Dr John Briffa: Heads you win (2024)

Migraine is one of the most common conditions that I see in practice, and the vast majority of sufferers have it affect their daily lives to some degree. As a result, I'm always on the lookout for potential solutions to this problem. Reading this month's edition of the medical journal Cephalalgia , I discovered that the ancient Egyptians used a poultice of ass's grease to relieve headaches. Interesting, I suppose, but not a whole heap of use to the 6 per cent of men and one in five women who regularly suffer from migraine attacks.

Migraines are not your common-or-garden headaches. The pain is usually felt on one side of the head, and is characteristically intense. I haven't had a migraine myself, but have heard enough 'head-in-a-vice' and 'nail-being-hammered-into-my-eye' descriptions to know their potential ferocity. Migraines often give rise to other symptoms including a need to be away from light, visual problems, and nausea and vomiting.

While a migraine attack won't kill anyone, I've heard a lot of people say that they sometimes wish it would. However, for those who are prone to migraine, help is at hand. Experience shows that nutritional approaches often do wonders to reduce the frequency and severity of attacks. Getting to the underlying nature of the problem is often the key to controlling migraine in the long term.

One potential cause of migraine appears to be the very drugs used to treat attacks. This appears to be true for migraine sufferers who take painkillers every day to keep their headaches at bay. Ironically, coming off conventional medication may bring tremendous relief in the long term. One way to do this is to go cold turkey. This usually leads to a horrendous headache for a few days, after which the body generally returns to a state of relative calm. Another approach is gradually to wean off the medication over several weeks. This method takes longer, but is an easier ride.

Before and during any reduction in medication, it can often help to look at correcting whatever imbalances might be at the root of the problem. There is good evidence that a major cause of migraine is sensitivity to specific foods. Certain foods are well known to trigger migraine. Sometimes referred to as 'the five Cs', these are: chocolate, cheese, claret (and other red wines), coffee (and other sources of caffeine) and citrus fruits. While these foods are commonly held to be the main culprits in migraine, research suggests that the most common food trigger is actually wheat. Cutting back on bread, pasta, pastry, and wheat-based breakfast cereals and crackers does seem to help a surprising number of migraine sufferers.

Migraine can sometimes be triggered if the level of sugar in the bloodstream gets too low (hypoglycaemia). This may well be the mechanism in individuals who can wake up with a headache or be prone to an attack if they skip a meal. To ensure a stable level of blood sugar, regular meals and snacks should be eaten, and the diet should be based around blood sugar-stabilising foods such as fresh fruits and vegetables, meat, fish, beans, pulses, nuts, seeds and wholegrain starches such as oats and brown rice.

During a migraine attack the blood vessels around the brain tend to constrict (shut down) and then dilate (open out). It is this second phase of dilation that is believed to cause the pain characteristic of migraine. Deficiency of magnesium tends to increase the risk of spasm and subsequent dilation in the body's arteries. Indeed, migraine sufferers have been found to have lower levels of magnesium in their bloodstreams compared to non-sufferers. One study found that 80 per cent of women treated with magnesium experienced an improvement in their headaches. Green leafy vegetables, nuts and seeds, and beans and pulses are good sources of magnesium. However, to get really useful quantities of this mineral into the system, I generally recommend a supplement containing 250mg to 350mg of magnesium, to be taken twice a day.

Another natural remedy which can often be effective is the herb feverfew ( Tanacetum parthenium ). The main active constituent in feverfew is believed to be a substance called parthenolide. Parthenolide appears to inhibit the release of inflammatory substances that may play a part in the blood-vessel changes typical in migraine. Feverfew has been found to reduce the frequency, severity and duration of migraine attacks, although it may take several weeks for benefits to become apparent. The daily recommended dose of parthenolide is 250mg a day.

In my experience, one or more of the above approaches is usually very effective in controlling migraine attacks. However, if all else fails, I suppose there's always the ass's grease.

Dear John...

Last year I was found to be suffering from a duodenal ulcer and was diagnosed with a H pylori infection. I took a course of conventional treatment, but tests reveal I am still infected. Do you have any advice?
David Meades, Shropshire

A The bacterium Helicobacter pylori is now recognised to be a common causative factor in many ulcers that occur in the stomach or duodenum (the part of the gut just after the stomach). Conventional treatment revolves around the use of antibiotics, antacids and bismuth. However, as your experience demonstrates, it is not always effective.

I can think of a couple of things that might help rid you of Helicobacter. One is Manuka honey from New Zealand, which has been found to inhibit Helicobacter in the test tube. It makes sense to include some in your diet. Take tsp, three or four times a day. Look for a brand labelled UMF 10+. UMF stands for 'unique Manuka factor', the substance believed to give the honey its bacterial-killing potential. Comvita and Medi Bee are good brands to look out for.

Another natural approach to H pylori comes in the form of mastic gum, a tree-extracted resin. This is available in health-food stores under the name Mastika - 1g of mastic gum should be taken each day for two to four weeks.

Nutrition news: 'C' your way to a healthy pregnancy

Vitamin C is a nutritional old favourite, and with good reason: it appears to protect us from a variety of conditions including heart disease, cancer and the common cold. Recent research has revealed that vitamin C may help reduce the risk of premature birth, too. Scientists at the University of North Carolina found that the lower a woman's intake of vitamin C before and during pregnancy, the greater the risk of premature rupture of the sac that encases the foetus and the fluid surrounding it. Women consuming the least vitamin C in the middle of their pregnancies had a 70 per cent increased risk of this condition. It is believed that vitamin C is important for the production of collagen, the substance that gives the foetal sac its strength. The researchers suggest that women might take a multivitamin and mineral supplement (those formulated specifically for pregnancy are freely available) both before and during pregnancy.

· If you have any issues you would like Dr John Briffa to address in this column, please contact him by email on life@observer.co.uk. Please note that Dr Briffa cannot enter into any personal correspondence

Dr John Briffa: Heads you win (2024)
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