Heading Off the Misery of Migraines
After 40 years of suffering, this teacher gets her life back!
by Amy Rothenberg, ND, DHANP
(This article first appeared in Homeopathy Today, the monthly magazine of the National Center of Homeopathy in Winter 2009, Vol. 29, No. 4. For more information on joining the NCH and subscribing to Homeopathy Today, click here.)
Linda, a 58-year-old kindergarten teacher, had suffered with migraines for more than 40 years. She could be struck at any time and without warning. A small flash of light, a slight wave of nausea were the only fleeting signs she would experience before a migraine was to begin. Next came the terrible, crushing pain all around her head, perhaps worse on the left side, with some nausea but rarely vomiting.
If a migraine struck during work, Linda would have to leave school, go home, lie still in a dark and quiet room, and sleep it off. Through the raising of her two sons, she would lean on her mother and husband to step in when she could not function, often two days at a time, two or three times a month. Though she dearly appreciated her family’s support, she also hated being reliant on anyone.
A hormonal connection?
Linda had always assumed her migraines would resolve with menopause, as they had been worse before her periods. In fact, she could count on getting a premenstrual migraine like clockwork. But when her periods ceased in her late 40s, Linda found no relief. In some ways, the headaches were even more bothersome; their unpredictability meant that she could not make plans nor reliably be available to friends and family.
An otherwise upbeat, positive person, Linda was starting to feel a bit desperate. These painful and life-disrupting migraines were really getting her down, and that’s what led her to my door.
Migraines wreak havoc
Migraines are more than just headaches. They are chronic and severely painful, and for some people, they can last for days, wreaking havoc on lives and plans. Migraines often have clear phases, including the aura (sensory warning signs of an impending attack such as flashes of light, blind spots, or tingling), nausea, and severe sensitivity to light and noise.
Ancient writings and historical artifacts tell us that migraines have been around for millennia, but this ailment is still not well understood. Over the years, it has been suggested that migraines are due to problems with circulation to the head and brain, but more recently, a neurological cause has been posited, perhaps related to brain stem malfunctioning.
Predisposition & triggers
We do know that family history can predispose people to migraines and that environmental factors can trigger attacks. Some sufferers are aware of their migraine triggers, such as certain foods or scents, loss of sleep, hormonal changes, or environmental allergens, but for others, there seems to be no rhyme or reason, and attacks come on randomly.
Conventional medical therapy relies on strong pain relievers and anti-nausea medicines to reduce the severity of an attack, as well as other drugs (e.g., beta-blockers, anti-depressants, anti-seizure medicines) to reduce the frequency of attacks. These drugs are not always effective or are not effective enough, however, leaving legions of suffering and frustrated patients. That said, allopathic approaches continue to develop, and those who have not sought care for some time might find a new medication that offers some relief.
Homeopathy can be miraculous
Of course, homeopathy should always be offered to migraine sufferers, and for some, the results can be miraculous. I have had the uncommon patient over the past 24 years who never had another migraine after receiving a homeopathic remedy. But what I more commonly see with homeopathic treatment is fewer migraine attacks of less severity and shorter duration. If a patient can go for months without an incident, better yet. If the patient has had migraines for a long time, as Linda had, or the family history of migraines is strong, good results may be harder and slower to come by. But I always give it my best shot, and we almost always get some improvement.
When I first see a migraine patient, I make sure they have already had or will soon get a thorough medical work-up to rule out other possible causes of severe headaches—such as sinus infection, teeth and TMJ issues, eye and visual problems, or structural difficulties related to being out of alignment in the neck, back, or shoulders. Digestive disturbance, hormonal issues (more common in women), blood sugar imbalance, and, of course, stress are other possible reasons for headaches. Lastly, and most disturbingly, migraine-like headaches can be due to a lesion in the brain, cancerous or benign, so it’s important to know what we’re treating.
I always take a careful history to see if the person knows what brings on their migraines, but even if they do not, I often suggest a trial avoidance of some of the common dietary triggers: alcohol (especially beer and red wine), monosodium glutamate (sometimes found in prepared Asian foods), chocolate, aged cheeses, food and drink containing the artificial sweetener aspartame, and caffeine (if used excessively). Very salty and overly processed foods can also trigger headaches in some people.
I also seek to understand the person’s headache in all its minutiae: what their headaches feel like, where the pain is on the head, what brings the pain on, what helps (if anything), and whether there are any concomitant symptoms, such as nausea, muscle aches, visual disturbances, aura, etc. Finally, I strive to understand the headache in the context of that person’s life. I invariably prescribe a constitutional remedy—a medicine aimed at the whole person, including but not limited to their migraines.
Healthy except for migraines
For Linda, an otherwise robust, health-conscious woman, the migraines were an anomaly. When she felt well, she exercised regularly, was active in her community, and enjoyed a wide circle of friends. She had been the person in the family who oversaw food shopping and enjoyed preparing healthy meals for her family of four. She did express frustration though at having gained an extra 20 pounds in the past decade and not being able to lose it.
At the first sign of a migraine, Linda used Imitrex® injections. Sometimes they would shorten her headache episode, but not always. Even though unreliable, Imitrex® was the only thing Linda had ever found that helped her symptoms once the headache took hold. She was growing concerned about using the drug, however, because her blood pressure had become slightly elevated since menopause, and she knew that Imitrex® was contraindicated for those with hypertension. She also knew her blood pressure was up in part because of the extra weight she was carrying around.
Linda had a few other complaints, such as mild arthritis in her hands. They were stiff, mostly in the mornings, and seemed to be getting worse over the years. The stiffness did not stop her from doing things though, and by lunchtime it was usually gone. She also mentioned that she tended to have constipation. Her screening lab work, which she brought to our first visit, revealed no other underlying concerns. She tended to be a bit chilly and to sweat easily.
Dwindling nest egg
Linda did complain of insomnia. She said that when she had worries about her husband or her extended family, she would have trouble both falling and staying asleep. This had always been true for her, but at the time of our first meeting, she was especially struggling. Her husband had lost his job a year earlier and though they had diligently saved for retirement, much of their money had been tied up in the failed company. Linda loved her work with small children and had enjoyed raising her own two sons who were now grown—but she had been anticipating a less hectic time of life. Now with her husband’s job loss and their pension funds dwindled, retirement any time soon was out of the question.
In my practice, I find that the economy and personal financial situations are among the biggest stressors in people’s lives right now, and they certainly exacerbate existing health issues, as was true for Linda. (An aside: perhaps many Americans who grew increasingly materialistic have little to fall back on when the money gets tight. Lack of strong family support or a sense of community—when piled upon mortgages that cannot be paid, health insurance that has lapsed, and mounting bills—only complicates the matter. It is my hope that beyond learning better ways to run our financial services industry, that as a country and a culture, we will also shift our values and priorities toward relationships with those we love, meaningful work that helps people, and pastimes that move beyond the acquisition of goods.
Worried nights, active days
Linda attributed her insomnia to mental over activity: making lists, worrying about what she had forgotten to do the day before, or fretting over what she had to do the next day. This low-grade anxiety, which mostly manifested at night, was ameliorated during the day by working, being involved in her life, and taking care of business.
The sense I got from Linda with regard to her financial situation and derailed retirement plans was that she would just plod onward. She really didn’t have a choice, so she would turn her vision toward getting the job done. It helped that she enjoyed the people and families she worked with and felt valued as a teacher.
Overall, Linda’s mind was quite clear, although she did complain about her memory of late; she didn’t know if it was just her age, her constant multitasking, or the financial stress. I asked if her poor memory was affecting her teaching, and she replied no, it was more the kind of thing where she would mislay her keys or forget why she had walked into a room.
Whittling down the remedies
I repertorize a patient’s case when they are sitting before me so, when I have whittled remedy choices down to a small handful and discarded those I know will not be relevant, I can ask more focused questions to help me count a remedy in or rule it out.
When I repertorized Linda’s case—including the nature of her headache, the mild inflammation of her joints, the chronic constipation, and her insomnia due to worry—and also considered her temperament (better from work, organized with attention to detail, etc.), the top remedy candidates were Calcarea carbonica, Silica, Carsinosin, Natrum muriaticum, and Nux vomica. I was satisfied with this list as I think that a patient needing any one of these remedies on a constitutional level would tend to be likable, responsible, tidy and organized (though each for different reasons), and at least somewhat forthcoming—all qualities that I felt applied to Linda.
Those who benefit from Carsinosin really want to be taken care of. Though they are quite even-tempered and kind, when they are feeling stressed, they will blow up emotionally or have some sort of strong physical discharge. I did not see these qualities in Linda, so I ruled out that remedy.
Likewise, Linda did not have the temperament or controlling nature of someone who needs Nux vomica constitutionally. Honestly, it would be hard to imagine a Nux vomica type as a middle-aged, female kindergarten teacher; the job requires undue patience, a quality most people who need Nux vomica have only in short supply.
The nature of Linda’s migraines certainly fit the symptom profile for Natrum muriaticum, but her physical general symptoms did not; that is, she tended to be chilly and somewhat constipated, just the opposite of someone needing Natrum muriaticum. I also would have expected to see some desire for solitude when sad or upset, as this is classic Natrum muriaticum behavior. But Linda went in the opposite direction, seeking input from friends and family when she had concerns. So I ruled out this remedy.
Down to two
In the end, I was left deciding between Calcarea carbonica and Silica, two remedies that share many symptoms. With Silica I expect to see more of an underlying weakness, almost toward fragility, which can make the patient become rigid, as a way to protect themselves. In Linda’s case, I did not see either weakness or rigidity, rather someone who was ameliorated by hard work and communicative connection, which fit the Calcarea carbonica profile. The fact that Linda had trouble losing weight, was chilly, and perspired freely confirmed my choice of Calcarea carbonica.
I asked Linda to take a daily dose of Calcarea carbonica 12c. I also suggested that she try the herb Butterbur along with some B-complex vitamins (see sidebar on page 39). And I recommended she take fish oil for its anti-inflammatory effects to help with her mild joint discomfort.
Excellent initial results
When Linda returned six weeks later, she lit up in the waiting room as I greeted her, and I knew before we walked back to the exam room that she’d had a good month-and-a-half. She’d suffered just one migraine, and the Imitrex® had taken care of it. This was a big improvement over the expected 3 to 4 (possibly more) migraines she would typically have had over six weeks. Linda also reported that she was feeling very good overall. She was sleeping better, and her joint discomfort and morning stiffness were completely gone. She added that for the first time in her life, she was having normal, easy bowel movements.
This was a wonderful first report. Although it was difficult to know what exactly accounted for her improvements (e.g., the Calcarea carbonica, the supplements, or even happenstance), I was not too concerned about that at this point. I just wanted her to have fewer, less severe headaches. When treating patients like Linda with long-term chronic conditions, we can typically say more definitively what is going on only by looking back after a year or two of treatment. That said, the news that she felt better overall and was not constipated for the first time in her life certainly made me think that Calcarea carbonica was working to good effect, as I wouldn’t have expected the supplements alone to account for this. I suggested she stay with the same treatment plan for the next few months.
When I saw Linda two months later for another follow-up, she had not had any migraines at all. This was a good report indeed!
The economy goes south
In the following several months, financial bad news hit her family, as it hit many others, when the economy really went south, and stress was taking its toll on Linda. When I saw her for her next follow-up visit, she’d had three headaches in three weeks and felt she was slipping. Two of the headaches were not helped with her usual Imitrex®, and days simply fell off the calendar while she rested in her darkened bedroom.
I assume for the most part that people respond to stress in predictable and patterned ways (often according to their constitutional type!), which is why I think Linda slipped back into migraines during this stressful period. It seemed likely that the 12c potency of Calcarea carbonica was not strong enough at that time. So I prescribed a dose of Calcarea carbonica 200c and encouraged her to continue taking the supplements.
Two months later, I spoke with Linda by phone. She reported that she was feeling better again overall and had suffered just one migraine, which was helped by the Imitrex®. We both were relieved that she was back on track with her healing.
An acute migraine remedy?
Many students ask me if it might make sense to use a homeopathic remedy at the moment of a migraine headache: either the constitutional remedy or an acute remedy or even a combination remedy. I have not found these strategies to be especially helpful, though I have tried them with many patients over the years. The best approach I have found is to aim the remedy broadly and to treat constitutionally, in an effort to reduce the overall number of migraines a patient has over time.
Getting her life back
Over the ensuing years, I have continued to work with Linda, and she is making good progress overall. She is definitely having fewer migraines, and when she does have a headache, the symptoms are less severe, they don’t last as long, and they are more predictably helped by her conventional medication. Linda often goes for months at a time without a migraine—a huge improvement over her 40-plus years of suffering with 2 or 3 migraines a month, each lasting for 2 or 3 days at a time. She is also finding ways of working with her stress and supporting her husband during his professional difficulties; these efforts at stress reduction should help her migraines to ease as well. Now and then, especially during times of stress, Linda has benefited from additional doses of Calcarea carbonica. Linda is extremely happy to “have her life back” and “to make plans and be able to keep them” these days. She eagerly sends friends and relatives to me as patients.
So, if you’re a homeopath, take on those migraine sufferers. If you’re a migraine sufferer, seek professional homeopathic help. Homeopathy and natural medicine have much to offer, and the results will generally please. To liberate someone from chronic or intermittent excruciating head pain is indeed rewarding for all.
Manage Migraines the Natural Way
In addition to homeopathy, many natural medicine approaches can help to both prevent and treat migraines. Most are individualized to the person and should be recommended—both the item and the dosages—by a reputable provider. Some approaches that I use with migraine patients include:
Proper hydration. The actual amount of fluid necessary varies from person to person based on constitutional type, activity level, and other dietary considerations, but for many people, being adequately hydrated is essential and can make a big difference.
Butterbur. A study in the December 28,2004 issue of Neurology revealed that the herb Butterbur (Petasites hybridus) was an effective preventive measure. Over a 4-month period, patients who took two 75 mg tablets of Butterbur a day reduced their frequency of migraines by 48 percent on average (vs. a 26 percent reduction in frequency in those receiving a placebo.) Experts suggest choosing Butterbur extracts guaranteed free of pyrrolizidine alkaloids (which are toxic to the liver), and taking this herb with meals. (* Lipton, RB, et al. Petasites hybridus root (butterbur) is an effective preventive treatment for migraine. Neurology 2004 63: 2240-2244)
Vitamin B-6. I often suggest high daily doses of Vitamin B-6 (e.g., 100mg/day) as a preventive. Because this vitamin is water soluble, I am comfortable using this kind of dosage. Usually, I suggest taking it with a B complex vitamin.
Stress Reduction. I suggest trying techniques like biofeedback, massage, and other stress reduction approaches, such as mindfulness meditation. Regular aerobic exercise should not be forgotten. I generally recommend these techniques as a preventive way to reduce a person’s overall stress level; but some people can use these tools to good effect during a migraine.
Hydrotherapy. Some patients will benefit from a short (5-minute) very hot foot bath at the onset of a migraine. Others do well with ice packs to the head. A combination of these treatments also works for some patients.
This article first appeared in Homeopathy Today (Winter 2009, Vol. 29, No. 4), the monthly magazine of the National Center of Homeopathy. For more information on joining the NCH and subscribing to Homeopathy Today, click here.