Digestion, health and nutrition: Dr. Anil Minocha, a gastroenterologist and nutritionist

Food triggers and natural supplements, treatments for migraine headache

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Many patients do not obtain the expected relief from migraine headaches by using the myriad medications alone. Complementary and alternative medicine is playing increasing role in the patient's preferences. Lifestyle modifications and use of supplements has frequently been recommended.

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Drs. Sun-Edelstein and Mauskop from the The New York Headache Center, New York reviewed the role of the role of food triggers and supplements for treatment and revention of migraine headaches. The findings were published in the Clinical Journal of Pain.

They studied the English language literature on preclinical and clinical studies pertaining to food triggers and supplements and migraines. They concluded as follows:

1. A thorough food/nutritional history using food diaries can help identify food triggers.

2. A subset of patients may be sensitive to foods that trigger headaches and these include the following:

• Phenylethylamine
• Tyramine
• Aspartame
• Monosodium glutamate
• Nitrates and nitrites
• Alcohol
• Caffeine

3. There is evidence to support the use of certain vitamins and supplements for preventing migraine headaches and many have been endorsed by the American Headache Society and American Academy of Neurology 2012:

• Magnesium
• Petasites hybridus aka butterber
• Mig-99 or Feverfew
• Coenzyme Q10
• Riboflavin
• Alpha lipoic acid

Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health

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Riboflavin prevents migraine headache

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Complementary and alternative medicine is being used for numerous chronic disorders including pain. A disorder of mitochondrial energy metabolism has been implicated in pathogenesis of migraine headaches. Riboflavin may help correct that. Riboflavin deficiency is rare. Studies indicate that high dose of B2 have prophylactic effects against migraine headaches. 

Is It Leaky Gut or Leaky Gut Syndrome?

 

Study

Schoenen et al. from the Department of Neurology, University of Liège, CHR Citadelle, Belgium conducted a randomized, double-blind, placebo-controlled examined the role of riboflavin (400 mg/d) in patients (n=55) suffering from 2 to 8 attacks of migraine headaches per month. 

 

Results

Greater than 50% improvement was seen in 54% of treatment group as compared to 19% in placebo. Riboflavin reduced the headache days from 57% as compared to 19% in placebo group. This was associated with a significant improvement in migraine index score of 39 in treatment group as compared to 8% in placebo. The number-needed-to-treat for effective response was 2.3.

 

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Migraine in children and adolescents

 

Study

Condo and colleagues from the Department of Neurological Sciences, University of Bologna, Bologna, Italy, conducted a retrospective study to examine the role of riboflavin for preventing migraine heaaches in pediatric and adolescent patients (n=41). The findings about beneficial effect of riboflavin were published in the Journal of Headache and Pain.

Methods

Subjects with migraine headaches receieved 200 or 400 mg/day oral dose of riboflavin for 3, 4 or 6 months.

Results

The riboflavin supplementation resulted in a significant reduction in migraine episode frequency and intensity (p<0.05). 

Follow up these subjects revealed that 68 percent of the subjects demonstrated a 50% or greater reduction in frequency of attacks. Adverse events included vomiting and increased appetite which the authors felt were unrelated to the riboflavin administration.

It should however be noted that other studies in children have however provided opposing results.

Do you take riboflavin or any other vitamin or supplement to prevent migraines? Please share.

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Below are some more topics you may be interested........Or click for Home page 

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Evidence based natural treatments of fibromyalgia	Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health
Herb/spice in kitchen to prevent cancer & boost immunity	Yoga improves blood pressure & diabetes
Food triggers for migraine	Botox works at both ends. Cheers!
Fish type, mercury toxicity risks versus benefits	Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health
Depressed? Want alternative medicine options?	Risks of heartburn and ulcer medications
Constipation? Think your colon has kinks?	Confused about probiotics on market? Knowledge is power

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How to treat depression: Role of alternative medicine

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Freeman and colleagues from the Center for Women's Mental Health at the Massachusetts Genneral Hospital wrote a report on the use of alternative and complimentary medicine in patients with depression. This CAM report on major depressive disorder or major depression by the American Psychiatric Association  apeared in the Journal of Clinical Psychiatary.

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The task force reviewed the relevant literature on individual alternative and complimentary medicine therapies for major depression. The studies on Individual CAM treatments for depression were examined for benefit as well as risks.

Conclusions of American Psychiatry Association:  The task force concluded that results of randomized controlled trials of commonly used alternative and complimentary treatments (CAM) for depression (MDD) show promise. The task force of these psychiatrists made a special mention of the following:

• Omega-3 fatty acids
• St John's wort (Hypericum)
• Folate or folic acid which is a vitamin
• S-adenosyl-l-methionine (SAMe)
• Acupuncture         Click to read more about acupuncture
• Light therapy
• Exercise
• Mindfulness psychotherapies  

Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health

Risks of CAM treatments: The biggest risk may be the possible delay in undertaking other well-established treatments.

Earlier, the Canadian Psychiatric Association and the Canadian Network for Mood and Anxiety Treatments (CANMAT) have comobied together to establish evidence-based clinical guidelines for the treatment of depressive disorders or depression.

The team led by Dr. Ravindran from University of Toronto published their report about use of alternative and complimentary medicine or therapies in depressive disorders in Journal of Affective Disorders.

Conclusion of the Canadian panel: There is Level 1 evidence to support the use of light therapy in seasonal major depressive disorder and for St. John's wort in mild to moderate MDD.

The team also made a special mention of the following therapies in management of depression:

• Exercise
• Yoga
• Sleep deprivation
• Omega-3 fatty acids
• SAMe 
  

Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health

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Cognitive behavioral therapy in irritable bowel syndrome

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Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health

Cognitive behavioral therapy or CBT appears to have a direct effect on global manifestations of irritable bowel syndrome(IBS) or spastic colon. This may not correlate with resolution of psychological distress. Improvement in IBS symptoms is associated with improvements in the quality of life and the improvement in psychological distress may be a reason for, effect of or part of it.

Is It Leaky Gut or Leaky Gut Syndrome?

Scientific basis

Cognitive therapy for irritable bowel syndrome results in decrease in limbic activity and improves digestive symtoms and anxiety. Thus CBT induced symptomatic improvement in IBS may be a biologically oriented change mediated by changes in neural activity of CNS foci that relate to hypervigilance and emotions.

• Drossman (2003) conducted a randomized, comparator-controlled, multicenter trial in 431 adults to examine the clinical efficacy and safety of cognitive-behavioral therapy versus education and tricyclic antideppressant (desipramine) versus t placebo in female patients with moderate to severe functional bowel disorders including IBS. Significantly higher number of patients responded in CBT group as compared to education (70% vs 37%). Desipramine was similar to placebo in intent to treat analysis.
• Kennedy conducted randomized controlled trial of the addition of nurse administered CBT to standard general practice management of IBS (antispasmodic agent mebeverine) in in primary care. The addition of CBT was significantly superior to mebeverine-only group at 3 months. Authors concluded that specially trained practice nurses can provide effective CBT to primary care patients with a clinical diagnosis of IBS, which although effective does not reduce service or social costs although the beneficial effects of the addition of CBT to antispasmodic therapy persist for up to 6 months.
• A randomized controlled trial (Ljotsson 2010) has documented that cognitive behavior therapy based on exposure and mindfulness exercises and conducted over the internet delivered via the Internet alleviating the total burden of symptoms and increasing IBS-related quality of life in patients with IBS. The treatment group reported a 42% decrease in primary IBS-symptoms as compared to 12% in controls.
• Another randomized controlled trial (Moss-Morris 2010) found that cognitive behavioral therapy based self-management in the form of a structured manual without much contact with the therapist contact is a effective for treatment of patients with IBS in primary care.
• In contrast to studies on CBT and IBS above, Boyce (2003) reported that cognitive behavior and relaxation therapy seem not to be superior to standard care alone in IBS.          

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Saccharin, aspartame and cancer risk

Cancer risk and consumption of arificial sweeteners especially saccharin, aspartame 

Please also read Healthy Alternatives to Sugar Devil

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• There has been an ongoing controversy over the health risks especially cancer risks due to consumption of artificial non-nutritive sweeteners like saccharin and aspartame. Most of the data about cancer risk has been based on animal studies. Question arises: What is the human data on cancer risk due to artificial sweeteners due to saccharin and/or aspartame.

  Gallus and colleagues from Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.provided an analysis of the integrated network of case-control studies between 1991 and 2004 in Italy on variety of cancers. The findings were published in the journal Annals of Oncology. The odds ratios for saccharin use and cancer risk are as follows:

  • Oropharynx 0.83 (95% CI 0.30-2.29)
  • Esophagus 1.58 (95% CI 0.59-4.25)
  • Colon 0.95 (95% CI 0.67-1.35)
  • Rectum 0.93 (95% CI 0.60-1.45)
  • Larynx 1.55 (95% CI 0.76-3.16)
  • Breast 1.01 (95% CI 0.77-1.33)
  • Ovaries 0.46 (95% CI 0.29-0.74) --------------Reduced risk
  • Prostate 0.91 (95% CI 0.59-1.40)
  • Kidneys 0.79 (95% CI 0.49-1.28)

• Oral cavity and pharynx 0.77 (95% CI 0.39-1.53)
• Esophagus 0.77 (95% CI 0.34-1.75)
• Colon cancer 0.90 (95% CI 0.70-1.16)
• Rectum 0.71 (95% CI 0.50-1.02)
• Larynx 1.62 (95% CI 0.84-3.14)
• Breast cancer 0.80 (95% CI 0.65-0.97) --------Reduced risk
• Ovaries  0.75 (95% CI 0.56-1.00)
• Prostate 1.23 (95% CI 0.86-1.76)
• Kidneys 1.03 (95% CI 0.73-1.46)

 In fact there was a significant less likelihood with use of total sweeteners and the risk for breast and ovarian cancer. On the other hand, there was a significant trend for total sweetener consumption and for laryngeal cancer.

Conclusion of the study: The authors concluded that there is a lack of association between saccharin, aspartame and other sweeteners and the risk of several common neoplasms.

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Update of above analysis for more cancers and sweetener risk: Bosetti and colleagues examined the role of sweeteners on cancer risk especially saccharin and other artificial or low-calorie sweeteners including aspartame. They conducted an update of their analysis of an integrated network of case-control studies conducted in Italy between 1991 and 2004 including data on cancers of the stomach, pancreas, and endometrium. The findings were published in the journal Cancer Epidemio Biomarkers Prev (2009).

The investigators found that after adjusting for confounding factors, odds ratios (indicating less or more risk; if you just want conclusions, just scroll down) ever users of sweeteners versus nonusers were as follows:

• Gastric cancer 0.80 (95% CI, 0.45-1.43)
• Pancreatic cancer 0.62 (95% CI, 0.37-1.04)
• Endometrial cancer 0.96 (95% CI, 0.67-1.40)

Conclusions of the updated cancer risk study: The authors concluded that the findings lent further support to the evidence on the absence of an adverse effect of low-calorie sweetener (including aspartame) consumption on the risk of common cancers in the Italian population.

Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health

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Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health

Modern medicine is joke of the future

 

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Modern and ancient medicine

 

--Just a thought from physician-comic

"Modern" medicine frequently is educated guess. Don't laugh at medical practices of past, Current practices may be butt of jokes in future (no pun intended).

Is It Leaky Gut or Leaky Gut Syndrome?

Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health