Reply To: Chronic migraines and headaches; fatigue; bloating; constipation; tingling and numbness (arms and legs)
- Chronic migraines and headaches; fatigue; bloating; constipation; tingling and numbness (arms and legs)
- Reply To: Chronic migraines and headaches; fatigue; bloating; constipation; tingling and numbness (arms and legs)
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Many thanks for your detailed case history of your client. You have mentioned a number of ongoing concerns – constipation, headaches ongoing although the migraines have decreased slightly, tiredness although this has recently improved as well. She also appears to have ongoing tingling sensations.
With regards to the constipation I appreciate that the medication from the consultant will help but it is not, however, a long term solution for this client. There can be many underlying factors involved with constipation and many of these you have investigated such as thyroid function, hormone health as well as food sensitivities. Restoring a healthy gut microbiome can be helpful for normal peristalsis particularly Bifidobacterium spp so the addition of the prebiotic and probiotic may be something to consider.
Dimidi et al. The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 2014, doi: 10.3945/ajcn.114.089151 https://tinyurl.com/oe8w92d
In many cases poor bile flow can be linked to constipation so I would consider looking a supporting bile flow with a supplement. Ongoing constipation can also influence the detoxification of toxins including endotoxins which can of course result in foggy head or headaches so ensuring daily bowel movements would be beneficial for this client. You mention that a stool test was conducted but I am not clear whether this is a comprehensive stool test – ie do you suspect there is still an ongoing gut infection in view of her health history? In addition, while she has identified a number of foods she appears sensitive too there may be other reactions and in this case array 10 Cyrex may be useful. Of course, there are other reactions such as salicylates, amines, histamine that may also be relevant. In some cases these are linked to gut dysbiosis and / or insufficient digestive function.
You mentioned she is complaining of tingling sensations – if this is linked just to the hands and arms this could actually be linked to other conditions such as carpal tunnel. Have you considered whether she is struggling with a viral infection for example which may be contributing to the ongoing tiredness and tingling sensations? It may be helpful to run a comprehensive viral screen to confirm.
Yes, vitamin B6 can be helpful but normally only where there is a deficiency, and at 20 mg it is not likely to be causing neurological symptoms. You could therefore consider a vitamin and mineral screen by Biolab to check levels of all B vitamins and other nutrients.
Fuhr JE, Farrow A, Nelson HS, Jr. Vitamin B6 levels in patients with carpal tunnel syndrome. Archives of surgery (Chicago, Ill. : 1960). Nov 1989;124(11):1329-1330. https://tinyurl.com/ybeofdec
If the tingling sensations is linked to nerve inflammation then Alpha-lipoic acid (ALA), an anti-inflammatory agent and powerful free radical scavenger, may be helpful. Other supplements to consider would be turmeric formulas and omega 3 fats.
Mijnhout GS, Kollen BJ, Alkhalaf A, Kleefstra N, Bilo HJ. Alpha lipoic Acid for symptomatic peripheral neuropathy in patients with diabetes: a meta-analysis of randomized controlled trials. International journal of endocrinology. 2012:456279. https://tinyurl.com/yb5ct7dq
With regards to her headaches it appears that her medication is helpful. The triptan drugs (e.g., sumatriptan, rizatriptan, eletriptan, and almotriptan) act on several specific mechanisms of a migraine headache, such as promoting vasoconstriction and blocking pain pathways in the brainstem. Triptans mediate these effects by activating certain serotonin receptors in cranial blood vessels
Ironically, taking too much migraine prevention medication for too long can lead to “medication overuse headache”. Medication overuse headache can become a chronic, self-perpetuating condition called “chronic daily headache”, in which patients experience daily headaches caused by medication overuse, but continue to use medication to relive the headaches. To prevent medication overuse headache, migraine patients should (on average) limit use of NSAIDs to 15 or fewer days a month and limit triptan or over-the-counter combination analgesic use to 9 or fewer days a month – do you suspect this may be a factor in view of her history? Perhaps attention to detoxification may be helpful
Young WB. Medication Overuse Headache. Curr Treat Options Neurol. 2001 Mar;3(2):181-188. https://tinyurl.com/yahdp37s
She has clearly noticed improvements with dietary changes. Avoidance of food allergies and/ or sensitivities may reduce or eliminate migraine symptoms and in addition there are other triggers to consider.
Monosodium glutamate (MSG) is a commonly used flavour-enhancer found in some soups and Chinese food.
Nitrites are preservatives found in processed meats such as hot dogs.
Tyramines are natural compounds found in wines and aged foods (e.g., cheeses).
Phenylethylamine is a stimulant compound found in chocolate, garlic, nuts, raw onions, and seeds.
Many of these nutritional migraine triggers have vasoactive properties (causes constriction or dilation of blood vessels) which is why they may contribute to migraine attacks.
Other potential dietary triggers include cow’s milk, wheat, eggs, alcohol, artificial sweeteners, citrus fruits, pickled products, and vinegar
Fukui PT, GonçalvesTR, Strabelli CG, et al. Trigger factors in migraine patients. Arq Neuropsiquiatr. 2008;66(3A):494-9. https://tinyurl.com/yay9frlk
While you have already suggested various interventions nutritionally there are a couple of others you could consider.
Butterbur – Butterbur extracts possess analgesic, anti-inflammatory, anti-spasmodic, and vasodilatatory properties, which may explain their efficacy for migraine prevention
Pothmann R, Danesch U. Migraine prevention in children and adolescents: results of an open study with a special butterbur root extract. Headache. 2005;45(3):196-203. https://tinyurl.com/yb45n7a3
CoQ10 (at doses of 100-300 mg daily) has been shown to be beneficial for preventing and reducing the frequency of migraine attacks among adults. These actions are attributed to CoQ10’s potential to interfere with inflammatory mechanisms and mitochondrial dysfunction, both of which have been implicated in the migraine process
Slater SK, Nelson TD, Kabbouche MA, et al. A randomized, double-blinded, placebo-controlled, crossover, add-on study of CoEnzymeQ10 in the prevention of pediatric and adolescent migraine. Cephalalgia. 2011;31(8):897-905. https://tinyurl.com/yaomqw2j
Riboflavin (i.e., Vitamin B2) contributes to cell growth, enzyme function, and energy production. One study involving 23 participants showed that supplementation with 400 mg riboflavin daily reduced headache frequency by an impressive 50% at three months, with improvement persisting through six months
Boehnke C, Reuter U, Flach U, Schuh-Hofer S, Einhaupl KM, Arnold G. High-dose riboflavin treatment is efficacious in migraine prophylaxis: an open study in a tertiary care centre. Eur J Neurol. 2004;11(7):475-477. https://tinyurl.com/gpj7d7x
Magnesium levels are often low in people with migraines / headaches. Furthermore, magnesium deficiency can trigger cortical spreading depression (CSD), platelet aggregation, vasoconstriction, and substance P release; all of which are have been implicated in migraine pathology. A dosage of 600 mg of magnesium daily has been shown to be effective for the prevention of migraine attacks
Koseoglu E, Talaslioglu A, Gonul AS, Kula M. The effects of magnesium prophylaxis in migraine without aura. Magnes Res. 2008;21(2):101-108. https://tinyurl.com/y9hgew87
So, there may be some additional tests that could be helpful in identifying underlying triggers as well as dietary modifications. I would also suggest a 2-4 week detox dietary approach avoiding common trigger foods and supporting detox pathways with supplement support
The following supplements are suggested for you to consider in light of your relevant expertise and intimate understanding of the needs of your client or patient. They may be used in isolation or as part of a multi supplement strategy, but at all times the consideration of their use should be tied into the specific needs of the individual you are responsible for.
Bowel movements and detox support
Lipid-X (BRC)(magnesium oxide) – take 2-4 daily
Securil (prebiotic) (ARG) – take caps after dinner (evening meal) – https://tinyurl.com/zwsz6mb
BifidoBiotics with L. sporogenes (ARG) – take 2 daily
Beta Plus (BRC) – take 1-2 with each meal (bile support) – https://tinyurl.com/hskrbum
Pro Greens (ARG) – take 1 scoop daily – https://tinyurl.com/gtqgbyo
Acetyl-Glutathione (ARG) – take 1 daily – https://tinyurl.com/gvh7csc
ALA Release (ARG) – 1-2 tabs with breakfast & dinner – http://tinyurl.com/hp72kvl
Enhanced Antiox Formula (ARG) – take 1 twice daily
For Migraines (specific formulas providing CoQ10, Riboflavin, Butterbur, Feverfew, Magnesium)
MigranX (BRC) – 1-2 caps twice daily (or even higher dose) – http://tinyurl.com/y8c5vggf
Low dose, but active form B vits
Bio-3B-G (BRC) – take 2 at each meal
I hope this helps with your client
Registered Nutritional Therapist Helen Perks is collaborating with Clinical Education to bring you the first-ever Functional Medicine book club for Practitioners.
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