Allopathic View of Natural Products for Migraine - Dr. Carolyn Dean MD ND

Allopathic View of Natural Products for Migraine

January 11, 2021

A Medscape Quiz “Any ‘Natural’ Products Effective for Migraine?” began with the case of a 43-year-old woman who had a 15-year history of frequent migraines and wanted to take “a natural product” to try and reduce the frequency of her headaches. She has been treated in the past with beta-blockers and tricyclic antidepressants and did not like the side effects.

I was curious to see what would be offered because I know migraines and headaches can be related to magnesium deficiency. My Online Magnesium Deficiency Survey of over 100,000 people shows a 40% incidence of migraine and headache so I know it’s a common complaint.

What did allopathic medicine have to offer? The first question on the quiz was:

Which of the following has been demonstrated in controlled clinical trials to be effective for migraine treatment and prophylaxis?

  1. Ginkgo biloba
  2. Folic acid
  3. Riboflavin
  4. Selenium

Of course, magnesium wasn’t even mentioned. Also, to me this is a trick question because how many controlled clinical trials of natural products have been carried out on migraine patients?

The answer is apparently Riboflavin, vitamin B2. The evidence is that riboflavin lessens oxidative stress, mitochondrial dysfunction, and neuroinflammation. The authors cite a 20-year old 3-month study of 55 migraine sufferers. They supposedly chose the study because it fit the “gold standard” of being placebo-controlled and randomized. The results found that two thirds of patients treated with 400mg of riboflavin reported at least a 50% reduction in headache frequency compared to 15% in the placebo group. A review article examined 11 clinical trials in both adults and children that were shorter and with fewer participants but the majority showed a consistent positive effect.

That is all well and good but 400mg of Vitamin B2 is a huge dose. Such a high dose will be synthetic and it can throw the other B vitamins out of balance. It is the typical high dose, medicinal approach of allopathic medicine when it tries to work with natural products.

The next question on the quiz mentions the case of a 23-year-old woman whose migraines are becoming more frequent occurring 6-8 days per month. Doctors are asked “Which of the following treatments has evidence for migraine prophylaxis?

  1. Verapamil
  2. Feverfew
  3. Amitriptyline
  4. Butterbur
  5. Lisinopril

Even though this was a quiz about natural products, 51% of doctors checked off the antidepressant Amitriptyline. However, apparently Butterbur is being used for migraine prophylaxis. And I haven’t even heard of this use – probably because ReMag and my B vitamin formula, ReAline work so well.

The discussion about this herb begins with the statement that “Use of butterbur is more controversial than riboflavin. A randomized, parallel-group study of over 200 patients had a positive response rate of 45%, three times better than placebo. Other smaller studies showed similar and even better results.

However, a strong word of caution came with the “endorsement” of butterbur. Pregnant and breast-feeding women should not take this herb and “Some butterbur products may contain pyrrolizidine alkaloids (PAs) — a major safety concern.” PA can cause liver and lung damage, possible thrombosis and cancer.

The 2012 American Headache Society and the American Academy of Neurology guidelines stated that butterbur had evidence for use and was a valid option for patients with migraine. Then they questioned their recommendation because of safety concerns.

There were only 4 comments on the article. Two of the 4 comments mentioned magnesium for the treatment and prophylaxis of migraine and I added the following comment from my “Magnesium Miracle” book. “Dr. Alexander Mauskop, working with the Alturas, has proven the connection between migraines and magnesium many times over and puts magnesium treatment into practice at the New York Headache Center.”[1] [2] [3]

Here is an except from Chapter Four of “The Magnesium Miracle:”

THREE THINGS YOU NEED TO KNOW ABOUT MAGNESIUM AND MIGRAINES

1. Magnesium prevents platelet aggregation and the thickened blood and tiny clots that can cause blood vessel spasms and the pain of a migraine.

2. Magnesium relaxes head and neck muscle tension that makes migraines

worse.

3. Magnesium, vitamin B2, and the herb feverfew are an important migraine therapeutic triad.

MIGRAINE MECHANISMS

Twenty-five million Americans suffer from migraines. Statistically, more women experience migraines than men, especially in the twenty-to-fifty-year age group. The following biochemical events involving low magnesium have been identified in migraine sufferers and may set the stage for a migraine attack.[4]

* In non-menopausal women, estrogen rises before the period, causing a shift of blood magnesium into bone and muscle. As a result, magnesium levels in the brain are lowered.

* When magnesium is low, it is unable to do its job to counteract the clotting action of calcium on the blood. Tiny blood clots are said to clog up brain blood vessels, leading to migraines. Several other substances that help create blood clots are increased when magnesium is too low.

* Similarly, magnesium inhibits excess platelet aggregation, preventing the formation of tiny clots that can block blood vessels and cause pain.

* Low brain magnesium promotes neurotransmitter hyperactivity and nerve excitation that can lead to headaches.

* Several conditions that trigger migraines are also associated with magnesium deficiency, including pregnancy, alcohol intake, diuretic drugs, stress, and menstruation.

* Magnesium relaxes blood vessels and allows them to dilate, reducing the spasms and constrictions that can cause migraines.

* Magnesium regulates the action of brain neurotransmitters and inflammatory substances, which may play a role in migraines when unbalanced.

* Magnesium relaxes muscles and prevents the buildup of lactic acid, which, along with muscle tension, can worsen head pain.

A group of 3,000 patients given a low dose of 200 mg of magnesium daily had an 80 percent reduction in their migraine symptoms.[5] This 2001 study did not have a control group, so the results could be questioned, but it aroused a great deal of excitement and triggered a flurry of research on magnesium and migraines. Much of that research was done by Dr. Alexander Mauskop, director of the New York Headache Center, working with Drs. Bella and Burton Altura, who have been studying migraines and migraine treatments for many years. This research team consistently found that magnesium is deficient in people with migraine and many other types of headache and, even more important, that supplementing with magnesium alleviated headaches.

Dr. Mauskop with the Alturas undertook many research studies using sensitive magnesium ion electrodes.[6] During one of their first studies they found a deficiency in Ionized Magnesium but not Serum Magnesium in migraine patients.[7] This discrepancy highlighted the lack of correlation between magnesium-deficient states and Serum magnesium. This is because only 1 percent of the magnesium in the body is found in the blood (serum). A measurement of magnesium ions, the active form of magnesium, is much closer to the total amount of magnesium in the body and indicative of magnesium-deficiency disease.

NOTE: You can do your own experiment to identify food allergies that may trigger migraines by following an elimination diet for 3 weeks and then testing foods individually such as: gluten, milk, sugar, yeast, corn, citrus and eggs.


[1] Mauskop A, Fox B, What Your Doctor May Not Tell You About Migraines. Warner Books, New York, 2001.

[2] Mauskop A et al., “Deficiency in serum ionized magnesium but not total magnesium in patients with migraines. Possible role of ICa2/IMg2 ratio.” Headache, vol. 33, no. 3, pp. 135–138, 1993.

[3] Mauskop A et al., “Intravenous magnesium sulphate relieves migraine attacks in patients with low serum ionized magnesium levels: a pilot study.” Clin Sci (Colch), vol. 89, no. 6, pp. 633–636, 1995.

[4] Weaver K, “Magnesium and migraine.” Headache, vol. 30, p. 168, 1990.

[5] Mauskop A, Fox B, What Your Doctor May Not Tell You About Migraines, Warner Books, New York, 2001.

[6] Mauskop A et al., “Deficiency in serum ionized magnesium but not total magnesium in patients with migraines. Possible role of ICa2/IMg2 ratio.” Headache, vol. 33, no. 3, pp. 135–138, 1993.

[7] Ibid

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