Margaret Moss looks at the macro and micronutrition that may be implicated in headache and migraine.

It was a really hot day. Jim groaned that his head was killing him, and he’d left his paracetamol at home. Lucy said he could have one of hers, and she would have one too.

‘ Hang on,’ said Frances. ‘All you’ve had since coming to work this morning is two cups of tea and tea is a diuretic. You are both dehydrated. It’s boss’s orders. Go and have two glasses of water each, and see if that helps.’
After a while, Jim did feel better. Lucy was still groaning. ‘You never have any salt, do you? And you go dizzy when you stand up. I bet you’ve sweated your salt out, and you won’t feel good till you have some.’ There wasn’t any salt in the office, but Lucy had a packet of crisps out of the machine, and soon felt better too.

Sally ached a lot, and had migraines once a month. The
doctor gave her ibuprofen for her aches, and Migraleve for when she had a migraine. She was afraid to take ibuprofen, as she knew it could cause ulcers. Was there something nutritional that she could do to make her feel better?

Sulphation
Sulphate is made by the body and has many uses. People with migraine tend to be inefficient at making sulphate.
Sulphate is made from cysteine, an amino acid, one of the building blocks of protein.

Healthy people have an average cysteine: sulphate ratio of about 100. When we tested a group of my clients with migraine, we found their average was 1922!

Histamine.
Sulphate attaches to histamine, preventing inflammation.

Leaky Gut
Sulphate is needed to prevent the gut from leaking. A leaky gut allows food components to reach the bloodstream before they are sufficiently broken down. They are then circulated around the body in the blood and can cause a variety of apparently unrelated symptoms.

Enzymes
Sulphate is needed for making digestive enzymes, which break down proteins, carbohydrates and fats, so they can be converted to energy, hormones, muscles or skin.
Because they do not make enough sulphate, people with migraine often have poor activity of their digestive enzymes. Oranges, radishes and spinach slow down the enzymes that transport sulphate.

Detoxification
The body uses sulphate for detoxification by attaching it to harmful chemicals, including amines and phenols, in order to excrete them. People with migraine have difficulty in tolerating these chemicals because of their low sulphate levels.
Phenols come in many foods, like onions, kale, soya, green beans, apples, broccoli, olive oil and celery. They also come in herbs containing plant oestrogen. Bioflavonoids are phenols (so Vitamin C with bioflavenoids could cause problems).
Red wine and red grapes contain phenols.
A lot of household cleaning chemicals are high in phenols.
(Simple phenol-free chemicals can be substituted: sodium bicarbonate for cleaning the fridge and cooker, soda crystals for washing the floor, dishes and clothes, and borax for disinfecting the toilet.)
Amines come in strong cheeses, chocolate, sour cream, over-ripe bananas, sauerkraut,
vinegar, salami and smoked fish.

Improving sulphation
I suggest that my patients avoid the food and chemicals which require high levels of sulphate to process properly, while increasing their sulphate intake.
Sulphate is best absorbed through the skin. I suggest Epsom salts (magnesium sulphate) - a whole cup in the bath,a few times a week.

Returning to Sally
Sally knew that vitamin C with bioflavonoids upset her, as did red wine. Luckily she hated spinach, but she resolved to stop drinking her daily orange juice.
Sally’s mother had rheumatoid arthritis, and her brother had
irritable bowel syndrome. These conditions are also often related to problems making or using sulphate.

Omega 3, fish oils & Vitamin A
I found that Sally consumed lots of trans fats in the hydrogenated oil in her biscuits. She rarely had fish.
It would be a good idea if she had plenty of fish, maybe every
other day, or else took a good quality fish oil from the flesh of fish, and not from the liver.

The Vitamin A in cod liver oil might make the migraines more frequent (see below) and anyhow, any contamination in the fish is likely to be concentrated in the liver. Nuts and seeds help as they provide vitamin E, which protects fish oil from being oxidised.

Menstruation & magnesium
Sally’s migraine often came a little before her periods. Having good oils, in nuts, seeds and fish helps prevent premenstrual problems, as do B vitamins, magnesium and zinc. The magnesium in the Epsom salts would be useful. Magnesium supplements have been found to be helpful in migraine.

Anti & probiotics
Sally had had antibiotics recently. She agreed to take some Lacto-bacillus Acidophilus and Bifidobacterium Bifidum, beneficial bacteria, to replace gut bacteria that may have been killed off by the antibiotics. Beneficial bacteria provide us with B vitamins.

Ginger
Sally agreed to incorporate ginger into her diet, and to have a ginger drink at the onset of the aura. Ginger, taken early on, has been found to be helpful in preventing and treating migraines.

Blood sugars & sweeteners
I explained that having tea, coffee or sugar also raises the blood sugar too fast. The pancreas responds by lowering the blood sugar quickly, leaving it too low. Low blood sugar leaves one more vulnerable to migraine.

I said to avoid coffee and tea, which are bad for the arteries, and have a diet that is low in sugars. She might well have a nasty migraine as a withdrawal symptom, but it would be worth it.
Sally asked if the glycaemic index (GI) diet would help but I suggested that this diet might not be ideal. Whatever you do, don’t replace sugar by aspartame. Additives including aspartame, monosodium glutamate, colourings, and preservatives in ham, bacon and sausage can provoke migraine.

Parsley, other vegetables, chromium, manganese, magnesium and B vitamins all help to keep blood sugar steady. Eat four
servings of vegetables and one of fruit a day, rather than lots of fruit, and not much vegetable.

Lectins
Sally had various aches and pains, and not just migraine. Lectins
(proteins that bind to carbohydrates) in whole grains, and in
pulses with their skins on, are involved in making uncomfortable rheumatic patches. Rheumatic patches in the neck are implicated in migraine.
Yes, refined grains have fewer nutrients than whole grains, but they cause fewer problems too. Red lentils are a nourishing food, and less likely to cause rheumatic patches than kidney beans.

Vitamin B2 - riboflavin
Riboflavin, of all the B vitamins, has been found to be particularly useful against migraine. This is a bright yellow substance and is needed for sulphate production.
Boron supplements should be avoided, because boron causes us to excrete riboflavin. Boron in tomatoes, peppers, apples, apricots, apple juice and cider is also unhelpful.
Purines in red meat, mackerel, herring and sardines need to be processed by vitamin B2 and molybdenum, and this can cause someone to make less sulphate.

Vitamin A
I have found that some of my clients, who have consumed a lot of vitamin A and carotene, recover from migraine by avoiding them in supplements, and avoiding liver, carrots, mangoes, and dark green vegetables, which contain a lot of vitamin A or carotene. Of course we need these substances, but not too much. The amounts that different people tolerate vary greatly.

Food isn’t everything
Migraines can be provoked by old fluorescent light tubes, candles,
perfume, fresh paint and varnish, and pesticides.
To economise on power, turn off unwanted light bulbs, rather than using low energy fluorescent bulbs. Use low solvent, or solvent free paint. Eat organic as much as you can afford to.

What then should a migraineur eat?
I suggested Sally have plenty of fish, vegetables, poultry and pork; a little sea salt; a little fruit; red lentils; nuts without skins, like macadamia nuts, cooked cashew nuts, and blanched almonds; white rice, organic white bread, tapioca, sago, and rice milk. She would bath in Epsom salts, and take an individually tailored, well-balanced mix of vitamins and minerals.

She reported that the withdrawal migraine was horrible, but she hadn’t had any attacks since, and other symptoms she had
forgotten to mention had also
disappeared.

To consult Margaret contact the Nutrition and Allergy Clinic 0161 432 0964 www.nutritionandallergyclinic.co.uk

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