Migraines: More than Just Headache

(This is a slight retooling of an article originally published in 2017).

Migraines aren’t just bad headaches. They’re “special” headaches. In addition to the headache itself, migraine sufferers can experience neurologic symptoms like sensitivity to smell and sound, digestive distress, mood disturbances, and stiff neck. These symptoms may occur hours or days before the headache; when the headache comes, these symptoms may go away, or they may get worse, amplified by physical activity, light and sound.

To further complicate things, some people have all these other neurologic symptoms without a headache. These “silent migraines” can be scary if you don’t know what’s happening. 

Anyways, after the episode passes, it’s common to feel tired and have difficulty concentrating for a day or two. Some people have one or two migraines their entire lives, often after periods of sustained, intense stress. Others may have four or five migraines a month.

For all the pain they cause, migraines are still poorly understood. We used to think that migraines were caused by blood vessels in the brain constricting, and then bouncing back. Now researchers believe this is a symptom of underlying brain dysfunction, where waves of activity sweep through the brain. And as to why it happens… still, poorly understood.

SO – let’s talk natural medicine. Bear in mind, everything I’m going to write about works differently than the others; everything is potentially complementary. You can try one or two, or all of the suggestions together if you need to.   

CAFFEINE: It’s natural, and it works

The headline says it all. Just because it’s in over-the-counter medications doesn’t mean it’s not natural! You can read about caffeine elsewhere. Try a big cup of coffee when you sense a migraine coming on. Combines well with CBD, too. See below for CBD. 

MELATONIN: MORE THAN JUST THE “SLEEP HORMONE”

Melatonin is a hormone produced in the pineal gland at the base of the brain when light stops hitting our eyes. Basically, it tells you when to sleep. But its effects are farther reaching than just that. Sleep is when the body repairs itself, and it turns out there’s research connecting melatonin supplementation with improvements in everything from irritable bowel syndrome and reflux to immune function and even cancer.

AND migraines. In one of the more impressive trials, 196 adults, averaging 7.3 migraine days per month, were randomized to receive either placebo, 25 mg of the drug amitriptyline, or 3 mg melatonin at night.

After 3 months, the melatonin group had 2.7 fewer migraines days per month, vs. 2.2 fewer in the amitriptyline group, and 1.1 fewer in the placebo group. The entire melatonin group reported 16 total side effects vs. 46 in the amitriptyline group. And – nobody is sure why this happened – patients in the amitriptyline group gained a little more than 2 pounds over the course of the study versus a very slight weight loss in the melatonin group.

Melatonin should be taken nightly, not just when you feel a migraine coming on. Melatonin has been studied in children as young as five.  

MAGNESIUM: ESSENTIAL MINERAL TO RELAX MUSCLES & MIND 

Magnesium is found in whole grains, beans, nuts, seeds, fruits, and vegetables. In other words, in whole, unrefined foods. It is almost absent in many refined and processed foods. Diets high in calcium also increase the need for magnesium. So, it’s easy to be deficient.

Magnesium has been reasonably well researched with migraines. Results have been mixed, with most trials showing slight or moderate benefit.
I’d argue that magnesium is pretty effective at preventing migraines – more so than a quick glance at the research would suggest. That’s because the published trials tend to use less bioavailable forms of magnesium such as magnesium chloride or magnesium sulfate. Or, at best, magnesium citrate (average, but not very good). 

My suggestion is to use a nice, robust dose of highly bioavailable magnesium glycinate or magnesium threonate. A good regimen is 600-1,200 mg of magnesium as glycinate per day, in divided doses. Or 150-300 mg as threonate.   

And ladyfolk rejoice: magnesium is safe during pregnancy and may be especially valuable for migraines associated with your period. 
It may take 2-3 months of regular use before it starts to work. Be aware that high-dose magnesium may cause loose stools – although less likely with the bioavailable forms. 

RIBOFLAVIN: VITAMIN B2 FOR MITOCHONDRIAL ENERGY AND NEUROLOGIC FUNCTION  

Mitochondria are the energy-generating power plants of our cells. Often, migraine sufferers have abnormalities in mitochondrial function. Vitamin B2 can help. 

Vitamin B2 has been the subject of clinical trials with migraines going back decades. A 2017 review published in the Journal of Clinical Pharmacy and Therapeutics compiled data from the nine best ones. (“Best” as in best-designed, not necessarily best results.) In all five trials with adults, B2 was effective. In the four with children, it was a mixed bag (but mostly effective). 

A standard dose is around 400-500 mg a day in divided doses. You generally take it for a number of weeks before it starts to work. 

BUTTERBUR: the herb for allergies, migraines, and more 

Butterbur is used for two things. First, it blocks the allergic response. We’ve written about that elsewhere. It also relaxes smooth muscle spasms, especially when caused by overactive nerves. Smooth muscle is the kind of muscle that lines the organs and tubes in the body (as opposed to skeletal muscle, which moves our limbs). Smooth muscle spasm is key to asthma, urinary incontinence (“overactive bladder”), and also involved in migraines.

 In the largest study to date, 245 adults who averaged at least six migraines per month were randomized to receive either 100 mg or 150 mg of butterbur extract a day, or placebo. After four months, the people on 150 mg a day were experiencing 48% fewer attacks vs. 36% fewer at 100 mg a day, and 26% fewer with placebo. The most common side effect was burping.

The root is used medicinally. But it contains pyrrolizidine alkaloids (PAs). The data here are controversial, but there is some indication that PAs may be rough on the liver. Until this is fully resolved, it is probably wise to use store-bought products that are extracted to remove the PAs. A standard dose is 50 mg extract standardized to 15% petasins (so 7.5 of petasins), three times a day. This is another one we take for two-three months.    

TWO BRAND-NAME PRODUCTS  

I try not to endorse brand-name products in writing. But there are exceptions.

Butterbur Extra. from the Vitanica company, is a simple product in the sense it’s not very “creative.” It simply takes most of what I’ve talked about (which is to say, most of what has been researched) and combines it in one bottle. A serving has 400 mg of high-quality magnesium, 400 mg of vitamin B2, a standard dose of butterbur, plus additional herbs feverfew and ginger. It’s a great formula for everyday use.

Clear Migraine from Clear Products is different. It combines herbs from the Chinese tradition with remedies from the homeopathic medical system to address pain, spasm, inflammation, and blood vessel constriction. I’m not sure if anything here is actually researched. But the net effect is something that actually works. At least for many people it does. The nice thing about it is, if it does work, it works relatively quickly. You take it when you’ve got one. You’ll know soon enough.

Debra asked me to share this email she received from a customer about Clear Migraine: “The Clear Migraine capsules worked. Within hours my son was up and around and actually asked me to go on a walk OUTSIDE with him (which is unusual even when he’s feeling well). If it were socially-distancing-acceptable, I’d come give you the biggest, squeeziest hug! Thank you thank you thank you! A miracle, for sure. (We’ve been to specialists, to doctors, none of whom helped one iota. This is like magic.)”

CBD and Cannabinoids: Pain and Stress

  If you have typical, headache-oriented migraines with pain, it’s really worth looking at CBD. CBD reduces stress, and it reduces pain. I tend to recommend 20-30 mg of CBD per dose for garden-variety pain and garden-variety stress.  Here I’ll suggest more.

The people I speak with who use CBD for migraines tend to use 50-150 mg, all at once. The idea is, you don’t just take CBD throughout the day to manage the pain. You take a lot all at once to sort of intercept or “head off” the pain. My suggestion is, start with 20 or 30 mg. Take another 20-30 in 2 hours. Take another 20-30 in two hours… until it works. Once you figure out the total dose that works, next time a migraine is coming on, jump into that total dose right away. 

Gajar ka Halwa

Rich Carrot Dessert Porridge with Cardamom+ Cashews

This dessert is easy to make. It requires patience, but no skill. It’s also grain-free, and about 50% vegetable; rich with dairy, and sweet with jaggery. Toddlers love it. Grown-ups devour it. “Gajar” (carrot) halwa may be the most familiar halwa, but you can also make halwa from beets, summer squash, even grains or red lentils. 

You’ll see other gajar ka halwas that are golden-reddish-amber in color, glowing and almost translucent. Meanwhile, this one is a little dusky. That’s because they use white sugar, and we use dark, rich jaggery. Also, we don’t peel the carrots. Trust me: this one is pretty enough, and it also tastes better. Plus, it’s more nutritious. I love jaggery, by the way. It has such a rich flavor. I make ice cream with it. I make cobblers with it. It’s the secret ingredient in the Debra’s kitchen oatmeal raisin cookies.

ANYWAYS — you can serve halwa warm or cold. You can even press it flat into a casserole pan about an inch deep, and chill it so it firms up. Then you cut it into rectangles or trapezoids for serving, like brownies you eat by hand. I strongly suggest serving it warm and soft, with a spoon, with vanilla ice cream.

Serves 8 nicely

¼-½ cup cow ghee ¼ C cashews or combination raw nuts
2 pounds carrots, grated medium fine 6 cups whole milk
1+ cup jaggery (crude unrefined sugar)1 generous tsp cardamon powder

Optional: 10 saffron threads, ¼ C golden raisins

Optional Substitutions: coconut milk for milk (use less); date or maple sugar for jaggery; coconut oil for ghee.  You can also use a spiced ghee like the chai-infused ghee from Ahara Rasa, new on our shelves this month.

1. Melt 1 Tbsp ghee over low heat in a large, wide, heavy bottom pot. (Wide and heavy are both important. Wide, so step 2 reduces faster. Heavy, so nothing burns).  Fry the cashews, stirring constantly. Then stir in the optional raisins until plump and shiny. Remove and set aside.       

2. To the same pot, add carrots, milk, and optional saffron. Cook at medium, stirring frequently, until milk has almost fully absorbed/evaporated.  You’ll see that when you push or stir the halwa aside, the liquid doesn’t fill back in again. This may take an hour.  

3. Add jaggery, and the halwa will become syrupy again. Cook until the jaggery is mostly absorbed, another 5 or so minutes. Use a little more jaggery if your carrots weren’t very sweet to begin with. 

4. Add the remaining ghee, and cardamon powder. Cook 4-5 more minutes. Garnish with nuts and raisins. You can do it up all pretty and geometrical like in the photo, or just scatter them.   

the Many Uses of Raw Apple Cider Vinegar

In 420 BCE Hippocrates used raw apple cider vinegar to clean wounds. Sung Tse, the 10th century creator of Chinese forensic medicine, advocated washing hands with a mixture of sulfur and raw vinegar to avoid infection during autopsies, and Roman soldiers mixed raw apple cider vinegar (RACV) with water and drank it as a strengthening and energizing tonic. So did Japanese samurai. (The addition of raw vinegar to drinking water killed infectious agents and made the water safe.)

In our own country, RACV was used to disinfect and speed up wound healing during the American Civil War and as late as WWI. Then, in the late 1950s, a man by the name of D.C. Jarvis wrote his best-selling book Folk Medicine: A Vermont Doctor’s Guide to Good Health. RACV was featured large. Jarvis promoted RACV for acid indigestion and wrote that most people who think they suffer from acid indigestion don’t, but instead lack sufficient hydrochloric acid. RACV in water before meals could be the solution, he said.

What is raw apple cider vinegar? It’s the old-fashioned, naturally fermented, unfiltered, unpasteurized vinegar with the “mother” still in it. The mother isn’t pretty; it makes the vinegar cloudy. But it’s the real deal and has enzymes which the clear pasteurized vinegars do not.

What are some ways you might want to try RACV? Got a sore throat? Mix 1 Tbsp raw apple cider vinegar in a big glass of warm water. Take a mouthful. Gargle and spit out. Take another mouthful and swallow. Take a mouthful and gargle and then spit out. Take another mouthful and swallow. Continue until the glass is empty. Do this every hour (a few hours are usually enough). Bye-bye sore throat.

Have a sprain or strain? Warm a cup of RACV and saturate a cloth. Apply to sprain 5 minutes every hour. Will you smell like a salad? Yes. Does it work? Also, yes. And there are those who say that sipping 2 tsp RACV in 16 oz water helps with weight loss (it helps break down fat, they say). Today we’ve got apple cider vinegar gummies for weight loss, digestion, and energy. Who wudda’ thunk?

Constipated? Dr. Jarvis said that starting the day off by drinking 1-2 Tbsp RACV with the same amount of honey mixed together in water helps with that, and others say drinking RACV each day helps with allergies. Webmd.com says that the effect of RACV on blood glucose levels is perhaps the best-researched and most promising of cider vinegar’s possible health benefits. Several studies found that it may help lower glucose levels. For instance, one 2007 study of people with type 2 diabetes found that taking 2 Tbsp RACV before bed lowered glucose levels in the morning by 4%-6%.

RACV helps extract calcium from the fruits, vegetables, and meat it is mixed with, helping in the process of maintaining strong bones. It’s rich in potassium, and potassium deficiency causes a variety of ailments including hair loss, weak fingernails, brittle teeth, sinusitis, and a permanently running nose.

RACV contains malic acid which is very helpful in fighting fungal and bacterial infections. This acid also dissolves and gradually eliminates uric acid deposits that form around joints, helping relieve joint pains.

How do I start each morning? With a spoonful of RACV and liquid chlorophyll (that’s another story for another day) in a mug of water. Tastes okay, and I’m convinced it’s doing me good. Try some yourself and let me know if you find some stubborn condition shifts in your body.

Dilly Egg Salad

I feel stronger, better, when I eat eggs (good eggs, from happy chickens). Maybe it’s because the protein in eggs is second only to mother’s milk for human nutrition. Their sulfur content, however, makes hardboiled eggs smell, and it’s the sulfur, the third most abundant element in our body, that helps make healthy skin and hair. Guess what else has lots of sulfur? Radishes! Here they add crunch and a pop of color.

8 large eggs1 C diced pink radish
¼-½ C mayo (choose good fats, sugar-free)1 Tbsp salt-cured capers
1 C chopped celery1 C sliced scallions OR ½ C minced red onion
½ C finely chopped fresh dill2 Tbsp lemon juice
1 Tbsp coarse prepared mustard1 tsp good salt like Celtic or Himalayan
1 tsp ground black pepper

Hard-boil the eggs. How I do it? I place eggs in a pot and cover them with cold water by 1 inch. Turn on med-high heat. When water comes to a boil, I turn the heat off, and cover the pot. I leave the eggs in the hot water for 10-12 minutes. 10-minute eggs have creamy yolks, while 12-minute yolks will be paler, with a chalkier texture. Drain eggs and transfer to a bowl of ice water. Leave eggs there at least 15 minutes. The ice bath stops the eggs from cooking anymore and makes them easier to peel. (You could leave eggs in the fridge overnight before using.)

While eggs are chilling, put the remaining salad ingredients in a large mixing bowl. Mix everything together.

To peel eggs, tap each on the counter all over. Starting at the top of the eggs, peel shell away. Sometimes I’m lucky and the entire egg peels easily. Other times, peeling under running water is the trick. Chop eggs. Add to salad. Toss everything again. Taste, adjust seasoning. Dots all.

Ribolitta: Your New Favorite Soup





Once again, our intrepid author / cook / photographer forgot to take a picture AFTER the recipe was completed. So… here’s a little montage of it being cooked. Imagine, though, if you will, crusty-soft-golden-brown crispy brothy chunks of bread beneath golden sizzles of parmesan, atop a dense vegetable soup, heady with garlic and rosemary. That’s the picture we should have taken!

Ribollita is the epitome of Italian peasant food. Simple. Flavorful. Nourishing. Balanced. Made from what’s lying around.  And, when executed with artistry, absolutely sublime.  A rich broth, heady with garlic and redolent of herbs.  A sprinkle of parmesan. Even a crust (sort of).  Peasant food, perhaps, but peasant food fit for a queen.  

The name Ribollita means “reboiled.” Traditionally, servants and peasants would make it from leftover bean-and-vegetable soup, thickened with some chunks of day-old bread, and then reheated with a few handfuls of greens. If you had some rosemary, great! Sometimes, you’d scrounge up a parmesan rind to infuse some flavor. 

If you actually have some nice garlicky minestrone around, you can skip right to step four. But I’m assuming you don’t, so we’re going to make this soup from scratch (well, except the canned beans…). And instead of just adding the bread, we’re going spread it on top, and bake it in the oven so the bread gets soft and brothy and crispy all at once. Like stuffing floating on soup.

Amply serves four   

1 can good chopped tomatoes (see #2 below for note about size)¾ pound rustic bread, old but not rock-hard. I use the Dan’s Brick Oven Bread.
2 bunches Tuscan kale 2-3 medium carrots
2-3 celery stalks 1 large purple onion 
1 small wedge parmesan or 1 cup grated.8 fat garlic cloves 
1/3 C extra virgin olive oil + more to drizzle 15-oz cooked white beans. I used the Jack’s brand butter beans. 
½ tsp crushed red pepper flakes, optionaltwo sprigs fresh rosemary, optional
6 cups watersalt to taste

1. Preheat oven to 425. Chop the carrots, celery, onion and garlic into soup-size chunks. Sautee in olive oil over medium heat, in a Dutch oven. Stir occasionally until softened, about 5 minutes. 

2. Meanwhile, drain the tomatoes, but save the juices. (To be clear, you want chopped tomatoes in thin juice, not crushed or ground tomatoes in thick sauce. The Cadia brand does nicely). I’ve been told a 15-oz can is more in line with tradition. But if you like tomatoes like I like tomatoes, go for a 29-oz can. Add to the pot and continue to cook and stir until they caramelize a bit, another 8-10 minutes. (This is why you leave the juices out: they caramelize better when they’re not too wet).

3. Add the reserved tomato juice, rosemary and pepper, beans, parmesan rind or 2 Tbsp grated parmesan (there are vegan options!), about 6 cups water, and 2 tsp salt; and simmer 8-10 more minutes. Remove the rosemary.   

4. Meanwhile, remove kale leaves from stems, and tear into chunks. Save the stems for stock some other meal. You won’t be able to fit all the kale in the pot until it starts to wilt, so add about a third… wait till it wilts… add more, etc. Finally, fish out the parmesan rind if you used it.

5. Tear the bread into rough chunks around the size of golf balls, give or take. Mix a third of the chunks in the soup to thicken, and nestle the rest on top. Sprinkle with some more parm, drizzle with some more oil. 

6. Bake at 425 about 10 minutes. Serve with more oil and parm if you want.   

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