Hormones and Migraines

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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

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