3 Types of Headaches + How to Prevent and Treat Each
By Eric Madrid MD
In this article:
Headaches are a common reason one will visit their doctor. Many who have chronic headaches have suffered from them for years. If you have no history of headaches but have developed a new onset of headaches, consult with your physician and make sure an accurate diagnosis is made and the cause is determined. Sometimes, headaches can be caused by high blood pressure, brain hemorrhages or rarely, brain tumors. Once a more serious cause is ruled out, a doctor frequently classifies a person’s headaches into one of the following categories.
These are one of the most common headaches people experience and one of the most common reasons for over the counter pain medications. Tension headaches are common during times of increased stress, anxiety, or depression. Frequently, tension headaches are described by feeling like a band is tightly wrapped around your head. Or as feeling pressure in the back of your head along with the neck muscles.
Dietary causes of a tension headache
- Low Blood Sugar
- Caffeine withdrawal or sometimes overuse
- Excess consumption of simple carbohydrates and processed foods
- Gluten sensitivities
- Artificial sweetener or food additive sensitivity
Supplements for Tension Headaches
- Magnesium – Magnesium is one of the most abundant minerals in the human body and is required for more than 350 biochemical reactions. Magnesium is commonly found in green leafy vegetables such as kale and spinach. As a supplement, it is available in a powder or as capsules. It is also known as the “stress mineral” and those with tension headaches frequently report it being useful. Epsom salt, which is made of magnesium, can also be beneficial when added to a warm bath. Most need 250 to 500 mg per day to help with headache prevention.
- Vitamin D – More than 70% of the world population is deficient in vitamin D, which can be made by simply spending sufficient time in the sunlight during the hours of 10 AM to 3 PM. Lower levels of vitamin D are associated with increased risk for tension headaches. Most who supplement need anywhere from 1,000 IU daily to 5,000 IU daily to reach optimal blood levels. Some may need up to 10,000 IU daily. Those taking higher doses should check with their physician.
A migraine headache is often experienced as a painful, throbbing pain that commonly causes nausea and light sensitivity. Worldwide, 1 billion people are affected. These headaches may occur weekly, monthly, or sometimes, only a few times per year. Some studies suggest that one in seven people will experience a migraine headache at some point in their life—almost one in five women and one in 15 men are affected.
Cause of Migraine
Migraines appear to be triggered by “malfunctioning nerves and blood vessels” in the brain, which inappropriately activates the trigemino-cervical pain system. While scientifically complicated, understanding how migraines start allows doctors to best prevent and treat them. In addition, there appears to be a genetic component to migraine headaches as mothers and daughters are frequently both affected. Prescription medications can work for many who take them.
Symptoms of a Migraine Headache
- Severe head pain
- Throbbing sensation
- Nausea and Vomiting
- Presence of an aura, or visualization of zig-zag lines
- Light and sound sensitivity
- Significant disability and missed workdays
Dietary Contributors of a Migraine
- Low blood sugar
- Wine – some are sensitive to sulfites in wine
- Cheese – specifically due to the amino acid tyramine, which increases as cheese ages
- Caffeine – may cause or relieve migraine symptoms in some
- Simple carbohydrates – common in processed foods, break down into sugar
- Gluten sensitivity
- Artificial sweeteners (aspartame is a common trigger of migraines)
Supplements and Migraine Relief
- Alpha Lipoic Acid – A 2017 study in the Journal of Medicinal Food showed that potent antioxidant alpha-lipoic acid, when taken at doses of 400 mg twice per day, could help prevent the frequency and duration of migraine headache.
- Coenzyme Q10 (CoQ10) – Studies show CoQ10 can help prevent migraines. A 2017 study concluded “… CoQ10 might reduce the frequency of headaches, and may also make them shorter in duration, and less severe, with a favorable safety profile.” Another 2017 study also showed benefit of CoQ10 supplementation in preventing migraines. Suggested dose: Co-Enzyme Q10 100 mg to 300 mg daily
- Omega 3-Fish Oil – A 2017 study in Nutritional Neuroscience showed that omega-3 fish oils could help reduce the duration of migraine headaches. A 2017 study, during which subjects took fish oil and curcumin (turmeric), showed a reduction in migraine headaches. Suggested dose: Omega 3-fish oil 2,000 to 4,000 mg daily. Divide into twice a day dosing.
- Folic Acid – Folic acid is a common vitamin taken, especially by pregnant women. A 2015 study showed that women who consumed higher levels of folate, especially in the form of green leafy vegetables, had fewer migraine headaches. A 2016 study found similar results when a folic acid supplement was taken.
- Magnesium – For the last decade, I have recommended magnesium to patients who are afflicted with migraines. Scientific research supports my doctoring experience. A 2017 study concluded that migraine headaches could be prevented with magnesium. A 2018 study in Headache found similar benefits in headache prevention. Suggested dose: 125 mg to 500 mg daily. Start low and increase the dose as needed.
- Melatonin – Melatonin, the “sleep vitamin” has been shown to be effective in preventing migraine headaches. A 2017 study compared 3 mg of melatonin with the prescription drug valproic acid. Melatonin was shown to be more effective and without side effects. A 2017 study in the Journal of Family Practice showed melatonin as effective as the prescription drug amitriptyline in preventing migraines. Suggested dose: Melatonin 3 mg to 10 mg each night at least 2 hours before bed.
- Riboflavin – Also known as vitamin B2. This vitamin has been shown to be effective in preventing migraines. A 2017 study in the Journal of Clinical Pharmacy and Therapeutics, which evaluated eleven studies concluded “Riboflavin is well-tolerated, inexpensive and has demonstrated efficacy in the reduction of adult patient's migraine headache frequency”. Suggested dose: Adults - Riboflavin 400 mg daily. Pediatrics - 100 to 400 mg daily.
- Ginger – Ginger has anti-nausea benefits which can be helpful in the treatment of migraine headaches. Its use is common amongst those who practice Ayurvedic medicine. A 1990 study demonstrated knowledge of ginger’s effectiveness in the treatment of migraines while a 2014 study showed ginger to be just as effective as the pharmaceutical drug sumatriptan when treating a migraine. Drinking ginger tea may also be helpful to minimize symptoms of nausea. Suggested dose: Ginger 250 mg to 500 mg once or twice daily.
- Feverfew – Feverfew ( Tanacetum parthenium) is a perennial herb well known for its medicinal properties. It is frequently used to help prevent migraines, and studies show some benefit. A 2017 study showed the combination of feverfew, when taken with magnesium and coenzyme Q10 could be effective in migraine prevention. Suggested dose: Feverfew 250 mg once or twice per day.
- Vitamin C and Vitamin D – Vitamin C and vitamin D have also been shown to benefit those with migraine headaches.
- Essential Oils – Chamomile and Lavender have shown benefit when applied to the upper lip or when used with a diffuser.
A cluster headache is the 3rd most common type of headache. These headaches usually last anywhere from 20 minutes up to two hours. Unlike tension and migraine headaches, cluster headaches tend to be one-sided.
They are also associated with a stuffy nose (on one side), eye tearing, and possibly even an enlarged pupil, on the side of the headache. Rarely, a person may have a droopy eyelid. Men between the ages 20 and 50 are at the highest risk and these headaches generally start without a warning.
Prevention of Cluster Headaches
- Routine physical activity
- Tobacco cessation
- Quality sleep (most need 7-9 hours each night)
- Oxygen therapy may be useful to help prevent and treat acute attacks
Supplements and Cluster Headaches
- Magnesium – A 1995 study showed that intravenous infusion of magnesium, in those who were magnesium deficient, may be beneficial in those with cluster headaches. A 1996 study also showed the benefit of intravenous magnesium in those with headaches. These findings indicate low blood levels of magnesium increase the risk of headaches. Suggested dose 125-500 mg per day.
- Melatonin – Melatonin commonly referred to as the sleep vitamin and taken by those with insomnia. However, melatonin may also be beneficial for those with headaches. A 2017 study concluded, “Melatonin may be effective in treating several primary headache disorders, particularly cluster headache and migraine.” A 2019 study showed similar findings.
- Kudzu extract – Kudzu extract comes from a root that is native to Asia, and its name is derived from Japanese, where kudzu means "plant". A small 2009 study showed. Kudzu was beneficial although more studies are needed.
- Essential Oils – Some studies have reported benefit when applying eucalyptus and peppermint oil topically to the painful area.
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