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18th August 2022

All About Migraines

All About Migraines

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Looking at the many aspects of living with migraine headaches as well as the diverse symptoms associated with various types of migraine. We will also venture into the field of symptoms, pain relief, and possible prevention.

When is a Headache a Migraine?

It’s not always easy to be sure whether the headache you are suffering is in fact a migraine. The NHS have set out guidelines to help with self-diagnosis, but there are certain instances where seeking medical verification and treatment is still advisable. The NHS make the point that there is no set test for diagnosing migraine and for a GP to reach a conclusion, a pattern of recurring headaches, along with other relevant symptoms must be available. This usually means that you will be asked to keep a symptom journal over a certain length of time to help with the diagnosis.

What are the symptoms of a migraine?

The most common symptom of a migraine is an intense headache, often, but not always, on one side of the head. It usually starts with a throbbing, pulsing sensation that increases with physical movement. The pain may spread to both sides of your head and can also affect your face and neck. It can sometimes disturb your vision and you may feel pain when combing or brushing your hair.

Other symptoms are:

  • Feeling of nausea
  • Being sick
  • Sensitivity to light and sound
  • Sweating
  • Feeling either very hot or very chilly
  • Lack of concentration
  • Abdominal pain
  • Diarrhoea

It is possible to experience any of these symptoms without having a headache, which makes diagnosis even more tricky.

In some cases, you may experience optical symptoms that can warn of an impending migraine. This pre-curser is known as a migraine aura, and it manifests itself in a variety of ways. You may see flashing lights, vivid colours, have blind spots or see zig-zag patterns. You may also experience tingling sensations in one of your hands, and this may travel up your arm and even reach your face. You may possibly feel dizzy and off balance, have speech difficulties and, in rare and extreme circumstances, lose consciousness. These symptoms can last for up to an hour and may be followed by a mild headache or no headache at all in some cases.

The NHS recommend that medical advice is necessary in instances where you have frequent or severe migraine symptoms that cannot be eased by taking painkillers such as paracetamol. If you have migraine symptoms on more than five days a month, even if over-the-counter medication does go some way to controlling the pain, you should see your GP to discuss some preventative treatment.

Various Types of Migraine

There are many different types of migraine, and each present with its own set of symptoms. No two people will have the same experience, even with the same type of migraine.

Here are some medically reviewed descriptions of commonly diagnosed migraines:

With Aura

Known as ‘classical migraine’. It involves visual symptoms such as flashing lights, lines, and shapes. Sometimes you might lose some of your vision for a while and possibly feel tingling in arms and legs. Migraine auras can also affect the way you experience taste, smell, touch, and speech. This type of migraine is very common.

A migraine with aura involves visual symptoms such as flashing lights, lines, and shapes.

 

Migraine Without Aura

Known as ‘common migraine’

Migraine With Brainstem Aura

Also called basilar migraine, it is associated with sensory, visual, speech and language symptoms. It may produce one or two of the following: slurred speech, vertigo (a feeling of dizziness), tinnitus (ringing in the ears), double vision, a sensitivity to noise of any kind.

Episodic Migraine

When you experience migraine attacks for up to about 7 days out of the month. If you have attacks for more than seven days each month you may have a more serious form of migraine such as high-frequency episodic. This denotes 8-14 headache days each month with some degree of migraine symptoms.

Chronic Migraine

A headache that recurs for more than 15 days each month for a period of three consecutive months. It is also when symptoms are present for at least 8 of those days.

Hemiplegic Migraine

Meaning paralysis on one side of the body. This type of migraine comes with an aura that causes temporary weakness on one side of the body. The aura symptoms only last for about 24 hours and the weakness is usually for less than 72 hours. The symptoms can easily be mistaken for a stroke, but without lasting nerve damage. It’s important to have this medically checked to rule out the possibility of stroke.

Silent Migraine

This is when you have a migraine without the headache. Aura is often the alert for the onset of this type of migraine. You may also experience feelings of nausea and it only lasts for about 30 minutes.

Abdominal Migraine

This is when the migraine affects your stomach rather than your head. The symptoms: stomach pain, nausea, loss of appetite, sickness. This often affects children but can also be suffered by adults.

Menstrual Migraine

This often happens 2 days before the start of a period and can last for 3 days after. This type of migraine is rarely accompanied by an aura.

Retinal Migraine

This type of migraine is very rare. It presents with flashing lights and bright colours with various other visual changes. Sometimes there is the loss of some or all vision in one eye. This loss of vision is only temporary and may last only for an hour at the most. It is usually followed by a migraine headache. If you do lose vision or have other vision disturbance you should visit a doctor as soon as possible.

Vestibular migraine

This is the one that is accompanied by vertigo. The spinning sensation can last between just a few minutes to several hours and is very incapacitating.

Vestibular migraine is accompanied by vertigo.

 

Status Migrainosus

This is a migraine that lasts longer than 3 days. It can sometimes be caused by certain medications or by withdrawal from medications. Pain and sickness from this type of migraine can be so severe that hospital care may be needed.

Migraine During Pregnancy

For women who are already prone to migraine headaches, hormonal changes during pregnancy can sometimes trigger a variance in symptoms. According to the Migraine Trust, many women experience an improvement in their symptoms, particularly during the second and third trimesters, and this is probably due to increased oestrogen levels as well as the presence of natural pain-killing hormones (endorphins).

Not everyone will find an improvement, especially in the early weeks. For some women their migraine attacks are unaltered, whilst some may find the frequency of attacks increases, but this is unusual.

There are often certain triggers to an attack and it’s a good idea to keep a note of such things as skipped meals, forgetting to drink enough water, lack of sleep and periods of stress. These can all contribute to bringing on a migraine.

Increased oestrogen levels during pregnancy can often improve migraine symptoms.

 

Migraine Without Aura - Studies have found that migraine without aura often improves after the first three months of pregnancy. This applies for approximately 7 out of 10 women.

Migraine With Aura - When you have a migraine with aura you may possibly continue to have attacks throughout your pregnancy. If you don’t normally suffer but a migraine presents for the first time while you are pregnant, it is most likely to be with aura and you should see your doctor to have possible causes checked out and establish safe treatment.

Treatments – If you are already taking migraine medication before pregnancy your doctor may advise that you stop these for safety reasons, but if attacks still occur then safer alternatives may be offered. Although it is known to be preferable to avoid taking medication during pregnancy, it is also harmful to you and the baby to suffer with untreated headaches which could lead to stress and sleeplessness. You may find certain non-drug treatments to be beneficial, but it is still good to discuss their benefits and possible side effects with your doctor.

The organisation known as Bumps (Best use of medicines in pregnancy) give reliable, evidence-based, accurate information about the use of medicines in pregnancy.
Complementary and Alternative Treatments – There are various non-drug treatments that you may find helpful. Massage, acupuncture, and reflexology are all beneficial. However essential oils should be avoided during pregnancy as certain oils can have an unwanted effect and in other instances their safety in pregnancy has not yet been sufficiently proven to be safe.

Migraine Triggers

Some cheeses such as stilton, camembert and cheddar can cause migraines.

 

Various things have been found to trigger migraine headaches. One of the difficulties in pinpointing a trigger is knowing whether what you suspect to be a trigger is in fact an early symptom of a migraine attack. Some of the most officially recognised triggers are:

  • Heightened Emotion
    • An attack may be triggered by feelings of stress and anxiety, nervous tension, following a shock, periods of depression and cruelly, even great happiness and excitement can cause the onset of a migraine.
  • Physical
    • Lack of sleep, poor posture, neck or shoulder tension, low blood sugar, strenuous exercise, jet lag.
  • Dietary Triggers
    • Haphazard mealtimes, missed meals, dehydration, alcohol, too much tea and coffee (caffeine), certain foods such as chocolate and citrus fruit. Foods containing a substance known as tyramine which is found in cured meats, yeast extracts, pickled herrings, smoked fish (such as mackerel and salmon. Some cheeses such as stilton, camembert, and cheddar. NOTE: All foods stored at room temperature rather than being kept in the fridge or freezer.
  • Hormonal changes
    • Migraines are sometimes experienced during menstrual periods, and this is due to fluctuating hormone levels. These types of migraine often occur between 2 days prior to the onset of a period and up to 3 days after.
  • Environmental
    • Such things as flickering screens, bright and glaring lights, a smoke-filled atmosphere, sudden loud noise, climate fluctuations such as high humidity or extreme heat or cold, strong smells and being in a badly ventilated room.
  • Medicines
    • Certain types of sleeping tablets, the combined contraceptive pill, hormone replacement therapy (HRT).

These triggers are likely to be completely unique to you, no two people have identical triggers or symptoms, so it’s important to keep a diary of dates and feelings experienced to help with diagnosis.

Preventing Migraine

Magnesium

Scientific research has found that there is a link between magnesium and migraines. It has been found that magnesium blocks signals in the brain that lead to migraines with an aura and changes in vision. Studies have also found that magnesium blocks chemicals that cause pain. It was discovered during trials that low magnesium levels can cause blood vessels in the brain to narrow, and this too may lead to migraine.

Magnesium is a mineral that occurs naturally in many foods. It plays a part in over 300 enzyme reactions in the body and is often added to food products as well as being available as a dietary supplement. Magnesium’s chief role is to promote efficient nerve function and help regulate muscle, blood sugar levels and blood pressure. It also helps make protein, bone, and DNA. Try including foods in your diet that contain magnesium, so these are dark green leafy vegetables, nuts, and whole grains.

Exercise

During times when you feel well and are not experiencing a migraine attack, exercise can help greatly in warding off further attacks. This is because regular exercise causes your body to release endorphins, the chemicals that fight pain. It also helps to ease stress and encourages better and healthier sleep patterns.

Better Sleep

Regular and sufficient sleep is one of the important factors in preventing migraines. If you are sleep deprived or also if you are getting more sleep than your body needs, you may be triggering headaches and reducing your pain threshold levels. Between 7 – 8 hours sleep each night is the recommended target and it is helpful if you can establish a habit of going to bed and waking at the same times each day.

Yoga

Slow and controlled movements required by the art of yoga are ideal when looking to prevent migraine attacks. Research has discovered that regular yoga sessions can reduce the number of attacks and make them less intense when they do occur.

Vitamin B12

Research studies have found that Vitamin B2, (riboflavin) can help prevent migraines. This vitamin is found in milk, cheese, fish, and chicken. It can also be taken as a vitamin supplement.

One study concluded that taking riboflavin could significantly reduce the frequency and number of attacks suffered.

A systematic review and meta-analysis of 9 randomised controlled clinical trials to verify the effectiveness of vitamin B2 on the frequency and pain levels of migraine attacks confirmed that supplementing with Vitamin B2 at a dose of 400 mg per day for three months had a significant effect on the days, duration frequency and pain sore of migraine attacks.

Treatment for Migraines

1. Acupuncture

If pain killers don’t work, some NHS medical practices offer acupuncture. If this is not an option, then you may have to pay to have this privately. There is significant evidence that a course of up to 10 sessions of acupuncture over a 5-8 week period may help.

2. Over-the-counter pain killers

Such products as paracetamol or ibuprofen may help to ease the pain of a migraine attack. It’s important to take them as soon as you are aware of an impending attack and not to wait until the pain gets worse. This gives them time to get into the bloodstream and ease your symptoms. If you can get soluble tablets, they are good as they are more quickly absorbed by your body.

3. Triptans

When over-the-counter pain killers are not helping you will need to see your GP. There are painkillers called triptan that you may find will relieve your pain. Your doctor may also prescribe anti-sickness medicine. Triptans are painkillers particularly for migraine headaches and they’re believed to work by reversing the changes in the brain that may be causing migraine headache.

Triptans work by causing the blood vessels around the brain to contract. This means that the widening of blood vessels is reduced and the attack may be avoided.

There are various ways of taking triptans, either by tablets, injection, and nasal sprays.

Possible side effects of triptans are:

  • Sensation of warmth
  • Tightness
  • Tingling
  • Flushing
  • Feelings of heaviness in face limbs or chest
  • Feeling sick
  • Dry mouth
  • Drowsiness

These side effects are usually mild and improve without treatment.

Migraine Self-Care

Fortunately, there are many non-drug related ways to help yourself to prevent, or at least reduce, the severity of migraine pain.

Diet

Food and drink are key in helping to prevent a migraine attack. Learning which foods are your own triggers is vital in helping yourself to manage frequency of attacks. It’s helpful to keep a daily food record so you can see what you’ve had prior to a migraine.

These foods are the most usual triggers:

  • Chocolate
  • Cheeses, especially those containing tyramine such as Cheddar, Parmesan, Swiss, feta, and blue cheeses
  • Foods containing nitrates such as hot dogs, deli meats, bacon, and sausage
  • Alcohol, particularly red wine
  • Monosodium glutamate (MSG). This is found in many processed foods and is used as a flavour enhancer
  • Processed foods are often found to cause an attack due to additives
  • Ice cream and very icy cold drinks
  • Pickles
  • Certain dairy products that contain cultures such as yogurt and buttermilk

Caffeine is a tricky one. A small amount may help to ease migraine pain and it is even included in certain migraine medications, but too much can bring on an attack. This means that limiting your tea and coffee is a good idea.

Feverfew

A favourite folk remedy for migraine, feverfew is a hedgerow and meadow herb with a flower that looks like a small white daisy. A member of the Asteraceae genus, botanical names for feverfew include chrysanthemum parthenium and pyrethrum parthenium.

The effectiveness of feverfew is based on centuries of its use in holistic medicine, however, four clinical trials have established that it has been found to be effective in reducing migraine symptoms when compared to a placebo, and that feverfew is safe to take.

Ginger

Feelings of nausea can be eased by drinking a tea made by steeping a little fresh root ginger in hot water. This works well for the kind of sickness feelings experience during or just before a migraine attack. In a 2020 review of studies, one randomised controlled study concluded that ginger may also have beneficial properties to help with migraine symptoms. Further research is needed to establish the extent of the benefits of ginger for treating migraine.

Ginger tea can help to ease nausea experienced during or just before a migraine attack.

 

Magnesium

A significant amount of clinical research has shown that many people who suffer from migraine also have a much lower level of magnesium than those who do not have migraines.

A 2021 study evaluated the effectiveness of magnesium oxide when compared with valproate sodium (migraine medication). It concluded that magnesium was as effective but without the adverse side effects of valproate sodium.

Research has also found that taking magnesium supplements can be effective against menstrual migraine.

Magnesium oxide is widely used as a preventative measure against migraine attacks. It can be taken in pill form and the usual dosage is 400-500 mgs per day. As magnesium is a natural mineral necessary for health, it may be considered a safe migraine treatment without the side effects of pharmaceutical medications. Rhttps://www.supplementplace.co.uk/magnesium-bisglycinate/ead more about the benefits of magnesium.

Yoga

The meditation skills learned during yoga classes, together with breathing exercises and body postures, create good health and feelings of well-being. A study conducted in 2015 found that yoga relieves the frequency, duration, and severity of migraine attacks. Yoga also helps with lessening anxiety and dispelling tension, both of which are migraine triggers.

Yoga can reduce the duration, and severity of migraine attacks.

 

Massage

It is believed that massage may reduce the frequency of migraine attacks. Massage is known to stimulate serotonin and as migraine is associated with low levels of serotonin in the brain, there is some evidence that it is helpful for migraine relief. The great thing is that it is generally a safe therapy with no adverse side effects.

Keeping Well Hydrated

Dehydration is a major migraine trigger. Drink lots of water throughout the day and especially when the weather is very hot or if you are exercising.

Sleeping Well

Lack of sleep is one of the migraine triggers and it is well researched and documented that getting the right amount of quality sleep is highly beneficial to health generally but also to help with the reduction of migraine attack frequency.

Getting into the habit of going to bed at about the same time each night and avoiding drinking caffeine late at night will help ensure a good night’s rest. Read more about getting enough sleep.

Migraine Supplements

Because many people have found that they can’t tolerate pharmaceutical migraine medication, there are various herbal preparations that have long been known to help with easing the symptoms of migraine, are effective and are not associated with any safety concerns.

Some of the top-rated supplements to help with migraine are:

Magnesium Malate

Known for its pain-relieving properties, magnesium malate is beneficial for helping reduce the symptoms and pain of headaches and migraines. It is also associated with support for cardiovascular health, muscle and nerve function, stress, diabetes, and bone health. Read more about magnesium malate.

Our magnesium malate is a highly bioavailable magnesium supplement with the added benefits of malic acid, ensuring that it is soothing to the digestive system.

 

Feverfew

This can be taken as a tincture by putting drops into water or juice. Our Feverfew Tincture is a 1:1 high strength tincture made from fresh feverfew flowering herbs. The plants are processed the same day as they are harvested. It is advised to take as soon as you are aware of the beginning of a migraine.

 

Vitamin B2 (Riboflavin)

A study review of 2015 into the benefits of vitamin B2 supplementation on migraine in adults and children found 11 eligible articles indicting that vitamin B2 ‘can play a positive role in reducing the frequency and duration of migraine attacks with no serious side effects.’

Our Super B Complex gives 3mg B2 Riboflavin and 30mg Magnesium, along with many other vital vitamins.

Co Enzyme Q10

Studies have shown that migraine patients who took 100 mg three times a day of CoQ10 which helps the body produce energy, had fewer attacks of migraine in the three-month duration of the study than those who took a placebo. They also had fewer days with headache and nausea.

Co Enzyme Q10 is produced naturally in the body and is essential for production of energy. The levels reduce in the body as you age so replacement with supplement has an anti-aging effect on energy levels.

Our Co Enzyme Q10 is produced using a microbial fermentation.

 

Help and Support

The Migraine Trust is the largest research and support charity for people affected by migraine in the UK. Their mission statement:

"Our role is to fund and promote new research into migraine, provide day-to-day support for people affected, and campaign for change. We provide evidence-based information and support – via our website and information – on all aspects of migraine and helping people with migraine experiencing difficulties at work, in education, or in accessing healthcare services."

Tel: 0808 808 0066

Website

Email

The Brain Charity offer help if you are affected by migraine. They cover more than 600 different neurological conditions and provide practical help and emotional support.

Tel: 0151 298 2999

Website: https://www.thebraincharity.org.uk/condition/migraine/

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