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The Case for Testing a Migraine Headache Patient's Adverse Reactions to Foods
(c) Immuno Laboratories, Inc.

About Migraine Headaches

Migraine is a kind of headache, which is severe and usually affects one side of the head. Migraine headache is caused by the narrowing and dilating of blood vessels on one side of the brain, and might continue for a few hours up to a period of two days. Migraine headache may worsen due to exposure to light. During Migraine headache, the patients suffer from periodic attacks of hemicranial pain, vomiting, photophobia, tiredness, irritability, and impaired concentration.

Migraine headache is of two types -- Common and Classical. During common Migraine there is a slowly developing severe headache that lasts from a few hours to two days, and is accompanied by nausea and occasional vomiting, with the condition worsening even at a slightest movement or noise. In Classical Migraine, prodrome or forewarning precedes the headache that is about half an hour before the onset of the actual headache, and is usually severe and of long duration. The symptoms of Classical Migraine include a temporary loss of vision, focussing problems, blind spots and flashing lights; possible speech problems; Occasional weakness or temporary paralysis of the limbs or extremities; nausea and vomiting; and sensitivity to light.

Migraine headache patients also report to have symptoms of neck pain, tenderness of the spinal joints of the neck, and limited ability to move the neck. However, the symptoms depend on the area affected. People between the ages of 25 to 44 years commonly suffer from Migraine, but children too are susceptible to the disease.

Causes of Migraines

Migraines have confounded many a researcher as to what causes Migraine attacks in some people while it does not affect others at all. However, almost all researchers who studied Migraine are of the unanimous view that Migraine is a hereditary disease since a family history of the condition has been traced by 70-90% of patients suffering from the disease. This also lends credence to the belief that some people are more prone to Migraine attacks than others, which is owing to possible genetic differences, probably in cell energy production.

According to researchers, Migraine, which is an allergic disease, may occur at night, during sleep, and usually happens on a cyclic basis through monthly and seasonal changes. Patients having Migraine headache suffer from fever, and upon waking up in the morning are likely to be more congested or suffering from headache, besides experiencing another peak in the late evening the same day. Researchers also found out that Migraine reactivity in the patients peaks at around 3 am. For women, Migraine headaches usually occur during the premenstrual week due to ovarian or pituitary hormonal changes.

Certain factors, called triggers, are known to cause Migraine headaches in individuals that greatly vary from person to person. The triggers include food allergies, skipping meals, too little sleep, too much sleep, certain chemicals, stress, vigorous exercise, car exhaust, caffeine, head trauma, fatigue, bright lights, and flashing lights.

Research has brought to light the fact that the pain of Migraine headache originates from blood vessels that supply blood to the brain. During the first stage of the Migraine headache, brain disturbances caused by Migraine can be stroke-like, and is most likely to occur before the pain is to develop. However, Migraine headache, in its more serious forms, can lead to causing stroke because during this stage active constriction of arteries, supplying blood to the brain compromise brain blood flow.

Adverse Reaction to Foods of Migraine Patients

For over 100 years medical literatures have propounded and established that dietary components have been playing an active role in the causing of Migraine headache. Hippocratic texts too have pointed out that Migraine headache and food intolerance are ancient phenomena. However, Living's classic monograph of 1873 was the first to unambiguously describe that Migraine headache attacks were indeed provoked by dietary components, and also cited four cases of food-induced migraine to prove this. Besides, several reports linking Migraine with food were published during the first half of this century. As such, researchers have pointed out that phases of the Migraine headache process are affected by dietary triggers by influencing release of serotonin and norepinephrine, causing vasoconstriction or vasodilatation, or by direct stimulation of trigeminal ganglia, brainsteam, and cortical neuronal pathways.

In Migraine headaches, diet has proved to be an important factor. According to a study, Migraine patients with respect to diet have been categorized into three main types. The first category of Migraine patients are those for whom all Migraines are caused by food reactions. They are estimated to be approximately 1/6 of all Migraine patients. In the second category, those Migraine patients come for whom foods is not at all accountable in their conditions. The third category belongs to those Migraine patients for whom foods may be triggers for attacks during times of increased susceptibility, particularly at times of stress.

Adverse foods reactions in Migraine headache patients are of two main types. In the first type, reaction takes place owing to specific chemicals found in certain foods, whereas the second one is general food intolerance. Usually, food reactions can take place anywhere from one-and-a-half hour to 12 hours after the food is ingested.

Published studies link food to Migraine headache relief

Undoubtedly, adverse foods reactions play a vital and big role in the condition of numerous migraine patients. According to studies, the condition of about 40% Migraine headache patients showed signs of remarkable improvement when certain foods were removed from their diet which they were reacting to. Another study indicated that about 90% of children reported that they stopped getting Migraine headaches completely when they took recourse to an allergy avoidance diet.

For several years now researchers have been able to deduce Migraine headache as one of the best examples of food reactive problems, and have drawn linkage between food ingestion, the circulating immune system and brain disturbances. As a matter of fact, for some of the Migraine patients single foods such as coffee, chocolate, and junk foods, can act as headache triggers, while alcoholic beverages are understood to be common triggers. Besides, normal food components such as milk, wheat, barley, rye, oats, corn, eggs, peanuts, soy, almonds, cashews, oranges and fish, can also sometimes act as headache triggers.

Foods, among other Migraine triggers includes processed meats containing high levels of nitrates and nitrates; and Tyramine-containing foods such as aged cheeses, nuts, beans, yogurt, beer, wine, pickled herring, chicken liver, yeast, coffee, citrus and canned figs, bananas, eggs, oranges, spinach and tomatoes. Food additives such as Monosodium glutamate (MSG) also cause Migraine attacks. Even, some spices as well as garlic and onion are also understood to be possible triggers of Migraine attacks. Besides adverse foods reactions, Migraine headaches, called Hunger and hypoglycaemic headaches, are triggered when patients skip their meals.

More Research on Migraine Patients and the food connection

Ever since the 1920s various researchers started conducting studies on Migraine patients by examining and manipulating the diets of individuals who were suffering from the disease. During their trials the researchers undertook elimination diets methodology. In 1930, researchers conducted a study on 55 Migraine patients among whom 29 patients (or 52.7%) reported complete or near-complete freedom from symptoms while 21 patients (or 38.2%) reported a partial improvement, when allergenic foods were avoided. Another study was conducted on 127 Migraine patients in 1935 with the help of an elimination diet, in which partial or complete relief of symptoms were reported by 66.3% of the patients. According to a study by Heymann in 1952, foods reactions proved to be the cause of Migraine in 15 of 20 patients.

In 1979, Grant conducted trials on 60 Migraine patients by using an elimination diet for determining food intolerances. He found out that when an average of ten common foods such as wheat, orange, eggs, tea and coffee, chocolate and milk, beef, corn, cane sugar, and yeast, were avoided the number of headaches per month fell dramatically with nearly 85% of patients becoming headache-free. In 1980, Wilson et al conducted skin-prick test on Migraine patients who were challenged with food antigens, and showed that there was a significant correlation between specific food allergens and the development of Migraine headaches.

In 1983, Egger et al conducted a double-blind controlled trial of oligoantigenic (limited food) diet consisting of one meat (lamb or chicken), one carbohydrate (rice or potato), one fruit (banana or apple), one vegetable (brassica), water and vitamin supplements, on 88 children with severe frequent Migraine, 93% of them reported significant improvement. During the process, the patients who did not respond to the first diet were treated to an optional diet that consisted of none of the foods in the first diet. In order to verify that the foods were in fact causing the migraine, after 3 or 4 weeks, in a double-blind format, excluded foods (one at a time) were reintroduced to patients who had no headaches or only one during the last 2 weeks of the diet. 26 of 40 patients or 70% reported to have experienced Migraine challenges after the reintroduction of provocative foods.

Food allergy as a cause of Migraine was studied by Mansfield et al in 1985 during which he conducted trials on 43 adults with recurrent Migraine with the help of Skin testing, elimination diets, double-blind challenges, and measurement of plasma histamine. There were 13 patients on a diet free of milk, egg, corn and wheat, and all the patients reported 66% or greater reduction in headache frequency. Migraine was provoked in 5 of 7 patients who were put on double-blind challenges, while placebo challenges did not report any Migraine case.

In 1985, Hughes et al conducted studies on 19 patients for assessing Migraine with the help of nutritionally supported fast (NSF) and nutritional supportive diet (NSD). The study concluded that during the fast all the 19 patients noted exacerbation of symptoms that was followed by nearly complete relief of symptoms, which the researchers, however, interpreted it as indicative of addictive withdrawal associated with food sensitivities. The patients were put on a trial of 3 to 18 months, and they continued to report improvement during the entire period.

According to studies, it is widely believed as per current estimates that approximately 30-40% of Migraine patients will continue to show marked improvement in their symptoms through the elimination of certain food items. However, on the contrary, some studies indicate that significant improvement will be witnessed in nearly 88-93% of Migraine patients resorting to dietary changes.

Conclusion

Several studies conducted over years conclusively prove that certain foods are linked to the exacerbation of Migraine headaches in most of the patients. As such, the list of foods acting as Migraine triggers may be exhaustive. The best way to deal with Migraine headache problems is to sufficiently educate the patients about all that causes the disease and how to avoid it. It becomes necessary for the patients to make themselves aware of the potential and possible triggers, and identify the food accordingly so that they may not have to face any such problem. Also, the patients would do well to maintain a diary and note down his/her Migraine headache condition on a daily basis in order that the problem is effectively treated.

References

1. Blau JN. Migraine: theories of pathogenesis. The Lancet. 1992; 339(8803):1202-7
2. Living E. On Megrim, Sick Headaches and Some Allied Disorders. J & A Churchill, London. 1873
3. Pagniez P, Vallery-Raddt P, Nast A. Therapeutique preventative des certaines migraines Presse Med (Paris). 1991; 27: 172
4. Brown RC. The protein of foodstuffs as a factor in the cause of headache. Wisconsin Med J 1920; 19: 337
5. Minot GR. The role of a low carbohydrate diet in the treatment of migraine and headache. Med Clin N Am 1923; 7: 715
6. Rowe A. H. Food Allergy Its Manifestations, Diagnosis and Treatment. Lea and Febiger, Philadelphia, 1931
7. Sheldon J.M., Randolph T.G. Allergy in migraine-like headaches. Am J Med Sci 1935; 190:232-237
8. Unger A.H., Unger L., Migraine is an allergic disease. J Allergy 1952; 23: 429-440
9. Balyeat RM, Brittain FL. Allergic migraine. Based on the study of fifty-five cases. Am J Med Sci 1930;180:212-221
10. Sheldon JM, Randolph TG. Allergy in migraine-like headaches. Am J Med Sci 1935;190:232-236
11. Heymann H. Migraine and food allergy. S Afr Med J 1952;26:949-950
12. Mansfield LE. Food allergy and headache. Whom to evaluate and how to treat. Postgrad Med 1988 May 15;83(7):46-51, 55
13. Grant EC. Food allergies and migraine. Lancet 1979;i:966-9
14. Egger J, Carter CM, Wilson J, et al. Is migraine food allergy? A double-blind controlled trial of oligoantigenic diet treatment. Lancet 1983;ii:865-9
15. Hughs EC, Gott PS, Weinstein RC, Binggeli R. Migraine: a diagnostic test for etiology of food sensitivity by a nutritionally supported fast and confirmed by long-term report. Ann Allergy 1985;55:28-32


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