Any other weekend migraine sufferers?

[Cookin4Love]

In the past couple of years, I have begun having migraines again after about a 15-year hiatus. Other than increasing job stress, there are no major changes that happened around that time. I do take rizatriptan as an abortive, which works fairly well, but not as well as it did a year ago. About 4 months ago, I had the worst migraine ever. The meds didn't touch it, and I was so bad DH nearly took me to the hospital. I was left with 7 hours of no memory, and about 48 hours of speech and cognitive dysfunction. The migraines have been worse since that time, and have somewhat changed characteristics (may be bilateral pain, more nausea). My doctor isn't overly concerned; he says that a severe one like that can cause sort of a reset that can take months to correct.

One of the interesting (?) things is that for every 10 migraines I get, 9 of them are on the weekend. There are no particular foods we eat at certain times or other things I can link--other than that on the weekend I get 8-9 hour of sleep each night instead of the 6 that I get during the week. And six is NOT enough. So I experimented this weekend with sticking to my regular, inadequate sleep schedule Friday night and getting up at 5:00 on Saturday. Migraine free. I slept 8.5 hours Saturday night and woke up with a migraine today. Could it be that simple? Or am I kidding myself?

But...because of other chronic healthy conditions, it really isn't feasible for me to not do a little bit of sleep catch-up on the weekends, and my work schedule doesn't often allow me to get more than 6 hours during the week.

Anyone else have this weird migraine pattern and perhaps has found a solution? I haven't ruled out food triggers, but so far haven't found any direct causal link that is consistent (other than MSG, which I avoid like the plague).

I'm just really frustrated to losing at least 1 day every weekend to a migraine--even with the meds due to the severity of my postdrome symptoms!

[moon]

I don't know if I have much to offer but
I had a few thoughts.

Is their anything in your bed clothes that you may have an allergy to? Pillows with
feathers would be a thought.
Are your symptoms worse when you have been cleaning? Do you have pets?

Have you noticed any relationship to the
foods you eat and headaches? Chocolate and yeast can be triggers for some.

Are your eyes light sensitive? If a light
shines in my eye I will usually have a headache.

I hope you get relief soon as I know how debilitating these headaches can be.

[Cookin4Love]

I don't know if I have much to offer but
I had a few thoughts.

Is their anything in your bed clothes that you may have an allergy to? Pillows with
feathers would be a thought.
Are your symptoms worse when you have been cleaning? Do you have pets?

Have you noticed any relationship to the
foods you eat and headaches? Chocolate and yeast can be triggers for some.

Are your eyes light sensitive? If a light
shines in my eye I will usually have a headache.

I hope you get relief soon as I know how debilitating these headaches can be.

Because of the pattern of the headaches (90% on weekends), I've more or less ruled out bedding-related issues, since I sleep on the same bedding every night.

I do get almost all of my migraines during the night and wake up with them--usually on Saturdays. That rules out any cleaning-related issues, as I usually work until 8 or 9 on Friday nights, then meet DH for dinner (different places), come home and go to bed. I have had the same dog for 7 years, so don't think it's that.

I eat a tiny piece of chocolate (about the size of a chocolate chip) twice every day (DH leaves it for me to remind me that he loves me). I eat bread every day. Again because of the weekend pattern, I don't think it's something I'm eating necessarily. Not that it couldn't be, but my dietary habits don't change a whole lot, and I don't have any particular eating patterns.

I am definitely light sensitive, but since I wake up with most of them, I don't think that's what is causing them. I do wear sunglasses if I'm out in bright light. I've even changed all three pairs of prescription glasses (regular bifocals, computer bifocals, and sunglasses) to the same shape and material of lens to eliminate that eye adjustment. It has helped eliminate mid-week migraines, but not the weekend ones.

Wish I had a magic answer and could get rid of them!

[Andrea_2]

One of the interesting (?) things is that for every 10 migraines I get, 9 of them are on the weekend. There are no particular foods we eat at certain times or other things I can link--other than that on the weekend I get 8-9 hour of sleep each night instead of the 6 that I get during the week. And six is NOT enough. So I experimented this weekend with sticking to my regular, inadequate sleep schedule Friday night and getting up at 5:00 on Saturday. Migraine free. I slept 8.5 hours Saturday night and woke up with a migraine today. Could it be that simple? Or am I kidding myself?

Just from your thread title alone, before even reading your post, the first thing I thought of was excessive sleep. I am not really a migraine sufferer, but I did go through a period of time of having headaches, neck pain and other symptoms that occurred only on weekends. I eventually realized that it was caused by getting more sleep on the weekends, and that it never occurred if I kept my sleep schedule the same as during the week. I sometimes feel like 6 hours of sleep isn't quite enough, but for me, anything over that really is too much, which feels far worse than not enough. So, to answer your question, YES, I do think it could be that simple.

[PurplePotato]

Some thoughts:

1. What if you wake up at the normal time but nap later?

2. Coffee/caffeine - do you tend to have more during the week? The absense of it could trigger.

3. Do you indulge more on your dinners out on Friday or during the day Saturday? A slight difference in nutrition or alcohol consumption? Is that your only "out" meal during the week? You could be sensitive to something added to the food - a preservative, a seasoning, etc - that you wouldn't find in whole, healthy foods cooked at home.

4. Exercise - different weekday vs weekend?

5. Do you get up and read the paper or such where your neck would be at an odd angle? Or even sit on the couch with head propped? That can totally do it for me.

6. Hair in a ponytail?

7. Do you drink less water? I know I do because I'm off my routine and then I get dehydrated, doesn't take much.

[Cookin4Love]

Some thoughts:

1. What if you wake up at the normal time but nap later?

2. Coffee/caffeine - do you tend to have more during the week? The absense of it could trigger.

3. Do you indulge more on your dinners out on Friday or during the day Saturday? A slight difference in nutrition or alcohol consumption? Is that your only "out" meal during the week? You could be sensitive to something added to the food - a preservative, a seasoning, etc - that you wouldn't find in whole, healthy foods cooked at home.

4. Exercise - different weekday vs weekend?

5. Do you get up and read the paper or such where your neck would be at an odd angle? Or even sit on the couch with head propped? That can totally do it for me.

6. Hair in a ponytail?

7. Do you drink less water? I know I do because I'm off my routine and then I get dehydrated, doesn't take much.

Haven't tried the up-early, nap later, but will have to if I'm only sleeping 6 hours on the weekends, too. With my fibro and lupus, I really have to get a little more sleep than 42 hours a week!

My caffeine consumption is pretty much the same all the time, but if I'm sleeping 'til 8:00 on the weekends, I'm about 2-3 hours late getting started. I am trying to slowly reduce my caffeine consumption, with the plan of eliminating it completely over my vacation this summer. I already know it makes me sick to cut it out, so it will be a couple of difficult weeks.

Friday dinners out are pretty much the same as others. We eat out fairly frequently, but even when I'm cooking at home, I get headaches as often. We don't drink alcohol, so I don't think that's it.

Right now, my exercise is pretty much non-existent, due mostly to my work schedule. Since I'm usually gone from home 16 hours a day, that doesn't really leave any time to do anything else Monday through Friday. And I usually work at least part of one day on the weekend (sometimes 10-12 hour days), which means I spend the rest of the weekend trying to catch up on all the other must-do's (cleaning, bill paying, family activities, etc.) as well as any scraps of entertainment we can build in.

Once I'm up, I'm up. I read the paper online. No ponytails--my hair isn't long enough.

I'm pretty consistent in water consumption--about 3 quarts a day.

The only thing I keep coming back to on the weekends is the change in sleep patterns--and less stress. I sometimes wonder if the reduction of stress chemicals in my body throws things out of whack, too!

Andrea--thanks for chiming in. It seems like confirmation that I'm not crazy!

[PurplePotato]

When I had to cut out caffeine I did it VERY slowly. I gradually added more and more decaf to the mix until it was all decaf. I think I took almost 2 months to do it - but I didn't suffer from any withdrawal headaches.

[Robyn1007]

I wonder if you could try cutting back 30 minutes at a time to see if you can find a balance somewhere between the 8.5 hours and 6 hours. Maybe you can get 7.5 without a migraine and at least get a little more.

If you can't find a solid trigger I'd urge you to see a neurologist. My cousin had been suffering from episodes that were being diagnosed as migraines for months. When she was in ICU before she passed we talked to a neuro who thought they were probably a type of seizure that is pretty rare. I'm sorry, I don't know they type.

Good luck! As a nearly daily headache (mostly not migraine though) sufferer I know how frustrating and debilitating they can be.

[LakeMartinGal]

I'm wondering if you may be getting the last couple of hours of sleep with the covers over your head? Or blocking your breathing, somehow? That can cause "turtle" headaches...

[Shugness]

Like someone else posted, as soon as I read your title, my first thought was you're sleeping too much on the weekends. And I base that on my personal experience - if I sleep in too late on the weekends, I will wake up with a headache, and in general feel like crap the rest of the day. Definitely not a migraine like you're dealing with, but a headache none the less. So I definitely think you can get too much sleep.

ETA: I read some article recently about how it's best to try and get the same amount of sleep every day, so if you can at all try and maybe get 6.5 hours of sleep during the week and 7 hours of sleep on the weekend? I agree that 6 is too little. I've found for me that 7 hours of sleep seems to work. That article I read said to get between 7-8 if I'm not mistaking.

[cherylopal]

So sorry to hear!

I also had two this weekend- my first two since sept!! which is unbelievable for me.

i blame it on the bright sun, white snow, cold air which is a trigger plus the added stress of parent conferences and worrying (not that i'm a worrier at all but i was fri!) about getting home before the snow on fri.

and i changed my diet just a wee bit- added more nuts so maybe i should watch for that-

my other triggers are
changes in my sleep patterns so i get up and go to sleep at almost my reg time on the weekends

mixing alcohol-- ie wine and then a night cap of whiskey is a big no no

not sure if this is any help to you

but i have noticed a *significant* decrease in the number and severity of my migraines since going whole foods vegan so maybe there is something to the food triggers

[funniegrrl]

I don't get migraines every weekend, but I'm familiar with some of what you are experiencing. I don't have any food triggers that I've ever identified. My migraines also usually appear during the night and I wake up with them. Alternately, a "regular" headache can turn into a migraine if I don't take care. Certain kinds of light can be a trigger for me, or can make things worse if I already have a headache.

Here's something I've discovered that might be related to your weekend problem: I often get migraines the day AFTER a busy or stressful day. Several years ago I read something that indicated that this was a "type" of migraine. Here are some examples:

Years ago I had a very stressful job, which sometimes also required 60 or more hours work. We often had deadlines -- grant applications and other things. It would be all-hands-on-deck, all-nighter, nail-biting frenzy leading up to such a deadline. When I woke up the next day, BOOM! migraine.

Went on vacation a couple of years ago with some friends to the beach. We got an early start on the drive -- it's about 8 hours. Busy day, excited about the trip. Went to bed at a reasonable hour, slept a reasonable amount of time, but that next morning, BOOM! migraine.

This weekend had a family gathering. Did some sight-seeing in the morning (spent several hours walking around), lunch out, trip to grocery store, cooked dinner for 10 people, fun with family in the evening, went to bed at a normal hour for a normal amount of sleep, BOOM! migraine the next morning.

It's something about the relaxing after a busy/hectic/tiring/stressful day that triggers the headache. I haven't found a cure yet, just know that it's a possibility.

Given the amt of pain you describe, though, I'd really follow up with a neurologist who specializes in migraines. Not all neurologists are suitable, you want a headache specialist.

[Rae]

Have you ever had a sleep study done? A friend of mine had constant headaches for a year, had a sleep study done, got a CPAP machine, and has been headache free for years now.

Your headaches happening after a decent, long sleep reminded me of my friend and makes me suspect that something is happening in your deep sleep to cause this. It doesn't sound like her headaches were as severe as yours, but your history with migraines may affect that as well.

Anyway, a sleep study may be worth a try?

[TKay]

I can't tell you how sorry I am that you're suffering with this. Ugh! Migraines are just the worst. To have one every weekend must be an utter nightmare.

Here's my experience and it's the first thing that popped into my head. I have talked with friends who are also migraine sufferers and we've come up with this theory.

Migraines hit after the stress has been relieved. For instance, my friend used to get migraines in graduate school, but not during times of the most stress. She'd get through finals with less sleep, increased caffeine, and a huge increase in pressure. Once everything was over and she could relax, bam! The migraine would hit. Dh gets migraines the same way. He'll have a major project at work, a big school deadline and then all the other normal stresses of life. As soon as he's done with his pressing deadlines, boom. Down with a migraine.

I don't know that our theory really helps you, but it could explain why the migraines hit when you're home and able to relax.

For me, my triggers seem to be lack of sleep, stress, dehydration and not taking enough time for myself. You know, like when you get in those periods of time where it's just go-go-go, taking care of what needs to be done and then moving on to the next obligation. Sounds like your work weeks are like that.

I don't know what the answer is. I wish I did. FWIW, my BIL gets migraines by date. It's like his body is on a regular schedule. He can practically look at the calendar and know what weekend he'll be down with a migraine. He's tried every medication there is, and can't seem to get any relief. I hope your body's chemistry resets itself and you don't have to have regular migraines forever. My gosh! That would be horrendous.

I'll send out good thoughts to you. I hope you find some answers--and some relief!--soon. I can only imagine how difficult it's been for you. Hang in there.

ETA: Funniegrrl and I must have been posting at the same time. We have the same idea about migraines (complete with the "boom!").

[VAcooker]

My caffeine consumption is pretty much the same all the time, but if I'm sleeping 'til 8:00 on the weekends, I'm about 2-3 hours late getting started...

I used to get really bad migraines as well. I found that for me, drinking caffeine on a regular basis has seemed to keep them at bay (I try to moderate my consumption so that I am not drinking too much coffee). I am wondering if the key to your weekend migraines is what you just said above--that you do not drink your coffee until a few hours later than you do during the week--perhaps this is triggering them? It would make sense that if you get up early on the weekdays and then have coffee you are fine but when you sleep in and do not drink your coffee first thing--you get a migraine.

I can tell you that when I do not have my coffee on a regular basis, I feel worse. I too will try to switch to decaf, but I found that when I drank only decaf (like when I was pregnant with my girls), I would regularly get massive migraines but when I drink a cup or so a day of caffeinated coffee every day, I do not get migraines. I know caffeine can be a migraine trigger or a migraine cure, depending on the person. For me, it seems to be the cure.

ETA: I think funniegirl's suggestion about seeing a neurologist specializing in migraines is a good one, if you do not already. If you do-then maybe getting a second opinion from another neurologist would be worth it?

[clairea]

I had a similar thought to funnygirl. Many of my migraines come right after a stressful event. It's almost like my body knows it just has to get me through, and then as so as something is over the migraine comes right on with a vengeance. That might have something to do with the timing.

I also encourage you to see a neurologist who specializes in migraines, especially since it sounds like your dr isn't giving you as much help as you might want. Do you take a daily migraine preventative in addition to your rescue med? If you are having a migraine almost every week perhaps that might be appropriate?

As others have posted, when I stopped drinking caffeine, I did so very slowly too. I think if you stop it abruptly it is likely to cause problems but if you take your time it will be fine.

[Meganator]

I have so far been blessedly free of migraines that others in my family suffer. But I will chime in regarding the de-stressing issue...my mom often got them right AFTER a stressful event (she also had them due to certain food triggers). So the relief the weekend brings to your stressful weekdays may be the reason you most commonly wake up with a headache on a Saturday. Unfortunately, that is a trigger that is less easy to address than simply cutting out a food trigger. FWIW, my mom's virtually stopped after menopause.

[Cookin4Love]

Well, it sounds like I could be right-on with the two most-likely triggers I've identified-extra sleep and stress reduction. Doesn't it suck that the two most healthy parts of my life are giving me migraines??? I'm going to be faithful to maintaining my sleep patterns for a month and see what happens. I think another key is going to be to try to manage stress more effectively--back to some meditation, and try to work in at least some mild exercise and more positive self-talk.

I haven't seen a neurologist; my GP really doesn't feel I need any further testing, as I have had such good relief with rizatriptan--until the mother-of-all-migraines a few months ago. I'm trying to play detective and be really diligent to eliminate everything I can think of. Then, if they persist, I think I have a really good basis upon which to insist on a referral to a neurologist.

I guess the bright spot is I can cram a lot more into my weekend with 5 or 6 extra hours that I don't spend sleeping!

[wintersummer]

My husband used to have bad migraines and I'd estimate about 80% were on the weekends. His physician told him they were "let-down" migraines (I think that's the term) - meaning, they would occur after stressful events. I wouldn't classify his job as overly stressful, but I know his weeks have periods of stress, just like all of us. I understand how you feel - you want to enjoy your weekend and don't want your migraine to take it away. My husband would take Maxalt, sleep about an hour or so, and generally be OK. Thankfully, his migraines have decreased to about one every 3 months. I wish you the best.

[cherylopal]

Well, it sounds like I could be right-on with the two most-likely triggers I've identified-extra sleep and stress reduction. Doesn't it suck that the two most healthy parts of my life are giving me migraines??? I'm going to be faithful to maintaining my sleep patterns for a month and see what happens. I think another key is going to be to try to manage stress more effectively--back to some meditation, and try to work in at least some mild exercise and more positive self-talk.

I haven't seen a neurologist; my GP really doesn't feel I need any further testing, as I have had such good relief with rizatriptan--until the mother-of-all-migraines a few months ago. I'm trying to play detective and be really diligent to eliminate everything I can think of. Then, if they persist, I think I have a really good basis upon which to insist on a referral to a neurologist.

I guess the bright spot is I can cram a lot more into my weekend with 5 or 6 extra hours that I don't spend sleeping!

I would very much agree with you that sleep is a trigger for you. I found that keeping my same sleep patterns even on vacation and the weekends made a huge difference (like today- still getting up at 5 even though school is canceled today) I really noticed a significant reduction in migraines by doing this. Seems a bit uncool to go to bed at 9 or 9:30 but that's what it takes to get my 8 hours in and it keeps the migraines away as well as other positive benefits so I do it. If I stay up on the weekend or other days because I'm out with friends etc, I seem to be able to cope way better since I'm on schedule the other days and I don't do it too often.

I also found that mediation helps and changing my mindset a bit. I listened to some CDs on the way to work from the library, found a few that helped- I like Thicht Nhat Hanh and Pema Chodron.

Good luck!!!

[menat]

Not specific to weekend migraines but as someone prone to them, I'm always hoping for new information:

Mark Hyman, MD
Practicing physician and pioneer in functional medicine
Posted: February 6, 2010 07:15 AM

How To Eliminate Migraines And Headaches In Less Than A Week

More than 10 million Americans have migraines creating a burden of mostly unnecessary suffering.(i) These severe, nearly disabling headaches can occur from once a year to three to four times a week. They can last from hours to days. They are often associated with an aura, light sensitivity, nausea, vomiting, and severe throbbing pain on one or both sides of the head. Migraines are even associated with stroke-like symptoms or paralysis in some cases ...

The cost to society is also enormous. Migraine headaches add $13 billion to $17 billion to our healthcare costs each year. These costs include medications, emergency room visits, hospitalization, physician services (primary care and specialty), laboratory and diagnostic services, and managing the side effects of treatment.

Migraines have indirect costs too. A headache is the most frequent pain-related complaint among workers. Focusing specifically on migraines, one study found that the annual cost to employers exceeded $14.5 billion, of which $7.9 billion was due to absenteeism and $5.4 billion to diminished productivity.(ii)

So this is a HUGE problem -- both to those who suffer and to society as a whole.

Worse, migraines are hard to treat and very difficult to prevent with conventional approaches. There are a host of preventive drugs -- calcium channel blockers, beta-blockers, anti-seizure medications, antidepressants, and more --which work poorly, if at all, and are accompanied by frequent side effects. Some doctors are now even using Botox to paralyze neck muscles in the hopes of easing migraines.

There is also a new class of medication called triptans (like Imitrex, Maxalt, and Zomig) that can stop a migraine once it starts. Though these have made migraine sufferers handle the attacks better, they also have serious potential side effects, including strokes, and are expensive. Still other treatments can lead to addiction or dependence. Not a pretty picture. And for many, none of these treatments work very well or at all.

The problem with migraines is the same one we see so often in medicine: We treat the symptoms, not the cause. We only deal with the effects of something and not the underlying 7 keys to UltraWellness. But using Functional Medicine I have been able to get nearly 100 percent of my patients migraine free within days to weeks!

In today's blog I am going to explain how I do that. I will tell you the story of one of my patients (a doctor herself) who, after years of suffering from migraines, finally came to me looking for relief. You will learn what I did to help her (as well as many others) and how you can apply the same measures to overcome your migraines. And I will give you 14 tips that will help you identify and treat the real causes of your headaches.

Dozens of Migraine Patients, Dozens of Different Cures

Many of my patients are doctors themselves and are often at the end of their rope. One was a physician from the Mayo Clinic, the Mecca of conventional medicine. This woman had severe, disabling migraines that made it nearly impossible for her to function at work. She depended on oxycodone (a strong morphine-like narcotic) and Zofran (a powerful anti-nausea drug used for chemotherapy patients).

She had seen every specialist at the Mayo Clinic and had traveled far and wide to other top neurology headache centers but never found relief. Unfortunately everyone she saw focused on her headaches, not her other symptoms -- which held all of the clues to her problem.

Migraines are no different from any other disease. It's simply the name we call a set of symptoms that are common in groups of people. This name tells us nothing about the cause of the symptoms, which may be very different depending on the person. In fact, there may be more than 20 different causes of migraine headaches!

My job is to be a medical detective and find these causes. It is not to simply prescribe powerful symptom-suppressive drugs. I remember very well working in the emergency room, treating all the chronic migraine patients with intravenous narcotics and nausea medication. I felt bad for them, but worse that I didn't have a way to prevent them from coming back.

Now I do.

Which leads me back to the doctor who came to see me from the Mayo Clinic who suffered migraines nearly every day for years with no relief. Here is what I did to help her ...

First, I asked her a lot of questions and learned she suffered from many symptoms including palpitations, severe constipation, anxiety, insomnia, muscle cramps, and menstrual cramps -- in addition to her migraines.

All of these symptoms are connected. They told me that her whole system was tight, irritable, and crampy. These symptoms are usually associated with severe magnesium deficiency,(iii) which often results from poor diet, caffeine, sugar, alcohol, and stress.

So I put her on high doses of magnesium and cleaned up her diet. Within a couple of days, she was migraine free and never had another migraine.

She's not the only success story.

Another patient had disabling migraines for 45 years and could not have a social life or plan anything because she spent most of her time in bed with the lights out. She also had an allergy to eggs. When we eliminated the eggs from her diet, her headaches disappeared. No eggs, no migraines. Three months after treatment she felt so good she decided to have an egg and ended up in the hospital with a three-day migraine confirming our original finding.

Another patient always had migraines before her period, along with severe PMS, bloating, sugar cravings, breast tenderness, and irritability. These symptoms are all related to hormonal imbalances.(iv) She had too much estrogen and too little progesterone. Getting her hormones back in balance relieved her of her migraines.

Yet another patient had genetic problems with her mitochondria and energy metabolism and needed high doses of vitamin B2 (v) and coenzyme Q10 (vi) to get relief. And another woman came to see me with persistent abdominal bloating after eating, which told me she had overgrowth of bacteria in her small bowel. When we cleared out these bacteria with a non-absorbed antibiotic, her migraines went away and didn't return.

One patient who lived on Diet Coke didn't get rid of her migraines until she gave up the artificial sweetener aspartame. Another had low blood sugar episodes that triggered migraines, so eating small, frequent meals of whole foods stopped the headaches. And finally, there was the woman who got headaches after exercise in the heat or with dehydration. We made sure she stayed hydrated and her migraines were permanently eliminated.

As you can see, even though these patients all had the same symptoms, their treatment was different in each case. So getting the full story -- with the keys of UltraWellness -- is so important. To heal from migraines you have to locate the causes of your headaches and address these underlying issues if you want to be free of pain.

To help you on that journey, here are the most important causes of migraines, their associated symptoms, tests to help identify problems, and treatments you can start using today.

Finding and Curing the Causes of Your Migraines

Food Allergy/Bowel and Gut Imbalances

• The symptoms: Fatigue, brain fog, bloating, irritable bowel syndrome, joint or muscle pain, postnasal drip and sinus congestion, and more.

• The testing: Check an IgG food allergy (vii) panel and also check a celiac panel because wheat and gluten (viii) are among the biggest causes of headaches and migraines. Stool testing and urine testing for yeast or bacterial imbalances that come from the gut can also be helpful.

• The treatment: An elimination diet -- getting rid of gluten, dairy, eggs, and yeast -- is a good way to start. Corn can also be a common problem. Getting the gut healthy with enzymes, probiotics, and omega-3 fats is also important.

Chemical Triggers

• The causes: A processed-food diet including aspartame, MSG (monosodium glutamate), nitrates (in deli meats), sulfites (found in wine, dried fruit, and food from salad bars) is to blame. Tyramine-containing foods like chocolate and cheese are also triggers.

• The treatment: Get rid of additives, sweeteners, sulfites, and processed food. Eat a diet rich in whole foods and phytonutrients.

Hormonal Imbalances

• The causes: Premenstrual syndrome with bloating, fluid retention, cravings, irritability, breast tenderness, menstrual cramps; use of an oral contraceptive pill or hormone replacement therapy; or even just being pre-menopausal, which leads to too much estrogen and not enough progesterone because of changes in ovulation.

• The testing: Blood or saliva hormone testing looks for menopausal changes or too much estrogen.

• The treatment: Eat a whole-foods, low-glycemic-load, high-phytonutrient diet with flax, soy, and cruciferous vegetables. Use herbs such as Vitex, along with magnesium and B6. Avoid alcohol, caffeine, sugar, and refined carbohydrates. Exercise and stress reduction also help.

Magnesium Deficiency

• The symptoms: Anything that feels tight or crampy like headaches, constipation, anxiety, insomnia, irritability, sensitivity to loud noises, muscle cramps or twitching, and palpitations.

• The testing: Check red blood cell magnesium levels. Even this can be normal in the face of total body deficiency, so treatment with magnesium based on the symptoms is the first choice.

• The treatment: Magnesium glycinate, citrate, or aspartate in doses that relieve symptoms or until you get loose bowels. If you have kidney disease of any kind, do this only with a doctor's supervision.

Mitochondrial Imbalances

• The symptoms: Fatigue, muscle aching, and brain fog, although sometimes the only symptom can be migraines.

• The testing: Checking urinary organic acids can be helpful to assess the function of the mitochondria and energy production.

• The treatment: Taking 400 mg of riboflavin (B2) twice a day and 100 to 400 mg a day of coenzyme Q10 can be helpful, as can as other treatments to support the mitochondria.

Keep in mind that sometimes a combination of treatments is necessary. Other treatments can be helpful in selected cases, such as herbal therapies (like feverfew and butterbur), acupuncture, homeopathy, massage, and osteopathic treatment to fix structural problems.

The bottom line is that this problem -- which affects one in five Americans and costs society $24 billion a year -- is almost entirely preventable, simply by following the principles of Functional Medicine and UltraWellness. So get to the bottom of your symptoms -- and get ready for migraine relief. It's the best way to move toward lifelong vibrant health.

Now I'd like to hear from you...

Do you suffer from migraines?

What treatments have you tried and how are they working?

Have you found a connection between the causes I've mentioned and your headaches?

What steps have you taken to address them?

Please share your thoughts by leaving a comment below.

To your good health,

Mark Hyman, M.D.

References

(i) Tepper SJ. A pivotal moment in 50 years of headache history: the first American Migraine Study. Headache. 2008 May;48(5):730-1; discussion 732.

(ii) Thomson Medstat, The Thomson Corporation, "New Data Estimate Migraine Headaches Cost U.S. Employers more than $24 Billion Annually," Press Release, 27 June 2006, http://www.medstat.com/news/newsdetail.aspx?id=545 (Accessed 2 August 2006).

(iii) Sun-Edelstein C, Mauskop A. Role of magnesium in the pathogenesis and treatment of migraine. Expert Rev Neurother. 2009 Mar;9(3):369-79. Review.

(iv) Martin VT, Lipton RB. Epidemiology and biology of menstrual migraine. Headache. 2008 Nov-Dec;48 Suppl 3:S124-30. Review.

(v) Schoenen J, Jacquy J, Lenaerts M. Effectiveness of high-dose riboflavin in migraine prophylaxis. A randomized controlled trial. Neurology. 1998 Feb;50(2):466-70.

(vi) Sándor PS, Di Clemente L, Coppola G, Saenger U, Fumal A, Magis D, Seidel L, Agosti RM, Schoenen J. Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial. Neurology. 2005 Feb 22;64(4):713-5.

(vii) Arroyave Hernández CM, Echevarría Pinto M, Hernández Montiel HL. Food allergy mediated by IgG antibodies associated with migraine in adults. Rev Alerg Mex. 2007 Sep-Oct;54(5):162-8.

(ix) Bürk K, Farecki ML, Lamprecht G, Roth G, Decker P, Weller M, Rammensee HG, Oertel W. Neurological symptoms in patients with biopsy proven celiac disease. Mov Disord. 2009 Dec 15;24(16):2358-62.

[Cookin4Love]

Well, I've had my first migraine-free weekend in about 6 months. I couldn't stick exactly to my sleep schedule due to some commitments, but I did limit myself to no more than 7 hours in bed. I'm tired, but have no headaches and more energy than I usually do.

I appreciate the willingness to share your stories and encouragement. I hope this is really the key, and that I can stay headache-free!

[funniegrrl]

That's good news, keep us posted!

[vbak]

I've been reading this post, and I'm glad to hear that you're feeling better. I've only had a few migranes in my life, and I was miserable. I can't imagine feeling like that every week-end.

In that longer post above, I thought it was interesting that a lack of magnesium was related to insomnia. I am a poor sleeper, so just maybe..

[cherylopal]

Well, I've had my first migraine-free weekend in about 6 months. I couldn't stick exactly to my sleep schedule due to some commitments, but I did limit myself to no more than 7 hours in bed. I'm tired, but have no headaches and more energy than I usually do.

I appreciate the willingness to share your stories and encouragement. I hope this is really the key, and that I can stay headache-free!

Yay for you!!!! Cross fingers this is the new pattern and that the migraines are history!

[oct2189]

C4L, so happy to hear of a successful weekend.
My dad experiences the same thing - migranes that come on for no apparent reason.
He usually drinks unsweetened coffee, but when he gets a migrane, coffee with sugar is helpful for him.
Fingers crossed for you going forward!

[PurplePotato]

That is very good news! Are you going to see if a nap is ok or not mess with success?

[Cookin4Love]

That is very good news! Are you going to see if a nap is ok or not mess with success?

I plan to, but this weekend was very busy and I couldn't work a nap in. It's just so nice to have had a whole weekend pain free!

[mbrogier]

I'm glad that you're having a pain free weekend. I've dealt with migraines for years.

I was just hospitalized because I had the worst migraine of my life which would get a bit better with sleep and meds and then get worse. For a MONTH. After two ER visits for IV pain and nausea meds, my doctors decided to hospitalize me for pain control and tests. --The weather here in Chicago has been weird, and we thought that and my fibromyalgia was causing the migraine to linger. I've had a lot of CT scans, so my doctors don't jump to do those unless absolutely necessary. An MRI would have been ideal, but I can't have that because of the implant for my bladder disease that includes metal on my spine. A special CT scan revealed a small BLOOD CLOT.

Because of my stroke history, the abortive triptan drugs are contra indicative. --If you have a clot somewhere, the increased blood pressure can make it move and block a small vessel causing a TIA or stroke. I had just enough of a blockage to cause migraine symptoms. I'm going back on coumadin after I have a small basal cell carcinoma removed from my forehead soon.

My pain doctor is a neurologist. He and my primary doctor had thought that my risk of recurrent stroke was very low since the hole in my heart was fixed-- this was before I developed pulmonary emboli from my clot factor disorder. Still they thought the risk was minimal. I tried the Relpax the week before I was hospitalized, but when I took the Relpax nasal inhaler I seriously thought I was going to stroke out. My head was just throbbing like my blood was being forced through a wind tunnel.

Many women don't realize that migraines are a stroke risk. I think that you need a new primary care physician! You had symptoms of a TIA--transient ischemic attack--a clot that hung around long enough to cause symptoms but resolved before causing permanent damage (which is called a stroke) a few months ago, and he blew you off. Go to a neurologist post haste!

Aspirin, chocolate and red wine thin the blood--so do lots of leafy greens high in vitamin K, so you may be thinning your blood out enough that your "migraines" are coming and going. There is also a hormonal component to how thick your blood is--it rises and falls through the day, week, month, even postmenopausal without HRT.

I hope I've scared you enough that you're going to take this seriously. I've been scared sh!tless. I know what it's like to not be able to feed or dress myself, and I *never* want to be there again. I am taking the steps to ensure that I do everything to protect myself. PLEASE get a second opinion.

--Think of the blood clot like you would plaque from heart disease. Enough can form in an area to constrict blood flow without totally blocking off the vessel. Blood can get very sticky. I think we think of blood clots with strokes like we would a solid structure getting obstructed in flowing water instead of gradual buildup that can sit in an area and cause symptoms when there's a temporary backup.

Only your neurologist will be able to tell you if you're really having migraines. I wouldn't take the abortans for headaches until after seeing a neurologist that ordered an MRI to ensure that no vessels were occluded as well as blood work to see how your blood is clotting, etc.

The pain and misery I went through last week will have been worth it if it helps you or someone else from having a stroke. Also, if you're having the worst migraine of your life, GO TO AN ER!!! Mention your past history. Figure out what local hospital is a stroke center. They will take you seriously. Heart disease and stroke is the #1 killer of women in the US.

[kriterion]

I'm new to this forum, not sure how to use it, but responding to Cooking4Love about weekend migraines.

I, too, get most of my migraines on the weekend. Been to all the specialists and doctors and none seem to be able to get me the help I need. It's really wreaked havoc on my social life. I cannot plan weekends because I never know if I will get the migraines. I've had these for 20 years now. They started during my periods, then when my periods started being so random during my perimenopause so did the migraines. And now they are mostly on the weekends. My joints ache; I feel heavier; lethargic; I can't see as well; I get cravings for sweets, especially chocolate; I don't think as well; I get angry real easy; depression spirals out of control when normally I am not depressed; I've gained weight; and lost out on a lot of my life. I've kept a food diary for a year and nothing turned up suspect. I do have a stressful job which I can see being the culprit, but why do I get most of the migraines on the weekends. Has anyone found any relief? Do people that find relief never get back on the forums to respond to our desperate pleas?