Head off the pain

Nutrition, hydration provide some relief from migraines

By Elise Oberliesen, Special to the Rocky

Published December 15, 2008 at 6 p.m.

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Inside the heads of a staggering 30 million Americans is a place migraines love to call home.

Considered a neurological disorder affecting the brain and its neurochemistry, migraines typically deliver intense throbbing pain localized to one side of the head. Many sufferers report light sensitivity, distorted vision and gut-wrenching nausea. Although more women report migraines than men, both genders suffer.

For many people, exercise can trigger migraines. Activities like running, cycling, swimming or weight lifting can trigger exertion headaches and sour almost any athlete's love of the sport. Learning to manage the pain and prevent onset is the best defense.

Julie Johnson, an ultra-runner with a 20-year competitive racing record, thinks nothing of hitting the trails for several hours. Before the Roadrunner Sports store manager heads out, she properly hydrates and brings along fluids. But even with careful discipline, Johnson occasionally battles headaches after crossing the finish line.

"I can usually pinpoint a headache to dehydration or an electrolyte imbalance," says Johnson.

With a headache in the making, Johnson keeps the hydration arsenal on the ready to chase away pain.

"I'll do an electrolyte drink - 20 ounces," she said.

After that, Johnson said, she drinks 20 more ounces over the next 30 minutes. Within a half hour, Johnson said, the pain is usually gone. But she still takes precautions to keep the headache at bay.

Should the headache come back later, Johnson curbs caffeine consumption and limits salt, which might tip the balance back toward dehydration.

For some athletes, migraines are triggered more from muscle pain than diet. According to some medical experts, many athletes suffer from a buildup of muscular tension brought on by exercise. During exercises like swimming or running, head and neck muscles may become tight enough to set off a domino effect, creating muscle spasms and blood-flow restriction. And that can become hours of downtime.

Treating migraineurs, as they are called, is somewhat of a specialty. Dr. Jack Klapper, a Denver-based neurologist, has treated a number of patients over the years. Without solid research in some areas, doctors must become good detectives.

For example, with exertion headaches, exercise intensity may be part of the equation, but no one can say for sure, said Klapper. For example, during an uphill climb, increased intensity forces the heart to pump more blood into large muscles. And that may be the perfect breeding ground for headaches.

"With the sudden onset of pain, I do think the vessels in the brain become dilated," said Klapper. That's a fairly safe assumption, he says, considering migraine drugs like Imitrex are constrictors that help slow down blood flow to the brain.

Prevention the best medicine

Patients who experience exertion headaches are usually prescribed an over-the-counter anti-inflammatory such as naproxen sodium before they hit the trail. Klapper said most patients respond well to taking one pill about an hour before exercise to prevent an exercise-induced headache. If a higher dose is needed, it may require a trip to the doc for a prescription.

Be careful not to use ibuprofen on a daily basis, says the Headache Clinic of Denver's Dr. Salwa H. Hanna, who since 1985 has treated more than 20,000 who suffer from headaches.

"I would caution against use of over-the-counter medicines such as ibuprofen, Excedrin or Anacin on a daily basis because they can cause rebound headaches," said Hanna.

With rebound headaches, the body develops a tolerance to the medication. Overuse of prescribed medicines such as Imitrex can cause the same issue, says Hanna, who suggested using such drugs only twice a week for migraines.

The diet connection

Exertion headaches are preventable. And the best way to accomplish this is with proper nutrition, Hanna said.

"Pull out the magnifying glass and read the fine print on nutrition labels," she said.

Words like organic and natural are misleading, she said; just because foods are organic, that doesn't mean they can't trigger headaches. The short list of offenders includes sugar and sugar substitutes such as aspartame; artificial flavors and preservatives, including MSG; high doses of caffeine; nuts; peanut butter; beans; aged cheese; and nitrates, commonly found in hot dogs and processed lunch meat.

Other contributing factors include sleep disturbances, stress, strong smells, perfumes, dehydration, drops in barometric pressure, hormones and alcohol.

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