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Friday, March 21, 2008

How to be Headache-Free


by Melanie Haiken
Don’t suffer—new remedies can keep you smiling.

More than half of the 30 million Americans who suffer from the worst kind of headache pain take only over-the-counter remedies—or nothing at all. But doctors now believe an unorthodox remedy such as a B vitamin or a series of Botox injections may help. How they work isn’t entirely clear. But the risks appear to be minimal, and the payoffs could be huge. Here’s our guide to the remedies experts find most promising.

Get your Bs
In people who suffer from frequent headaches such as migraines, tests show their brains seem to be consistently low on energy, leading to painful overreactions when the brain is pushed by bright lights, loud sounds, or lack of sleep. Riboflavin appears to help solve the problem, Kaniecki says. While the recommended daily intake for a healthy adult woman is only about 1 milligram, a high dose (400 milligrams daily) cut the frequency of migraine attacks by nearly 60 percent in one study, and there are no known risks from taking that much. You have to use it daily for at least a month before you’ll see results, because your body needs time to adjust. A bottle of 100-milligram supplements sells for about $6.99 at most drugstores and is available for less on the Internet.

Magna magnesium
Magnesium also seems to correct brain hypersensitivity. The dose needed is considerably more than the 50 milligrams in once-a-day vitamins; patients took up to 800 milligrams daily in studies that found significant reductions in the number of days with headaches, and in the intensity of pain. That amount may cause diarrhea or gas in people with sensitive stomachs, but taking a calcium-magnesium combo pill can offset these side effects. Both magnesium and calcium-magnesium supplements are available at pharmacies for $10 or less. Give it at least a month, preferably 3 months, before deciding if it’s worth it, experts say.

The butterbur effect
Butterbur, an herb, has been used for centuries by Europeans to treat fever, asthma, and inflammation. Thanks to a convincing study published last year, clinics around the country are using an extract from its roots, called Petasites. Patients who took 75 milligrams twice a day for 4 months cut their incidence of migraine attacks almost in half. The dosage is important: A second group that took 50 milligrams twice a day got no benefit.

Butterbur may prevent spasms of the blood vessels in your head, Lipton says, and curb inflammation inside the vessels. The only side effect of taking the herb appears to be an unfortunate tendency to burp. The brand used in the study, Petadolex, is available only in 50 milligram capsules; take one three times a day. Look for it in drugstores, health-food stores, and on the Internet.

Do the Q Co-enzyme Q10, an antioxidant found in meat and nuts, may also crank up your brain’s ability to use energy. “The data are very encouraging,” says Mark Green, MD, of Columbia University. In a recent study, researchers gave 42 patients either co-Q10 or a placebo and found that the antioxidant reduced the frequency of attacks by 47 percent, as well as the amount of nausea. A 1-month supply will run you $40 to $60, and you’ll need to take a fairly high dose (300 milligrams every day) for at least 2 months before you’ll feel better. Buy it wherever it’s sold in bulk; the Internet may be your best bet.

A new use for Botox
A new Mayo Clinic study found that Botox cut by more than half the number of headaches suffered by people who get migraines 15 or more days per month. But this remedy doesn’t slay headaches by forcibly relaxing or paralyzing muscles. Instead, experts say, it seems to block pain signals to the brain. Injections are usually applied at numerous sites in the scalp and neck every 2 to 3 months. A big drawback: It’s $1,000 per treatment, and insurers usually won’t cover the cost. Many headache clinics offer Botox therapy; ask your local hospital or neurologist for a referral.

A pain-piercing approach
In a recent study, German insurance companies followed 15,000 headache patients and found that those getting acupuncture in addition to OTC pain remedies suffered 44 percent fewer headaches than those relying on medication alone. How and why acupuncture works is unknown. Another recent study compared it with so-called sham acupuncture, in which needles are inserted at sites not usually used by an acupuncturist, and found both methods equally effective at combating migraines. No one’s sure how to explain that, but having your body repeatedly stuck with needles certainly seems to help. Experts believe the real thing is effective enough to be added to the arsenal of available treatments in many reputable clinics. Their advice: Find an acupuncturist specializing in headaches, and continue regular sessions for several months. The American Academy of Medical Acupuncture can refer you to acupuncturists with MD degrees.

— Melanie Haiken, the former health editor of Parenting, writes frequently about alternative medicine.

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