The Eye Center News

Migraines have inflammatory triggers causing decreased blood flow and impairment of the nervous system. The pain, sensory, and motor changes depend on which nerves and blood vessels are involved. 

They often begin with an aura or prodrome premonition at the beginning which usually lasts up to 30 minutes. Afterward, pain and residual effects can last up to 72 hours.

+ a colorful or dark jagged blind spot
+ constipation
+ dizziness
+ food cravings
+ hallucinations
+ stroke-like symptoms
+ increased thirst
+ mood changes
+ neck stiffness
+ synesthesia
+ twitching
+ yawning 

Classic Migraine Symptoms
+ Sharp deep aching pain, pupil abnormalities, bilateral aura, some light sensitivity, & headache. Dizziness, nausea, and vomiting are also common.
+ Acephalgic Migraine: Aura only; more common past age 50
+ Increased risk of stroke in women

Common Migraine Symptoms
+ Severe deep throbbing eye pain on one side of the head without aura
+ Often associated with stress, depression, and anger management issues especially triggered by low blood sugar. Memory and decision making are impaired for 2-3 days. 

Concussion Headache Symptoms
+ Post-concussion or traumatic brain injury headaches resemble migraine with or without aura and are often frequent and severe. They also impair decision making.
+ Early use of anti-inflammatory medications and n-acetyl cysteine (NAC) are beneficial to reduce damage and improve decision making. Even late use helps.
+ I have found they respond well to multivitamins with high concentrations of B vitamins with l-methylfolate, methyl B12, and high levels of riboflavin.  Vitamin D and antioxidants including C, E, alpha lipoic acid, and n-acetyl cysteine (NAC) are very beneficial. 

Known Triggers for Migraine

+ Artificial Sweeteners (Aspartame, etc.)
+ Blood Pressure Elevation
Also increases the risk of stroke
Bright Flickering Lights
Caffeine Withdrawal
Fasting, skipping meals, low blood sugar
Nighttime snacking may help
Fermented Foods (wine, beer, chocolate, & cheese contain tyramine)
MSG, a food flavoring additive
Monthly hormone cycles, especially at menarche and menopause
Smoking: Stop Smoking!
Vitamin D, B12, Folate, Riboflavin, or B6 deficiencies
Weather changes

Summary/Big Picture

Migraine has many causes and is part of a larger complex syndrome of headache.

Conventional medical therapy should be augmented with:
+ Lifestyle changes
+ Behavioral changes
+ Targeted nutritional therapy

Summary Lifestyle and Nutritional Recommendations for Headache Control

+ Don’t Smoke! Essential!

Replace the current diet with a high fiber, low gluten, low sugar, low starch, Mediterranean dietReduce red meat and saturated fats, increase cold water fish intake.  Essential
+ Reduce alcohol, aspartame, fermented foods and drinks, gluten, histamine, MSG, and tyramine.
>>> Especially be careful of
aged hard cheese, cured meats, meats with nitrates, and red wines

+ Restore
normal sleep cycles by being in bed in the dark from 11 pm to 6 AM, whether you sleep or not, stay in the dark. Essential
+ Sleep Apnea: If you snore or sleep poorly: ask your doctor for a sleep study. Essential
+ Reduce bright lights, and cell phone, computer, or television use after 10 PM.
+ Sleep in a dark room, with no television or LEDs shining to illuminate the room (lights suppress melatonin). Take 3 mg of melatonin 30 minutes before bedtime if needed for a few days to establish habit, but not long term.
+ Regular mealtimes, avoid random fasting, and skipping meals.
+ Avoid low or high blood sugars. Observe patterns of eating & fasting and adjust.
Carry a few small fructose, glucose, or sucrose sugar candies in the pocket only for emergencies with the onset of headache, irritability, and hypoglycemia. Target blood pressure < 130/80 mmHg
+ SEX: Sexual activity may increase or decrease migraine pain. Experiment.
+ Stress: Change what you can, learn a meditative or bodywork practice to deal with what you can’t.
+ Psychological counseling and biofeedback are helpful.
+ Acupuncture is often as beneficial as medications.
Maintain serum levels of Vitamin D of around 50 ng/ml.
Supplement the diet with vitamins, minerals, and nutraceuticals which reduce inflammation and improve blood flow.
100 mg/day of co-Q 10, 100-600 mg/day of magnesium, & 10+ mg/day of Riboflavin
One of the following daily:
EyefolateTM (a high quality over the counter supplement) which I have found beneficial.
OcufolinTM (pharmaceutical grade Medical Food) rich in cofactors to reduce inflammation & increase blood flow. Studies show it reduces homocysteine and increases retinal blood flow.
CerefolinNAC® (pharmaceutical grade Medical Food) may be of benefit for concussion because of the higher doses of purified L-methylfolate, Methylcobalamin, and N-acetyl cysteine.  Most affordable when ordered from Brand Direct Pharmacy online.

Dr. Brown

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Dr. Craig Brown!