Migraines and MAID (Canada's euthanasia program)
A conversation on TwXtter inspired this post. Peace be with you, and I hope for migraine free days too.
A comment I made in passing about (my opinion) migraines not being something to go to the ER for, generated hurt feelings in a reader with a severe history of migraines - so severe they have considered the end-of-life (end-your-life) MAID program as a way out of their pain. (MAID facts) That is sad, but relatable. During my worst migraine years, it got bad enough that at times I was ready to just be done with my head - suicidal in a way of just wanting out of the pain and it had no emotional ramifications at all. I just was tired of the stabbing pain.
My rating system was not 0-10 with 10 being most severe. It was more descriptive of what I felt. My scalp has a specific pain location and MRI imaging found that blood vessels in the area were “tortuous” (Brave AI summary) - an appropriate word I thought. It means the vessels in the area are twisted or convoluted. Injury can be a cause and I was a forceps baby. There has been a bald spot on my head in that area as long as I can remember.
Is my migraine a pounding needle like spot? - Mild.
Or a pounding icepick? - Worse.
Or a pounding steak knife? - Really not good.
Or was it the pounding railroad spike? - I just don’t want my head anymore.
The conversation on social media was about my having said I was shocked when I learned that people go to the ER for migraines. And I said ~ they just need to be coped with. The ensuing conversation revealed that while I might have gotten more immediate pain relief by going to an ER, that my experience with migraine had gone better. While vomiting excessively can be part of it, dehydration for me never became severe enough to make it a medical emergency. While a ‘pounding railroad spike’ migraine might seem like an emergency to the body, migraines are really not ‘life threatening’ in the way that dehydration can be.
When you see the medical system as a route to health, then you might end up a decade later on ten medications and still have severe daily pain - that is where the person considering MAID suicide is at currently.
For the government to make suicide an easy out, to save on health care costs, seems like a bad thing to me. It took me a while, but I have mostly gotten to no-migraine months. If I had taken the suicide route, it would have ended my life ~ the early 2000s. Adding iodine in 2005, and then following the Marshall Protocol for a year and a half ~ 2006-8, is what helped to curb the severity of my migraines and the number of triggers, but I didn’t get into that in this post. Mold is still a trigger for me and lack of nutrients that I discuss below can be a trigger, or excess of excitotoxins or other environmental toxins like smoking too much can be a cause.
The problem is that government funded health care is not going to help the person in Canada to achieve no-migraine months. Most of my strategies, discussed below, or the Marshall Protocol and high dose iodine, are not funded or even screened for consistently by Western medical practitioners.
Migraines are a big topic, this is a long post, but it is not everything there is to know about migraines.
Discussed in the post: an overview of pain and migraines; acid/alkaline balance; electrolyte balance/hyponatremia - low salt; inflammatory signaling - deserves more info on topical magnesium; methylation cycle dysfunction and how riboflavin might help; pyroluria and low B6 and zinc; excitotoxins - glutamate, aspartic acid and other amino acids; too much or too little glycine; and poor detox of phenols and amines - salicylate excess.
Related posts:
Migraines are very disabling because it is in-the-brain-pain and you can’t really think, or move, or digest well.
Pain is variable I have noticed. Internal pain from headaches or in the gut can be more disabling, harder to ignore and get on with life, than pain from a surface wound.
I had a scalp biopsy at one point during my migraine years to assess for eczema in the area of the bald spot and the external wound was practically no big deal compared to migraine pain. My recent broken toe/bruised foot made me realize that I do have a high pain tolerance and almost kind of enjoy a low-level throbbing - as if it is an awareness of my existence. I am a little messed up though from childhood stuff. I am not suggesting that is a good thing. Pain was not unpresent at random times from family members ‘playing’ or showing affection. Dissociating was an escape for me at times.
Dissociation can be associated with self-injury during the dissociation, which might lead to an endorphin rush, but later leads to some pain and healing. Dissociation or self-injury is kind of an escapist behavior that can become habitual or addictive. Eating the wrong things, once I had a firm association that they likely would cause a migraine the next day, was somewhat of a self-injurious pattern that I had to work on stopping. Recognizing that one little taste generally does not work helped me to stop risking a little taste or a few blue M&Ms.
Migraines can become a frequent problem as painkillers that are used may provide some immediate relief but they can cause ‘rebound headaches’, so use of them is really just putting yourself on a Merry-Go-Round of recurring headaches.
Migraines are unlike other headaches in that it seems to be a vascular constriction or expansion issue leading to poor blood flow in a certain region and that means low oxygen levels are reaching that area and that hurts - the body signals pain.
TRP channel overactivation seemed to have been a causal trigger for my headaches, but poor sleep and dehydration were also triggers. My salicylate sensitivity has been with me longer than my awareness of it as a causal problem. Major triggers for my migraines, early, were red food dye #40 and #27. Then yellow food dye became one too. I was left eating Blue M & M’s for a while, until chocolate became a migraine trigger food too. I could use blue gel Ibuprofen capsules but not red pseudoephedrine tablets. Mint lozenges were a favorite until I realized they were a migraine trigger too. I had thought it was mint as a TRP channel activator but mint as a salicylate could be reason too.
For about fifteen years I lived with weekly migraines that might last 3 days. Laying in bed was needed with lights out and a cool compress over my eyes and forehead, (a freezable sore-ankle gel pack wrapped in cloth).
Speeding forward to the Why's? Why do migraines occur?
Inflammatory signaling is involved and that can mean poor detox and poor methylation is involved and lack of glutathione. Lack of nutrients from poor diet or metabolic differences might be causing the dysfunctional detox and methylation pathways. Vitamins B2 and B6, zinc, magnesium and sodium might be low or extra high doses might be needed due to genetic differences. Electrolyte imbalance and/or lack of dietary salt or excess sweating might be causal of low sodium - hyponatremia. Electrolyte imbalance for other reasons might be a causal factor and low potassium or calcium levels might be seen.
Elevated histamine might be a factor leading to headaches the next day and strobe lights or driving at night or watching an action movie can be a cause of mast cell degranulation and elevated histamine.
Migraines are associated with obesity and elevated leptin; and also with autoimmune disease and elevated CRP, Substance P, inflammatory cytokines, IL-6, IL-1β and TNF-α. (Demartini, et al., 2023)
Environmental or dietary toxins are also causal by adding to the inflammatory signaling. Emotional stress can be causal as it causes us to make formaldehyde internally and that can be a TRP channel activator and migraine trigger. Formaldehyde is also in smog or first, second or thirdhand smoke, and it can be a dietary risk in older bottles of juice, aging causes creation of it within the bottled juice. Off-gassing of volatile chemicals from ‘new car’ or ‘new carpet’ or new vinyl shower curtain can be causal.
Acid/alkaline balance matters
When the body is overly acidic, that can also increase problems with excreting salicylates and symptoms might worsen until the body is more alkaline again.
We tend to get overly acidic when the body is inflamed for any reason or when methylation cycles are dysfunctional and the body is burning energy anaerobically.
Inflammatory cytokines IL-6 and IL-1β IL-6 and TNF-α tend to be elevated in migraines (variable in the research somewhat, so not suggested as a biomarker), and migraines are associated with autoimmune diagnosis which tends to have elevated cytokines. While Substance P does tend to be elevated consistently in migraines, making it a potential biomarker, trials of inhibitors of Substance P for migraine treatment didn’t provide relief. (Demartini, et al., 2023) That suggests that we need to figure out what is causing the elevated Substance P and stop that - modify diet and lifestyle to reduce the inflammatory signaling.
Anything elevating IL-6, IL-1β and TNF-α likely could be causing the increase in Substance P also, so identifying anything inflammatory in the diet and lifestyle and removing it would be the therapeutic strategy. Adding pomegranate peel, niacin, butyrate or other Nrf2 promoters would also likely be helpful.
Cyclooxygenase 2 (COX-2) tends to be elevated in migraine and it promotes the prostaglandin PGE2. Pomegranate peel might be helpful as a preventative as it inhibits COX-2. Migraines are more likely during the week prior to menstruation because of increase in some prostaglandins like PGE2, along with a drop in estrogen levels. (Demartini, et al., 2023)
“Among the members of the prostaglandin family, the most studied in migraine mechanisms is prostaglandin-E2 (PGE2). Serum levels of PGE2 are lower in EM patients than in HC [155], but no difference has been reported between EM and HC in PGE2 saliva levels [156]. During a migraine attack, plasma and saliva PGE2 levels increase compared with a pain-free period [48,152,157]. Notably, during migraine attacks, the serum levels of cyclooxygenase 2 (COX-2), an enzyme implicated in the production of PGE2 [158], were higher in migraine patients than in HC [159]. PGE2 serum levels positively correlated with headache frequency in migraine patients [155].” (Demartini, et al., 2023)
Excitotoxin amino acids include glutamate and aspartic acid and seem to be correlated with migraine or migraine with aura.
Many studies have found a correlation between elevated glutamate/glutamic acid and migraine or migraine with aura. It may be useful as a biomarker to test for migraine and assess type. Episodic migraine is considered to be migraine presence less than 15 days per month and chronic migraine is considered to be more than 15 days per month for three months or longer. (Demartini, et al., 2023)
Increased levels of the excitotoxins glutamate and aspartic acid were seen in patients with migraine or migraine with aura (seeing stars/sparkles or other vision changes I think). Glycine was also measured but I didn’t buy access to learn more details about what form was being measured. (D’Andrea, et al., 1991)
“Platelet levels of glutamic and aspartic acid and glycine were measured in patients with migraine with aura, migraine without aura, tension headache and cluster headache. High levels of these amino acids were found in patients with migraine with aura compared to normal subjects and other headache groups. During headache, glutamate levels further increased in migraine with aura patients. These findings may have relevance to the neurological symptoms of migraine with aura.” (D’Andrea, et al., 1991) *Paywall, this is the Abstract.
Glutamic acid, glycine, serine, arginine and tyrosine were found to be elevated in the saliva of people with migraine or migraine with aura. Glycine and serine have calming roles. Glutamic acid can be an excitotoxin - glutamate. Tyrosine is known to cause headaches and is in aged cheeses or red wine.
“In this study, free amino acid concentrations were measured by RP-HPLC in the saliva of 23 migraineurs without aura, 14 migraineurs with aura, and 20 healthy subjects. Significantly higher concentrations of glutamic acid, serine, glycine, arginine, and tyrosine were found in the saliva samples of both groups of migraineurs relative to the control group. It is suggested that amino acids causing hyperexcitability in the central nervous system may be linked to the pathogenesis of migraine.”
Elevated glycine might indicate a back-up is occurring in methylation cycles. Yes, lack of methylated folate could be a cause of elevated glycine which is then a dangerous thing.
“GCS catalyzes the interconversion of glycine into serine and it requires N5-N10-methylene tetrahydrofolate or tetrahydrofolate [31, 32]. The physiological importance of the GCS in degradation of glycine is characterized by its defect in humans which results in glycine encephalopathy and very high levels of plasma glycine.” (Razak, et al., 2022)
Lack of Dimethylglycine (DMG) or Betaine (TMG) can also be a cause of brain over-excitement or methylation cycle dysfunction (and other problems, (Razak, et al., 2022)).
Dimethylglycine is a calming signaling chemical within the brain. It helps cool the brain before sleep. (Razak, et al., 2022) I have tried 1/2 teaspoon in a glass of water before bed, mix with a little sodium or potassium bicarbonate if it seems too acidic for your taste preference or stomach. We all may be getting too little glycine now, compared to glyphosate from the GMO crops and use of RoundUp as a desiccant on many crops.
Trimethylglycine has a critical role within the methylation cycles. It can donate a methyl group leaving Dimethylglycine. The DMG might then go on to be used for making a molecule of our main endogenously created antioxidant, glutathione, or it might be remethylated back to TMG for reuse in the methylation cycles.
My genetic differences leave me low in glycine, and the entire US population is likely lower than they used to be because of the increased use of glyphosate in our food. It competes with glycine but would make a protein ineffective if it was made with glyphosate instead of glycine which has been shown to be possible in work by Seneff & Samsel. Glycine is also available in the form TMG or betaine. I have a gene allele that slows down conversion of TMG to DMG and the two have different roles in health. Really rich sources of TMG like quinoa kind of leave me feeling queasy after eating a standard serving - so I don’t I stopped eating quinoa.
Lack of glycine also increases the salicylate sensitivity as glycine is needed to excrete salicylates.
Poor detox of phenols and amines
Poor detox of phenols and amines can be genetic and would add to headache risks - the red and yellow dyes are phenols. Other medications and the ibuprofen could also add to a phenol/salicylate excess problem . . . and cause headaches. Avoiding free glutamate, aspartic acid, and tyramine can help prevent headaches in people who are prone to headaches and who may also be poor detoxer’s of phenols and amines. Red wine was the first or an early thing I noticed that was a migraine cause. It made me laugh and have fun - I liked it until the next day. Red wine is rich in free amino acids.
I managed my migraine problem by watching for patterns and stopping use of anything that seemed causal - or tried to stop use. Binge/emotional overeating is a problem for me and I would have slip ups, but severe pain is a motivator to not have slip ups and I got better at skipping little tastes of binge prone foods. One blue M&M can just set off a sweet tooth desire for more.
As I restricted more and more things to try to have more migraine free days than migraine days, my internal motto would be “as long as I can still have chocolate”, but then I became sensitized to chocolate too. Life was kind of depressing and the grocery store had become a trauma triggering place with what seemed like “nothing for me to eat”. There really isn’t much to eat there for me besides some whole foods. I do mostly cook my own foods now.
Chocolate is a phenol food, so is coffee and many herbs and spices.
Pyroluria - vitamin B6 and zinc matter
A genetic issue with breakdown of hemoglobin for reuse of the parts can cause chronic excretion of vitamin B6 and zinc when normally it would be reused again. People with pyroluria need a high dose vitamin B6 and zinc supplement most days, for their entire life.
Low vitamin B6 and zinc can be a cause of migraines and other mood and physical symptoms.
People with congenital (birth) gene differences like Down’s Syndrome are more likely to also have pyroluria than the average person. It might be 40% of Down’s syndrome patients - BUT - the Western medical system doesn’t really believe in the problem or screen for it typically or treat it. Lack of zinc and B6 will disrupt the methylation cycles and many other functions within the body and can cause migraines.
Forgetfulness can be a problem. I REALLY need those two supplements most days of the week in order to not get a little weird/more ADHD → scattered thinking, racy thoughts, hard to stay focused or complete things. Salicylate excess seems to be part of ADHD symptoms as it causes similar changes in thinking and mood. Doing things too fast and too recklessly can occur when salicylate is in excess. Losing my cell phone in my own purse (twice - different purses though) and freaking out about a lost phone, searching everywhere for it but never thoroughly enough to find it in the purse . . . is an example of what salicylate excess can look like.
Taking ibuprofen or Excedrin or aspirin for a headache would all make a salicylate excess worse. Caffeine is also a polyphenol too. Mint is a salicylate, so my mint lozenges were also adding to salicylate excess.
Methylation cycles, MTHFR, and riboflavin
If your methylation cycles aren’t functioning well, then sulfate metabolism and glutathione production would be thrown off, which means breakdown of the phenols and salicylates wouldn’t work well and other drugs might also accumulate instead of being broken down. Gene differences in MTHFR were focused on as THE problem in methylation, and giving methyl folate was/is the standard solution. But it turns out that high dose riboflavin might be safer for the C677 allele as the dysfunction is in keeping a cofactor of B2 attached to the enzyme. Having plenty of B2 all day long, helps keep resupplying the MTHFR enzyme with the cofactor it needs.
Taking high dose folate is more problematic because it can inhibit methylation cycles as a negative feedback control. Excess cysteine as a supplement also can act as a negative feedback control and put the brakes on the methylation cycles. This means, random high dose supplements CAN make things worse. Over methylation or under methylation can both cause negative mood and physical symptoms.
The high dose riboflavin doesn’t seem to have any negative feedback controls. Taking 100 mg several times per day is a recommendation by Bethany Briggs. Her tip is to keep the urine the bright yellow of a highlighter marker and that indicates that the body had plenty of B2 for methylation purposes - yes, it is being dumped in ‘expensive’ urine but what price is not having migraines worth to you? Bright yellow urine is not a high cost to pay.
A product example, MigreLief by Akeso, puts in two tablets - 400 mg of riboflavin (B2) with 360 mg of Magnesium (citrate and oxide) and 100 mg of Feverfew, an herb known to help with migraines. They do seem to be recommending taking this product as a daily preventative - twice a day. (store.migrelief.com)
This product does contain titanium dioxide in the fine print, I notice now, and I try to avoid that. It is a heavy metal nanoparticle which the body has a hard time excreting. It is added to supplements and foods as a whitening agent. Riboflavin is bright yellow and yet these tablets are whitish/caramel colored. The fine print lists the titanium dioxide and caramel color. What was wrong with pretty yellow?
Pomegranate peel can help with excretion of heavy metal nanoparticles though, but I would rather avoid the ingredient. Feverfew is also available as an herbal supplement, and I take that instead. (Feverfew for migraine/Brave AI summary)
I have found this product helpful during a migraine, but I don’t take it daily. I use a 100 mg riboflavin instead, about 2-3 times per day now.
Low sodium - lack of salt can be a headache cause
With the salicylate sensitivity, salt retention became a problem and so I greatly restricted that to try to reduce leg swelling. I ended up over-restricting it and found that low level headaches were a result. I try to use some but not loads of salt now.
In research by Pogodo, et al., published in the Headache journal, severe headache or migraine history was found to be inversely correlated with sodium intake - in other words the people who ate the least sodium, (per total calories), were the most likely to also have a history of headache, (in the NHANES 1999-2004 study/database). (Pogodo, et al., 2016)
“Results from both crude and covariate‐adjusted analyses of the relationship between dietary sodium and migraine status are shown in Table 2. Compared to respondents with the lowest dietary sodium residuals, there was a significant trend of decreasing odds of migraine history with increasing levels of dietary sodium residuals (OR = 0.93, 95% CI = 0.87, 1.00, P = .0455);” (Pogodo, et al., 2016)
Disclaimer: This information is being provided for educational purposes within the guidelines of Fair Use and is not intended to provide individual health guidance.
Reference List
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