Migraine and tension headaches are among the most common medical problems. Some people have frequent headaches, while others hardly ever have them. Both chronic and recurring headaches may be painful and distressing but rarely reflect a serious medical condition. However, a change in the pattern or nature of headaches -- for instance, from rare to frequent headache, or from mild to severe -- could signal a serious problem and calls for prompt medical attention.

Cause of Frequent Headaches
Emotional or physical stress, genetic, hormone level fluctuations, weather changes, glare/flickering lights, premenstrual syndrome, lack or excess sleep, missed meals, alcohol, chocolate, birth control pills, menstruation all can cause headache. Drugs such as antibiotics (tetracycline, Bactrim) corticosteroids, Accutane, tamoxifen, Tagamet are also known to cause frequent headache.
        Most chronic headaches are muscle tension headaches, migraines, or head pain with no obvious cause. Many headaches are related to problems with the eyes, nose, throat, teeth, and ears. Most chronic headaches attributed to eyestrain are actually tension headaches; a new, severe pain in or around the eyes may signal high fluid pressure (glaucoma) in the eye and is a medical emergency. High blood pressure may produce a throbbing sensation in the head, but high blood pressure rarely causes chronic headaches. Estrogen is likely in involved in migraine headaches.

Migraine Headache Treatment -- simple suggestions for headache relief
Wake up at the same time each morning.
Exercise at least 3 times a week. Exercise stimulates endorphins.
No smoking, no caffeine after 3 pm.
No artificial sweeteners.
No MSG (monosodium glutamate).
Reduce or eliminate red wine, cheese, alcohol, chocolate, and caffeine.
Try a gluten free diet.

Nutrients and Herbs potentially helpful in migraine headache
I am currently not aware of any herbs or supplements that are a headache cure

Petasites also known as butterbur
5-HTP may be helpful (see below)
Feverfew may help a small percentage of users. 1 capsule 3-4 x/day for one month, then decrease dosage to 25 mg of dried herb twice daily.
Magnesium
CoQ10 - see study below
Melatonin may reduce migraine headaches.
Biofeedback
Aspirin may help in acute migraine headache

Subscribe to a FREE Supplement Research Update newsletter. Twice a month we email you a brief abstract of several new studies on various supplements and natural medicine topics, including migraine and tension headache, and their practical interpretation by Ray Sahelian, M.D. See link at top of page.

Headache Diagnosis
Usually a doctor can determine the cause of a headache from the patient's medical history and a physical examination. However, occasionally blood tests may be needed to detect an underlying illness. Only rarely are chronic headaches caused by brain tumors, brain injuries, or lack of oxygen to the brain. If the doctor suspects a tumor, stroke, or other problem with the brain, computed tomography (CT) scanning or magnetic resonance imaging (MRI) may be ordered to provide images of the brain.

Exercise Your Head
An exercise program that helps retrain the muscles of the head, neck and shoulder area reduce the frequency, intensity and duration of tension headaches. The exercises are easy to perform and take little time, and are effective. Many people treat such headaches with over-the-counter pain relievers, putting themselves at risk for experiencing "rebound" headaches when the medication is stopped. A craniocervical training program (CTP), in which a person performs a series of exercises to restore effective control of the muscles in the head, neck and shoulders, could be helpful against tension headaches. Researchers randomized 81 tension headache sufferers to six weeks of physiotherapy including massage and other techniques (the control group), or to the same physiotherapy program plus CTP (the experimental group). People in the craniocervical training group underwent 15 minutes of instruction on the technique, which involves flexing the head and neck with light resistance supplied by a latex band. They were then told to perform the exercises at home for 10 minutes twice daily. During the six-week program, headache frequency, intensity and duration fell in both groups, with no significant between-group differences. However, headaches had worsened among people in the control group by six months after the end of the exercise program. At the end of the exercise program, 52 percent of people in the control group experienced a 50 percent or more reduction in headache frequency, but just 35 percent had this amount of reduction in headache frequency six months later. In the CTP group, however, 82 percent saw a reduction of 50 percent or more in headache frequency at the end of the exercise program, and 85 percent saw this reduction six months later. Six months after the program, people in the CTP group were taking 65 percent less medication than they were before the study, while the control group showed no reduction in painkiller intake. Cephalalgia, August 2006.

Medical Treatment of Headache
Excedrin migraine
Beta blockers
Tricyclic antidepressants
Prochlorperazine
Cafergot
NSAIDs
Triptans - There are several so-called triptan drugs designed for treating migraines -- and if one doesn't work, another might.

5-HTP beneficial for headaches
Serotonin is a brain chemical involved in mood, appetite control, sleep, and a number of other important functions. Many antidepressants, such as Prozac, and other medicines have their effects by influencing levels of this brain chemical. Interestingly, there is an over the counter nutrient called 5HTP, which stands for -5-hydroxytryptophan, that also influences serotonin levels. When you take a 5-HTP pill, it makes its way to the brain where it can be converted into serotonin. In addition to having a role to play in mood disorders and weight control, 5-HTP has been found to be helpful in headaches. In a study conducted at the University of Coimbra in Portugal, 65 patients with chronic tension-type headaches were treated with 5-HTP or placebo for 8 weeks. In comparison with the group treated with placebo, there was no statistically significant change in the number of days with headache or in headache intensity in the group treated with 5-HTP; however, there was a significant decrease in the consumption of pain killers. During the 2 weeks after treatment, there was a significant decrease in the number of days with headache and reports from patients indicated that they were pleased with the benefits from 5-HTP. Previous studies have also indicated that 5-HTP may be helpful in the prevention or reduction in severity of migraine-type headaches.
        Dr. Sahelian comments: 5-HTP is appropriate for those who have headaches associated with mild depression and poor appetite control. The daily dose is best limited to less than 50 mg. Take a break from use two days a week and one week per month.

Tension Headache and Migraine Headache Research Update
A type of movement therapy designed to promote relaxation may help chronic headache sufferers deal with their pain. The study of 33 adults with frequent tension-type headaches or migraine found that the therapy -- known as the Trager approach -- appeared to reduce bouts of head pain and help patients cut back on medication. The Trager method, named for its founder, Dr. Milton Trager, is a mind-body type of movement therapy that aims to reduce the tension that people unconsciously hold in their bodies. It involves massage-like sessions in which a practitioner certified in the technique gently moves and stretches the muscles and joints to try to relax the body. Patients are also taught sequences of movements to do at home. The Trager approach is promoted for treating lower back pain and other musculoskeletal woes, but the new study is the first to evaluate its effectiveness against chronic headache.

Efficacy of coenzyme Q10 in migraine headache prophylaxis: a randomized controlled trial.
Neurology. 2005 Feb 22;64(4):713-5.
Riboflavin, which improves energy metabolism similarly to coenzyme Q10 (CoQ10), is effective in migraine headache prophylaxis. We compared CoQ10 (3 x 100 mg/day) and placebo in 42 migraine headache patients in a double-blind, randomized, placebo-controlled trial. CoQ10 was superior to placebo for attack-frequency, headache -days and days-with-nausea in the third treatment month and well tolerated; 50%-responder-rate for attack frequency was 14.4% for placebo and 47.6% for CoQ10 (number-needed-to-treat: 3). CoQ10 is efficacious and well tolerated for migraine headache.

A combination of riboflavin, magnesium, and feverfew for migraine prophylaxis: a randomized trial.
Headache. 2004 Oct;44(9):885-90.
To determine the efficacy for migraine prophylaxis of a compound containing a combination of riboflavin, magnesium, and feverfew. Previous studies of magnesium and feverfew for migraine prophylaxis have found conflicting results, and there has been only a single placebo-controlled trial of riboflavin. Randomized double-blind placebo-controlled trial of a compound providing a daily dose of riboflavin 400 mg, magnesium 300 mg, and feverfew 100 mg. The placebo contained 25 mg riboflavin. The study included a 1-month run-in phase and 3-month trial. The protocol allowed for 120 patients to be randomized, with a preplanned interim analysis of the data after 48 patients had completed the trial. RESULTS: Forty-nine patients completed the 3-month trial. For the primary outcome measure, a 50% or greater reduction in migraines, there was no difference between active and "placebo" groups, achieved by 10 (42%) and 11 (44%), respectively (P=.87). Similarly, there was no significant difference in secondary outcome measures, for active versus placebo groups, respectively: 50% or greater reduction in migraine days (33% and 40%, P=.63); or change in mean number of migraines, migraine days, migraine index, or triptan doses. Compared to baseline, however, both groups showed a significant reduction in number of migraines, migraine days, and migraine index. This effect exceeds that reported for placebo agents in previous migraine trials. CONCLUSION: Riboflavin 25 mg showed an effect comparable to a combination of riboflavin 400 mg, magnesium 300 mg, and feverfew 100 mg. The placebo response exceeds that reported for any other placebo in trials of migraine prophylaxis, and suggests that riboflavin 25 mg may be an active comparator. There is at present conflicting scientific evidence with regard to the efficacy of these compounds for migraine prophylaxis.

Endometriosis -- caused when tissue that normally lines the uterus grows at other sites -- may produce more than pelvic pain. It seems to increase the risk of migraine headache. Previous reports have linked endometriosis with a variety of disabling conditions, such as autoimmune diseases, chronic fatigue syndrome, and fibromyalgia.

Types of Headache
Cluster headache - When high doses of the drug verapamil are used to prevent cluster headaches, a severely painful type of headache, about one in five patients will develop some form of cardiac irregularity. Some of the trade names that verapamil is sold under include Calan, Verelan or Covera.
Sinus headache
Migrane headache

Migraine Headache
Certain weather conditions indeed appear to increase the risk of migraine, but people still tend to overestimate weather's influence on their headache. The most common conditions people believed caused their migraines included rain, bright sunshine, high humidity and hot temperatures.
     New research involving male-to-female transsexuals lends further credence to the theory that sex hormones, such as estrogens,  are involved in migraine generation. It is well known that migraine headaches are more common in women than men. Questionnaires were sent regarding headache symptoms and frequency to 50 transsexuals who had recently undergone sex reassignment surgery, all of whom were taking hormonal therapy. Thirteen (26 percent) fulfilled criteria for migraine or probable migraine, similar to the number of cases of migraine in genetic females that would be expected. In contrast, the expected number of cases of migraine headache in genetic males is significantly lower.
     People who suffer from migraine headaches appear to express more genes that produce platelets, the specialized components in blood that are involved in clotting.

Migraine Headache symptom
A migraine headache is a severe head pain, often on one side of the head, and frequently described as throbbing in nature. Migraine attacks may include nausea and vomiting, photophobia (intolerance to light) and sometimes intolerance to noise. Migraines are usually recurrent and episodes can last anywhere between several hours to 3 days. A migraine attack has the potential to temporarily disable a person, and can interfere with work or interpersonal relationships.

Airplane Headache
Severe headaches that develop during airplane travel appear to be the result of rapid changes in pressure, rather than the high altitude or other causes.

Headache emails
Q.  Just thought I'd thank you for your advice on 5-HTP and chronic > headaches. I have had these periodically for much of my adult life. (I am now 55.) They seem to come in cycles--or at least when they effect me if will be each day for a few weeks, then they mysteriously will go away for a few months. I have NEVER found anything that will remove them, and I've tried lots-- Fish oil, Evening Primrose, Vit C, B-complex, E, calcium, magnesium -in large doses beyond just regular amounts; over-the -counter drugs; caffeine; no caffeine, anti-histamines, avoidance of foods, etc. (Never tried prescription meds for this as I stay away from them , if I can help it.) Ginkgo,
Feverfew.... Etc. Etc. Etc!
     With this headache pain, which always starts early in the morning (and sometimes goes away by evening, only to be back again the next day,) there would be stiffness down the back of my neck and shoulders; mild  depression, fuzzy and backward thinking; tiredness, sadness, lack of motivation and self-esteem; loss of creativity (hard to cope with as I am artistic by nature and trade;) any aches and pains seemed amplified. I could always function with basic duties, but could not think beyond that. This took chunks of time out of my life and made me unproductive beyond the basics. I also get restless legs,( which I have had since childhood,) tho not always at the same time as the chronic headache. I have one daughter (out of 4 children) who experiences very similar symptoms but more migraine headaches, plus more depression and occasional anxiety attacks and sleep problems (this was worse during puberty She is 18 now.). Different forms of mental problems run in my mother's side of the family--Bi-polar, Anxiety, Obsessive/compulsive, Depression, in several relatives. HOWEVER, we tried 5-HTP and both of us found a very marked and rapid difference. I opened a capsule of 50 mg. and took it sublingually. In about 45 minutes it made such a difference! My mood brightened, energy was boosted, and most of the pain in my neck and shoulders and head went away (I had had this for about 4-5 days this time.) I took another 50 mg. All pain and other symptoms were soon gone. That was the first day. Since then I have used only 50 mg, some times splitting it into 2 doses. (This was because it was back again in the morning.) I am mindful of warnings not to overdo taking 5-HTP, also I don't want it to stop working, or build up a tolerance, or an increased need, etc. . I intend to only use it when I am in these cycles, and only the smallest dose necessary. (Sublingual method works best for this.) My daughter took 150 mg, divided, the first day, and 100 or 50 mg. on subsequent days. She will, I think, need to experiment a bit, BUT--she had had a migraine for three days and the first day's dosage removed it so that she was migraine free the next day. She has tried (reluctantly, esp. on my part) several migraine remedies, and 13 (Yes, 13!) anti-depressants over a few years, which gave her bad side effects and never helped the problems.
     So you can see that we are excited about 5-HTP! I did a lot of reading about it and information on serotonin deficiency , and some people's receptors being too short and thus not sensitive (and how this can be genetic,) etc. We intend to be prudent with its useage, so it can continue working well for us, as it is the ONLY thing that
has helped. I myself have had this headache come and go for 30 years, so I am happy to find something that made a difference. And as a parent, I am thrilled to have found something that can help my daughter not experience such disturbing symptoms. Perhaps this can help someone else, too. Thank You!
     A. We are really glad 5-htp is working for you and it appears you are using it prudently. Please keep us updated.

Frequent Headache