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Vestibular Migraine, Neurological Disorder

vestibular migraine balance uv lights headaches tinnitus

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#1 Mind

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Posted 23 May 2015 - 12:23 PM


I have a friend who has been dealing with a neurological disorder for several years now. It is very stressful for him and makes it difficult for him to work in an office setting (and life has become a rather hellish experience). When symptoms become severe, he has to take a break and go to a darker quieter location in order to "recover".

 

The symptoms include tinnitus, trouble with balance, migraines, sensitivity to computer screens and UV lights, among other things. He has undergone a battery of tests for years, including MRI, checking for cancer, SSCD, etc... He has seen many top specialists. Finally this year one neurologist suggested vestibular migraine as the main "disease". He is going to test out 5 different drugs (mainly SSRI's) and see if they help. Has anyone else experienced vestibular migraines, or something similar? Any ideas on treatment?



#2 FW900

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Posted 23 May 2015 - 01:54 PM

Has he been to a neurotologist or an ENT at least? It sounds like there may be something wrong with his inner ear if balance is affected and that could be causing a lot of his symptoms.

 

Glutamate is theorized to cause a lot of these chronic headaches and migraines. Barbiturates are very effective for headaches (which is one reason aside from epilepsy why they haven't gone away) as opposed to other GABAergics, as they partially block AMPA receptors further dulling glutamate transmission. Taking them all the time unfortunately will result in rebound migraines, so they must be used sparingly.

 

Memantine and other NMDAr antagonists also would dull glutamate release and they have been used successfully for chronic migraines: Memantine in the preventive treatment of refractory migraine. Subjective tinnitus is also theorized to be caused by glutaminergic dysfunction, and memantine has evidence of treating this also (search pubmed for memantine + tinnitus).

 

I'm not a professional but I'd strongly suggest he try memantine based on the above and get a prescription for fioricet (contains a barbiturate) for days when his symptoms are the worst. He might as well try indomethacin too, probably the best NSAID for headaches in my opinion.



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#3 OneScrewLoose

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Posted 28 May 2015 - 01:42 AM

SRRIS, really? For migraines? Tricyclics are the standard for migraines. Be wary of the doctor. I attached a study that should help a lot. One part of it:

 

 


Three studies reported observations when several drugs were used, either as monotherapy or in combination. In a retrospective review of 89 patients diagnosed with migraine-related dizziness or vertigo, 79 were treated pharmacologically [Johnson, 1998]. Drugs used included benzodiazepines in 90% (mostly clonazepam), tricyclic antidepressants in 42% (amitryptiline or nortryptiline), betablockers in 35% (propanolol), selective serotonin reuptake inhibitors in 7.6% of patients (fluoxetine, sertraline or paroxetine) and calcium-channel blockers (verapamil or diltiazem) in 7% of patients. With this approach, a substantial response (defined as improvement of symptoms such that they would no longer interfere with daily activities) was seen in 92% of patients with episodic vertigo, 89% of patients with positional vertigo, and 86% of patients with nonvertiginous dizziness. None of the patients responded to the calcium antagonists used. At the moment of improvement, 44% of patients were receiving one drug, 33% were receiving two drugs and the remainder were receiving between three and six drugs.

 

So, Clonazepam, Nortriptyline, and Toprol XL might make a potent combo (I like Toprol, time-released metoprolol, because it lasts 24 hours and there's no need to worry about dosing. Being beta-1 specific, it does not have a lot of the sides of other beta blockers).

 

It also notes that H1 antagonists/antihistamines like Benadryl, and especially Promethazine, can help with acute symptoms.

 

Good luck.

Attached Files

  • Attached File  VM.pdf   94.79KB   4 downloads

Edited by OneScrewLoose, 28 May 2015 - 01:43 AM.


#4 Jochen

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Posted 24 June 2015 - 10:41 AM

not much in this one except physical vestibular therapy: http://www.ncbi.nlm....les/PMC3105632/

 

Some ideas through the 'Brain that heals itself' from Norman Doidge

maybe a bit out there, but I would look into the work of Tomatis, Madaule or Ron Minson.

An alternative could be the 'PONS' device kind of treatment.



#5 Mind

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Posted 24 June 2015 - 05:32 PM

Thanks for the suggestions so far. My friend is trying out various SSRI's lately. These have only lowered the volume of the tinnitus a little bit.



#6 Duchykins

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Posted 24 June 2015 - 10:40 PM

I've been a migraineur for almost 12 years now.   What you've listed sounds like pretty standard common migraine (migraine without aura) symptoms.

 

Vestibular migraine isn't wholly accepted as a true migraine variant (yet? who knows).  The reason for this is that many of the neurological symptoms associated with migraine are caused by the usual irritation and excitation of major nerves around the brain and face.  We know migraines can be accompanied by sinus inflammation, tearing, and postnasal drip (all of which abruptly disappear once the migraine resolves).  It makes perfect sense that the inner ear can be affected to because of the intimate relationship between the sinuses and inner ear.  Tinnitus during migraine can be easily attributed to over-excitation of auditory nerves, especially if the migraine itself was triggered by excess extracellular glutamate (which is common).  This is the same reason tinnitus is a common symptom of benzo withdrawal, or anything that has downregulated GABA.  A migraine attack can also screw with someone's ability to speak clearly or coherently (I used to get this one all the time, speech slurring and skipping whole parts of sentences).  It can also cause weakness in muscles (I'm not just talking about hemiplegic migraine here) and affect walking, standing, holding objects in the hand, stuff that requires a high degree of fine motor coordination like typing and writing by hand.  Other neurological symptoms include stuff like sensitivity to motion, increased urination, excessive yawning "for no reason", difficulties with reading comprehension, other cognitive skills, other things. Migraine is definitely not just a really bad headache.

 

Most doctors, even neurologists, have not kept current with the scientific literature on migraine.  They are woefully undereducated in the mechanism of migraine, causes, effective prophylaxis and proper abortives.  We still see MDs giving migraineurs prescriptions for narcotic and opiate painkillers (these are the worst classes of drug a doc can prescribe for migraine because they not only do not interrupt a migraine but can make it worse and increase frequency of migraine on the rebound).  All I have to say about that is that if his neurologist didn't give him one of the triptans to try then it's time for a new neurologist.

 

It is true that some of the SSRIs have been used off-label for migraine prophylaxis, and from what I can tell their efficacy is about the same as treating depression itself (meaning they don't seem to outperform placebo, results vary in the extremes including the meds triggering migraines and making them worse).  The tricyclics seem to be popular for some apparent reason, amytriptyline particularly.  For me personally, amitriptyline was a nightmare, I kept waking up with headaches that quickly became migraines.  But I have spoken to other migraineurs who believe it helps them.

 

Some of the anticonvulsants have been tried on migraines, also with varying degrees of success.  The type of migraine also makes a difference here.   Classic migraine (migraine with aura) has a slightly different mechanism than common migraine (migraine without aura) and responds better to treatments that have less effect on common migraine.   Gabapentin, depakote, topamax are the favorite anticonvulsants prescribed by doctors.  I have tried all three and I could only tolerate the gabapentin's side effects (topamax triggered nasty migraines for me) at low doses.

 

Other shit commonly attempted in migraine prophylaxis: atypical antipsychotics, beta-blockers, hormones, botox

 

I will just put a personal note in here to say that I've been through all of the above except botox over the past decade, and the only prescriptions so far that have truly worked to reduce both the frequency and severity of attacks is bupropion and ambien.  I only list ambien here because a migraineur's need for regular sleep pattern comes before anything else.  This includes keeping the same hours on weekends, no staying up late to party, read, or whatever it is people like to do on weekends.  Go to sleep at the same time every single day, no exceptions.  Do not "sleep in" on the weekends either, keep the schedule the same, sleep the usual weekday hours.  The migraine brain does not like change.   Most people probably do not need to resort to sleep aids like ambien in order to achieve this, they can do it just by making lifestyle changes and sticking to those changes, but some do need it if they have a long history of abnormal sleep patterns.  The bupropion is not as commonly prescribed for migraine prevention and from what I've read about it so far, its efficacy seems to vary just as much as all the other migraine prophylactics.  

 

The bottom line is figuring out what your specific problems are.  Migraine brains tend towards over-excitation and hyper-reactiveness to environmental triggers that wouldn't affect others.  Neuronal excitability is altered in migraineurs.   I'll list a small variety of issues commonly observed in migraine:

 

inadequate dopamine going around to modulate glutamate  

 

hypersensitivity to dopaminergic stimulation (this is why opiates and opiods are usually shit treatments for migraines; they are dopamine agonists that also mess with glutamate) (possible applications for dopamine antagonists and reuptake inhibitors) (counterintuitive but the reuptake inhibitors don't force extra dopamine where it's not supposed to go, unlike agonists, so this could help so people keep dopamine leveled out if they don't tolerate the antagonists well)

 

inadequate GABA going around to control glutamate

 

inadequate mitochondrial energy production and/or transport  (this is a big one because it impacts so many different things in brain that are known to be associated with migraine)

 

spikes in serotonin level (the belief that chronically low serotonin is the cause of migraines is generally wrong, we now know that lowered serotonin in often observed during a migraine attack because, for as yet unknown reasons during the cascade of effects once migraine is triggered, the body starts dumping serotonin and excreting it through urine--the opposite has been observed at the onset of migraine prodrome, a sudden increase in serotonin followed by serotonin loss)  This is why they started throwing SSRIs, tricyclics at migraineurs, with limited success.

 

Genetic mutations found to be associated with migraine:

 

CKIdelta (two distinct mutations in here affecting synthesis of casein kinase 1) 

PGCP and MTDH/AEG-1 on chromosome 8  (EAAT1 and/or EAAT2 abnormalities affecting glutamate uptake & interfering with the brain's ability to clear glutamate)

 

 

Prophylactic supplementation demonstrated to be effective across different migraine types (in order of importance according to my personal experience)

 

coQ10  (I do 100 mg once a day after a few months of 150-300mg /day as done in different migraine studies)

riboflavin (studied at 400mg/day in migraineurs but I've found effectiveness at 150-200 mg)

magnesium (inclusion of all major electrolytes including potassium and calcium must be kept in mind) (up to 600 mg/day in migraine studies)

butterbur (this can be risky if butterbur is purchased from poor manufacturers) (maybe keep this as a last resort kind of thing)

 

COMBINE!  Nutrition-related supplements for migraine prophylaxis are not very effective taken alone, they need to work together to get any return on your money.

 

 

Very little clinical evidence for at this time, but honorable mentions:

 

all other active B vitamins (no analogs to interfere with uptake of active Bs)

methylcobalamin or hydroxocobalamin (up to 5 mg, sublingual, no cyanocobalamin)

pantethine (300 mg, can go up to 600 mg so don't worry about extra in B complex if it's there)

Albion multimineral 

zinc (up to 35 mg with multimineral)

lysine (500 mg twice daily)

taurine (500 mg once or twice daily)

citrulline (500 mg once of twice daily)

creatine (500 mg once daily) (there is no good reason to go over 1 gram a day, ever and if used inappropriately can easily trigger migraines)

carnitine (tested with magnesium in migraine reduction) (not acetylcarnitine, these do not have identical mechanisms with carnitine in the brain)

theanine

GABA

vitamin D (no more than 2,000 IU)

vitamin C (no more than 500 mg)

vitamin A (as beta carotene no more than 10,000 IU)

vitamin E (natural d-alpha, 200 IU)

n-3 (low EPA, DHA no more than 450 mg -- scientific evidence supporting omega 3 supplements in migraine is weak and conflicting)

 

None of these are likely to abort a migraine in progress nor are intended to abort migraines (except perhaps lysine which actually is sometimes given intravenously by doctors for this purpose).  Neither are most of these likely to be terribly effective by themselves (eg all the supplements that support mitochondrial energy and transport -- coQ10, riboflavin, creatine, citrulline, ribose, carnitine, pantethine, taurine, electrolytes -- work best when taken together in modest doses) .  Those last ones are important because low cellular energy = decreased glutamate excitotoxicity threshold = beaucoup migraines ... low cell energy also interfering with histamine breakdown and various important neurotransmitter synthesis, other shit that matters to migraineurs

 

 

 

Keep in mind to try:

 

zyrtec 10 mg (not claritin)

other antihistamines

 

 

Stop immediately:

 

daily caffeine use (taper down) (caffeine withdrawal symptoms often last a week but can go up to a month) (people that say caffeine kills their headaches are dealing with caffeine withdrawal even 5-6 days out) (after the withdrawal period it's okay to still have some caffeine periodically)

energy drinks (stop today and this is not simply due to caffeine)

skipping meals

drinking alcohol 

daily or regular OTC analgesic use (excedrin, ibuprofen, tylenol, aspirin, etc)

smoking (patches and vaping are okay for migraine because the triggers involve nearly everything but the nicotine in tobacco products)

 

 

Reduce in diet or simply be aware of common triggers:

 

nitrates (common sources: deli meats, hotdogs, celery, lettuce, commercially bottled water, etc)

histamine 

tyramine

phenylethlyamine (because of tyramine)

phenylalanine (goes back to tyramine)

eggs

dairy

soy sauce, teriyaki sauce

most fruit juices

high protein meals (don't slam your body with protein, you want a slow but steady influx over the day)

smoked or dried foods (meats, sometimes fruits)

artificial sugars (stop eating "sugar-free" crap) (strongly avoid aspartames)

stop eating "low-fat" and "nonfat" crap

stop eating "low carb" crap (migraneurs need complex carbs, but not simple carbs)

 

Popular supplements that can easily trigger migraines:

 

ginseng

arginine

glutamine

tyrosine

phenylalanine (all forms)

various protein powders/drinks/snackbars (these usually deliver relatively high concentrations of glutamic acid, aspartic acid, phenylalanine, tyrosine, tryptophan; these are best taken in smaller amounts over the day as one would get from whole foods)

noopept

sunifiram (or anything else that is strongly glutamatergic)

aspartates 

 

 

Lifestyle DO:

 

consistent sleeping hours

mild-moderate exercise (big workouts can trigger migraines)

mind the air quality in your home 

healthy snacks throughout the day

well-rounded diet

hydrate

fiber (one reason is to keep estrogen moving out of the body; affects serotonin and a whole host of shit)

probiotic (among other things, probiotics help GABA in the gut--this is why kefir is an old-school feel-good food)

'ware the noise pollution

'ware the bright lights

'ware the strong odors (perfume, cologne, cleaning products, etc)

'ware the weather (barometric pressure)

 

 

Dogmatic or quack bullshit you might find on the internet claiming to be the answer to migraine:

 

low-carb diets (unless by "low-carb" they mean only weeding out simple carbs while leaving plenty of complex carbs)

high-protein diets

other extreme diets (high fat, super high carb, gluten-free, wheat-free, raw vegan, vegan, etc.  Migraineurs need balance above all things.  There is no reason for these until you have a diagnosis of certain conditions that your personal migraines are linked to and that need certain kinds of strict diets)

(migraineurs try these diets all the time and more often than not, they get an increase in migraines.  A reduction in common migraines are the exceptions with all of these diets, not the rule)

high dose coconut oil

high dose fish oil

high dose vitamin C

nearly every "migraine diet" in history (aside from avoiding super common triggers like alcohol, migraineurs are too different for these diets to work on most)

 

chiropractic (as migraine is a genetic/neurological problem, this will not work for true migraines but may help headaches specifically caused by physical injury)

acupuncture (similar to chiropratics but less useful, mostly as placebo, does not perform better than "fake" acupuncture)

 

phytoestrogen scaring (phytoestrogens are not true estrogens and actually have some antiestrogen properties which is why they are associated with lower rates of prostate, uterine, ovarian, breast cancers -- meanwhile, the dairy products that are chock full of true mammalian estrogen have none of these properties.  I'm not saying dairy is bad because, for people who are lactose tolerance, it's not really such a bad thing.  I'm just saying don't let bullshit like this lead to your making changes in your diet that could leave you worse off than before)

chocolate scaring (chocolate is not really a trigger, it's just associated with migraine due to the cravings people get while in prodrome; the migraine already started and the brain is trying to stop it)

MSG scaring (aside from being wary of soy sauces, teriyaki sauces due to the fact that they are fermented) (studies keep failing to find that MSG consumption exacerbates migraines) (remember that this is just glutamate which you do need to have in your diet and get all the time from protein, but don't want a lot of in one sitting: we're back to balance)

 

 

 

These are tiny, off the top of my head lists.  It's a mess, I know.  Don't look to me for more comprehensive answers because 1) we still have a long way to go to learn more about migraine, and 2) I don't know everything about migraines despite being very strongly motivated in the last decade to learn as much as one person can learn about migraines, in order to stop them

 

While there is quite a lot of bullshit and old myths about migraines on the internet, this can be successfully navigated by doing five things: sticking to the scientific literature and keeping notes on yourself, looking for patterns, turning your fear of migraines into willpower to stick to methods that work to reduce them, and experimenting on yourself, to try to pinpoint what your own weaknesses are and what works best to mitigate those weaknesses.  No two migraineurs seem to have the same sensitivities, triggers, or effective prophylactics, prescription or not.  

 

The best advice to give a migraineur is to get on the internet and educate themselves about migraine.  Knowledge is the best medicine for most people getting migraines.  This will save a migraineur months and years of suffering, playing musical chairs with prescriptions and their side effects, and general frustration with their doctors.  Right now, with how many doctors ignorant of the most current discoveries in migraine, that is the only real way a migraineur can take charge, empower themselves to get their migraines under control so the migraines don't control them.  As much, heh.  The migraines still control you a bit because you are basically rearranging your life around them, even if you achieve a major reduction in the migraines, because you have to keep doing it, probably for the rest of your life or until better pharmaceuticals are invented.


Edited by Duchykins, 24 June 2015 - 11:37 PM.

  • Well Written x 1

#7 ceridwen

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Posted 24 June 2015 - 11:37 PM

@Mind could your friend be electrically sensitive. Are his symptoms triggered by electricity? There is a Wiki on electrical hypersensitivity. This often triggers neurological problems



#8 Duchykins

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Posted 24 June 2015 - 11:38 PM

@Mind could your friend be electrically sensitive. Are his symptoms triggered by electricity? There is a Wiki on electrical hypersensitivity. This often triggers neurological problems

 

 

No.



#9 Mind

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Posted 30 June 2015 - 05:48 PM

@Mind could your friend be electrically sensitive. Are his symptoms triggered by electricity? There is a Wiki on electrical hypersensitivity. This often triggers neurological problems

 

I suppose it is not out of the realm of possibility, but it just developed about 10 years ago, and my friend is in his mid-40s. It has gotten a little worse over the last 2 or 3 years. I have told him often that he should get more regular sleep. I think it is a significant part of the problem.

 

He also said thank you very much Duchykins, for the very detailed response. Your information has given him some hope and new things to investigate.



#10 Duchykins

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Posted 01 July 2015 - 05:11 AM

I am happy to aid a fellow migraineur and sincerely hope he can figure out how to control migraines at least a little bit and improve his quality of life. Tell him I am available for brain-picking any time since I glossed over quite a bit in order to just get the basics out.

And you are a very good friend to help him like this. :)

#11 APBT

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Posted 01 July 2015 - 08:51 PM

Duchykins is clearly quite knowledgeable and was less than luke-warm on beta blockers. FWIW, I have a close family member (male) who has struggled with major migraines for decades.  He has found permanent relief with inderal.



#12 Duchykins

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Posted 01 July 2015 - 08:58 PM

Duchykins is clearly quite knowledgeable and was less than luke-warm on beta blockers. FWIW, I have a close family member (male) who has struggled with major migraines for decades. He has found permanent relief with inderal.


I'm really sorry about that, it wasn't my intent to imply anything on that list, beta blockers, botox, atypical antipsychotics etc as ineffective. These have been demonstrated to help with migraines in some people. But like many of the other methods, its kind of a crapshoot and usually a matter of trial and error.

#13 Jochen

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Posted 02 July 2015 - 05:03 AM

well, I used to have severe migrain headaches (as in first small throbbing pain, then later head almost exploding kind of painm which makes me unable to function. Think worst toothache *10)  as well, but luckily that is a thing of the past (haven't had a severe attack in about 2 years now - *knock on wood').

 

I did start to do a bit more exercise, started to meditate again, focus even more on my food intake, take some supplements, ...

 

The thing that did help me in general after an attack is the LLLT. I personally use a 850nm 3 times per week on my skull, but the one that has helped me most anecdotally the most is an intranasal version (I have an 810nm).

 

and of course it is the combination of all the things that I have done that led to the solution. YMMV.

 

In my initial comment I was trying to find something specifically for OP's version of migrain. Just wanted to throw in my anecdotal quick story. There is a potential light at the end of the tunnel ...

 

Good luck!



#14 Duchykins

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Posted 03 July 2015 - 04:59 AM

well, I used to have severe migrain headaches (as in first small throbbing pain, then later head almost exploding kind of painm which makes me unable to function. Think worst toothache *10)  as well, but luckily that is a thing of the past (haven't had a severe attack in about 2 years now - *knock on wood').

 

I did start to do a bit more exercise, started to meditate again, focus even more on my food intake, take some supplements, ...

 

The thing that did help me in general after an attack is the LLLT. I personally use a 850nm 3 times per week on my skull, but the one that has helped me most anecdotally the most is an intranasal version (I have an 810nm).

 

and of course it is the combination of all the things that I have done that led to the solution. YMMV.

 

In my initial comment I was trying to find something specifically for OP's version of migrain. Just wanted to throw in my anecdotal quick story. There is a potential light at the end of the tunnel ...

 

Good luck!

 

 

After the attack?  It didn't abort an attack?  Or decrease the frequency of attacks?

 

I'm interested in this LLLT because I vaguely remember something about it possibly boosting ATP production, and if so then that means there is possible application in people whose migraines are caused by dysfunctions with mitochondrial energy.  However, I do distinctly remember mentally categorizing it with acupuncture (placebo).  So that means I read some paper that found its efficacy probably only slightly superior to placebo; I wouldn't have associated LLLT with acupuncture or chiropractic for any other reason.

 

I suppose I should try to go find those papers again.  But I'm feeling pretty lazy right now.

 

I'd like to know more about your experience, if you don't mind telling me. 



#15 PeaceAndProsperity

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Posted 03 July 2015 - 01:08 PM

Has anyone tried glutamine antagonists as a migraine treatment? Since it is described that people with migraines are sensitive to glutamine found in cheese and elsewhere, I think this would make sense.

 



#16 Duchykins

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Posted 04 July 2015 - 04:20 AM

"glutamine found in cheese "

 

When cheese and migraine are mentioned together, it's always the tyramine content that is being referred to.  Tyramine is found in any aged foods and naturally occurs in any foods that are allowed to sit out and ripen or otherwise age (in the fridge, etc).   So for example, the longer a banana sits on the counter and ripens, the more tyramine it will have by the time you eat it.     Cheese wouldn't be a special source of glutamine anyway since you're going to find significant amounts of it in any protein source, especially meat.



#17 PeaceAndProsperity

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Posted 04 July 2015 - 05:27 PM

"glutamine found in cheese "

 

When cheese and migraine are mentioned together, it's always the tyramine content that is being referred to.  Tyramine is found in any aged foods and naturally occurs in any foods that are allowed to sit out and ripen or otherwise age (in the fridge, etc).   So for example, the longer a banana sits on the counter and ripens, the more tyramine it will have by the time you eat it.     Cheese wouldn't be a special source of glutamine anyway since you're going to find significant amounts of it in any protein source, especially meat.

"MSG or excess glutamine/glutamic acid consumption can worsen vasodilatory migraines because glutamate excess causes vasodilation."

http://selfhacked.co...-and-solutions/ (to quote a random example from Google)

I read elsewhere that among the triggers of migraine attacks such as loud noises and stress, glutamine was one of them.

"A growing body of preclinical and clinical data supports the notion of aminergic dysfunction in migraine headache including alterations in both the glutamatergic and glutaminergic systems"

http://www.ncbi.nlm....les/PMC2714306/



#18 Duchykins

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Posted 05 July 2015 - 03:38 AM

 

"glutamine found in cheese "

 

When cheese and migraine are mentioned together, it's always the tyramine content that is being referred to.  Tyramine is found in any aged foods and naturally occurs in any foods that are allowed to sit out and ripen or otherwise age (in the fridge, etc).   So for example, the longer a banana sits on the counter and ripens, the more tyramine it will have by the time you eat it.     Cheese wouldn't be a special source of glutamine anyway since you're going to find significant amounts of it in any protein source, especially meat.

"MSG or excess glutamine/glutamic acid consumption can worsen vasodilatory migraines because glutamate excess causes vasodilation."

http://selfhacked.co...-and-solutions/ (to quote a random example from Google)

I read elsewhere that among the triggers of migraine attacks such as loud noises and stress, glutamine was one of them.

"A growing body of preclinical and clinical data supports the notion of aminergic dysfunction in migraine headache including alterations in both the glutamatergic and glutaminergic systems"

http://www.ncbi.nlm....les/PMC2714306/

 

 

Yeah I know all of that, and more on the topic of glutamine.  I mentioned it in my first post here.   What I said was that CHEESE was not a particularly special source of glutamine, when CHEESE and MIGRAINE are talked about, it is the TYRAMINE in cheese that is the problem.

 

I also said that studies keep failing to show that MSG consumption really does increase rate of migraine.  Example:  

 

http://www.ncbi.nlm....pubmed/16999713

 

CONCLUSIONS: MSG has a widespread reputation for eliciting a variety of symptoms, ranging from headache to dry mouth to flushing. Since the first report of the so-called Chinese restaurant syndrome 40 years ago, clinical trials have failed to identify a consistent relationship between the consumption of MSG and the constellation of symptoms that comprise the syndrome. Furthermore, MSG has been described as a trigger for asthma and migraine headache exacerbations, but there are no consistent data to support this relationship. Although there have been reports of an MSG-sensitive subset of the population, this has not been demonstrated in placebo-controlled trials.

IMPLICATIONS FOR PRACTICE:

Despite a widespread belief that MSG can elicit a headache, among other symptoms, there are no consistent clinical data to support this claim. Findings from the literature indicate that there is no consistent evidence to suggest that individuals may be uniquely sensitive to MSG. Nurse practitioners should therefore concentrate their efforts on advising patients of the nutritional pitfalls of some Chinese restaurant meals and to seek more consistently documented etiologies for symptoms such as headache, xerostomia, or flushing.

 

Now as I've told others before, a 500mg dose of glutamine supplement can sometimes trigger a migraine in me if I have other triggers occurring around the same time.  It is not every single time but it was enough that I threw away the glutamine after one week.  But I can still wolf down a bunch of chicken with no problem, chicken which has way more than 500 mg of glutamine (suggesting the glutamine is best absorbed with all the other chemicals it naturally occurs with).   MSG riddled food is a different matter and doesn't seem to bother me unless it's really salty and has something fermented in it; in other words, there is no pattern of migraine and MSG for me, I'm sure MSG probably has some effect but it is minimal by comparison to real and very consistent triggers like alcohol and barometric pressure changes.

 

 

http://selfhacked.co...-and-solutions/

 

I have read this article before, last year.  Twice and three times over; I dissected the hell out of it during my "research."

 

Selfhacked is not a good source of information about migraine.  In fact I'm not sure if it's a good source of anything if this is the average quality of its articles.  There are some useful, true bits in this migraine article but there are other bits that are flat wrong, or are questionable conclusions, reached by the author attempting to interpret scientific data without sufficient background knowledge, that can be harmful to migraineurs if they make decisions about their lifestyle based on that information.  

 

For example, that article repeatedly says that tyramine causes vasoconstriction (true) but the author makes it seem as if it only causes vasoconstriction headaches (nonmigraine), a migraineur reading this article and not being pre-armed with info about tyramine would come away from this article with the impression that tyramine is not a migraine trigger.  BAD.

 

Another example, the author writes that since serotonin is a vasoconstrictor (it is actually one of the most potent, most important vasoconstrictors in the body), people who get tension-type headaches (vasoconstrictive) might tend to have elevated serotonin, perhaps from tryptophan in food or SSRIs.  This is entirely plausible.  However, the author again presents this as vasoconstriction problem (nonmigraine).  Again, a migraineur would come away from this thinking that elevated serotonin would not trigger migraine (or worse, assume that they have chronically low serotonin on this information alone).  VERY BAD.

 

Yet another example: acetylcholine.  The author presents acetylcholine as a vasoconstrictor.  WRONG.  Under different circumstances, ACh can cause either dilation or constriction, but causes dilation more often than constriction.   Glutamate, histamine, and acetylcholine have an interesting relationship: they tend to rise and fall together (but not always).  ACh triggers glutamate release, for example (and vice versa, and things that stimulate ACh release also tend to trigger glutamate release, and vice versa). This is relationship with glutamate is one of the reasons choline has potential nootropic uses.  ACh has also been documented to trigger histamine release as well (at least in rats).

 

Migraineurs tend to benefit from various anti-cholinergic agents as prophylactics.  From experimentation with myself at least, I know that I am sensitive to foods high in choline, cholinergic agents and acetylcholinesterase inhibitors.  I have already beaucoup ACh.

 

"Excess glutamate/glutamine."  The author says this a lot.  I get the distinct impression he doesn't fully understand what he's talking about.  Migraine and "excess" glutamate is about extracellular glutamate and the calcium channels of cells.  He talks a lot about glutamate but never once mentions the actual process of excitotoxicity.  This is important because there is no universal "level" of extracellular glutamate at which a migraine is triggered.  The threshold varies day to day and even different times during a single day.  It's also important because you can do simple things to raise your threshold such as keeping your electrolytes up, keeping cell energy up, other things that will decrease the chances of more calcium channels opening despite increases in extracellular glutamate.

 

I think perhaps the most egregious error with the selfhacked article is the way it presents vasoconstriction vs vasodilation headaches: that vasoconstriction has nothing to do with migraines (wrong) and it acts as if vasoconstrictive agents will not cause migraines (also wrong, very wrong).

 

A lot of different things can trigger migraines, in fact every cause listed in that article can trigger migraine, because above all the migraine brain does not like change very well.  It's overexcitable and does not adapt well.  This includes vasoconstrictive changes in the brain.  Lots of caffeine, serotonin spikes, stress, etc can easily kick off the migraine cascade, which would then become a vasodilatory problem.  As I said before, the body begins dumping serotonin at the onset of migraine, sometimes after a sharp increase in serotonin from whatever the patient's baseline is.  Ergo, the out of control vasodilation.   This is why slamming the brain with serotonin can usually abort an attack.  But this does not mean that low serotonin was the original cause of the migraine.  It was a symptom of the migraine itself.

 

 

 

So ... yeah, that was the short version.  I could say a lot more about just this one article but I think I'll stop there.  Lots of bullshit on the internet, as I stressed in my first post.

 

 

 

But you also said 

 

 

"I read elsewhere that among the triggers of migraine attacks such as loud noises and stress, glutamine was one of them."

""A growing body of preclinical and clinical data supports the notion of aminergic dysfunction in migraine headache including alterations in both the glutamatergic and glutaminergic systems""

 

That is about abnormalities in our aminergic pathways (involving what we do with monoamines), not ingesting glutamine as a trigger.  This study is not even about the cause or mechanism of migraine, but the increased perception of pain and efficacy of various migraine treatment regimens.

 

 

 

The biggest reason migraineurs have increased sensitivity to pain is the same reason anyone with a chronic pain condition has an increased sensitivity: pain pathways are strengthened, reactivity to pain stimulus strengthened because they are stimulated so often and for such extended periods of time.  This is a side effect of a basic survival mechanism.  Pain memory is old news.  Also, "neurons that fire together wire together," perhaps you've heard that before--it's in play with migraines, it's probably part of the reason migraines can actually alter your brain structure.  We can even have these things I like to think of as phantom migraines, which is the lingering perception of pain despite the fact that the actual migraine had been aborted: the nerves haven't quite settled down yet.  It can last up to a few hours in my personal experience.  You can tell if the migraine attack has been aborted by the disappearance of all the other symptoms, even if you have this vague sensation of pain or throbbing afterward.  

 

Migraineurs can also trigger more attacks simply by being afraid they will happen.  That kind of terror stresses you out pretty bad.  The nocebo effect is in action here.  This is one of the reasons a "migraine diet" might actually lead to a decrease in attacks: because the migraineur feels more in control.  In other words: placebo.

 

 

_____________

Bottom line: going out of your way to decrease your glutamine intake will mean you synth less GABA.  That's not good and will lead to problems unrelated to migraine, if not eventually increasing the rate of migraine attacks (and increasing fear of attacks and probably fear of everything else too).   This is why migraine diets often fail; they try to cut out nutrients that are necessary.  

 

The only sustainable way of handling the gluta- issues in migraine is to focus on normalizing what our brains do with these neurotransmitters


Edited by Duchykins, 05 July 2015 - 03:47 AM.


#19 sheepdog_lord

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Posted 15 May 2023 - 02:53 AM

I know this is kind of an older thread but did your friend ever get relief from their chronic migraines? dealing with the same thing myself right now and it blows...



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#20 sheepdog_lord

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Posted 15 May 2023 - 11:56 PM

I suppose it is not out of the realm of possibility, but it just developed about 10 years ago, and my friend is in his mid-40s. It has gotten a little worse over the last 2 or 3 years. I have told him often that he should get more regular sleep. I think it is a significant part of the problem.

 

He also said thank you very much Duchykins, for the very detailed response. Your information has given him some hope and new things to investigate.

 

idk if you saw my post above since this topic is so old, so i wanted to quote this. Apologies if you have -- just curious to hear about the resolution to this if there is one







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