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Hormones and Migraines

More and more women come to see me with concerns about headaches; particularly migraines. Most of these women have been worked up by neurologists and have tried numerous prescription drugs that are either ineffective or cause unacceptable side effects.

Nancy, age 46, described years of migraine occurrences that started shortly after menarche. The timing was a big clue for me. Although she experienced the headaches in a random and frequent pattern, she ALWAYS had one the day before her menstrual flow each month. After trying several medications, including the birth control pill which actually caused an increase in the headaches, she consulted me.

Fluctuations in hormones affect the dilation and constriction of our blood vessels. Treatment focusing on balancing hormonal fluctuations typically eradicates this type of migraine. Nancy had a multitude of other hormonal symptoms in her premenstrual phase. Her appetite, especially for sweets increased. She became constipated and more fatigued. Her temper quickened and she felt agitated and foggy headed for the week prior to the onset of her menstrual flow. Her menstrual cycle was regular, but she consistently had a very heavy flow lasting 7 days. She had been slightly anemic in the past and used an iron supplement reluctantly as it caused constipation.

She had excellent blood test results that her PCP had ordered. I ordered additional tests including DHEA sulfate, Pregnenolone, and RBC Magnesium.

Nancy had tried Feverfew in the past. Many of my patients have reported no help from Feverfew, yet I was not convinced that the failure was actually due to Feverfew not working but more likely from a poor quality Feverfew product. While waiting for the lab results to come back, I started Nancy on Vital Nutrients Feverfew 0.7% 120 mg, one capsule two times daily between meals. When she returned for her follow up visit three weeks later, Nancy reported a 50% reduction in migraine occurrence and a slight decrease in the severity of pain. As I expected, her Pregnenolone was below detectable limits and her RBC magnesium was in the low normal range. DHEA was normal.

Although already encouraged with just the addition of Feverfew, Nancy started Pregnenolone 10 mg- 1 capsule before breakfast, Triple Mag- 1 capsule at dinner, PMS Support- 1 capsule 2 times daily starting 10 days after the start of her menses continuing until the menstrual flow started, OsteoNutrients -3 at bedtime and MultiNutrients with Iron and Iodine- 2 capsules two times daily with food. At her two month follow up, Nancy reported only having 1 mild headache since her last visit. Her energy was improving and her menstrual flow at her last cycle was 5 days in duration and considerably less heavy.

I have seen Nancy for over 3 years since her initial visit and she has had only a few headaches in that time period. We have reduced both the Pregnenolone and PMS Support as her laboratory values have improved and she has not used Feverfew in almost a year.

I could write dozens of cases similar to this with equally good results. I have also found that women with sleep disturbance who suffer from chronic migraines benefit greatly from the addition of Melatonin (I start with 3mg each night between 8-9 p.m., regardless of bedtime) to the above regimen. For further information see: Toglia, JU Melatonin: a significant contributor to the pathogenesis of migraine in Med Hypothesis 2001 Oct; 57 (4):432-4.