Almost everyone gets a headache once in a while, and for most people an aspirin or two is usually enough to make it go away.
But for 45 million Americans, the headaches keep coming back—monthly, weekly, and even daily. By the numbers, the problem of recurrent headaches is quite serious. Every year, headache-driven absenteeism and medical expenses cost the US some $50 billion. Americans spend more than $4 billion a year just on over-the-counter headache pain relievers.1
Of the different types of headache, perhaps the most dreaded and disabling is migraine headaches. In this article, we will focus on migraines—their symptoms, several theories that have been advanced to explain what causes migraines, and research that suggests magnesium, riboflavin, and other natural agents may be effective aids in preventing and treating migraine headaches.
A Headache “Sampler”
Migraines are just one of several different kinds of headache, each having its own causes, symptoms, and treatments.
Tension headaches account for about three-quarters or more of all headaches. “Tension-type” headaches produce mild-to-moderate pain on both sides of the head. The pain is steady and comes gradually rather than all at once, and later fades away. Tension headaches are commonly associated with stress, but also may be linked to emotional problems such as depression. Most tension headaches respond to standard over-the-counter painkillers.
Migraine headaches afflict approximately 28 million Americans and produce excruciating pain that can leave victims nearly crippled for hours or days at a time. Some people experience symptoms besides pain. The migraine may be heralded by an aura, a strange feeling marked by flashing lights or other visual disturbances. Dizziness and nausea, chills or sweat, and double vision or slurred speech may accompany migraines. Noise or light may make everything feel worse. Women are more than twice as likely as men to suffer from migraines. “Migraineurs” (those with migraines) continue to suffer despite the numerous medications prescribed by their physicians.
Cluster headaches arrive in groups. For days, weeks, or even months on end, they strike one or more times a day. Each headache may be relatively brief, lasting perhaps 30 to 90 minutes. The pain begins mildly, but quickly becomes unbearable. One side of the face at a time is typically affected, with the pain centering around the eye on the affected side. Some 1 million Americans suffer from cluster headaches, which typically attack men; 90% of victims are male, with most in their twenties, thirties, and forties.
Exertion headaches are linked to physical activities such as exercise, sex, laughing, and coughing. They often strike during or just after strenuous activity. While not considered dangerous per se, exertion headaches may indicate a stroke or other problem and therefore should be brought to the attention of a physician immediately.
Organic headaches are messengers telling you that something is amiss, and that could be anything from elevated blood pressure to a brain tumor. The headache pain may be accompanied by fever, neck stiffness, confusion, difficulty in speaking or moving, or other symptoms. The pain tends to grow worse, either increasing with each headache or striking more frequently. Organic headaches account for fewer than 1% of all headaches.
Other kinds of headaches, such as those associated with hangovers, constipation, and low blood sugar, often can be cured by attacking their underlying causes.
Because headaches can signal a serious underlying illness, it is best not to self-diagnose them. If you experience unexplained, unusual, or particularly severe headaches, if they strike more often or in different ways than in the past, or if your headaches are associated with any other symptoms, you should consult your physician immediately.
Focus on Migraines
Migraine symptoms range in severity from miserable to crippling; migraines can ruin an afternoon or immobilize their sufferers for days on end.
Migraines come in several varieties. The classical migraine strikes a small percentage of sufferers, and is heralded by the visual disturbances known as the aura. Most migraines, however, are common migraines, and lack the aura. Other types include: basilar migraines, which can trigger fainting, poor coordination, and double vision; hemiplegic migraines, which make it difficult to move one side of the body; ophthalmoplegic migraines, which interfere with vision; retinal migraines, which darken or completely obliterate vision during an attack; and menstrual migraines, which are tied to a woman’s monthly cycle.
Although researchers have not yet determined the cause of migraines, they have offered several theories:
Vascular theory. Blood vessels in the brain and head are supposed to contract and expand on command, thereby reducing or increasing blood flow to the brain at the appropriate times. The vascular theory argues that for migraine sufferers, the contraction-expansion mechanism in the blood vessels goes awry, interfering with blood flow in the brain and head. Eventually, these vessels become too relaxed and their walls too permeable, allowing fluid from the blood to leak into surrounding tissues, triggering pain and inflammation.
Serotonin theory. A neurotransmitter called serotonin helps control pain sensations, sleep, mood, and other bodily actions and feelings. A deficiency of this neurotransmitter can trigger migraines by encouraging inappropriate contraction and relaxation of the arteries. A lack of serotonin may also lower the pain threshold, making everything hurt more.
Neural theory. Migraines begin when certain regions of the brain become irritated. The body responds to the irritation by releasing chemicals that, among other things, cause the blood vessels to become inflamed and irritate the nerves.
Still other theories have been advanced to explain the genesis of migraines. Deficiencies in brain energy metabolism, both between and during migraine attacks, may be to blame.2 Some studies point to platelets, the tiny substances that help blood clot; platelets may be structured differently in migraineurs, making them more likely to aggregate.3 Nutritional imbalances and deficiencies also have been suggested as a cause of migraines. Indeed, a mounting body of research suggests that magnesium and other natural agents can play an important role in the prevention of migraines.
Magnesium for Migraines
Magnesium helps muscles, including those surrounding arteries, to relax, and this may be why a deficiency of this mineral is linked to migraines. Researchers have learned that some of the same things that deplete the body’s supply of magnesium—including stress, alcohol, and pregnancy—can trigger migraines in susceptible people. They also have discovered that certain medicines that successfully treat migraines mimic magnesium’s actions by:
- Keeping open blood vessels in the brain
- Preventing sudden spasms that “clamp down” on arteries
- Keeping the blood thin and flowing by preventing platelets from sticking together inappropriately
- Helping to maintain the stability of cell membranes
- Interfering with the inflammation-producing substances released at the onset of a migraine.
While magnesium may help ease migraines, not just any kind of magnesium will do. The two forms of magnesium that circulate in the blood are “bound” and “free.” The bound form is “tied” to other substances and is relatively inactive. The free form is not bound to other substances and remains active, a characteristic that researchers believe enables it to counteract the effects of migraines.