“No. I’m sorry, but I can’t. I have a headache.”
Chances are, whoever is telling you that is telling you the truth—at least 50% of the time. Half to three-quarters of the world’s population has had at least one headache within the past year, according to the World Health Organization. About 30% of those people reported having migraine headaches. Even more amazing is that 1.7% to 4% of the world population state that they have headaches on 15 or more days every month.
Headaches of all types were collectively shown to be the third-highest ranked causes of disability, according to the Global Burden of Disease, while migraine headache was ranked as the sixth leading cause.
And ya know, it’s kind of hard to be content with who I am or the life I’m living if I have to do it with a headache!
So, I thought we’d chat about it and how #LiveYourValue can help you.
The International Headache Society divides Headaches into two classes:
Primary Headache Disorders: headaches due to blood vessels, nerves, muscles, or chemicals in the head and neck region only.
Secondary Headache Disorders: primary condition located outside the head and neck region trigger pain sensitive-nerves, blood vessels, muscles, or chemicals in the head.
One thing I would like to interject before I continue is that I tend to view headache more as a “symptom” as opposed to a “diagnosis”. Having said that . . .
In this blog, Part 1 of 2, I will focus primarily on two of the three “primary headaches,” namely Migraine and Cluster. In Part 2, I will dress Tension-Type Headache as well as the “secondary headaches.” So let’s dive in.
Types and Symptoms of Primary Headaches
1. Tension-Type Headache
- The MOST common primary headache
- Characterized by a feeling of pressure or tightness around the head
- Typically affects both sides of the head
- The pain can radiate to or from the neck
- Caused by stress and/or arthritic problems with the neck
2. Migraine Headache
- Second most common primary headache
- Described as an intense, throbbing pain
- Typically only affects one side of the head
- Can have other symptoms like nausea, tingling of hands, vision changes, and a feeling of lightheadedness
- Cause of a migraine is dilated blood vessels in the head, which then puts pressure on the trigeminal nerve (suspected but not proven)
There are many ‘triggers’ that have been shown to trigger a migraine, these include:
Emotional Triggers:
- Stress
- Depression/anxiety
Physical Triggers:
- Hormones
- Certain sites, sounds, and smells
- Alcohol, caffeine
- Foods and food additives
- Changes in sleep pattern
- Weather changes
- Low blood sugar
- Medications (esp. oral contraceptives and blood pressure pills)
3. Cluster Headache
- The least common primary headache
- Typically occurs the same time of day—most common at night
- Described as quick onset, brief, but extreme pain focused in or around one eye and typically it always involves the same side of the face
- Can have other symptoms like tearing and redness of the eye as well as redness and swelling of the affected area
- Cause of a cluster headache is dilated blood vessels in the head, which then puts pressure on the trigeminal nerve (suspected but not proven)
There are two triggers that have been shown to trigger cluster headache:
- Alcohol (and makes a current headache more intense)
- Smoking
Basic Differences Between Migraine and Cluster
Migraine Headache Cluster Headache
Throbbing, pulsating Non-throbbing
One side of head involved One side of head involved
Can affect both sides of head Same side always affected
Can have vision changes, nausea No vision changes, nausea
Last hours to days Last 30 minutes to hours
Seek dark, quiet during attack Restless, agitated during attack
More common in women More common in men
Now let’s chat a bit about the traditional treatments, i.e., pills for migraine and cluster headaches:
Over the counter treatment options:
- Aspirin
- NSAIDS such as Ibuprofen, Motrin, Advil, Aleve
- Tylenol
- Excedrin (Aspirin, Tylenol, Caffeine)
- Caffeine
If you are having an active migraine, chances are you will be prescribed a medication that falls in the class of a “Triptan.” These medications are used for active headaches and not used for the prevention of further headaches. (I will address those in a bit.)
Commonly prescribed Triptans/Traditional treatment for an active migraine or cluster headache include:
- Almotriptan (Axert)
- Eletriptan (Relpax)
- Frovatriptan (Frova)
- Lasmiditan (Reyvow)
- Naratriptan (Amerge)
- Rizatriptan (Maxalt)
- Sumatriptan (Imitrex, Onzetra Xsail, Sumavel DosePro, Zembrace)
- Zolmitriptan (Zomig)
The mechanism of action of these medications, in general, is to bind to certain serotonin receptors in our bodies and when they do, they reduce inflammation and cause the blood vessels in our head to constrict and, hopefully, alleviate our migraine or cluster headache.
Traditional prevention (i.e., prophylaxis—pro-for-lax-is) of migraine and/or cluster headache typically involves the use of the following:
- Propranolol (Inderal) – blood pressure med
- Amitriptyline (Elavil) – antidepressant med
- Divalproex (Depakote) and sodium valproate – seizure med, bipolar med
- Topiramate (Topamax) – seizure med
What are some drawbacks to the ‘Triptan’ meds?
The major concern with all of the “Triptans” is that they cause blood vessel constriction and, as such, may increase our risk of having heart issues such as an irregular heart beat, chest pain caused from poor blood flow to the heart muscle (angina), a heart attack, or even a stroke.
Certainly, these risks are higher if we already have heart disease, high blood pressure, or have other risk factors for heart disease like diabetes, obesity, or use nicotine products. Therefore, although the risk is very low, typically these medications will not be prescribed. But here they are, along with the possible side effects.
- Propanolol: drop in blood pressure, fatigue, constipation, lack of sex drive/ability
- Amitriptyline: fatigue, constipation, dry mouth, vision changes, lack of sex drive/ability
- Divalproex: nausea/vomiting, drowsy, weakness, abdominal pain, diarrhea, weight gain
- Topiramate: drowsy, dizzy, nervous, tingling of hands and feet, diarrhea
Somewhat Newer Meds/Old Med With A New Use:
- Botox injections (once used to correct crossed eyes and still used for aesthetics)
- Newer meds developed solely for prevention of chronic migraine headache
- Emgality
- Aimovig
- Ajovy
So, what’s a safer, healthier option to work toward while being treated?
Yes, you guessed it . . . #LiveYourValue, aka LYV!
Fact is, the choices we make every day can help treat and prevent headaches just like they can treat and prevent other physical and emotional issues.
For instance, you might be able to reduce headaches by simply . . .
- Trying Coenzyme Q10
- Choosing foods rich in Magnesium and B vitamins
- Avoiding foods that are high in nitrates, nitrites, and histamine
- Avoiding alcohol and increasing green tea and caffeine use
- Considering Acupuncture
- Getting quality sleep
- Choosing to hydrate the body
and . . .
- Reducing stress by aligning the life you want with the life you are living. EVERY little thing can help.
Stay tuned for Part 2.
Remember, today and everyday, live your value one choice at a time. This world would not be the same without you in it.
-Dr.D
LYV
