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HeadWay, Issue #059 -- Migraine, headache and Botox
July 21, 2008

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In this month's issue:

Botox for migraines and headaches

Probiotics and Migraine

Say what?!  Neurotoxin

If you think you missed last month's issue (June), you didn't!  I wasn't able to get it out last month, so this month you're getting (I hope) and especially interesting newsletter, packed with helpful information.  Thanks for your patience!

Botox for migraines and headaches

"...botulinum toxin injections should not be offered to patients with episodic migraine and chronic tension-type headaches.  It is no better than placebo injections for these types of headache."

This is what Dr. Markus Naumann, head of the Department of Neurology at Augsburg Hospital in Germany had to say about Botox and the newly developed guidelines from the American Academy of Neurology in May.   The guidelines suggest that doctors not offer Botox as a treatment for migraine and tension-type headache.  Why this position?  Is Botox really only as good as needles filled with no medicine at all?

Using Botox for migraine has been controversial from the get-go.  First, researchers pointed out that migraine doesn't come from muscles (which Botox relaxes), but from chemicals in the brain.  Ok, responded the pro-Botox crowd.  But maybe tense muscles are a major migraine trigger.  Today, there have been a number of theories about why Botox seems to help some people with migraine.

Tension-type headaches seem more reasonable.  After all, actual muscle tension does tend to be involved.

But in June reports came out on a new study out of the Headache Care Center in Springfield, Missouri.  The patients did report fewer migraine attacks, and better quality of life when taking Botox (as opposed to a placebo).  The results weren't dramatic, but did tend to support earlier small studies that showed a benefit to Botox injections.

So - is it a help or not?

Why the conflicting studies?  Well, here are a couple of possibilities.  First, different studies measure results in different ways.  For example, you may end up with the same number of attacks, but they may not be as bad.  Did the study measure frequency, and intensity, and quality of life?  What about the time frame?  What if Botox doesn't really start to help until a few treatments (over several months)?

Another question researchers need to ask is, which people can Botox benefit?  There is emerging evidence that people with certain types of headache, even different types of migraine pain, may benefit more than others.  A general group of migraineurs may not benefit greatly, but a sub-group may have dramatic results.

Sound vague?  That's because it is!  The bottom line is, we need more studies - larger, carefully conducted studies, before we'll have a better understanding of the Botox and migraines connection.

However, you can read more about earlier Botox studies, and some more recent information about Botox for migraine.

In the end, many people have seen positive, even dramatic improvements from Botox treatment.  Dr Randolph W. Evans, clinical professor of neurology at Baylor College of Medicine (Houston, Texas, USA), sums it up:

"... many headache specialists, including myself, believe that there is a subset of patients with chronic migraine who do benefit from botulinum toxin who may not benefit from other treatments.  Patients with chronic migraine can be especially resistant to treatment.  Many of us have a number of these patients who did not respond to numerous medications but had a dramatic response to botulinum toxin — for which many of them are paying cash — that we doubt is a placebo response." (from MedScape: New Guidelines From AAN on Botulinum Neurotoxin Issued)

Probiotics and Migraine

Regular readers of know that I've talked a lot about the connection between what we eat - the stomach - and migraine attacks.  There is an increasing amount of evidence that what happens down there is very connected to what happens on top of your shoulders.  Books such as The Second Brain have been the starting point to a great deal of new research.

There are a number of approaches to helping keep away migraine attacks through the stomach.  One approach is probiotics.

There has been an increased interest in probiotics over the past few years - maybe you've seen commercials celebrating new probiotic products.  The goal of probiotics is to get good bacteria into your body.

Your body needs good bacteria.  But often the bacteria can be depleted.  If you've ever taken antibiotics, and suddenly ended up with diarhea, you know what I'm talking about.  The antibiotics depleted both the good bacteria and the bad.  Without the good, your body couldn't function properly for a while.

But things like stress may also deplete your supply.  Or, during travel you may end up with a lot of competing bacteria that cause problems.

Why probiotics are often a waste of money

What you need is the right kinds of bacteria, lots of it, right down into your intestines.  But many products don't deliver.  By the time you eat there, there is far less bacteria than what is promised on the label.  (for more, read Testing bacteria levels)

Certain types of yogurt are good, but don't have the strong variety of probiotics that some capsules now have.  I looked at the research on a number of probiotic products.  I felt my best bet based on the available data was Nature's Way Primadophilus Optima, which contains 14 probiotic strains.  You take one capsule a day.  I wanted something that would give me the maximum benefit for the cost, and as opposed to many other types Primadophilus Optima seemed to have better performance.  Click the link to find out more about this particular supplement and the strains it includes.

You might want to try something else - just remember, the key is to get a product that actually delivers high amounts of good bacteria, even after some time on the shelf.  What the label says isn't always what you get into your mouth!

If you decide to try a probiotic, be sure to keep it refrigerated.  The longer the capsules are kept at room temperature, the less good bacteria you'll get when you actually go to take it.

Say what?!  Neurotoxin

Botox is actually botulinum toxin A, a neurotoxin.  Neurotoxins are poisons that work specifically on nerve cells.  Though neurotoxins can be deadly, the amounts given in treatments like Botox are minuscule, and generally not considered dangerous.  Often poor handling of food causes dangerous amounts of neurotoxins, leading to botulism (a type of food poisoning).

Thanks for reading!  Remember, if you have feedback or ideas for future issues, visit the HeadWay MailRoom.  Your password is nomoache.
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