want to eat other foods that are high in selenium as well, such as blue corn and fish skin (so if you eat fish, be sure to eat the skin – this will also help to detoxify any heavy metals in the fish).

Cautions: Selenium is a sulfur-based molecule, and those with sensitivities to sulfur-rich food will not do well on selenium supplements or foods high in selenium until they address their sulfur issues.  See Dr. Greg Nigh’s protocol for more info.

Sulfur-rich Foods

It’s true that some people with migraine can’t tolerate sulfur-rich foods.  This is a sign of a compromised phase 2 sulfation detoxification pathway in the liver and should be addressed with your holistic health provider or in a migraine relief coaching session.  For those who can tolerate sulfur-rich foods, they are very beneficial for cleaning the liver among other functions.  It’s interesting to note that glutathione, the most important antioxidant in the body which is normally low in those with migraine, is a sulfur-based compound.  The best sulfur-rich foods are:

  • radishes, horseradish, mustard
  • bok choy, cabbage, mustard greens
  • protein-bound sulfur in meats
  • onions and garlic

Cautions: Those with SIBO may have high sulfur and will need to address their sulfur sensitivities before eating sulfur-rich foods.  See Dr. Greg Nigh’s protocol for more info.

Methylating Foods

You don’t have to take methylfolate or methylcobalamin to methylate properly (these may actually cause problems for those with migraine).  Foods high in choline and trimethylglyceine can also lend methyl groups, help your liver to detoxify, and prevent migraine.  The best source of choline is egg yolks.  Poultry, rice, and peanuts are also good sources, as is sunflower lecithin.  It’s best not to overcook egg yolks so that you preserve some of the sulfur as well.  Choline is also important for improving levels of acetylcholine, the neurotransmitter which regulates the vagus nerve, improves vagal tone, and reduces inflammation.

For trimethylglyceine, eat foods from the amaranth family – quinoa. I personally love incorporating organic quinoa orzo into my dishes. The trimethylglyceine in quinoa and beets will also help your liver to detoxify excess xenoestrogens, so go slow and gentle on these – especially on the beets. Eating organic liver sourced from healthy animals is also a good way to support methylation (and will also provide you with balanced levels of copper and zinc, as well as B vitamins).

Cautions: Overmethylation can also cause headaches, so avoid methylated B vitamins. Beets are also a good source of trimethylglycine but because they are a migraine trigger they are best avoided (they are high in arginine, nitrates, and oxalates).

Healthy Fats

Because migraine is caused in part by lymphatic congestion, and the lymphatic system is a lipid-based system (ie, a fat-based system), consuming healthy fats is essential to support your body’s ability to detoxify. Fats are also a superb form of energy that are easily utilized by the body and do not (contrary to popular belief) lead to weight gain.

Saturated fats are preferable because they don’t go rancid/get oxidzed as easily as unsaturated fats.  Saturated fats also have many other beneficial properties.

  • The most important fat to implement into your diet is olive oil.  The oleic acid in olive oil increases the diamine oxidase enzyme responsible for the breakdown of histamine.  Olive oil also has analgesic (pain relieving) qualities similar to Ibuprofen.  Another benefit is that it is not processed with the use of solvents such as hexane as many other vegetable oils are.  It’s important not to cook olive oil at high heat, however.  Drizzle it onto food once it has been cooked, or use it in salad dressing.  The olive oil you purchase must be virgin unrefined organic olive oil.
  • Coconut oil is a superb oil for supporting gut health.  The fatty acids in coconut oil increase butyric acid (butyrate) in the colon (prebiotic foods, once digested, also produce butyrate). Butyrate increases GABA, the calming neurotransmitter in the brain, which also puts the brakes on glutatmate toxicity. Butyrate also increases ketones in the liver, thereby optimizing blood sugar regulation and even ATP energy generation on a neuronal level.  Butyrate also helps to maintain the integrity of the gut lining. People who are sensitive to the sulfur in coconut meat are usually not sensitive to the oil.  Always buy organic virgin unrefined oil.
  • Ghee (clarified butter) and butter are both excellent fats to incorporate into the diet liberally, with ghee being even better than butter because it contains no casein and can withstand high temperatures.  Ghee should be your high heat cooking oil (you can learn to make your own here).  Both ghee and butter contain 3-4% butyric acid, the highest source for any food. However, unlike coconut oil, butter and ghee contain omega-3 fatty acids which are needed to balance other Omega-6 vegetable oils. Omega-3’s have been shown to decrease inflammation and mediate pain.  It’s very important to buy only grassfed, pastured, or organic ghee or butter to avoid contaminants which tend to bio-accumulate in the fat of animals raised for butter.
  • Red Palm Oil is an amazing oil which contains tocotrienols, a rare and important form of vitamin E, as well as squalene, a potent antioxidant which aids the body’s ability to eliminate environmental toxins, including radiation. Red palm oil is beneficial for arthritis, gastrointestinal upset, and gout.  It boosts energy and improves circulation. It helps to improve absorption of vitamin D and build important hormones such as progesterone (a glutamate scavenger). This amazing oil in unrefined red form is has also been shown to help with lead detoxification in rats, and to decrease blood platelet aggregation (ie, makes blood cells less sticky).  To top it off, red palm oil is also one of the highest plant-based sources of CoQ10.  Red palm oil is a medium-heat oil.  It is important that it be sourced in a way that doesn’t destroy ecosystems.  I use Nutiva Organic Red Palm Oil, which is grown in Ecuador rather than SE Asia so does not negatively affect Orangutang habitat.
  • Lard and tallow are both excellent fats and also contain omega-3 fatty acids. Because lard and tallow are both rendered down from the entire animal, the issue of purity is crucial.  This is not a type of fat that I personally use often because it is challenging to find quality sources of grassfed, pastured, or organic lard and tallow.  (Unfortunately, I am not convinced that all pastured animal products are pure. I live in Oregon where I regularly see cattle grazing in open fields directly next to roundup-ready corn fields, which are sprayed with glyphosate.)

Cautions: Oxidized oils can seriously disrupt enzyme function, so making sure your oils are of top quality is key.  Also, overall people with migraines have poor liver and gallbladder function – therefore, while healthy fats are important, it is still valuable to not go overboard with fat or oil consumption even when they are of quality. For more information on fats and oils read the book “Deep Nutrition”.

Meat and Seafood

As always, the most immediate issues here as meat consumption pertains to migraine are freshness and quality (that means canned fish and salami are not supportive of migraine).  Unfortunately, most meat that we purchase, even that which we consider fresh, is actually somewhat aged.  Beef and lamb are usually cured/aged, and fresh fish such as salmon can be on the shelf for as long as 18 days prior to sale.  The presence of bacteria in these less-than-fresh meat products may not be a huge problem for people who only get migraines once in awhile.  However for those who are stuck in chronic migraine, it’s important that much fresher meat be consumed, such as meats and seafoods that were frozen at slaughter.

If you are highly sensitive to histamine, then the meats need to be eaten fresh and right away after you prepare them.  Leftover meats and especially canned fish like tuna have been known to trigger migraines.

Quality is also important, so opt for meats from the healthiest animals you can find, raised without the use of antibiotics or genetically engineered grain.  Buy organic meats whenever possible or better yet, buy localy-produced meats.  However, it appears that often times smaller-scale farmers raising local meat still use genetically engineered grains or may not be able to afford organic grain. There is also one issue to consider which is that animals raised by organic standards have probably still been vaccinated using genetically-engineered vaccines.

Another glaring problem is that of industrial feedlots and the enormous cost to the environment in the production of mainstream meat products and the inhumane treatment of animals raised for food.

Image by Mishka Henner

Because of these problems, I feel that eating less meat is better when it comes to eating healthy and consequently, reducing migraine.  I don’t see how we can eat sick animals that are destroying the environment, and expect to get better on that.

As with any food, individual preferences and tolerance will play a role here.  It is valuable to consider also whether or not you have sufficient stomach acid to break down the meat that you are eating, since undigested meat can ferment in the colon.  Therefore, eating smaller portions of meat (2-3 ounces per meal) for optimal digestion, and eating it less frequently, are options to consider.  It appears inevitable that the more meat is consumed, the less vegetables and fiber-rich food are consumed, because meat is so filling.

I want to mention one other potential problem with meat consumption.  Although the amino acids in meat are very valuable as building blocks for enzymes and building tissue, the breakdown of animal protein also results in nitrogen in the body.  This nitrogen converts into ammonia, and under normal circumstances, the body is able to convert the ammonia into urea and excrete it in the urine via the urea cycle.

However, due to certain genetic polymorphisms, as much as 30-40% of the population may be compromised in their ability to effectively eliminate ammonia as urea.  For this group of people, eating less meat is important as one way to reduce ammonia.  It is also possible that there are other ways that ammonia builds up in the body even in the presence of intact urea pathways.  This is something I am currently researching.  It is clear that a buildup of ammonia in the body leads to leaky gut syndrome and, in combination with the presence of glutamate in the system, contributes to encephalopathy (brain inflammation) and therefore is probably a contributing factor in migraine. For an excellent podcast on this topic, please listen to Chris Masterjohn on “Are We All Evolved to Eat a High Protein Diet?

(Incidentally, the alternate pathway for urea elimination in those with compromised urea cycles is via arginine.  As it turns out, lysine will block arginine since it shares the same receptor site, and lysine rich foods just so happen to be foods like parmesan that we recognize as migraine triggers.  Intriguing.)

Last of all, I do want to mention the value of organ meats for healing.  Of all meat, organ meats are the highest in fat-soluble vitamins crucial for bodily repair.  Therefore if you have access to quality organ meats and are not offended by their flavor, making fresh pate or eating liver or heart may be hugely supportive to your health, especially the health of your liver and heart.

Vegan Diets

To what extent are vegan diets supportive of migraine or detrimental to healing?  My personal view is that vegan diets are a great cleansing diet for a limited amount of time.  They are especially valuable as a way to get a huge amount of plant matter into your body, and reset your relationship to meat.  If you go back to eating meat after having been vegan, like I have, you will notice just how dense and hard to process meat is compared to other foods.  On the other hand, this density is valuable for grounding and also seasonally may be more appropriate at some times than at others (in winter, for example).

The vegans I know all eat very differently, so having the absence of meat or dairy be the defining characteristic of veganism is not actually a description of how each vegan will eat.

Historically, there are no examples of vegan societies (that I am aware of).  This does not mean that it is not an evolutionary step that more and more people are choosing to eat vegan given the environmental and ethical issues that arise with our problematic culture of meat production.  Just because wide-scale veganism has never been seen before doesn’t meant that it’s not worthwhile to try it.  But, it appears from my research that it is extremely difficult to get the same quality and amount of essential fatty acids and fat-soluble vitamins such as A, D, and E which are crucial to healing and especially important for lymphatic and brain health while on a vegan diet.  (One workaround for vitamin A as a vegan is red palm oil, since the beta carotenes in red palm oil convert more readily into vitamin A in this fat-based substance than eating beta carotenes from other plant sources).

Whether or not being vegan in general is healthy or not, I am not convinced that it is healthy for a sick person who is trying to heal to try to do so while vegan.  People with migraine may be less efficient at converting plant-based nutrients into similar forms found already in animal products than vegans without chronic illness. One of the most important vitamins for healing migraine is vitamin A in the form of retinol, which is needed to make ceruloplasm so that copper can be bioavailable for DAO and MAO to break down histamine and tyramine.

Teas and Coffee

As I mentioned in a previous blog post on the benefits and drawbacks of coffee, tannins in both coffee and some teas are problematic because they bind to and deplete essential B vitamins.  Therefore if you consume coffee or tea it’s essential to take a B vitamin complex to replace these (however, B vitamin supplementation can also be a migraine trigger itself – stay tuned for more blog posts on this topic and how to deal with it.)  For a healthy herbal coffee recipe alternative, click here.  The healthiest caffeinated teas are green tea and guayusa.  Guayusa is an Amazonian tea in the holly family (a relative of Mate), but does not contain tannins so will not deplete your body of B vitamins.

The noncaffeinated teas most supportive or gentle for those wanting to prevent migraine are listed below.  They are all delicious and many are also medicinal. My current favorite hot beverage is chamomile tea with honey and coconut cream (also a prebiotic). The last three in the list here are bitter and therefore supportive of liver health.

  • ginger
  • chamomile
  • holy basil
  • dandelion root
  • passionflower
  • lemon balm
  • black seed (nigella sativa)
  • chicory
  • peppermint
  • chaga
  • lemon balm
  • moringa
  • nettle
  • neem leaf
  • feverfew
  • butterbur

Herbs, Spices, and Flavorings

  • Liberally salt your food.  Sodium increases the uptake of Diamine Oxidase enzyme in the cell (thereby reducing histamine). It also helps cells to stay hydrated by bringing water into the cell.  Additionally, it helps to increase blood volume, meaning more blood will get to the head, preventing migraine.  Salt can raise blood pressure, which for most people with migraine is good (since migraineurs generally have low blood pressure). Unfortunately, most sea salt has been shown to be contaminated with plastic estrogens.  Therefore, use Himalayan pink salt or any other salt mined from ancient stores.
  • The most supportive spices are ginger, garlic, onion, chive, parsley, cardamom, oregano, pepper, thyme, rosemary, mint, black pepper, black seed (nigella sativa, roasted), mustard, and basil.  Many of these spices have anti-inflammatory and medicinal compounds.
  • You can also get creative adding flavor to foods with lemon zest, orange zest, lavender water, or rose water.
  • Absolutely remember to avoid the top high-histamine spices: cayenne, cinnamon, nutmeg, clove, chilli. Also watch out for turmeric (curcumin), which is high in salycilates and reduces DAO.

Sauces & Dressings

It’s true that eating low histamine can be pretty dire in the sauces department.  Many sauces contain MSG, soy sauce, vinegar, or some kind of “umami” (Japanese for “goodness”) flavor.  Without these high histamine flavor options, it’s true that food will be a bit more bland. Below are a few options

  • Homemade tomato relish instead of catsup (use fresh tomatoes, lemon juice, salt, and maple syrup and blend).  Tomato does have some naturally-occuring MSG in it but fresh tomato should not be a problem for those who do not have chronic migraine – wheareas tomato paste and sauce is more potent and problematic.
  • Cheese-free pesto
  • Nut-based creamy sauces, like this creamy ranch dressing
  • Cream-based sauces like this lemon cream sauce are fine as long as they don’t contain additional cheese or wine.

Dairy

Because most dairy consumed is in cultured or fermented form (yoghurt, cheese, etc), eating low-histamine means cutting out most dairy. On the other hand, dairy contains prebiotic galactooligosaccharides as well as riboflavin and balanced electrolytes.  I have had clients report getting temporary alleviation from raw milk fasts! (Although unfortunately, the results weren’t repeatable).

Caution around dairy consumption is important, though, because dairy is mucous-forming as well as acidifying.  Many people can’t handle the casein, lactose, or milk proteins as they change after pasteurization (as compared to raw dairy).

The safest dairy to eat is butter, ghee, cream and milk (ideally in raw form).  The safest form of cheese is fresh mozarella cheese (but eating this won’t help you prevent migraine, it will just add a smaller load to your histamine than, say, parmesan cheese will). Opt for the freshest, most local organic unpasteurized milk if it is available.  Raw milk contains valuable enzymes for digesting milk.  Unfortunately many local producers of raw milk can’t afford organic grain so it can be challenging to find both local and organic milk.

Grains

These days, with the dominant trend in Paleo cooking, grains are being avoided by more and more people.  Grains are carbohydrates, and carbs are also being demonized.  I will never be able to demonize carbs, because it is through consumption of prebiotic starches found in carbohydrate foods that I got well. I have seen mixed evidence as to how bad the presence of phytates in grains really are. Phytates contain inositol, which is an essential compound for improving receptivity in neurons to important neurotransmitters. I believe that grains are an important part of a healthy diet, eaten in moderation. On the other hand there is evidence that relying on too many grains, especially whole grains with the bran intact (where the phytic acid is) can lead to nutrient deficiencies.

  • For migraine, quinoa is the most supportive grain, for reasons already mentioned (helps detoxify the liver of xenoestrogens and also methylate).
  • Rice is an important grain for those with migraine as it is a prebiotic when served cold (though rice grown in the deep South of the United States is often contaminated with arsenic – YUM).
  • Corn can be problematic because culturally, we don’t usually process it in the way that traditional cultures did through use of wood ash lye (this is known as nixtamalization).  Consuming polenta and corn chips not processed through nixtamalization can lead to niacin deficiencies – so if you eat corn, opt for tortillas, tamales, hominy, or other corn products properly processed with lye.
  • Millet is the most alkaline grain, though it is very high in oxalates and can interfere with thyroid function as well as contribute to pellagra (niacin deficiency), so avoid millet.
  • Wheat contributes to glutamate load. A very small amount of organic wheat, if tolerated, is fine.I believe that the majority of problems people are having with grains (and especially wheat) has to do with:
  • the presence of herbicides and pesticides sprayed on conventional grains, especially the presence of glyphosate/roundup on conventional wheat
  • inability to properly process carbs due to gut flora imbalances and subsequent vitamin B depletion necessary for proper carbohydrate metabolism
  • rancidity in grains, especially grains that are milled
  • oxalates in grains, which people are intolerant to due to the presence of pesticides and herbicides in their diet, from which the body makes oxalates. (For a great podcast on oxalates, click here).
  • the presence of vitamins used to fortify grains, such as folic acid in wheat, which is not well tolerated by those with migraine due to the fact that it contributes to glutamate overload
  • the presence of potassium bromate and other flour treatments, especially in wheat, which may interfere with thyroid function
  • the fact that many grains like wheat are specially bred now to contain higher amounts of gluten than those in the wheat strains we evolved eating
  • genetic engineering of grains: while wheat is technically not an approved genetically engineered product, large test plots of GMO wheat have contaminated the food supply.
  • Cross-contamination of GMO corn grown for feed has also infiltrated the corn supply.  (Blue corn is the safest corn to eat and also high in selenium).

Nuts and Seeds

The crucial thing to keep in mind when consuming nuts and seeds is their rancidity.  Nuts and seeds can be preserved and stored in the freezer for a few months to prevent this.  Nuts and seeds are amazing healing foods because they contain many important minerals like copper and zinc, vitamin E, as well as selenium and tryptophan needed for proper neurotransmitter functioning.  However, nuts are also a known migraine trigger.  I believe this is because they are generally high in arginine, which feeds latent herpes viruses living on the cranial nerves and in the brain, as explained here.

Brazil nuts are well known to be high in selenium so many people eat a few of these daily to get sufficient selenium.  Unfortunately because Brazil nut trees do not require selenium themselves, their uptake of selenium is entirely dependent on the soil the tree is growing in and is highly variable.  They also go rancid easily.

With all of these considerations, eating very small portions of fresh, unroasted and unsalted nuts according to tolerance is healthy. One way to do this is to buy your nuts with the shell on, as this keeps them fresh and prevents overeating.

Beans and Pulses

As mentioned in the section on prebiotic foods, beans and pulses are a very valuable source of nutrition for those battling migraine – they are full of prebiotics and protein as well as important B vitamins.  If you tolerate them, they should be eaten liberally. Many people who think they don’t do well with beans may want to try waiting a few weeks before ruling them out – it could be that the prebiotics are causing increased gas as they change the gut flora for the better.  Gas is a normal and expected side-effect of eating prebiotic foods initially, but this dies down after a few weeks of consistent consumption. If you are sensitive to the lectins in beans you will need to address that before being able to reap the benefits of beans. However, I am not convinced that lectins are necessarily a huge problem especially as they are disabled by heat.  It could be the presence of other things such as sulfur in beans that give people issues when they have an underlying sulfur sensitivity.

Sweets

Many migraineurs have trouble with sweets and carbs.  This is due in part to depleted gut flora and the subsequent low B vitamin levels needed to process carbs.  For those who do tolerate some sweets, the best sweeteners are small amounts of maple syrup, honey, or coconut sugar. Honey is actually a prebiotic (though it also contains sulfur).

Some foods, such as carob and coconut meat, provide less concentrated sweet flavor.  Feel free to peruse my recipe section for safer sweet treats, such as my “Lower Histamine Carob Almond Fudge Recipe” and others.  When in doubt, eat seasonal fresh organic fruit for a sugar fix if you tolerate it. Absolutely avoid all dried fruit including dates and raisins as these are major migraine triggers.

Avoid these Obvious (but Unfortunately Ubiquitous) “Foods” – if You Don’t Already

It should go without saying that in addition to avoiding fermented and high histamine foods, it is important not to consume “food-like” substances (aka, highly processed “foods”), genetically-engineered foods, foods sprayed with herbicides and pesticides, and animal products from animals raised on genetically-engineered grains or foods sprayed heavily with herbicides and pesticides.  In other words, in addition to eating low histamine, eat organic and local as much as possible if you really want to prevent migraine.

Best Food Storage – Canned, Tetrapack, or Frozen?

For those times when you are unable to eat completely fresh food, opt for frozen food over canned food.  Even BPA-free cans contain harmful chemicals.  Anything that is shelf stable is probably not supportive of migraine and will contain histamine, tyramine, putrescine or cadaverine.  Any food that is shelf-stable could be a potential migraine trigger, whether from the way that food changed on the shelf or because of the packaging they sit in.  Foods that you normally would buy in tetrapacks, such as nutmilks, broths, etc should be discarded and made from scratch.

Finally, Perform a Fridge and Cabinet Audit if You Really Want to Prevent Migraine

Many of the problematic foods will be in your cabinets in the form of condiments and canned foods. Also the doors of your fridge will contain many histamine-triggering foods as well. Refer to the list of high-histamine foods and systematically rid your kitchen of them – or designate them to a separate shelf if you live with people who eat histamine-rich foods. It’s hard to resist temptation and prevent migraine when these foods are scattered througout your kitchen.

After you’ve done the purge of histamine-rich foods, set the intention to eat organic whenever possible.  While organic standards do not ensure that foods are completely free from chemicals, eating them does lower our exposure by orders of magnitude – for some foods more than others.  If you cannot afford organic food (we all could if it was subsidized in the same way “conventional” food was), it is worthwhile to take the time to educate yourself about which foods are the most heavily sprayed.  Spinach, strawberries, and potatoes, for example, absolutely need to be eaten organic as these are some of the most pesticide-laden crops.  Click here to educate yourself about the Environmental Health Working Group’s “Dirty Dozen”, and other resources for eating clean, such as their “Clean Fifteen” list of conventional foods least sprayed.  EWG even has a Healthy Living App.

One food that absolutely must be eaten organic is wheat – if it is eaten at all – as well as barley, beans, and oats – all of which are often sprayed with roundup (Glyphosate) at harvest time to evenly dry and “ripen” them before going to market.

 

 

Does Niacin (B3) Contribute to Migraine and Histamine Intolerance?

niacin

Updated Oct. 26, 2017. Since writing this article I’m more and more convinced of the benefit of niacin to those with migraine, despite the fact that niacin is a methyl sponge.  Stay tuned for more blog posts on niacin.

Migraineurs generally have high histamine, high homocysteine, low blood sugar, dilated blood vessels and consequent low blood pressure, and liver and gallbladder problems – in addition to the splitting head pain! Niacin (nicotinic acid), as it turns out, is known to contribute to, cause, or exacerbate all of these problems.  On the other hand, niacin reduces glutamate and increases serotonin, which in and of itself is hugely relevant to those with migraine.

We need B vitamins, without a doubt.  Migraineurs especially benefit from B2 (riboflavin), B5 (pantothenic acid), and B6 (pyruvic acid).

If you have migraines, you probably have already been prescribed B vitamins, especially methylated B12 or methylfolate. The problem is that supplementation with either single or combined B complex vitamins can often trigger migraines. Clearly, we need (some or most) B vitamins, but it appears we often can’t tolerate them.  Why are we deficient and why can’t we tolerate supplementation?  How do we get out of this chicken-and-egg conundrum? And is niacin (nicotinic acid) one of the culprits in migraines triggered by B vitamins?

First, a Word about Forms of Niacin and Food Sources

Niacin is available in three forms – niacin (nicotinic acid), niacinamide (aka nicotinamide), and inositol nicotinate.  Niacin will cause a flush, while niacinamide and inositol nicotinate will not.  While all forms are good for their ability to heal schizophrenia, niacinomide is not as effective as niacin or inositol nicotinate for lowering cholesterol. It appears that niacinamide and inositol nicotinate may be more supportive of those with migraine if it is true that they don’t trigger mast cell degranulation in the same way that niacin does (this is discussed later in this article). Slow-release niacin capsules are also available (but not recommended, according to the research I’ve done).

Foods containing niacin include turkey, chicken, liver, mushrooms, peanuts, and tuna. Nutritional yeast also contains very high levels of niacin – and is a known migraine trigger (hmmmmm . . . ). Also, you can buy histamine-degrading probiotics which produce niacin. One of the histamine-reducing strains that produces niacin, b. infantis, can be purchased as a stand-alone probiotic (I found this brand, though I have never tried it so am not promoting it specifically). B infantis also produces the b vitamins folate, biotin, and thiamine.

The Benefits of Niacin

I don’t believe in demonizing any food or essential vitamin, especially not niacin.  Like all B vitamins, niacin has an important role to play in our health. Below are some of the properties of niacin, most of which are beneficial to those with migraine:

  • helps reduce nitric oxide
  • thins the blood
  • improves cholesterol levels
  • acts as a sleep aide
  • has been shown to be especially helpful in healing schizophrenia, alcoholism, and arthritis
  • increases serotonin levels by slowing the loss of tryptophan (a deficiency in niacinamide will
    drive breakdown of tryptophan. Reduced levels of tryptophan will result in decreased levels of serotonin). (Source)
  • acts as an important cofactor in glutamine synthetase enzyme, thus reducing glutamate levels (which get elevated in part due to methylfolate).
  • breaks down norepinephrine, epinephrine, and estrogen (as a cofactor for the COMT enzyme)
  • protects against both UVA and UVB damage (while sunscreen only protects against UVA.
  • helps stimulate production of hydrocholoric acid in the stomach (Source)

Potential Problems with Niacin for Migraineurs

Nevertheless, as mentioned, niacin is a “methyl sponge”.  It requires SAMe for its metabolism, and thereby contributes to a drop in methylation.  Bad reactions to niacin indicate deficiencies in SAMe.

Niacin also has a range of other effects that are known to be associated with migraine. According to the Mayo Clinic, niacin supplementation may also result in the following symptoms (I have reordered these in order of their relevance to this discussion):

  • migraine
  • headache
  • stomach upset
  • vomiting
  • diarrhea
  • dizziness
  • liver damage
  • nausea
  • hypothyroidism
  • increased homocysteine levels
  • insulin resistance
  • abnormal heart rhythms
  • heartburn

In addition, niacin also

  • Raises histamine (again, by way of mopping up methyl)
  • Contributes to a drop in methylation
  • Depletes/lowers B9 (folic acid)
  • Depletes/lowers B6 (which we need to produce the DAO enzyme among others)
  • Dilates blood vessels (and thereby lowers blood pressure)

One testament to niacin’s ability to raise histamine is the typical face flushing that accompanies it’s use.  It was previously assumed that the flushing is the result of a histamine response.  It is now understood that the flushing is a result of prostaglandins.  According to practitioners of Orthomolecular medicine, people with low histamine need more niacin to get the flush than people who already have high histamine (and migraines) do.  It is said that people with high histamine will flush with just 50mg of niacin whereas people with low histamine may need as much as 150mg to flush.

One Major Cause of Low Vitamin B (and Niacin) Levels:
Gut Flora Imbalances

It could be said that migraine is essentially, at its root, a chemical sensitivity and lymphatic congestion issue caused by gut dysbiosis and excessive chemical pollution including pharmaceutical medications.  The solution is to heal the gut by rehabilitating gut flora (with help from B vitamins), and in so doing also support the building blocks for optimal nutrient absorption, enzyme function, blood sugar metabolism, blood pressure regulation, and detoxification.

Our gut flora normally manufacture B vitamins in our body for us (with the exception of B12) – assuming the particular gut flora that produce them have not been depleted by antibiotics and medications.  When our guts are assaulted by pharmaceuticals and stress, the healthy gut flora are thrown off in favor of histamine-producing bacteria and we become deficient in B vitamins; hence, the need for supplementation.  Different B vitamins have different functions, but they work together as a whole family (which is why I question the use of single B vitamins).

The human gut microbiota supplies its host with essential nutrients, including B-vitamins.. . . [H]uman gut bacteria actively exchange B-vitamins among each other, thereby enabling the survival of organisms that do not synthesize any of these essential cofactors. . .  [I]n addition to diet, the gut microbiota is an important source of B-vitamins, and . . . changes in the gut microbiota composition can severely affect our dietary B-vitamin requirements. (Source)

If gut flora produce B vitamins, would supplementing with a probiotic to replenish the gut flora help with B vitamin production? Maybe, in theory – but because probiotics are made through fermentation they can often trigger migraine as well. Normally I am not in favor of probiotics for migraine because the “good”, histamine-degrading bacteria are mixed in with some histamine-producing bacteria.  Fine and good if you have great gut health – not so great if you already have an overload of histamine.

Dr. Stasha Gominak, a neurologist who started to help her migraine patients by improving their sleep and gut health, is NOT in favor of probiotic supplementation, but she IS in favor of vitamin D and B supplementation:

Current suggested treatments for the ‘wrong’ intestinal bacteria are probiotics and fecal transplants (poop from one person given as an enema to another person to implant the ‘right’ bacteria). Neither of these work for very long. I think  the problem is not the supply of the bacteria it is the intestinal environment. We have to supply the happy, helpful bacteria what they need to thrive and they’ll replace the bad guys.  My experience has been that the ‘happy, helpful’ bacteria need the proper amount of vitamin D (enough so we aren’t sucking up every bit of it for our own use, this is usually a D25OH blood level of greater than 40 ng/ml. ) plus larger doses of B vitamins for about 3 months. (Source)

The bottom line is that when gut flora are thrown off and detoxification pathways are compromised, inflammation and histamine increase as the body tries to flush out the waste that would otherwise have another means of exiting the body.

Which Bacteria Produce Niacin?

Recently, it was discovered which bacteria produce niacin:

The two most commonly synthesized vitamins of the human gut microbiota genomes were riboflavin and niacin, with 166 and 162 predicted producers, respectively. . . . . However, the two synthesis pathways are distributed differently over the five phyla. Riboflavin synthesis is mainly found in Bacteroidetes, Proteobacteria, and Fusobacteria, but it is only found in half of the Firmicutes genomes and very few Actinobacteria. In contrast, the niacin biosynthesis pathway is more evenly distributed over the genomes of the five phyla. Such differences between the distributions of these two pathways can have various explanations. First, this variation may reflect their evolutionary history; riboflavin synthesis appears to be more ancient than the NAD biosynthesis pathway. Second, the biosynthesis of riboflavin and its derivatives is a quite straightforward pathway, whereas the biosynthesis of NAD is very complex and includes numerous versions of salvage pathways in various bacterial taxa. (Source)

It’s also great news that at least one of the histamine-degrading probiotic bacteria – b.infantis – also produces niacin:

Niacin, or vitamin B3/nicotinic acid, is an essential nutrient, whose importance is often characterized by the consequences of insufficient intake. Symptoms such as nausea, skin problems, headaches, and, in severe cases, pellagra can result from niacin deficiency. . . . Similar to other B vitamins, B. bifidum and B. infantis appear to be good producers of niacin. (Source)

Methylation and Niacin

Phase 2 detoxification pathways are the routes through which our cells hook activated toxic substances up with small nutrient groups, neutralizing them and making them water-soluble so they can be eliminated in urine.  One of the major detoxification pathways is called methylation. Our detoxification pathways get overwhelmed by chemical assaults, some of them exacerbated by genetic polymorphisms (like MTHFR, but also those related to sulfation and glutathionation).

These days, it’s all the rage to blame all manner of histamine issue on gene polymorphisms such as MTHFR.  And that’s clearly playing a role in people’s elevated histamine issues and histamine intolerance – since those who have high histamine are undermethylated.

But as pharmacist and functional medicine practitioner Suzy Cohen points out, you can be undermethylated without the MTHFR polymorphism – because pharmaceutical medications can also compromise your methylation:

The biggest mistake you could make is thinking that methylation problems don’t apply to you because you don’t have the gene mutation . . . I assure you that your medicine has the capacity to mess up your methylation! (Source)

It’s also worth considering an alternative viewpoint on methylation, Anthony William’s perspective as a medical medium that:

The MTHFR gene mutation test is currently in its infancy and is not as accurate as the medical community believes. . . The MTHFR gene mutation test . . .  is just a basic test that reveals inflammation in the body. Although this test is given under the guise of a gene test and a real gene is being looked at, it is ultimately only able to indicate if there is inflammation in the body. . . The inflammation that triggers off a positive MTHFR gene mutation test stems from toxic byproduct wreaking havoc as it moves from the liver into the bloodstream. This can play a part in producing abnormal homocysteine levels. Eventually, this “dirty” blood prevents proper methylation or the conversion of folate or folic acid. (Source)
People can also be OVERmethylated and LOW in histamine.  While that’s not generally a problem people with migraine have (if their migraine is part of a picture of histamine intolerance or overload), using B vitamins such as methylfolate and methylcobalamin CAN eventually tip people into an overmethylated state.  At this point, niacin is very useful, because it mops up methyl. (For more information on overmethylation as compared to undermethylation, click here). 

But for those of us who are generally UNDERmethylated, taking a B complex vitamin that includes both methylated forms of B12 and Folate will be counterbalanced by the presence of the niacin.  And if the amount of niacin is very high, the total overall effect could theoretically result in a deepening of the methyl depletion.

So, it’s complex.

Some Additional Considerations Re: Niacin and Methylation

When I spoke with one of the formulators at NOW supplements, they explained to me that 1) quantities of niacin in B complex vitamins are formulated based on a general target market and the ratios presented by the marketplace and competition, as well as by recommended daily allowances set by the National Institutes of Health – B complexes are NOT formulated in ratios meant to prevent undermethylation or specifically for those with migraine.

Also, you can get migraine from both under-and-over methylation, though they are accompanied by different psychological states (undermethylated being more depressive, foggy, and lethargic – overmethylated being more amped and full of tension and anxiety).

There is more to migraine than methylation.

 

Niacin Can Both Trigger and Treat Migraine.
What is Going on Here?

The literature and anecdotal evidence for how niacin affects migraine is all over the board. There are case reports of people getting rid of headaches using high doses of niacin, as well as a few studies that show people getting resolution of migraine with niacin (some with intravenous niacin, some via the oral route). Finally, there are also anecdotal reports of people’s migraines being triggered by niacin.

There is more to consider about niacin than the fact that it is a methyl sponge. Niacin is also a “histamine liberator”, which might be why taking it would initially raise histamine but eventually clear it out.  The ability of niacin to clear out histamine (and glutamate) may explain its ability to benefit those with migraine.  Dr. Hoffer, the founder of Orthomolecular medicine and huge proponent of niacin, said:

“It is necessary to give enough (B3) to empty the histamine storage sites to a level at which there is no time to replenish them by the time the next dose is taken. It may require 6 to 8 grams per day for some people.” (Source)
As it turns out, niacin has been used to treat histadelia (high histamine), as well as histapenia (low histamine). Jonathan Prousky, ND, points out that:
Using niacin to treat histadelia might seem contradictory considering it will augment the release of histamine from basophils and tissue mast cells. However, there is evidence that the niacin flush is mediated by the release of prostaglandin D2 (PGD2) from dermal macrophages and not from degranulation of basophil and tissue mast cells. Further, Hoffer suggested that daily intake of niacin gradually lowers total body histamine by chronically depleting storage levels. Niacin has a complicated mechanism of action that modulates histamine release, lowers total blood histamine, and increases the production of PGD2. (Source)

 

What to Do?

Given that people with digestive-based migraines generally already have high histamine, LOW blood pressure, and blood vessel dilation, it seems logical that their symptoms would be exacerbated by niacin.  Because niacin depletes B6, which is needed to make the histamine-degrading enzyme DAO (diamine oxidase), additional supplementation with B6 may be beneficial for those choosing to supplement with niacin.

Upon reviewing all of this evidence for and against niacin, I initially felt very cautious about niacin, and thought it might even be the culprit B vitamin causing so many migraines in people who take a B complex. But ultimately, I’ve found that intellectual and research-based ideas of how beneficial something is only go so far.  Especially when the evidence is mixed or split as to different qualities of a substance, it comes time to experiment. This is where the rubber meets the road.

While everyone may react differently, my observation in clients taking niacin with migraine is that it is actually very beneficial.  It appears that its glutamate-lowering and serotonin-raising effects far outweigh its undermethylating and other effects, at least in those people with migraine who have excess glutamate as its cause. Furthermore, it appears that the flushing form of niacin works to abort migraine while the non-flushing forms do not.  I also found out that coffee contains a fair amount of niacin and this may be one reason it helps to get rid of migraine.  Intriguing!

Other Potential B Vitamin Migraine Triggers

I was always suspicious of methyl B12 as a stand-alone supplement, because I’ve personally experienced migraines triggered by B12. I have come across some evidence that B12 can be toxic in the presence of glutathione depletion.  Glutathione is our most powerful and abundant antioxidant in the body, and migraineurs are generally low in it. (As it turns out, triptans – the most popular drug for the treatment of migraine – also deplete glutathione.  This is another way of saying that triptans cause inflammation).

Not only folic acid, but also methylated forms of folate can be problematic also because they may increase glutamate and lower serotonin levels. The politics of methylfolate and which forms are available in supplement form as compared to prescription form are especially complex.

I will share more research on this topic in my online course, as well as my blog post on how I make my own customized vitamin B blend.

[author] [author_image timthumb=’on’]http://www.simplywell.info/wp-content/uploads/2016/04/Marya.jpg[/author_image] [author_info]Marya Gendron is a biodynamic craniosacral therapist, health coach, and wellness researcher. She specializes in chronic migraine headache relief and alleviation of brain fog, indigestion, and histamine intolerance through plant-based solutions.

The SimplyWell Protocol is available here, or you can book a consultation with Marya.
Learn more about Marya’s healing journey here.
[/author_info] [/author]

Coffee and Migraine Headaches: Benefits and Drawbacks

The majority of migraineurs I see in my coaching practice are addicted to coffee.  And why not?  After all, coffee constricts blood vessels and thereby alleviates headache symptoms. There’s a good reason why caffeine is added as a key ingredient in some NSAID migraine meds like Excedrin: caffeine lowers adenosine levels (but like all other migraine meds as well as coffee itself, Excedrin also causes rebound headache). Coffee actually has a lot of great health benefits, some of them particularly relevant to those with migraine, which is probably one reason why so many with migraine are so dependent on it.  All of us also know that coffee consumption has some drawbacks as well – causing us to either feel physically or psychologically bad for drinking coffee when we do. So are coffee and migraine headaches incompatible, or complimentary?

Quite a few of us yo-yo between these two states: going through phases of intense coffee use and then denial, back and forth.  Others have wholeheartedly and without reservation accepted their coffee obsession, without any qualms.  A few lone souls have actually managed to completely stop drinking coffee.

Coffee is just too delicious and too sacred a ritual for the majority of my clients to give up with any ease.  Usually I will recommend that people NOT try to give up coffee in the early weeks of implementing the SimplyWell Migraine Relief Protocol because I think it is often unrealistic and too challenging to expect people to start drastically new dietary and lifetsyle habits while also going through withdrawal from their favorite drink.

But when we recognize we’ve reached a place where we are truly ready to do anything to heal, the time comes to really take stock of what we consume regularly, ESPECIALLY if our use of it is chronic, addictive, or we feel we literally can’t function without it.  That’s a sign that the substance offers substantial benefits but is also probably being misused.

Like all foods with inherently dynamic properties, there is ample evidence for both the benefits and drawbacks of coffee consumption as it relates to those with migraine.

Above all, my intention here is simply to share some of the research that I’ve found on both the positives and negatives of coffee and migraine headaches and how I personally choose to interface with coffee.  My intention here is neither to demonize or glorify coffee.  It’s a food grown from a plant, and you know how I adore plants.  I believe we need to be able to integrate food into our life while being very mindful and educated about each food’s properties, and then check in with our inner body wisdom and experience to make the final call about how much to incorporate that food into our life.

Coffee and caffeine’s affects on us are complex and vast. The most thorough and balanced article on coffee’s benefits and drawbacks that I was able to find concludes that much of the research on coffee is conflicting at best, because:

. . . most research studies observe and measure the effects of a single dose of caffeine rather than the effects of chronic ingestion. Yet most coffee drinkers drink coffee daily. As a number of studies have shown, single-dose experiments don’t necessarily reflect the effects of our regular routines. . .  [But what is clear is that] caffeine impacts whether certain chemicals are available; how receptive our brains are to them; and whether we’re even making those chemicals in the first place (Source).

Coffee benefits for those with migraine

Coffee imparts certain benefits to those with migraine especially.  The question is whether these short-term benefits are worth the drawbacks. So first, what’s so fabulous about coffee, above and beyond the taste and the ritual, specifically for those with migraine? Here are the highlights that I find intriguing:

  • “Chronic caffeine intake has been shown to increase the receptors of serotonin (26-30% increase), GABA (65% increase), and acetylcholine (40-50%). This may contribute to the elevated mood and perceived increase in energy we feel after a coffee.” (Source)
    Why this is relevant: Migraineurs tend to have lower levels of most neurotransmitters, including serotonin and acetylcholine, but more receptor sites for them (presumably because their levels are so low, they need more receptors to benefit from the few that are available). Coffee inadvertently increases receptivity to serotonin, GABA, and acetylcholine BECAUSE it depletes our bodies of them (maybe not such a good thing, but the initial effects of increased receptivity feel good).
    “In the human body, when neurotransmitter receptors . . . increase their sensitivity, it generally suggests a reduction in functional capacity and activity of neurons associated with those receptors. Either the brain needs more chemicals to do the job, or the neurons involved aren’t working as hard. This might mean that a certain neurotransmitter is in short supply, or that its activity needs to increase.” (Source)
  • Caffeine inhibits blood platelet aggregation (it does so by inhibiting the release of serotonin). Why this is relevant: Migraineurs generally have thick, sticky blood.
  • Caffeine synergizes with progesterone, and increases its concentration in blood and tissues. (Source)  Why this is relevant: progesterone is a glutamate scavenger.  It is also essential for the production of cortisol, which puts the brakes on histamine.  Progesterone offsets estrogen, an excessive amount of which contributes to histamine overload and interferes with proper signaling in your thyroid gland.  Increased progesterone can improve liver and thyroid function as well.  All of these are good things for those with migraine.
  • Coffee contains magnesium and potassium. Other vitamins and minerals found in coffee include vitamin K, riboflavin, niacin, folate, pantothenic acid, choline, calcium, phosphorus and manganese, but these are not present in dosages high enough to warrant drinking it. Why this is relevant: Migraineurs get migraines due in part to deficiencies in essential vitamins and electrolytes.
  • Caffeic acid, found in coffee as well as other plants like celery and the herb Danshen, lowers CGRP levels.  Why this is relevant: CGRP, an inflammatory neuropeptide, has shown to exist in higher levels in those with migraine.
  • Coffee raises blood pressure.  This is perhaps the greatest benefit of coffee, and explains why it can get rid of a headache once in awhile.  Coffee raises blood pressure by way of stimulating adrenaline. Why this is relevant:  those with migraine generally have low blood pressure, so raising it and thereby getting rid of the headache is a huge relief. The blood vessel constriction and raising of blood pressure results in reduced blood flow to the brain.  Check out these before and after images of the brain after coffee consumption.
  • “Caffeine affects the activity of a naturally occurring and necessary brain substance called adenosine. Adenosine levels in the blood go up during migraine attacks. Furthermore, adenosine when injected into a vein can trigger migraine attacks. Adenosine is widely available in the brain, and can produce many effects including less brain electrical activity, temporary widening of blood vessels, and control of some aspects of sleep and movement. Adenosine acts by sticking to specific receptor molecules on the surfaces of some brain cells. Caffeine can block the action of these receptors, and, thereby, stop the effects of adenosine. We do not know how these effects of caffeine result in acute anti-migraine and pain control actions.” (Source)
  •  Caffeine shows promise as a means to reduce β-amyloid levels which cause lesions in the brains of migraineurs and those with Alzheimer’s. So far, this has been demonstrated in transgenic mice.
  • Coffee is high in niacin.  One cup of coffee contains about 40 mg of niacin. Niacin helps to lower glutamate and increase blood flow in small capillaries of the body.

Coffee drawbacks for those with migraine

  • Despite increasing receptor sites for serotonin, caffeine inhibits the release of serotonin. Why this is relevant: low serotonin is a major cause of migraine, and elevating serotonin’s levels also serves to stop the overproduction of inflammatory brain chemicals like glutamate and CGRP. While lower serotonin levels result in increased receptor sites (as discussed in the benefits section), low serotonin is not a good thing for migraineurs.  Changes in serotonin levels from coffee consumption lead to the “characteristic withdrawal symptoms (such as agitation and irritability) when coffee intake is stopped. The brain has come to expect more action in its serotonin receptors, and when its abundant supply of happy chemicals is abruptly cut off, it gets crabby. . . .” (Source) To help with migraine symptoms, we want to increase serotonin, not inhibit it.
  • “Caffeine produces its stimulant effects by inhibiting the release of GABA and thereby allowing the increase of excitatory neurotransmitters. The less GABA, the more nerve transmissions occur. Think what too much coffee feels like: that is the sensation of glutamate without enough GABA.” (Source) Why this is relevant: migraineurs need to increase their GABA.  They can do so through improved gut health and consumption of prebiotics as outlined in the SimplyWell Migraine Relief Protocol.  Inhibited GABA is not desirable for migraineurs, because it leads to excess glutamate (which in turn leads to excess CGRP, an excitatory neurotransmitter elevated in those with migraine).
  • Coffee inhibits the absorption of iron, as well as vitamin B6 and thiamine.  This is true even in the case of decaf coffee, because the nutrient depletion happens not by way of caffeine, but by way of the tannins in the coffee that bind to these minerals and vitamins.  For this reason, tannins in tea are also problematic and steal B vitamins.  Why this is relevant: Iron and B6 are both involved with the synthesis of serotonin, dopamine, and GABA. B6 is also needed to create Diamine Oxidase (DAO), the enzyme that breaks down histamine. Thiamine is important for the creation of acetylcholine, which is needed for proper vagal tone and to keep inflammation in the body down. Migraineurs are generally anemic and low in these vitamins already.  They need the constituents necessary to produce serotonin, DAO, dopamine, GABA and especially acetylcholine.
  • Increased alertness (or anxiety) due to caffeine may be mainly due to blockage of adenosine receptors which normally inhibit glutamate release. Why this is relevant: migraineurs have high levels of glutamate, which causes excitotoxicity in the brain.  We need our adenosine receptors to be working properly so as to prevent an excessive buildup of glutamate. Glutamate released into synapses is normally reabsorbed back into neurons by the ion-exchange transport system, or soaked-up by astrocytes which convert the glutamate into glutamine (a molecule which cannot cause excitotoxicity). However part of the pathology of migraine is imbalanced electrolyte levels which impact the effectiveness of ion-exchange.
  • Caffeine increases cortisol, adrenaline, and epinephrine, mimicking a state of acute stress. Why this is relevant: stress increases histamine and inflammation, which we all have enough of already.
  • Caffeine is metabolized more slowly in women, especially those on oral contraceptives or postmenopausal hormone replacement therapy, due to the fact that it is detoxified using the same enzyme used to metabolize estrogen. Why this is relevant: more women than men get migraines and many women are on hormone replacement therapy or oral contraceptives.
  • Chronic coffee consumption increases insulin resistance. This typically occurs with a diet high in refined sugars and starches, and many people consume their coffee with pastries or refined carbs. This horrible combination creates inflammation and neurotransmitter imbalances. Why this is relevant: Migraineurs already have imbalanced sugar metabolism and low blood sugar.  We don’t need more.
  • Caffeine decreases vitamin D receptor protein expression (Source).  Why this is relevant: Vitamin D is essential for lowering inflammation, proper digestion, deep sleep, and for serotonin production.
  • Coffee is a diuretic, ie, dehydrating. Why this is relevant: As migraineurs, our kidneys and adrenals are already stressed out from the constant inflammation in our system.  Due to their compromised status, we already excrete important vitamins and minerals like sodium, magnesium, and the B vitamins faster than most people.  And we are already dehydrated.
  • Coffee is acidifying. Why this is relevant: due to having compromised kidney function, most migraineurs also have compromised pH balance (ie, are already acidic).
  • Coffee consumption causes dependency and uncomfortable withdrawal symptoms. “Studies of caffeine dependency and tolerance show that daily caffeine users are actually more motivated to consume it to avoid withdrawal symptoms, than to experience the lift that its stimulant properties may provide.” (Source)
  • “Research has shown that some conditions, such as long-term antibiotic use or excessive consumption of alcohol or caffein can deplete inositol stores. Suboptimal levels of inositol can negatively impact brain function, and memory loss may be an indication of inositol deficiency.” (Source)

The healthiest coffee

The healthiest coffee to drink is cold-brewed, organic water-pressed decaffeinated coffee.  Conventional processes used to decaffeinate coffee use a lot of harmful chemicals.  Decaf coffee contains some caffeine.  And it is still acidifying for the body.  Once you have bought your water-pressed decaf coffee, you can cold brew it according to these instructions here.

Alternately, you can make an herbal “coffee” substitute using healing herbs that actually support digestion, liver health, and adrenal function.  Check out my chicory, dandelion, and chaga “coffee” recipe here.

The ultimate question is always: what does your bodywisdom say about your coffee consumption?

I’ve learned over the years that I actually don’t love coffee.  I love the flavor and ritual of coffee.  And there is something about the joy of doing something that I tell myself I shouldn’t just because it’s fun to live a little, to indulge in life’s pleasures and to counterbalance any tendency towards strict denial in life.  But ultimately I’d rather have a clear head, healthy kidneys, and a happy stomach.  So I only drink coffee about twice a month to remind myself that I don’t actually enjoy the feeling coffee gives me, even while I love the taste.

So what’s the takehome?

Is the occasional cup of coffee going to counterbalance all your efforts to get rid of your migraines?  No. Will occasional cups of coffee actually be supportive to you as someone with migraines?  Yes.  Is the consumption of daily cups of coffee, even decaf coffee, going to undermine all of your other good lifestyle habits?  If you are consuming coffee in excess out of stress, depletion, and a deep sense of fatigue – absolutely. We may want to keep in mind that caffeine is a defensive toxin designed by various plants to repel herbivores from its the berries and seeds. On the other hand, humans evolved eating small amounts of toxic substances which stimulate the liver.

What do the neurologists say about caffeine consumption if you have migraine?

It is important to emphasize that caffeine consumption is rarely the sole “cause” of frequent headaches including migraine. However, it is a modifiable risk factor, unlike many other unavoidable migraine triggers. Caffeine is often a significant and overlooked contributor to the problem of frequent and chronic daily headache. Migraine sufferers should use caffeine less frequently or remove it entirely as one component of a program of therapies for success, and it requires no prescription. (Source)

[author] [author_image timthumb=’on’]http://www.simplywell.info/wp-content/uploads/2016/04/Marya.jpg[/author_image] [author_info]Marya Gendron is a biodynamic craniosacral therapist, health coach, and wellness researcher. She specializes in chronic migraine headache relief and alleviation of brain fog, indigestion, and histamine intolerance through plant-based solutions.

The SimplyWell Protocol is available here, or you can book a consultation with Marya.
Learn more about Marya’s healing journey here.
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Migraine Headaches Caused in Part by Antibiotics

Are Migraine Headaches Caused by Antibiotics?

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The majority of people do not think that antibiotics cause migraine headaches – or that pharmaceutical medications used to manage their migraines may be directly inhibiting their ability to heal.

If you ask most people with migraines if indigestion, inflammation, muscle tension, and hormones are all part of their migraine headaches, quite a few of them will say YES. Many of these people are also aware that getting plenty of potassium and magnesium is important for proper electrolyte balance, but may not understand why their electrolyte levels are off.

Increasingly, more and more people are also aware of a disorder called Histamine Intolerance, and understand that their indigestion and migraine headaches may be resulting from an overload of histamine which occurs in the gut when the body is unable to break histamine and tyramine-rich foods down due to an enzyme deficiency (primarily, DAO, aka diamine oxidase).

Most migraineurs are also aware that dilated blood vessels are implicated in migraines, but won’t see a connection between their low blood pressure and the blood vessel dilation during migraine.

This constellation of symptoms can be very difficult to understand, and rarely do we see a clear presentation for what these different symptoms have to do with each other much less what their underlying cause is.

In this article, I’d like to share with you the pieces of the puzzle as I have come to understand them in the process of healing my own migraine headaches and histamine intolerance.  It’s my (layperson’s) belief that even sporadic antibiotics cause migraine by way of negatively affecting primarily the gut flora and the kidneys.

Laypeople and medical doctors use the term “cause” and “causation” differently.  Strictly speaking, it is inaccurate to claim that antibiotics “cause” migraine headaches, in the sense that we know that many migraine headaches have other or multiple confounding causes as well.  In a very general way, this article is simply pointing out that antibiotics can be one of the major causative factors in the development of migraines in many but not all cases of migraine, and that this is often not fully recognized.  Clearly, antibiotics is a huge category of drugs with many different specific effects depending on the type of antibiotic used, but generally speaking, they are all recognized to negatively impact gut flora balance and kidney health.

Please note that this hypothesis and all the information contain here is based off of my own research, self-experimentation and observations helping others as an experientally-trained health coach, and not as a traditionally-trained medical doctor.

Mainstream and Alternative Classifications of Migraine Headache and the Role of Pharmaceuticals in Migraine Causation

The International Headache Society’s ICHD-3 classification system outlines three types of migraine: migraine with aura, migraine without aura, and retinal migraine. Migraine types formerly thought to be distinctive disorders, such as chronic migraine and hemiplagic migraine, are now being classified as “complications” of migraine.

In contrast, clinical nutritionist Byron J. Richards has created his own classification system for migraine headaches because, “From a practical point of view the different types of headaches that Western medicine classifies have little use in fixing the source of the problem and stopping the headaches from happening in the first place.”  He classifies migraines into four types of headache: Lymphatic/Pressure Headaches, Hormonal Headaches, Blood/Toxic Headaches, and Nerve Inflammation Headaches. He says:

It is a sobering commentary on the skill of Western medicine that their toolbox for this issue is limited to a variety of pain killers – which sometimes treat or manage the pain in a symptomatic way and sometimes don’t work so well. While some type of pain killing is better than the headache, getting stuck in the rut of ongoing painkiller use is also problematic and not addressing the source of the problem.(Source)

WebMd doesn’t recognize that antibiotics cause migraines.  It describes “medication headaches” and reports that many drugs, including antibiotics, can induce “acute headache”:

Many drugs can induce acute headache, including nitroglycerin, antihypertensive agents (beta-blockers, calcium channel blockers, angiotensin-converting enzyme [ACE] inhibitors, and methyldopa), dipyridamole, hydralazine, sildenafil, histamine receptor antagonists (e.g., cimetidine and ranitidine), NSAIDs (especially indomethacin), cyclosporine, and antibiotics (especially amphotericin, griseofulvin, tetracycline, and sulfonamides).

If, however, we know that many people with histamine intolerance manifest with symptoms of migraine, the question becomes which medications in particular lower DAO or trigger mast cells to release histamine. A growing list of medications known to be indirectly implicated in migraine headaches, histamine intolerance, and mastocytosis is outlined here.

In addition to the direct impact of meds on mast cells, gut microbiome, kidneys, and liver (not to mention thyroid, pancreas, etc), it is well established that many pharmaceuticals are “Drug Muggers” – they steal vital nutrients needed by the body to make enzymes and complete any number of important functions, like facilitating muscle relaxation. (So, deficiencies in vitamins and minerals caused by pharmaceuticals can contribute to hypertension of muscles in the neck and cervical area.  These nutritional deficiencies are compounded by gut inflammation and leaky gut caused by antibiotics).

Notice that none of the explanations in this section for how meds affect us implicate antibiotics in chronic migraine. So why do I insist that antibiotics are the main culprit?  Because their use leads to a predominance of histamine-producing bacteria in the colon, and hormonal, electrolyte, and blood pressure problems that manifest due to kidney dysfunction. If we look at the history of people with migraines, they almost all have had numerous doses of antibiotics throughout their life (who hasn’t?).  Many who have tried my protocol confirm that their migraine headaches started after a major surgery or dose of antibiotics. This assault so undermined their own body’s resilience that a chronic debilitating condition resulted.

It’s my view that these cases are not a result of that single dose of antibiotics or pharmaceuticals, but rather, that the person was already compromised from intermittent antibiotic use throughout their life and that one incident was the straw that broke the camel’s back.  As with many other pharmaceuticals (such as vaccines), the question is: how many doses can the body handle, and at which point is a threshold reached that tips the body over into chronic inflammatory disease?

All medications probably affect the microbiome, which explains why people who take daily pain meds or migraine meds do not respond as well to the SimplyWell Migraine Relief Protocol as those who only do occasionally. From an evolutionary perspective, pharmaceuticals and synthetic chemicals are novel and challenging for our bodies. We did not evolve to process them.

Why do so many people with migraine headaches have high levels of histamine?

It’s great that more and more people, including physicians, are becoming aware of the problem of histamine intolerance. Anyone familiar with histamine intolerance will know that DAO (diamine oxidase) is one of the enzymes that breaks down tyramine and histamine, both of which are found in a lot of foods, especially aged or fermented foods (and supplements).  Therefore, the idea goes, histamine intolerance is caused by low DAO levels. This is the classical perspective on histamine intolerance.  It’s also well known that some opiates trigger mast cells to degranulate and release histamine that way.  This is called mastocytosis.  So clearly there are many routes through which one can end up with a lot of inflammation (ie, histamine) in the body. A DAO level test can be done, but if a person were to show normal levels of DAO, this would not mean that they don’t have histamine intolerance, in my view.  It would only mean that there was so much histamine in the body that even normal DAO levels couldn’t break it all down.

I personally prefer to refer to the symptoms of an overfull “bucket” of histamine as “Histamine Overload” rather than “Histamine Intolerance.”  “Histamine Intolerance” implies there is a malfunction in the person’s body, whereas “Histamine Overload” correctly describes an excessive amount of histamine caused by factors that have overwhelmed the body’s ability to break it down.

I feel its always important to remember that the view of disease that sees the body as a malfunctioning machine that needs to be fixed is outdated and inaccurate. The body is incredibly sophisticated and intelligent, and sends off alarm signals and symptoms when it has been assaulted, overwhelmed, or is lacking the support it needs to function optimally.

I think the more important and overlooked factors in Histamine Overload manifesting as migraine headaches (besides low DAO) are:

  • Excessive bacteria in the gut (colon) that produce histamine.  (Histamine-producing bacteria include: Lactobacillus casei, Lactobacillus delbrueckii, Lactobacillus bulgaricus, Lactobacillus reuteri, and Lactococcus lactis, Enterococcus faecalis, and various types of E. coli.This is rectified by prebiotics that feed friendly bacteria, as outlined in the SimplyWell Migraine Protocol.
  • Estrogen dominance.  Estrogen is known to suppress DAO and increase histamine. Estrogen dominance is also addressed through the ingestion of specific plants in the SimplyWell Migraine Protocol.
  • Damaged cell receptor sites for DAO. DAO receptor sites are affected by Na+ and Cl- levels, ie, electrolyte balance (Source here).  Could the damage to the the kidneys and the subsequent effects on electrolyte balance be affecting not only DAO levels, but also cells’ receptivity to DAO? The SimplyWell Migraine Protocol improves electrolyte balance and cell receptivity to DAO.

Why do so many people with migraine headaches have dilated blood vessels, low blood pressure, and electrolyte imbalances?

There seem to be mixed views as to whether migraine is an issue of constricted or dilated blood vessels.  But it is clear that with migraine, there is less than optimal blood flow and that this leads to loss of oxygen to the brain and attendant pain.

Constricted blood vessels would seem to logically be the cause of lack of blood flow, whereas it would seem dilated blood vessels would lead to more blood flow. However, the opposite is true.  The important key to understand here is that dilated blood vessels are also associated with low blood pressure.  Most migraineurs have low blood pressure, so while the vessels may be dilated and wide open for the blood to flow, if the pressure of that blood is low, it will not be able to bring the blood and oxygen to the head.

Additionally, low blood pressure will prevent good circulation to the extremities, which is why many with migraine headaches have cold hands and feet, tingling in hands and feet, and various peripheral neuropathy issues.

So the root question is actually, “Why do so many migraineurs have low blood pressure?”  Well, what regulates blood pressure?  The kidneys do.  They regulate blood pressure partially by way of how they regulate electrolyte balance.  Antibiotics are known to cause electrolyte imbalances via damage to the kidneys. This can be mitigated as outlined in the SimplyWell Protocol by consuming the optimal levels of potassium to sodium electrolytes (2:1 ratio), which will raise blood pressure, increase DAO levels, and improve cellular respiration and metabolic function.

As it turns out, there are also bacteria in the digestive tract that help to regulate blood pressure as well.  Therefore, anything that assaults the colonic bacterial balance and the kidneys (ie, antibiotics) will seriously compromise a person’s ability to regulate their blood pressure.

Researchers at The Johns Hopkins University and Yale University have discovered that a specialized receptor, normally found in the nose, is also in blood vessels throughout the body, sensing small molecules created by microbes that line mammalian intestines, and responding to these molecules by increasing blood pressure. The finding suggests that gut bacteria are an integral part of the body’s complex system for maintaining a stable blood pressure. (Source)

To make matters even worse, stress also dilates blood vessels, as does histamine.  So once you are caught in a state of inflammation and high histamine, which in and of itself is very stressful, your blood vessels will be constantly dilated.  When this happens, small amounts of blood proteins (fibrin, glubulin, and albumin) leak into the interstitial spaces, get trapped around the cells compromising optimal electrolyte balance and cellular respiration, and congest the lymphatic system.  When the lymphatic system is congested and cannot be fully cleaned out via the venous blood because the kidneys are congested from antibiotics, varying degrees of sepsis result.

I’d like to give credit to Angela Stanton (creator of the Stanton Protocol) for her insights into low blood pressure and the importance of salt to raise blood pressure.  Stanton’s protocol is based on reduced carbohydrate consumption and increased potassium and salt intake.  Her protocol does not address histamine intolerance or inflammation in the gut, however.  The prebiotics in the SimplyWell Migraine Protocol are an example of how healthy sugars from root vegetables can and do lower insulin sensitivity, thereby making carbohydrates easier for the pancreas to process, and less triggering for migraineurs.

What role do hormones play in migraine headaches?

The adrenal glands sit atop our kidneys and regulate our stress hormones.  Going through a surgery or getting antibiotics is extremely stressful, especially if the damage done from that surgery leads to a debilitating condition like chronic migraine headaches.

For many women like myself, the triggering surgery may have been a c-section operation.  So on top of antibiotics and the stress from the surgery, the mother is going to have taxed adrenals from sleep deprivation from caring for her child, and in some cases years of breastfeeding which can be literally very draining even in the absence of migraine headaches.  There are clearly many compounding factors that contribute to stress and adrenal fatigue, but I contend that it is the original stress to the kidneys from antibiotics and surgery that undermine the mother’s ability to be resourced and resilient in the face of the new challenges of motherhood.

The adrenal glands use progesterone to make cortisol. Therefore, the more stressed out you are, and the the more cortisol you produce, the more progesterone you will need to manufacture it.  Progesterone puts the brakes on estrogen.  If progesterone becomes depleted because of the high demands on it by the adrenals, there will be an excess of estrogen in the system.  Estrogen suppresses DAO, thus leading to excessive histamine.

The liver processes estrogen. Many people try to treat their migraines by focusing on liver health, but it may make more sense to heal the gut first and thereby support the liver. Some bacteria in the colon act to help detoxify the body, and therefore can be seen as a “second liver” (see Dr. Perlmutter’s book “Brain Maker” for more info). If the liver is already overloaded because the colonic bacteria that act as the second liver are missing, the liver will be more compromised, further contributing to the hormonal imbalance.

Luckily, this situation can be mitigated by improving gut flora balance and eating estrogen-reducing foods like raw carrot as featured in the SimplyWell Protocol. Once the most debilitating symptoms of histamine overload and migraine headache subside, sleep patterns will be re-established, the body can rest and repair itself and the kidneys/adrenals will gradually heal.

The SimplyWell Migraine Protocol can mitigate the damage done to the gut and kidneys by antibiotics.

It’s important to note that while clearly, not all migraine headaches have the same root causes, people with different migraine types are responding well to the SimplyWell Migraine Protocol, indicating that in many cases, migraines with the same root cause (imbalanced gut flora and compromised kidneys) can manifest with different symptoms in different people.

I developed the SimplyWell Protocol in January of 2016. It is a completely drug-free, plant-based approach to migraine headaches that relies on the use of specific vegetables and fruits (especially prebiotics available in various humble starchy roots) to feed healthy gut flora, balance estrogen levels, clean out the liver and gallbladder, and support kidney function (and thereby lymphatic health).

I didn’t fully understand why or how the protocol worked when I first discovered it, but the past nine months of research have shown me specifically why the plants used in the protocol work so well, and has helped me to connect the dots as to how and to what extent my different migraine symptoms were related to each other.

It was through the firsthand experience of reducing inflammation in my colon and the subsequent disappearance of my migraines that I realized that compromised digestion was the primary source of my histamine load and therefore, that antibiotics were the primary culprit in my imbalance. It was also in the process of cleaning up my diet and doing a few six day grape fasts which flushed my kidneys out of large chunks of mucous that I started to look into the connection between antibiotics and kidney disease.  It is well established that antibiotics damage the liver, thyroid, gallbladder, and kidneys, but it took me months to realize the implications of compromised kidney function on blood pressure, hormonal and electrolyte balance, and chronic migraine headaches.

The bottom line?

There is an enormous need for us to discover alternatives to pharmaceutical treatment, which are not only ineffective at addressing the root cause, but in many cases are exacerbating or undermining the body’s self-healing abilities.  This suppressive approach to medicine is in its death-throes.  People are waking up to a new paradigm of medicine that involves a return to common-sense, self-care, and natural solutions.  The problems is that while many people believe in a very general way that food is medicine, it can take years to discover which foods are the best medicine for specific conditions like chronic migraine headaches.

We are in the process of reclaiming our Folk Medicine and also discovering new applications for plant-based solutions that address modern problems largely caused by pharmaceuticals that our grandparents didn’t have to deal with and so were not in the lexicon of their Folk Medicine before it was lost.

I’m overjoyed to offer the Simplywell Migraine Protocol to the Folk as a gift from Mother Nature as she continually reveals options for us that are gentle, nourishing and profoundly effective at addressing intense chronic pain conditions such as migraine headaches. Part of my excitement in sharing these plant-based solutions comes from all the positive “side-effects” of truly holistic medicine (like clear skin, more energy, deeper sleep, improved gum health, diminished PMS and cramping during menstruation, etc).  The good news is that the body doesn’t know how to selectively heal, which is why a whole host of bothersome long-term ailments simply dissolve once the body is truly supported through proper nutrition.

It’s my hope that we can start to wake up to the reality of the damaging effects that antibiotic medications are having on our whole physiology, which for some of us manifests as migraines.  Luckily, there are very simple, affordable, and gentle plant-based solutions to reverse this damage, as outlined in my SimplyWell Migraine Protocol

[author] [author_image timthumb=’on’]http://www.simplywell.info/wp-content/uploads/2016/04/Marya.jpg[/author_image] [author_info]Marya Gendron is a biodynamic craniosacral therapist and health coach specializing in chronic migraine headache relief and alleviation of brain fog, indigestion, and histamine intolerance through plant-based solutions. She practices out of Portland, Oregon. In January of 2016, Marya healed herself of chronic debilitating migraine headaches caused by pharmaceutical medications she received after a c-section operation. Her life purpose is to educate people about broader health-care and self-care options through promotion of specific fabulous medicinal foods that have been forgotten or ignored. She is actively trying to form a Folk Medicine movement to transform the culture of suppresive and poisonous medications to one of holistic health accomplished through an educated, pro-active, and mutually-supportive community.[/author_info] [/author]

 

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