Lifestyle Matters in Migraine Treatment

by Kulreet Chaudhary, MD, Scripps Memorial Hospital La Jolla

One of the newest approaches to treating migraine headaches is also one of the oldest: making dietary and lifestyle changes designed to prevent, rather than just medicate, migraines.

For years, we have been treating migraines with medication. If the migraines worsened, we’ve increased the medications or added new ones. In the new model—and this applies not just to migraines but to medicine in general—we determine why people develop health problems and what we can do to reverse them.

In my practice, I start with the basics. What are you eating? Drinking? What are your sleeping habits? How do you deal with stress?

Digestion, in particular, has been found to play a key role in migraines. In 2008, the medical journal Headache published a study that suggested that improving digestion might have a positive effect on controlling migraines. The conclusion: focus on helping patients adjust their diets to promote better digestion, and their migraines will improve as a result.

One of the first things I talk to my patients about is lunch. Many people have fast food or a vending machine snack for lunch, or just skip it altogether. That’s a recipe for trouble, because for migraine sufferers, lunch is the most important meal of the day. At lunch time, digestion is at its strongest, and missing this meal can throw off the entire digestive system. Plus, skipping lunch can lead to hypoglycemia or low blood sugar, which is a proven trigger for headaches. Many of my patients have found that eating an appropriate lunch every day has an enormous impact on their migraines.

What should you eat? Your best choices for lunch—and for every meal—depend a great deal on your individual physiology. Everything you eat translates into a biochemical reaction in your body, so the “right” diet for you depends not just on ratios of carbs, fat and protein but on the biochemistry of the foods you eat and how they interact with the biochemistry of your body. I follow an Ayurvedic approach which advocates specific dietary recommendations based on three physiology types, and create a detailed diet for each patient that is not only specific to his or her physiology, but also changes over time as the patient’s physiology changes.

Migraines are affected not only by what you eat, but what you drink as well. Many people are in a chronic state of dehydration, often caused by not enough water and too much caffeine from coffee, tea, soda and energy drinks. The first step is to reduce caffeine intake slowly; doing so abruptly can cause withdrawal headaches, so gradual reduction is important. At the same time, I have patients start increasing the amount of water they drinking.

For patients with poor digestion, I recommend a “digestive tea” that can be made at home
by combining one-half teaspoon each of coriander seeds, cumin seeds and fennel seeds. Mix these with a liter of water, boil for 10 minutes and strain. Pour the tea into a thermos and sip it throughout the day.

The third major area I address is the sleep cycle. Many people don’t know that the “ideal” time to sleep is between 10 p.m. and 2 a.m. This is when your body experiences its deepest and most regenerative sleep. I call this “anti-inflammatory” sleep because it maximizes the impact that sleep has on reducing harmful inflammation in the body. In order to get the full benefit, you need to be asleep by 10 p.m.—which means going to bed well before then.

Making these types of lifestyle changes can have dramatic results: 75 percent of my migraine patients who have changed their diet and sleep cycles no longer need any migraine medications, and the remaining 25 percent have significantly reduced the amount of medications they use. Some of these patients had suffered with migraines for 20 or 30 years!

All headaches aren’t the same, and all individuals aren’t the same, so we can’t treat every patient the same. We need to consider the individual factors that contribute to headache, and take personalized approaches if we wish to cure disease.

Kulreet Chaudhary, MD, is a neurologist at Scripps Memorial Hospital La Jolla. Join Dr. Chaudhary for a free presentation on traditional and alternative treatments for migraines on Wednesday, April 21, at 6 p.m. at the Schaetzel Center on the Scripps La Jolla campus. For more information or to register, please call 1-800-SCRIPPS. “To Your Health” is brought to you by the physicians and staff at Scripps Memorial Hospital La Jolla.