Living Positively
Migraine Headaches
New Migraine Research
Caffeine Addiction
Ask Dr. J: Omega-3
Oil Doses
References
In the Health News
Diet and Disease
Recipe of the Month:
Potato/Bean/Tomato Casserole
Dear Friends,
A recent article suggested that
cancer survivors are often left
with a poor quality of life from
their experience with the disease
itself or from the treatments.
However, this does not have to
be the case. Regardless of the
disease or treatment (and less
toxic alternatives are often helpful),
lifestyle choices can lead to
a vigorous, healthy, and rewarding
life. The power of positive feelings,
a winning attitude, regular exercise,
and supportive nutrition and dietary
supplements can all combine to
create enduring and enjoyable
daily living.
The career of Lance Armstrong
is an example of how a person
can survive the most intensive
treatments and bounce back with
a rich, successful life. You don’t
have to be in the Tour de France
to achieve the benefits of healthy
lifestyles, but you do have to
take charge of your life and your
health.
The recent study suggests that
cancer survivors have lower quality
of life than age-matched controls
who have never had cancer. The
survey shows that 31 percent of
cancer survivors report having
fair or poor health, compared
to only 18 percent of the controls.
Only 13 percent of the cancer
survivors reported having excellent
health, but the researchers did
not look at how lifestyle and
attitude relate to these results.
These healthier choices can clearly
contribute to a positive outcome.
This is not to glibly pass off
the physical and emotional stress
of having cancer, or the side
effects of the treatments with
surgery, radiation, and chemotherapy,
but some of my healthiest cancer
patients have been those who were
determined not to succumb to the
emotional trauma of the diagnosis.
In Norman Cousins’ books,
Anatomy of an Illness, The Healing
Heart, and Head First, he describes
his own experiences with healing—of
himself from a debilitating and
life-threatening collagen disease
and then heart disease, and of
numerous cancer patients in group
sessions while he was on the faculty
of medicine at UCLA.
Cousins emphasized not only the
power of laughter and positive
emotions, but the value of nutrition
and dietary supplements (he took
huge doses of vitamin C orally
and intravenously during his first
major illness, and unexpectedly
recovered—at least it was
unexpected by the medical community).
During those group sessions, his
experience with patients showed
him that the patients with cancer
who did well were those who accepted
the diagnosis (they were not in
denial) but did not accept the
negative prognosis. They mounted
a vigorous defense both emotionally
and nutritionally, and survived
far longer than expected, with
a superior quality of life.
The power of positive feelings,
a winning attitude, and positive
actions to enhance one’s
health may be immeasurable, but
it is clearly visible in those
who choose to take charge of their
health.
Migraines can be debilitating
headaches related to vascular
spasms followed by dilation of
blood vessels. They are often
associated with initial warning
symptoms (prodrome, or aura) of
blurry or double vision, or flashing,
bright lights, or localized vision
loss prior to the headache and
accompanied by nausea, vomiting,
irritability, mood changes, and
severe light sensitivitiy. Some
people just get the visual auras
with no real headache, referred
to as “optical migraines.”
Common migraines (as opposed to
"classical") occur without
the prodrome.
These are not simple headaches,
possibly lasting for hours or
days, and localized inflammation
of tissues around the brain can
make the pain worse. Migraines
can be triggered by hormonal changes;
weather patterns; bright, flashing,
or fluorescent lights; foods,
such as chocolate, wine, cheese,
caffeine; aspartame; and specific
food sensitivities. Abnormal regulation
of blood sugar (hypoglycemia)
may also trigger migraines.
Dietary changes may make a considerable
difference in migraines. Avoiding
refined sugar and eating five
or six small meals can help stabilize
blood sugar levels and may reduce
the frequency of migraines. It
is best if food selections are
high in fiber, which delays absorption
of the naturally occuring sugars.
Also, avoid food additives.
A number of dietary supplements
have been helpful in preventing
migraines, but it is much more
difficult to treat them once started.
Magnesium doses of 300 to 600
mg daily can decrease migraine
attacks, especially those related
to premenstrual syndrome. Riboflavin
(vitamin B2, 400 mg daily) significantly
lowers migraine incidence and
the number of days of symptoms.
In a 1998 controlled study of
55 patients, 60 percent improved
on riboflavin compared to only
15 percent who were given a placebo.
Many people benefit from supplements
of the herb, feverfew. I recommend
standardized extract containing
250 mcg of parthenolide, one of
the apparently active components
of the herb, although there may
also be others. Feverfew has anti-inflammatory
properties and inhibits platelet
aggregation. You may need to take
feverfew for a month or more to
see the reduced frequency of migraines.
In addition to these supplements,
5-hydroxy tryptophan (5-HTP) has
been shown in a number of studies
to reduce symptoms with daily
supplements of 200 to 600 mg.
This is a derivative of the amino
acid tryptophan, and is a precursor
of the neurotransmitter serotonin.
I and many colleagues have found
supplements of ginkgo biloba to
help patients with migraines.
Ginkgo may help by reducing platelet
activating factor, a suspected
contributor to migraines.
A recent small trial strongly
suggested that supplements of
melatonin could reduce the frequency,
duration, and intensity of migraine
headaches. Thirty-four patients
were studied for three months,
and although the study was short
and not double-blind, the results
were significant.
In a variety of migraine types,
melatonin levels have been found
to be abnormal. In this study,
the patients were given 3 mg of
melatonin 30 minutes before bedtime.
At the end of the study, 25 patients
had greater than 50 percent reduction
in the number of headaches, including
eight with no headaches and seven
with 75 percent reduction. None
of the subjects had any increase
in symptoms or side effects. Overall,
duration and intensity of the
headaches was reduced and medication
use declined significantly.
Although most doctors and researchers
will caution that this research
is not definitive, and may even
recommend against taking action
based on it, I disagree. While
this study was small and not blinded,
the value of melatonin as an antioxidant
for the brain and other tissues,
its value in insomnia and depression,
and the lack of side effects make
it worth trying.
Some preliminary open trials
suggest that coenzyme Q10 can
help with migraines also. In a
2002 study, 32 migraine patients
were given 150 mg of coQ10 per
day, and after three months, the
number of days with migraines
and the frequency of headaches
were reduced by 60 percent.
Another recent study shows that
patients have increased migraine
intensity if they have high levels
of glutamate (not glutamine) in
their plasma, platelets, and cerebrospinal
fluid. Glutamate is found in MSG
(monosodium glutamate), a common
food additive that may precipitate
migraine headaches.
Coffee and other caffeinated
beverages are ubiquitous, socially
accepted stimulants that are taken
for granted among our cultural
habits. While the occasional consumption
of caffeine is likely to be relatively
harmless, it is not without some
potential problems.
Caffeine is a stimulant and a
diuretic causing calcium loss
in the urine and an increased
risk of osteoporosis. It may also
cause acid indigestion. For those
not habituated to it, even one
cup of coffee can cause anxiety,
hyperactivity, rapid heart rate,
and arrhythmias. Evidence shows
that this amount can lead to signs
of addiction, particularly the
dependence on the morning cup
to prevent withdrawal symptoms
of headaches, fatigue, nervousness,
irritability, and depression,
and even flu-like symptoms. (Even
decaf can cause gastric irritation
and digestive upset.)
A literature review of over 60
studies, shows that withdrawal
was evident in 50 percent of subjects
within 12-24 hours after abstaining
from caffeine. Symptoms were more
severe with higher consumption,
but were evident even if subjects
drank only one cup of coffee daily
(coffee contains 90-150 mg of
caffeine; green or black tea has
about 30-50 mg, and sodas from
30-55 mg).
The peak of withdrawal symptoms
occurs within one to two days,
and may last from two to nine
days. Habitial coffee consumption
is related to a desire (conscious
or not) to avoid withdrawal symptoms.
Coffee has some health value.
It is full of antioxidants and
may reduce the risk of diabetes.
However, red bush tea (with no
caffeine) and green tea (preferably
decaf) are even healthier and
have fewer associated risks.
Q. What is the
right dose of omega-3 oil, either
from fish or flaxseeds?.
—RL, Maryland, via email
The typical recommendation for
flaxseed oil (containing alpha-linolenic
acid, or ALA) is from 1 to 2 teaspoons,
up to 2 to 3 tablespoons, depending
on individual needs. I use it
on salads and as a garnish for
steamed veggies, and I don’t
measure it, but as with any oil,
it is high in calories. One recent
study suggests that although flaxseed
oil does not increase the risk
of prostate cancer, ALA (from
vegetable as well as milk and
meat sources) may be associated
with more aggressive tumor behavior
in men who have those cancers.
Most evidence shows that flaxseed
oil decreases prostate cancer
risk, so I suspect flaxseed oil
may not be the cause.
Fish oil supplements have more
anti-platelet and anti-inflammatory
effects than flaxseed oil, and
the usual dose varies depending
on why it is being taken. Typical
doses range from 2000 mg twice
a day, to 12,000 mg per day. Capsules
contain varying amounts of omega-3
oils, usually about 300 mg total
of the combination of EPA (180
mg) and DHA (120 mg). Some people
recommend larger proportions of
the DHA, especially for children,
and such capsules are also available.
The larger doses are used for
inflammation, such as arthritis
and auto-immune diseases, and
for heart disease, strokes, and
asthma. One ounce of wild salmon
contains about the same amount
of omega-3 oil as one typical
capsule.
Yabroff KR,
et al., Burden of illness in cancer
survivors: findings from a population-based
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Anatomy of an illness (as perceived
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Dec 23;295:1458-1463.
Millichap JG,
Yee MM, The diet factor in pediatric
and adolescent migraine. Pediatr
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Lipton RB,
et al., Aspartame as a dietary
trigger of headache. Headache
1989 Feb;29(2):90-2.
Bianchi A,
Role of magnesium, coenzyme Q10,
riboflavin, and vitamin B12 in
migraine prophylaxis. Vitam Horm
2004;69:297-312.
Schoenen J,
et al., Effectiveness of high-dose
riboflavin in migraine prophylaxis.
A randomized controlled trial.
Neurology 1998 Feb;50(2):466-70.
Boehnke C,
High-dose riboflavin treatment
is efficacious in migraine prophylaxis:
an open study in a tertiary care
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Peres MF, et
al., Melatonin, 3 mg, is effective
for migraine prevention. Neurology
2004 Aug 24;63(4):757.
Rozen TD, et
al., Open label trial of coenzyme
Q10 as a migraine preventive.
Cephalalgia 2002 Mar;22(2):137-41.
Peres MF, et
al., Cerebrospinal fluid glutamate
levels in chronic migraine. Cephalalgia
2004 Sep;24(9):735-9.
Juliano LM,
Griffiths RR, A critical review
of caffeine withdrawal: empirical
validation of symptoms and signs,
incidence, severity, and associated
features. Psychopharmacology (Berl)
2004 Sep 21.
Elta GH, et
al., Comparison of coffee intake
and coffee-induced symptoms in
patients with duodenal ulcer,
nonulcer dyspepsia, and normal
controls. Am J Gastroenterol 1990
Oct;85(10):1339-42.
Salazar-Martinez
E, et al., Coffee consumption
and risk for type 2 diabetes mellitus.
Ann Intern Med 2004 Jan 6;140(1):1-8.
Siddiqui IA,
et al., Antioxidants of the beverage
tea in promotion of human health.
Antioxid Redox Signal 2004 Jun;6(3):571-82.
Although antidepressants can
relieve serious symptoms, they
can also lead to an increased
risk of adolescent suicide. The
link has been played down by the
FDA, accused of blocking a congressional
investigation (Reuters, September
9, 2004). Another drug, Vioxx,
a treatment for arthritic pain,
is associated with an increased
risk of heart disease, and has
just been recalled by Merck, although
they and the FDA knew as early
as 1999 about the associated risks
(PRWEB Sept 1, 2004).
a. Curcumin, a component of turmeric,
may prevent childhood leukemia.
A report by researchers in Chicago
shows that this spice inhibits
the white blood cell effects of
some of the risk factors for leukemia,
such as infections, radiation,
chemicals, pesticides, and viruses.
In lab studies, this spice blocks
replication of leukemia cells
and interferes with the effects
of cigarette smoke and processed
foods. At the same meeting, other
researchers reported that eating
oranges and bananas helped protect
children from leukemia. (Turmeric
may protect against leukemia-scientist.
Reuters, Sep 9,2004)
b. Red meat consumption, and
especially processed meats such
as hot dogs and bacon, is associated
with a significant increased risk
of type 2 diabetes. Results from
the Women’s Health Study,
evaluating 37,309 participants,
showed that the highest meat consumption
was associated with a 28 percent
increase in diabetes risk, and
43 percent for processed meats
(Song Y, et al., A prospective
study of red meat consumption
and type 2 diabetes...Diabetes
Care. 2004 Sep;27(9):2108-15).
Cholesterol, animal protein, and
meat-source (heme) iron were also
associated with greater risk.
Harvesting potatoes and tomatoes
makes me think of the many ways
to use these versatile and tasty
foods. Slice some potatoes about
1/4 inch thick, and some tomatoes
a bit more thickly, and alternate
several layers of each in a baking
pan, with a thin layer of cooked
pinto beans in between. As you
put down each layer, sprinkle
some crushed garlic; minced scallion
greens; fresh or dried basil,
thyme, or chopped cilantro; freshly
ground pepper; chili powder; or
other spices to taste (this can
also be made with a curry flavor),
and if you like you can spread
a garnish of grated parmesan,
feta cheese, or crumbled tofu
in one or two of the layers. You
can use a small amount of sea
salt if you skip the cheese. Make
several layers, as it will cook
down. Bake this in a preheated
oven at 400 degrees, for about
40 minutes, but test regularly
to see when the potatoes are soft.
