Migraine support with Dr Kellie

I have been a migraine sufferer for almost all my life. I can remember doing a trial avoiding histamines as a kid. I understand how intrusive migraines can be. If they aren’t laying you out flat, they can create heavy headaches that make it hard to get through the day.

Many people normalize their headaches. It’s just what we do—we have to get through the day. If there are a few miserable days, it is what it is. Many don’t even discuss it with their family doctors, managing with over-the-counter pain relief instead.

The Importance of Seeking Help

Checking in with a family doctor is essential. A referral to a neurologist may be necessary, especially if your migraines are new or different. This helps rule out any underlying conditions. One of the first treatment options is to try rescue medications called triptans. Triptans, like Imitrex or Ralpax, can work well and feel essential for day-to-day functioning. Unfortunately, they can be quite expensive and won’t address the frequency of migraines. All these rescue options can lead to rebound headaches. For me, while Ralpax worked well at first, I started to experience a rebound headache 48 hours after every dose.

Migraine Prevention

With more frequent headaches and migraines, it’s often better to explore preventative medications and options. This is where Naturopathic Medicine comes into play. A few years ago, I was referred to an amazing neurologist. She understood Naturopathic medicine and shared valuable insights. She said, "It's your job as a Naturopathic Physician to help decrease the things that will push you into a migraine headache. It's my job, as your Neurologist, to help you find the things that will make your migraine threshold more stable."

Some helpful prescription medication options for stabilizing that migraine threshold include low-dose amitriptyline, calcium channel blockers, beta blockers, and several seizure medications like topiramate and lamotrigine. CGRP antagonists (gepants) are also effective. Amitriptyline is an older generation antidepressant. At low doses, it can be very helpful for managing chronic pain conditions, including migraines and fibromyalgia. Side effects vary, but with amitriptyline and beta- and calcium channel blockers, they commonly include fatigue, dry mouth, and constipation.

It may seem odd that antiepileptic drugs are used for migraines, but research supports their use. Topiramate has strong evidence behind it and can be titrated down after six months of use with ongoing benefits. However, its side effects can be profound. They may include cognitive side effects like fatigue, mood changes, dizziness, and word-finding problems. It absolutely cannot be used in pregnancy.

Gepants are particularly interesting. They can be used as preventative medications and as rescue meds. This is handy because they don’t usually cause rebounding. They become preventative when used more frequently. Unlike triptans, which are more effective at the onset of a migraine, gepants can be used later into the headache. This is helpful because migraines can sneak up and resemble tension headaches before escalating. Many folks hesitate to use rescue medications until they are sure the headache won’t be managed with usual headache tricks.

Naturopathic Options for Migraines and Headaches

So, how do we use Naturopathic Medicine for migraines? There are many avenues to explore, as numerous triggers can lead to headaches. It’s important to look at the individual’s full picture to decide on a therapeutic course. There is often a strong hormonal influence, so supporting the estrogen/progesterone balance is a strong starting point. I often use herbal medicine or bioidentical hormone replacement to support these balances.

Research supports the use of specific herbs or supplements in headache prevention. Melatonin has been examined in several ways, including head-to-head trials with amitriptyline and valproic acid. It has consistently shown effectiveness in reducing the frequency, duration, and intensity of migraines. I also use a blend of magnesium, CoQ10, butterbur, feverfew, and B2 for migraine prevention. This combination is well tolerated and can be very effective.

The Take-Home Message

Many people suffer from migraines and headaches, feeling they have to power through without seeking treatment. However, there are numerous therapeutic options available, both pharmaceutical and herbal or nutraceutical. It’s crucial to check in with your primary care provider or a neurologist to ensure there aren’t any underlying issues that need immediate attention.

The best approach considers the frequency, timing, known triggers, and other symptoms such as menstrual or digestive complaints. No one should have to push through without support. We all deserve to feel our best and take control of our health.

For more information on holistic and inclusive natural healthcare, feel free to explore our services at Cardinal Point Health.

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