I have had three migraine headaches in the last seven months. I know a migraine is coming on because I will get a circular watery image in my right eye and then the image gets bigger in shape, then disappears. After it disappears, I will get a massive migraine. Each time I am usually exercising really hard — climbing a mountain or snowboarding. At first I thought it was because I haven’t had enough salt/electrolytes intake in my diet. I increased my salt intake after migraine #2 but I still got migraine #3. Any suggestions?
Signed,
A Red-Headed Migraine in Maine
Dear Red-Head,
It sure sounds like a classic migraine, although “tension” headaches can also start with auras (sensory changes like that watery image) before the onset of the headache. Also, about 80% of migraines don’t start with an aura, so it gets confusing! Let’s assume it’s a classic migraine.
Rather than just cover up the symptoms with a pharmaceutical medicine, I try to identify the root cause of the problem. In your case it looks like heavy exertion may be related. In other people, subtle food allergies and/or sensitivities are often to blame. Or maybe dust, pollen, animal dander or mold exposure. Stress is a very common cause for migraines — there are a number of hormonal changes due to stress that actually change the blood flow in your brain. Sometimes it’s impossible to know exactly what sets off migraines. A good functional medicine doctor should be able to assist you in tracking down the cause.
In your case, it sure sounds like a combination of dehydration and electrolyte imbalance is giving you a one-two punch in the noggin! Migraine headaches result from a really complicated interplay of environmental and genetic factors leading to a dysfunctional trigeminovascular reflex. Skip through the medical gobbledygook and basically the wiring and plumbing are a little screwed up. Blood flow issues lead to neurological hyperactivity, which leads to more blood flow problems.
So how do you break this vicious cycle and get your brain back? Well, preventing a migraine from hitting you in the first place is the best course, of course. Make a strong effort to stay well hydrated — this means drinking half your body weight in ounces of filtered water the day before you hit the slopes! Try to drink good quality, filtered water. And avoid plastic bottles of all kinds, even Nalgene-type bottles, to cut down on hormone-disrupting plastics. (Use a stainless steel or glass bottle instead.) When you are exercising, keep drinking and add a little electrolyte solution to your water; inexpensive and healthy mixes can be found at health food stores. Avoid sports drink products which are mostly sugar and artificial dyes.
There are two herbal remedies that have a decent track record of preventing migraines: feverfew (Tanacetum parthenium L. Schultz-Bip.) and butterbur (Petasites hybridus). Riboflavin at 400 mg a day can also be helpful. Be sure to take these every day even if you don’t have a migraine.
If you still get an acute attack, there are many options in the natural medical world that may be helpful. These range from herbal nutriceuticals to intravenous vitamin therapy to acupuncture to osteopathic and chiropractic manipulation to biofeedback techniques. Which one you choose really depends on what is causing the migraine. Pharmaceutical remedies can also help break an attack.
One last thing — if your headaches are getting worse and worse, or if you have other neurological problems, be sure to see a doctor right away to rule out other medical conditions. I recommend finding a good integrative medicine practitioner and doing a little detective work together.
Sean McCloy, MD, MPH, MA is the medical director at Maine Integrative Wellness in Portland. He is dual board-certified in family medicine and holistic medicine. He specializes in integrative family medicine and can be seen walking around the Old Port with his therapy dog, Hershey. Send questions for Sean to editor@themaineswitch.com.