Dealing With Headaches

Ever envied guinea pigs? Lord knows I have. Well, you may not have the fuzzy fur or the little pink lips or the jellybean-like physique, but you can play the metaphorical guinea pig in helping out with a Phase Two clincial trial for a new migraine drug made by Big Pharma giant Eli Lilly.

Say Hello to LY2590443

This will be the usual double blind study, so nobody knows what drug you get. The choices could be the mystery new drug, sumatriptan, a placebo pill or a placebo injection. I do not know if this new migraine drug will be in a pill form or an injectable form.

You need to be between the ages of 18 - 65 and have been diagnosed with migraines and get from between 2 - 8 migraines a month. You need to have had migraines (with or without aura) for at least one year. All sexes are welcome.

For more information about joining the cinical study, call 1-877-CTLILLY or 1-317-615-4559.

Don’t Apply If

Eli Lilly has listed some exclusions that can keep you from becoming a human guinea pig. These include:

• Being a drug addict or alcoholic
• Being pregnant
• Recently donating blood of 500ml or more
• Suffering from a “major psychiatric disease” (I do not know if depression would be included in that category).
• Being otherwise unhealthy or having some sort of chronic medical condition

The study also prefers people fluent in English and are willing to keep a diary about their experinces with the new migraine drug. There are several medical centers participating in the clinical trial all over America.

And the best part is that this time around there are no actual guinea pigs being used.

are one of the worst forms of pain that you can experience. They are so bad that your WOULD wish them on your worst enemy. Cluster headaches tend to start about an hour or so after you’ve gone to bed. For some unknown reason, they happen to men more than women. There has been a theory bandering about that sleep apnea may have something to do with cluster headaches.

Please keep in mind that I am not a doctor and this all mostly speculation on my part. (So, what else is new?)

Sleep Apnea

Sleep apnea is when your breath is cut off momentarily when you sleep. If you’ve ever had to sleep in the same house as someone with sleep apnea, you never forget the noise. Sleep apnea can be from malformations, growths or other problems with the throat.

However, it tends to happen in people that are overweight. The weight of the flesh on the neck is enough to choke off air. But most cluster headache patients are concentration-camp thin. This is because most cluster headache patients with sleep apnea have OSA (obstructive sleep apnea).

Studies

A study was done in 2000 on sleep apnea and cluster headaches that appeared in Neurology. Sleep disordered breathing in patients with cluster headache mentioned that 5 in 20 human volunteers had both sleep apnea and cluster headaches. Some of those 5 didn’t even know they had sleep apnea. This could suggest that some cluster headache patients might not realize that they also have sleep apnea.

There is a new paper planning to be published this year written by The Pain Center at Cedars-Sinai in Los Angeles that backs up the former study.

Hope this helps.

A happy thought for a Monday, I’m sure. But if you are a woman with migraines, you can’t take your heart health for granted. You will be more prone to having heart attacks and strokes than women who don’t have migraines. Yet more proof that life is not fair.

But why do women migraineurs have more strokes and heart attacks? New research from America may find that the culprit is a gene varaint called angiotensin-converting enzyme (ACE) D/I polymorphism. (Can’t exactly make a greeting card poem out of that one, can you?) It might not even be that particular variant, but another variation that is often found in women containing the aforementioned gene variant.

Damn, I need an Excedrin. And I really wish I had paid attention more in science class.

Study Specs

This research was a follow up to this study published in Neurology in July 2008. The study consisted of a questionnaire sent to 25,000 white women (why only white women, I have no idea). All of these women were tested to see if they had the gene variant with the really long name.

Of that 25,000, only 4,577 were migraineurs. Narrowing it down even further, 1,275 had migraine with aura and 625 had a heart attack or a stroke. There was an initial hypothesis that women that had migraines with aura were more prone to stokes and heart attacks than women that have migraines without aura, but that didn’t pan out.

Practical upshot: more research needs to be done.

In The Meantime

You know the drill — quit smoking, limit alcohol intake, eat a low-fat, varied diet, exercise regularly and work on non-chemical means of stress management — like not trying to understand these genetic research papers.

Many migraineurs are prescribed beta-blockers taken daily in order to prevent migraines. This is an off-label use, but many migraineurs have benefited. Now, a Dutch study has come out suggesting that beta-blockers may have another potential off-label use — blocking bad memories in the brain.

Study Specs

The study was on 60 people with a laboratory-induced phobia. 30 of them were given propranolol (stuff I was on for a month, but my body hated it) and the other a placebo. They tested how startled a person was by flashing a picture up of the thing they had been conditioned to hate.

Conditioned to hate? These 60 were given “mild electric shocks” whenever pictures of spiders were flashed before them, in the hopes of creating bad memories with spiders (or pictures of spiders). I thought getting mild electric shocks would condition you to hate medical researchers and not spiders, but that’s why I don’t volunteer for these things.

Anyway, the propranolol group were far less started by pictures of spiders than the placebo group. The theory is that the beta blocker has somehow blocked the way the brain processes attaching emotionas to memories, particularly bad ones. The participants claimed that they still could remember being shocked when shown pictures of spiders, it just didn’t seem all that frightening to them.

Also, the researchers say that more work needs to be done before anyone with a severe phobia or post traumatic stress could be helped by this.

More Harm Than Good?

Although I’m not a doctor, I think I can safely claim that it’s never a good idea to take medications you really don’t need to take. There’s also concerns over whether taking a pill to block out bad memories may also block out good memories. There is also a concern that this may predispose someone to Alzheimer’s.

If you are concerned about long term side effects with beta blockers for your migraine prevention, then talk to your doctor. Don’t just stop them, because then you will get a migraine, and that will definately leave a bad memory.

Got a spare tire — (and I don’t mean the kind you can find in the boot of your car?) If you do, and you are between 20 - 55, chances are that you also have migraines, no matter if you are a man or a woman. This is the conclusion of a study of 22,211 human guinea pigs done by prestigious Drexel Hill University’s College of Medicine.

How Fat Is Too Fat?

The particular kind of fat that the Drexel researchers looked at was belly fat and not general fat or even how obese a person was. They measured belly fat by measuring the circumference of a person’s waists.

However, obesity does give you serious health problems such as heart disease, diabetes and problems breathing. So, you stil need to loose it if you are overweight or obese. (Wait … that sentence didn’t come out right … oh, never mind …)

Women migraineurs with abdominal fat were 37% more likely to get more migraines than women migraineurs without abdominal fat. In men, the odds were 20%.

Must Love Migraineurs

If you already have migraines, and then grow a spare tire, then you will be likely to have a greater frequency of migraines. If you don’t have migrains and get a spare tire, then — you get a spare tire and some sniggers behind your back. If only the cause of migraines was that easy…

The study also noted that it was aware that women and men’s body fat tends to store in different areas of the body. They also noted that women are still three times more likely than men to suffer from migraines.

If you have one head trouble, it can easily lead into another. The current issue of General Hospital Psychiatry features a study done by the University of Manitoba that says the first symptom of mental disorders — is a migraine.

Just one note before we move on. The writer of this blog not only has migraines and chronic headaches, but she also had endogenous recurring depression (yes — that’s a mental problem. No surprise there, huh?)

Study Specs

4,181 mental patients were studied, with 11% of them reporting problems with migraines. This is apparently considered too high of a number to be considered a coincidence. The mental disorders the participants had included “major depression, general anxiety disorder, dysthymia, bipolar disorder, panic attacks, panic disorder, substance abuse disorders, agoraphobia and simple phobia.”

Having one physical problem (like migraines) that compunds another problem (like depression) is called comorbidity. I like to think of it as the “misery loves company syndrome”.

It is unknown why one head problem brings on another, although the study gives out some theory about “the low acticity of enzymes”. If you have migraines and aren’t depressed or anxious, then either you have some deep-seated problems or are taking some really painkillers.

11% Seems Damn Low

I’m really suprised that the researchers only came up with a figure of 11%. In my family, it’s 100% — all of my family members have depression and some sort of chronic pain. I was lucky enough to get migraines.

Others may agree that the 11% number is too low. The Park Nicollet Headache Clinic in St. Louis claims that 83% of the migraineurs they see have mental or mood disorders.

Seriously — has anyone ever met a person who had migraines and wasn’t just a little loopy?

Yes, I am aware that the title of this blog is Dealing With Headaches, but fear of geting Alzheimer’s is a very real fear for many people with migraines and chronic headaches. One head problem can so easily lead to another head problem. According to a new study from Northwestern University’s Feinberg School of Medicine, the culprit for Alzheimer’s may also be the culprit for some headaches: low blood sugar.

Brain Makes Glucose

For the last few years, scientists have wondered if Alzheimer’s is really Diabetes Type III, because the brain makes glucose and not just the pancreas. Sugar is good for your head, in a way (as long as it’s blood sugar). The new study theorizes that when the brain is depreived or starved of glucose, then this triggers the beginning of Alzheimer’s.

How do they know that? Alzheimer’s patients have “sticky clumps of protein” (amyloid plagues) inside of the arteries in the brain. It’s thought that those clumps are produced by an enzyme (BACE1)which is caused by a protein known as “elF2alpha” (which I swear was on a vanity license plate I saw last week). But what causes the proteiun — well, that’s kinda the mystery. But it’s now thought the process starts by the brain not getting enough oxygen and glucose.

The study worked on the brains of mice and humans in order to come to its conclusions.

Preventing Alzheimer’s

The study gave some recommendations for preventing brain malnourishment — and they are very close to recommendations for depressives, diabetics, migraineurs or those with chronic headaches. These tips include:

• Regular exercise. This helps keep the arteries in all your body parts working, not just your brain. This can slso help with stress, which can contibute to the next tip.
• Manage hyptertension (high blood pressure) and do whatever you can to avoid high blood pressure. This includes regular exercise, eating a low-fat diet, not smoking and not abusing alcohol (which is all calories and no nutrition). Of course, you still need to see your doctor for help in this area, too.
• Manage your stress, preferably through non-chemical ways. Stress can make you make very unhealthy food choices or make you want to smoke and drink in the first place. The study didn’t recommend any particular type of stress management technique.

Hope this helps.

FMH migraines are also known as familial hemipleic migraines and, as the name implies, they run in families. This is a nasty type of migraine that often is accompanied by problems standing, fever, paralysis of a limb or side of the body and auras that can last days. It is thought that FMH migraines are caused by a mutation in a gene known as CACNA1A, also thought to be a player in cortisol spreading depression.

There is no known cure, but FMH migraines can be managed. Now, there’s a new study out that states that women with FMH migraines shouldn’t take hormones or they will get migraines more frequently. However, the study was done on mice and not on actual women with FMH migraines.

I’ll resist the urge to rant against using animals in medical experiments and just plow on with the study details.

Study Specs

The study on mice was done at Massachusetts General Hospital. No word as to whether a certain Major Charles Winchester III participated (In joke for M*A*S*H fans.) The female mice had their ovaries removed and then were given estrogen replacement therapy. Female mice were chosen because more women get FMH migraines (and migraines overall) than men.

And this is where the study gets a bit incomprehensible. I’m assuming the mice in the experiment had the genetic mutation required for FHM migraines. They are known in the study as “FMH1 mutant mice”. Although I’ve been called very empathic with animals, I’m not entrely sure how you know a mouse has a migraine. (I’m serious here. Do they do brain scans? Check the supplies of mouse Imitrex in the mouse medicine chest? What?)

If I’m interpeting the study correctly, the scientists induced a migraine in the mice through chemical means of “brief topical application of 300 mM KCl”. If I got that wrong, I’m sure I’ll hear about it.

Although this study’s title is “Genetic and hormonal factors modulate spreading depression and transient hemiparesis in mouse models of familial hemiplegic migraine type 1” and the somewhat comprehsible parts lean towards this being a depression study, it’s get a lot of news on blogs devoted to headaches and migraines. So, I’m just joining in on the fun.

The Practical Upshot

Don’t be a lab mouse. Or if you do, try to get in on those medical marijuana studies.

There’s been a lot of bad news in 2008 for makers and takers of supplemental vitamins. They haven’t quite proven to be the natural cure-all as sometimes they are touted to be. For example, a study on Vitamins E and C to help with preventing prostate cancer proved the vitamins didn’t seem to change a man’s health in any way. In another study done in Copenhagen University, vitmains didn’t seem to give any benefit and were harmful in mega doses.

Migraineurs and people with chronic headaches sometimes take multi-vitamins and nutritinal supplements in the hope to leesen the intensity and frequency of head pain. Taking mega doses of magnesium is a popular alternative or complimentary migraine treatment, as well as a combination of magnesium and calicium. Some people also take mega doses of vitamin B2 in order to treat their headaches.

Does this mean you should toss out all of your multivitamins?

Not Necessarily

You do need vitamins, minerals and all of that good stuff in order to get healthy and stay healthy. You can get everything you need if (and this is a big if) you eat a varied, balanced diet full of fresh foods every day.

Odds are that you live in the real world and eat an unbalanced diet. Then, taking a multi-vitamin can be beneficial. In this way, you get just the amount that you need or nearly the amount that you need. Before you take any nutritional supplement or multi-vitamin, you should talk to your doctor. He or she may ask you to do a blood test for a complete blood cell count to be sure that your body isn’t lacking in any vitamin or mineral that may make you ill.

For example, I have iron-poor blood. My body seems to have a tremendous problem absorbing iron, even if I take it in food and multi-vitamins. So, I have to take a once-a-day little iron supplement. It helps my energy levels.

More Is Not Better

The problem with vitamins not helping to cure some problems like migraines or chronic headaches is that more of a good thing turns out to be a bad thing. Mega doses of anything is never a good idea, even if it is something natural like vitamin pills. So, vitamins aren’t bad for you, but they are if you take too much or not take them at all.

Although sticking needles in your body doesn’t seem like the best remedy for chronic headache, it’s better for you than aspirin. That’s the findings of a new study done by Duke University. Comparing accupuncture to regular aspirin, acupuncture gave the most releif to those suffering from chronic headaches.

Study Details

About 4,000 human guinea pigs volunteered for this one, and God/dess bless you all. You’ve probably saved the lives of 4,000 real guinea pigs. Anyway, the study was blind in that paitents were wither given aspirin, acupuncture or “sham acupuncture”, where acupuncture needles were insterted in other areas of the body not used to help treat chronic headaches. In the study, chronic headaches also included migraineurs and chronic tension-type headaches.

Acupuncture’ s benefits to your body are not apparent on the first visit. According to the study, you need five or six visits to get long-term relief. Many acupuncturists or Traditional Chinese Medicine practitioners also prescribe Chinese herbs along with acupunture treatments, but I could not find if any herbs were added in the study.

65% of the acupuncture group found releif in the severity and duration of their attacks while only 45% of the aspirin group did. Comparing sham acupuncture to real acupunture, sham acupuncture didn’t do too shabby at 45% while real acupuncture gave 53% relief. (That’s due to the placebo affect.)

Doesn’t It Hurt?

Acupuncture needles are incredibly thin — even thinner than innoculation needles. Usually, you don’t feel anything, but sometimes you do. Then, the needles feel like a mosquito bite or, at the worst, a bee sting. However, dogs, cats and horses tend to fall asleep during their acupuncture sessions and you will probably feel sleepy, too. Animals tend to go for acupuncture treatments for back problems, arthritis or chronic allergies that aren’t responding to conventional therapy.

Acupuncture is one of the few alternative therapies that some health insurance companies will cover (all or in part). You have to check with your health insurance to see about payment. You may need a referral from your primary doctor.

Don’t Toss Your Meds

In case you do get acupunture for chronic headaches or migraines, don’t expect to go completely off of the painkillers. It is nice to be able to lower your dose when you can, since long term use of painkillers can bring on health problems like ulcers.

And, as always, please don’t use this blog post in the place of your doctor’s advice.

Hope this helps.

If you’ve been attention, you’ll notice that I didn’t have a You Tube Clip of the Week last week. That wasn’t just because I was swamped with work and a cranky computer. It’s getting harder and harder to find decent, informative and code-embeddable clips about chronic headaches, migraines, art inspired by them or their treatment when you don’t feel like being insoired anymore. More and more I’m finding video spam, nonsense or really, really, really bad songs with the word “headache” in them. Really.

When you have a problem finding a decent video on any topic, a good YouTube channel to check out is CSPANJUNKIEdotORG. He/she/it has an unhealthy obesession with capital letters, but other than that, you can find the best of the best cable news videos. Thank you, CSPANJUNKIEdotORG.

This CNN report makes an easily understandable interpetation of a migraine clinical study of migraineur’s brains that came out last year. I wrote about that study a couple of times and I’m still having trouble understanding it.

The main gist is that migraineurs have a slightly different brain structure than “normal” people’s brains. One area of the brain is thicker than it would be in “normal” brains. Why the brains are different is still the million dollar question. But it’s a good clue as to where to start looking for answers.

The only thing the reports don’t go into is just what makes up a “normal” brain. At my age, I’m really starting to wonder if a “normal” brain exists. Anyway, enjoy the clip.

What’s this? Have I stepped into an alternate universe where good things actually happen? In the last couple of weeks, my home town won the World Series, the guy I voted for actually won the Presidential election and now a new study has come out saying migraines in women can be good or you. If you are a woman with mgraines, try to comfort yourself with the thought that you are 30% less likely to get breast cancer.

You Read That Right

The Fred Hutchinson Cancer Research Center published their startling findings in this month’s issue of Cancer Epidimeology, Biomarkers and Prevention. In case you let your subscription lapse, don’t worry — the study’s results have also been plastered on the blogosphere and major network news. The study looked at 3,412 women in the Seattle area, of which 1938 had already been diagnosed with breast cacner.

The study concentrated on women and breast cancer, but please be aware that men get breast cancer, too. And when men get breast cancer, it’s usually fatal.

Anyway, the clinical study concluded that women with mgraines were 30% less likely to develop the most common types of breast cancer than those women who sail through life without a head pain in the world and who have no sympathy for any women with migraines.

There is justice.

Why Is This?

Although the study’s researchers and doctors are not 100% sure as to why there’s a correlation between migraines and less breast cancer in women, they do have some threories. It’s thought that women with migraines have lower levels of estrogen in their bodies, and estrogen and progesterine does seem to play a factor in the development of many kinds of breast cancer. The study also notes that women on the contraceptive pill (chock full of womanly hormones) tend to get more migraines than when they stop taking the pill.

Just to interject a personal note, I was on the “mini-pill” for a few years. My body didn’t get pregnant, but I did feel drugged, achey (all over my body) and not very horny. So, in a lot of ways, it was a great help for me not getting pregnant.

In Conclusion

If it’s a choice between breast cancer and migraines, I’ll stick with the migraines.

About this time last year, research from Chicago’s Rush University Medical Center noted the correlation between “hole in the heart” (PFO) and migraines.

The Truth Is Out There

PFOs (not to be confused with UFOs) PFO (patent foramen ovale) is a teeny-tiny hole in your heart thought to be caused by a birth defect. This is not a lethal condition, but it is thought to affect 25% of the human population. PFOs are also thought to have something to do with strokes.

At the time the Rush study announced their findings, they also were looking for volunteers for a clinical trial called MIST II held in over 40 medical centers and hospitals across America.

Sadly, that study was cancelled, but another study from Philadelphia’s Thomas Jefferson Univeristy Hospital is backing up last year’s study and a previous one done in the UK. The study was led by Dr. Stephen Silberstein.

What Did Silberstien Find Out?

Dr. Silberstein looked at 131 migraineurs. Of those 131, 86 for them has PFO as well. That’s about 66%. All of the migraineurs in the study did not know if they had PFO or not — but they sure as hell knew they had migraines.

Actually, 182 people werein the study, but only 131 completed it, so we’re just going to focus on that lot. Dr. Silverstein also noted that there were patients with other kinds of RLS, of which PFO is the most famous member. What’s RLS? That stands for “Right to Left Shunt”. This shunt, nomatter what string of letters you want to call it, apparently has some blood skip going through the lungs to be filtered. Silberstein also noted that 55 patients in the study had “a moderate to large amount of bubbles streaming into the brain.”

How this all causes migraines, exactly, is unknown. What bubbles into the brain has to do with ANYTHING is beyond me…but I tell you, I’ll never be able to look at a glass of carbonated soda in the same way ever again.

As always, this study ended with a call to do more clinical studies. Anything involving both migraines and strokes means big money to any Big Pharma agent sniffing around and hopefully the next logical step could be taken — can we close this hole in the heart witout surgery and, even if we had to get surgery, does it stop all migraines?

As if we didn’t have enough trouble already, a new Italian study has come out warning migraineurs that they may be more suseptable to devloping blood clots in their veins than non-migraineurs. Blood clots are potentially lethal and only things you wish on your worst enemies — or even casual enemies. The study’s results have come out in the September 16 issue of Neurology.

Study Summary

In case you let your susbscription to Neurology lapse, don’t panic. Here’s what you need to know. The study had 574 human guinea pigs participating, all over the age of 55. Only 111 had been diagnosed with migraines. All of the human guinea pigs had their necks and thighs scanned with ultrasounds to see if they had hardening of the arteries. They also had their medical histories taken into account. 19% of the migraineur group had venus thrombosis, while only 8% of the non-migraineurs did.

Although the study shrugs its shoulders about why migraineurs would have more blood clots, they do say that they doubt that migraineurs get hardening (or narrowing)of the arteries more often than other people. That migraineurs are prone to hardening of the arteries is a theory that has never been proven, not even in this study.

I almost lost my Mom to a blood clot back in 2006. She began having migraines when she was 24. She shook on a warm day, she was having trouble figuring out what was going on and she complained of pain in her chest and spreading up her neck to her jaw. She had a blood clot in her leg which dislodged and got caught in her lung. I called an ambulance immediately and they arrived incredibly quickly.

No Big Surprise

This finding shouldn’t come as any major surprise to those with migraines or living with someone with migraines. There have recently been studies centering on women’s heart problems and migraines. Women with migraines are more prone to strokes and heart attacks.

It’s not clear yet why migraines would affect circulation. Of course, when you are in agony, your heart does pound. It is also unknown whether medications that migraineurs take may be affecting their cirulation system. There’s a lot of “if”s at the moment.

Ressurecting Old Theory

One of the theories about the causes of migraines is that blood vessels are dialating and constricting. However, this is considered an old, outdated theory, but not by everyone. There are still plenty of doctors who advocate it.

So far, the only known treatments for cluster headache are injections of sumatriptan you have to give yourself and oxygen therapy, which insurnace companies won’t cover in America and requires running to a hospital with an oxygen chamber. Is there a more conveinent solution? Hopefully now, there is. Clinical studies have concluded that Zomig nasal spray(zolmitriptan) can help reduce the pain of cluster headaches a half hour after taking it.

Study Details

Zomig comes in tablet, injectable and nose spray form, but the European studies were done with just the nasal spray. 121 adluts were goven a double blind test where they may be snorting either Zomig or a placebo. Two doses of Zomig was used in the test — one at 5mg and the other at 10mg. Bother doses helped to cut the intensity of the pain.

There are two kinds of cluster headache victims. There is the usual episodic cluster headache (comes and goes) and chronic cluster headaches (never goes away). The studies included members from both groups, with more episodic than chronic cluster headache volunteers.

There were several studies performed. The results were pooled together and presented at the European Headache and Migraine Trust International Congress, held in London last week. I’m afraid I haven’t been able to find out who funded these studies. I’ve got a teensy-weensy little feeling it might have been Astra-Zeneca, the makers of Zomig. WebMD reports that Astra-Zeneca “supported this research”. Hmmm.

Zomig is only licensed for migraine treatment and not licensed for cluster headache treatment in the UK or the USA. It is in Germany, the Netherlands and Denmark.

Fellow triptan drug Imitrex has also been used as a cluster headache treatment, but results have been mixed. Verapamil can lead to heart problems and can’t stop an attack once it starts.

Cluster Headache FAQ

Cluster headaches is one of the most painful conditions a human being can have. Even as a long-time migraineur, I concede that cluster headaches are more painful than migraines or even concussions. Cluster headaches usually affects more men than women and sets in when you are about 28, 29 or 30. Attacks tends to come in cycles, usually starting a short time after the victim falls asleep and happening for many nights in a row before mysteriously vanishing into the choas from whence it came.