Headaches – Complementary and Alternative Medicine (CAM) Treatment

This page is focused on CAM treatment of headaches, an approach that emphasizes  reducing the frequency and severity of headaches.

For conventional management of headaches, see: Accurate Education – headaches.

 

Complementary and Alternative Medicine (CAM) is defined by the National Institutes of Health (NIH) Center for Complementary and Alternative Medicine as, “those treatments and healthcare practices not taught widely in medical schools, not generally used in hospitals, and not usually reimbursed by medical insurance companies.”
See Complementary and Alternative Medicine (CAM)

 

See also:

Headaches – Low Volume CSF Headaches

For information regarding individual foods, nutrients, vitamins and supplements:

   Nutrition and Pain

 

 

.

CAM – Headaches

 Chronic headaches are a common problem, affecting an estimated 28 million Americans. There are many types of headaches although migraine and tension headaches account for the vast majority. For those who suffer from chronic daily headaches, defined as more than 15 debilitating headaches per month, the distinction between migraine and tension headache can become blurred as these headaches begin to blend in character and behavior.

 

The management of chronic headaches is an extensive subject and includes emergency management, abortive management of acute headaches and preventative management. At this time, the focus here will be on preventative management with emphasis on CAM supplements. It should be stressed, however, that behavioral approaches to headache prevention are extremely important and effective means of reducing the frequency and severity of debilitating headaches. Behavioral approaches include exercise, cognitive behavior therapy, deep relaxation techniques, yoga, tai chi, and mindful exercises such as meditation.

See: CBT, Yoga and Tai Chi).

Supplements Effective for Headache Prevention

Acetyl-L-Carnitine & Alpha Lipoic Acid (aka Thioctic Acid)

There  is evidence to suggest they are helpful in reducing the frequency and severity of migraines and the pain associated with fibromyalgia.

See Acetyl-L-Carnitine

   Dose: 500-1000mg 2x/day

 

See Alpha Lipoic Acid

   Dose: 600mg/day, take on an empty stomach

 

Avocado-Soy Unsaponifialbles (ASU)

This may improve the pain and stiffness associated with arthritis, especially in the hips and knees. It has an excellent safety record.
Dose: 150mg twice/day

 

Bromelain

Derived from pineapples, Bromelain may be effective for acute inflammation and for acute flare-ups of chronic inflammation as found in arthritis and LBP.
Dose: 250mg – 300mg twice/day
Precautions: Purchase only preparations that are enteric coated to allow for best absorption. Contraindications: Should not be used with warfarin (coumadin)

 

Butterbur

Butterbur (Petasites Hybridus) may be very helpful in reducing the severity and frequency of migraine headaches and is safe for children. It also can be helpful with seasonal allergies. Clinical benefits may not become apparent for 2-3 months. It is marketed under the brand name Petadolex.
Dose: 75mg 2x/day x 4 weeks then 50mg 2x/day (available as “Petadolex”)
Precautions: Do not ingest the plant itself, it contains a toxic alkaloid that must be removed prior to ingestion. Be certain that the product label confirms this. Some people may experience stomach upset, including gas, when they take butterbur. It is not recommended for young children or women who are pregnant or breast-feeding. Side effects may include belching.

 

CoQ10

This enzyme cofactor may be effective in reducing the frequency of migraine headaches by up to 50%, CoQ10 has few side effects (gastrointestinal, incidence less than 1%). It is considered safe for older children. Also likely effective in fibromyalgia.

Dose: 150-300mg/day

See CoQ10

 

Devil’s Claw

Derived from an African plant and used in Europe for decades, this may improves low back pain and the pain associated with arthritis. It has an excellent safety record.
Dose: 150mg/day

 

Feverfew

Though generallly not thought to be as effective as butterbur in managing migraine headaches it nevertheless can be helpful.
Dose: 100-125mg/day (CO2 extract)
Precautions: To be most effective, the leaf must be freshly picked, freezed dried or a CO2 extract. People who take feverfew for a long time and suddenly stop taking it may have headaches, nervousness, insomnia, stiff muscles, and joint pain.

 

Magnesium (Epsom Salt)

Magnesium may be very effective in preventing migrain headaches. Magnesium in the form of epsom salt baths is absorbed through the skin and may reduce the frequency and severity of headaches, sometimes dramatically. It also may help protect against the development of diabetes. It is estimated that 60-80% of people older than 50 are magnesium deficient.

Dose: 350-700mg/day or epsom baths 3-4x/week
Precautions: Caution with kidney disease. Diarrhea is a common side effect.

See: Magnesium

 

Melatonin

See:  Melatonin

 

Omega 3

This supplement offers many benefits including improving the pain associated with fibromyalgia, arthritis and the pain associated with menstruation. It is also an excellent supplement for improving the health of the heart and has been shown to reduce mortality associated with heart disease. It also reduces the severity and frequency of migraine headaches. Some studies argue for the need to obtain Omega 3 from fish oil or natural sources (fish, kia seeds) to be effective.

Dose: 2 – 4gms/day of Omega3 (total of EPA + DPA).

Rhodiola Rosea

This plant has been used in folk medicine for hundreds of years to improve mental clarity and fatigue. Studies show that it may be effective for anxiety, depression and insomnia.
Dose: 340mg – 680mg/day
Precautions: Purchase only preparations that are labelled “Standardized to 3% Rosavin) to assure proper quality and dosing.

See: Rhodiola Rosea

 

Riboflavin

May require up to 3 months before full benefits may be appreciated. Studies found up to 68% improvement in migraines
Dose: 400mg/day

 

Salicin

Salicin is chemically related to aspirin and offers the same pain benefits but does not affect platelets so it offers no protection against heart attacks or strokes. It is derived from willow bark but can be found in many other plants including meadowsweet, willow bark, cottonwood, poplar, aspen and wintergreen. This is actually an abortive for headaches, not a preventative.
Dose: 240mg /day

Contraindications: Should not be used by those allergic to aspirin.

 

SAMe (S-adenosylmethiomine)

This is a precursor to many of the neurotransmitters that play a role in pain and depression. Having been in popular use in Europe since 1975, SAMe may offer relief for the pain of arthritis with effectiveness equal to ibuprofen and other non steroidal anti-inflammatories (NSAIDs). It is also useful for treating depression with effectiveness equal to many prescription antidepressants. It may take one or more weeks of use for the benefits to be fully appreciated. SAMe appears to be free of any interactions with other medications and has few if any side effects.

 

Dose: Up to 1200mg – 1400mg/day. Start by taking 200mg twice a day and build the dose up slowly, increasing the dose every week or so until a maximum benefit is perceived.
Precautions: SAMe should be avoided in those with bipolar disorder as it may trigger manic behavior.

See: SAMe

 

Commercial Products

Trigemin

Trigemin contains comprehensive multivitamins and combines the key ingredients riboflavin, magnesium, feverfew, and co-enzyme q10 that have been shown to reduce the frequency, and intensity of migraine headaches. Headache sufferers may find that it is easier to take one dietary supplement rather than each individual ingredient separately, savings in costs and quantity of pills.

www.Trigemin.com
(877) 938-7432 Ask for Amy and receive a 20% discount on your purchase

 

References

 Headaches – Medication-Overuse Headaches

  1. Update on Medication-Overuse Headache and Its Treatment – 2015
  2. Medication-overuse headache – a review – 2014
  3. EFNS_guideline_2011_treatment_of_medication_overuse_headache
  4. Practical management of medication-overuse headache – 2006
  5. Medication overuse headache is a manifestation of opioid induced hyperalgesia – a neuroimmune hypothesis and novel approach to treatment – 2013
  6. Medication-overuse headache and opioid-induced hyperalgesia – A review of mechanisms, a neuroimmune hypothesis and a novel approach to treatment – 2012
  7. Codeine, Heightened Pain Sensitivity and Medication Overuse Headache – A Neuroimmune Hypothesis and Novel Treatment Strategy. – 2015
  8. A Critical Evaluation on MOH Current Treatments. 2017 – PubMed – NCBI
  9. The journey from genetic predisposition to medication overuse headache to its acquisition as sequela of chronic migraine – 2018
  10. Treatment of withdrawal headache in patients with medication overuse headache – a pilot study – 2017
  11. Health and quality of life in patients with medication overuse headache syndrome after standardized inpatient rehabilitation – 2017
  12. OnabotulinumtoxinA in the treatment of patients with chronic migraine – clinical evidence and experience – 2017
  13. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) for the prevention of tension-type headach – 2015 – PubMed – NCBI
  14. Treatment of medication-overuse headache – A systematic review. – PubMed – NCBI
  15. Effect of selective serotonin reuptake inhibitor treatment on the prognosis of patients with medication overuse headache – 2018
  16. Advice alone versus structured detoxification programmes for complicated medication overuse headache (MOH) – a prospective, randomized, open-label trial – 2013
  17. Detoxification for medication overuse headache is the primary task – 2011
  18. Detoxification for medication overuse headache is not necessary. 2012 – PubMed – NCBI
  19. Treatment of withdrawal headache in patients with medication overuse headache -a pilot study – 2017
  20. Inhibition of toll-like receptor 4 alleviates hyperalgesia induced by acute dural inflammation in experimental migraine – 2018

 

 Headaches – Medication-Overuse Headaches – Novel New Management

  1. Medication overuse headache is a manifestation of opioid induced hyperalgesia – a neuroimmune hypothesis and novel approach to treatment – 2013
  2. Medication-overuse headache and opioid-induced hyperalgesia – A review of mechanisms, a neuroimmune hypothesis and a novel approach to treatment – 2012
  3. Codeine, Heightened Pain Sensitivity and Medication Overuse Headache – A Neuroimmune Hypothesis and Novel Treatment Strategy. – 2015
  4. The journey from genetic predisposition to medication overuse headache to its acquisition as sequela of chronic migraine – 2018
  5. OnabotulinumtoxinA in the treatment of patients with chronic migraine – clinical evidence and experience – 2017
  6. Inhibition of toll-like receptor 4 alleviates hyperalgesia induced by acute dural inflammation in experimental migraine – 2018
  7. Botulinum Toxin Type A—A Modulator of Spinal Neuron–Glia Interactions under Neuropathic Pain Conditions – 2018

 

 CAM, Headaches – Overview

  1. Headaches – Diet & CAM Summary
  2. Dietary Supplements for Pain and Headache _Supplemental Article

 

CAM, Headaches – Butterbur

  1. Prophylaxis for Migraine- Herbal Remedies

 

CAM, Headaches – Vitamin D

  1. Vit D levels in pain and headache patients

Emphasis on Education

 

Accurate Clinic promotes patient education as the foundation of it’s medical care. In Dr. Ehlenberger’s integrative approach to patient care, including conventional and complementary and alternative medical (CAM) treatments, he may encourage or provide advice about the use of supplements. However, the specifics of choice of supplement, dosing and duration of treatment should be individualized through discussion with Dr. Ehlenberger. The following information and reference articles are presented to provide the reader with some of the latest research to facilitate evidence-based, informed decisions regarding the use of conventional as well as CAM treatments.

 

For medical-legal reasons, access to these links is limited to patients enrolled in an Accurate Clinic medical program.

 

Should you wish more information regarding any of the subjects listed – or not listed –  here, please contact Dr. Ehlenberger. He has literally thousands of published articles to share on hundreds of topics associated with pain management, weight loss, nutrition, addiction recovery and emergency medicine. It would take years for you to read them, as it did him.

 

For more information, please contact Accurate Clinic.

 

Supplements recommended by Dr. Ehlenberger may be purchased commercially online or at Accurate Clinic.

Please read about our statement regarding the sale of products recommended by Dr. Ehlenberger.

Accurate Supplement Prices

 

 

.