Headaches: Hunting down the cause of your pain

| By Dr. Ronald Hoffman

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Is your pain in the head a pain in the neck? Stress, certain foods, food additives and hormones can initiate headaches.

Researchers have classified many different types of headaches that include sinus headaches, exertion headaches, fever headaches, menstrual headaches and bilious headaches. To simplify let’s examine the three major categories of headaches.

Tension or muscle contraction headaches often are caused by anxiety and stress. These headaches are characterized by dull pain that begins in the neck or back of the head and squeezes the forehead area. They are characteristically described as having a “rubber band” tightened around your head.

Migraine or vascular headaches affect approximately 28 million people and four times more women than men. Migraines can begin suddenly or present with warning signs, such as aura. They are characterized with one-sided sharp throbbing pain that may induce vomiting, dizziness and hypersensitivity to sounds and light.

Cluster headaches, which also are vascular, affect approximately 1 million people per year in the United States. Cluster headaches usually cause pain on one side of the head, occur in groups or “clusters” and can last for days at a time.

Anxiety and stress are the most common triggers of headaches. Avoiding all controllable situations that commonly cause stress and tension, such as over-scheduling appointments and dodging upsetting confrontations and situations, may help you avoid some of your headaches. There are some steps you can take to help you handle the stressors in your life that you can’t directly control and help you avoid tension headaches. Stress reduction exercises—such as biofeedback, meditation and yoga—can help you to become a stress survivor. Let’s not forget about moving the muscles below your head. Exercise is a great stress reducer.

Dietary allergies play a major role in the onset of headaches. Identification of allergens in your diet can result in elimination of that cantankerous throbbing in your head. However, in clinical practice, I eliminate specific known headache triggers commonly found in one’s diet prior to receiving the results of allergy testing. Let’s explore some the common dietary headache inducers.

A group of phosphoproteins in milk are commonly referred to as “casein.” Casein, which comprises 78.7 percent of all the protein in milk, is a major trigger of migraines and other types of headaches. Many practitioners eliminate all sources of casein in the headache sufferer’s diet. To eliminate all casein one must avoid all dairy and the many foods in which it is found. It is commonly listed as sodium caseinate, calcium caseinate or milk protein on many food labels. These three main ingredients are found in sports bars, sports drinks, packaged goods and commercial tuna fish in a can. (How do you think they pack tuna into a perfect hockey puck shape?) An excellent book on the effects of casein and headaches is How To Rid Your Body of Pain by Dr. Daniel Twogood.

Another common dietary headache trigger is tyramine. Tyramine is a phenolic amine found in various foods and beverages. The following list depicts tyramine sources that should be avoided.

Cheeses: All aged and mature cheeses. Because it is impossible to know the exact tyramine content, all cheeses should be avoided including but not limited to cheddar, Swiss, blue cheese, mozzarella, Parmesan, Romano, cheese spreads, cheese casseroles or any foods made with cheese.

Yeast, brewer’s and extracts: This group includes brewer’s yeast, extracts such as marmite and fresh homemade yeast-leavened breads; yeast found in prepared foods, soups, canned foods and frozen foods should be checked for the addition of yeast abstracts and should be avoided.

Meats/fish: Pork and all smoked, aged, pickled, fermented or marinated meats must be avoided including but not limited to pickled fish, pickled herring, meat extracts, livers, dry sausages or prepared meats such as salami, bologna, pepperoni, frankfurters, bacon, bologna, liverwurst and ham.

Also avoid: Chocolate, over-ripe bananas, citrus fruits (oranges and grapefruit), sauerkraut, broad fava beans, Italian beans, tofu, soy sauce and miso soup.

Beverages: Coffee, tea, cocoa, beer, ales (domestic and imported), wines (especially Chianti), vermouth, whiskey and liqueurs such as Drambuie and Chartreuse. Non-alcoholic varieties of beers and wines also should be avoided.

Supplements to avoid: Yeast vitamin supplements, L-tyrosine, NADH.

The ubiquitous flavor enhancer MSG must be avoided. Monosodium glutamate is directly associated with the onset of headaches in many people. According to George Schwartz, M.D., MSG is found in many common grocery items and is usually hidden in the ingredient label. The following list should help you avoid MSG and illustrate the fact that this substance is not only found in Chinese food.

Definite sources of MSG: Hydrolyzed protein, sodium caseinate or calcium caseinate, autolyzed yeast or yeast extract, gelatin.

Possible sources of MSG: Textured protein; carrageenan; vegetable gum seasonings; spices; flavorings; natural flavorings; flavorings of chicken, beef or pork; smoke flavorings; bouillon; broth or stock; barley malt; malt extract; malt flavoring; whey protein; whey protein isolate; soy protein isolate or concentrate; soy sauce or extract.

For more information on MSG, click this link http//www.nomsg.com, or refer to the book In Bad Taste: The MSG Symptom Complex by George R. Schwartz, M.D.

Caffeine can cause headaches. If you are a coffee drinker that decided to quit and had that classic “caffeine withdrawal headache,” you know the pain-inducing power of this substance. Even the caffeine content in standard over-the-counter pain relievers can cause a rebound headache. When trying to kick the coffee habit, wait until the weekend or when time off from work is available. Next, try a coffee substitute product.

Avoiding tannins may be helpful for some sufferers of headaches. Tannins are found in black tea, many herb teas, apple juice (though not apples), dates, kiwi, peach, berries, coffee, chocolate, carob, alfalfa, red wine, many alcoholic drinks, walnuts and pecans.

Other substances to avoid include hydrogenated oils, sugar, food additives (especially sulfites), alcohol and tobacco products.

Environmental allergies can play a role in the onset of headaches. Working with a progressive medical center to identify such allergies can result in treatment called neutralization and desensitization, which can help alleviate headaches if it is part of the cause.

Hormones may be the cause of your headaches. Sixty percent of women’s migraines are linked to their menstrual cycle. Migraine-type pain shortly before, during or after menstruation or at mid-cycle may indicate a variation in estrogen levels. Further, hormone neutralization/desensitization may be beneficial therapy when treating headaches. A knowledgeable holistic physician can identify such problems.

Controlling blood sugar is an often overlooked yet important part of any headache treatment protocol. Never consuming carbohydrates alone, eating small frequent protein-rich meals, and avoiding all refined sugars and flours from one’s diet are just some of the steps to stabilizing blood sugar to head off a headache.

Certain supplements can help ease that pain in your head. Doses of the following supplements should be tailored to each individual by a certified nutritionist.


Other causes of headaches that need to be examined include TMJ (temporomandibular joint) syndrome, brain tumor, spinal misalignment, overdoses of vitamin A and hypertension. It is imperative to see a doctor if you are suffering from headaches.

According to the National Headache Foundation, your genes may play a role in you becoming a migraine victim. If both your parents had migraines, you have a 75 percent chance of inheriting that pain. If only one parent is a migraine sufferer, your risk drops to 50 percent. If a distant relative has migraines, your risk sinks to 20 percent.

Migraines may damage part of the brain that responds to pain and activates the fight-or-flight response. According to a recent study, scientists imaging the brain have found that blood flow to certain parts of the brain increases dramatically during the course of a migraine. Researchers at the University of Kansas Medical Center found that migraine and chronic headache sufferers had more iron in a part of the brain called the periaqueductal gray region than those without headaches. The researchers mapped the brains of 51 subjects divided into three groups: 17 without migraines, 17 with migraines and 17 with episodic migraines that progressed into a condition called chronic daily headache. They used magnetic resonance imaging in combination with a technique to map changes in the concentration of iron. According to researchers, the concentration of iron corresponds to the amount of damage—more iron indicates the potential for free radical damage. The results of the study were presented at the International Headache Conference on July 1, in Manhattan.

The periaqueductal gray region sits in the brain stem, which extends up from the spinal cord and controls many involuntary processes. One of its main functions is to diminish pain. Researchers postulate that chronic migraines can lead to increased sensitivity to pain, even when they don’t have a headache. K. Michael Welch, the vice chancellor of research at the University of Kansas Medical Center, believes that though future studies are needed, we should be very aggressive about preventing migraines.


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