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Foods and Supplements in the Management of Migraine Headaches
Abstract
Although a wide range of acute and preventative medications are now available for the treatment of migraine headaches, many patients will not have a significant improvement in the frequency and severity of their headaches unless lifestyle modifications are made. Also, given the myriad side effects of traditional prescription medications, there is an increasing demand for "natural" treatment like vitamins and supplements for common ailments such as headaches. Here, we discuss the role of food triggers in the management of migraines, and review the evidence for supplements in migraine treatment.
A review of the English language literature on preclinical and clinical studies of any type on food triggers, vitamins, supplements, and migraine headaches was conducted.
A detailed nutritional history is helpful in identifying food triggers. Although the data surrounding the role of certain foods and substances in triggering headaches is controversial, certain subsets of patients may be sensitive to phenylethylamine, tyramine, aspartame, monosodium glutamate, nitrates, nitrites, alcohol, and caffeine. The available evidence for the efficacy of certain vitamins and supplements in preventing migraines supports the use of these agents in the migraine treatment.
The identification of food triggers, with the help of food diaries, is an inexpensive way to reduce migraine headaches. We also recommend the use of the following supplements in the preventative treatment of migraines, in decreasing order of preference: magnesium, Petasites hybridus, feverfew, coenzyme Q10, riboflavin, and alpha lipoic acid.
... Orsakir mígrenis eru ekki að fullu þekktar en eru taldar vera truflanir á samspili raf-og boðefnakerfi heilans. 7 Lyfjameðferð við mígreni skiptist í bráða-og fyrirbyggjandi meðferð. Bráða lyfjameðferð er notuð til að stöðva mígrenisköst og minnka sársauka en fyrirbyggjandi meðferð til að faekka köstum. ...
... 23 Reykt kjöt og aðrar unnar kjötvörur innihalda nítrít og nítröt en þessi efni eru talin geta valdið mígreniköstum vegna áhrifa þeirra á nituroxíð losun og aeðavíkkun í heilanum vegna þess. 7 Engar erlendar rannsóknir gefa til kynna að lakkrís sé algeng faeðukveikja. Lakkrís inniheldur efni sem kallast glycyrrhizin sem getur í miklu magni valdið lágu kalíum í blóði, þreytu og háþrýstingi. ...
... 29 Aðrar tegundir af mataraeði sem rannsóknir hafa skoðað snúa að hlutfalli ómega-3 og ómega-6 fitusýra, lágkolvetna eða kolvetnasnauðu mataraeði, mataraeði með lágt fituhlutfall og Miðjarðarhafsmataraeði. 1 Þegar kemur að faeðubótarefnum eru vísbendingar um að til daemis magnesíum, coensimQ10, ríbóflavín, D-vítamín og ómega-3 geti dregið úr höfuðverkjadögum og styrkleika höfuðverkja. 7 Almennt naeringarástand einstaklinga virðist þó skipta máli er kemur að virkni faeðubótarefna, þar sem til að mynda magnesíum er aðeins talið vera gagnlegt fyrir þá einstaklinga sem eru með lágt gildi magnesíums í blóði. 7,30 Styrkleiki rannsóknarinnar felst meðal annars í að gögnum var safnað frá tveimur ólíkum hópum. ...
Background and aims: Migraine is a neurological disorder that is characterized by severe headaches and temporary motor and sensory disturbances. Migraine triggers are internal or external factors that can increase the likelihood of a migraine attack. Some individuals with migraine associate their attacks with the consumption of certain types of food, but no have been conducted in Iceland. The aim of the study was to estimate the proportion of individuals with migraine in Iceland who associate their symptoms with consuming certain types of food. Methods: An electronic questionnaire was submitted to two groups (≥18 years old), members of the Icelandic Facebook group ‘Migreni’ (n=395 and to patients being treated by a neurologist (n=108), with the question if they thought certain foods could trigger migraine attacks. A total of 503 opened the survey (19.6% in the Facebook group and 65% managed by a neurologist). Response options were never/rarely, sometimes, often, or always. Other questions included types of migraine, medication use and background. Results: Out of 466 participants, 354 individuals (76%) claimed that food often or always triggered their migraine. The proportion was higher in the Facebook group than in the neurologist group (78% vs. 66%, p=0.007). Red wine and skipping meals (hunger) were the most common food-related triggers, reported as triggers often or always by >50%. Other common food triggers included white wine, liquorice, and smoked meat; they were reported as triggers by 20-50% of participants. Conclusion: Food seems to be a common migraine trigger, and the main food-related triggers were similar to those reported in other studies. However, previous studies have not shown liquorice as a common food trigger for migraines, and smoked meat was found to be a more common trigger than seen in other studies.
... One of the body's natural omega-3 fatty acids (O3FA) is eicosapentaenoic acid (EPA, Figure 4) which can be found in various types of algae as well as in fish inhabiting cold deep waters. Studies have shown adding EPA to the diet can reduce the severity and frequency of migraine headaches likely by inhibiting prostaglandin levels and serotonin activity [72]. ...
... Butterbur is the root extract of Petasites hybridus, a perennial shrub that was used since ancient times for its medicinal properties such as fever, wound healing, muscle spasm, and migraine prophylaxis. The active agents are likely its sesquiterpenes such as petasin and isopetasin (Figure 7) [72,134]. Isopetasin can activate transient receptor potential ankyrin 1 (TRPA1) channels, resulting in neuropeptide containing nociceptor excitation and consequently heterologous neuronal desensitization. ...
... Petasites may also act through calcium channel regulation and peptide-leukotriene biosynthesis inhibition. These effects on pain and neurogenic inflammation may count for its role as an antimigraine treatment [72,135]. [136] and isopetasin [137]. ...
Complementary and alternative medicines such as herbal medicines are not currently part of the conventional medical system. As the popularity of and global market for herbal medicine grows among all age groups, with supporting scientific data and clinical trials, specific alternative treatments such as herbal medicine can be reclassified as a practice of conventional medicine. One of the most common conditions for which adults use herbal medicine is pain. However, herbal medicines carry safety concerns and may impact the efficacy of conventional therapies. Unfortunately, mechanisms of action are poorly understood, and their use is unregulated and often underreported to medical professionals. This review aims to compile common and available herbal medicines which can be used as an alternative to or in combination with conventional pain management approaches. Efficacy and safety are assessed through clinical studies on pain relief. Ensuing herb–drug interactions such as cytochrome modulation, additive and synergistic effects, and contraindications are discussed. While self-management has been recognized as part of the overall treatment strategy for patients suffering from chronic pain, it is important for practitioners to be able to also optimize and integrate herbal medicine and, if warranted, other complementary and alternative medicines into their care.
... The contribution of dietary factors within the lifestyle modification has been recognized; however, proposed beneficial changes in lifestyle, consider a broader spectrum to not only include dietary aspects, but also monitoring of exercise, sleep, and stress. 49 ...
... It has been proposed that modification of lifestyle might prevent migraine, which in turn would decrease the burden to individual patients, and health-related costs. 50 However, due to the complexity of migraine, as a multidimensional disorder, and also the complexity of designing studies to test how dietary factors can influence migraine, 49 inconsistency exists in the literature, ranging from a limited importance of dietary modification for migraine to some promising effects. Cross-sectional studies have been important in providing an overview of potential triggers; 51 however, if the goal is to prove (or falsify) that a causal or a bidirectional relationship exists in the diet-migraine interaction, prospective studies with proper control groups must be designed that are also longitudinal in nature. ...
... Since an involvement of neurogenic inflammation in migraine 68 has been suggested, this might be an explanation. In addition, dairy products (eg, cheese) and meat 49 are not present in a vegan diet and these components have often been reported as migraine triggers in the literature. 69,70 Therefore, absence of these components in a vegan diet might exert an antiinflammatory effect against migraine. ...
Migraine is a common headache with a large negative impact on health. Several endogenous and exogenous factors can influence the severity and frequency of migraine, for example, lifestyle factors including dietary factors. Consequently, lifestyle modifications and dietary considerations have been reported beneficial to moderate clinical features of migraine. Much effort has been invested in determining the lifestyle factors (eg, stress, exercise, sleep, and diet) that trigger migraine to develop recommendations and guidelines for prevention. Diet has also been investigated with a major focus on the content of the diet and to a lesser extent on the amount, pattern, and quality of diet. Identification of dietary factors in migraine has led to nutritional interventions with a major focus on elimination of triggers, and weight control strategies. Several so-called migraine diets have consequently been proposed, for example, the ketogenic diet. Some theories have considered epigenetic diets or functional food to help in altering components of migraine pathogenesis; however, these theories are less investigated. In contrast, evidence is being accumulated to support that some mechanisms underlying migraine may alter dietary choices, for example type, amount, or patterns. Since a causative relationship is not yet established in migraine-diet relationship as to which comes first, this concept is equally valuable and interesting to investigate. Only limited epidemiological data are available to demonstrate that dietary choices are different among patients with migraine compared with individuals without migraine. Differences are reflected on quality, composition, pattern, and the amount of consumption of dietary components. This view emphasizes a potential bidirectional relationship between migraine and diet rather than a one-way influence of one on the other. This targeted review presents examples from current literature on the effects of diet on migraine features and effects of migraine on dietary choices to draw a perspective for future studies.
... Nitrates and nitrites, authorized food additives in the European Union, serve various purposes such as preserving food color, preventing botulism, and imparting a cured or smoked flavor [79,80]. Nitrates are unstable in acidic conditions, and so spontaneously decompose to nitrites and nitrogen dioxide. ...
... Tyramine, derived from the amino acid tyrosine, is an amine found in various foods such as aged cheese, cured meats, smoked fish, beer, fermented items, and yeast extract [79]. Monoamine oxidase (MAO) enzymes in the body are responsible for metabolizing tyramine [75]. ...
Migraine is a prevalent neurological disorder characterized by significant disability and triggered by various factors, including dietary habits. This review explores the complex relationship between diet and migraine, highlighting both triggering and protective roles of dietary patterns and specific nutrients. Evidence suggests that certain foods, such as alcohol, caffeine, chocolate, MSG, nitrates, and tyramine, can trigger migraines in susceptible individuals. Conversely, dietary interventions, including carbohydrate-restricted diets, ketogenic diets, vitamin D3 supplementation, omega-3 fatty acids, Mediterranean dietary patterns, and increased water intake, have shown potential in reducing migraine frequency and severity. Observational studies also indicate that maintaining a healthy diet, rich in fruits and vegetables and low in processed foods, is associated with better migraine outcomes. The effectiveness of these interventions varies among individuals, underscoring the importance of personalized approaches. Future studies should further explore the role of diet in migraine management, focusing on randomized trials to establish causality and refine dietary recommendations for patients.
... Multiple studies have shown that folate plays a significant role in the pathophysiology of severe headache or migraine (26)(27)(28)(29). Folate is necessary for the metabolism of homocysteine to methionine (30). ...
... As a result, data regarding the primary food sources of folate were not available in the NHANES database. Previous studies showed that folate-rich foods include legumes, leafy green vegetables, fruits, nuts, whole grains, and animal liver (27)(28)(29)(30). ...
Background
The aim of this study was to assess the association between dietary folate intake and severe headache or migraine.
Methods
This cross-sectional study utilized the National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2004. Weighted logistic regression models, restricted cubic spline (RCS) regression, sensitivity analysis, and stratified analyses were performed to evaluate the association between dietary folate intake and severe headache or migraine.
Results
A total of 4,107 participants were included, with 704 individuals (17.14%) experienced severe headache or migraine. After adjusting for all covariates, an independent association was found between dietary folate intake and severe headache or migraine (OR = 0.77, 95% CI: 0.64–0.93, p = 0.005). When folate intake was categorized, individuals in Q2 (251.21–356.00 μg/d), Q3 (356.19–514.00 μg/d), and Q4 (≥515.00 μg/d) had ORs of 0.95 (95% CI: 0.75–1.20, p = 0.660), 0.86 (95% CI: 0.67–1.12, p = 0.266), and 0.65 (95% CI: 0.48–0.89, p = 0.007), respectively, compared to those in Q1 (≤251.00 μg/d). The RCS regression showed a linear negative relationship between dietary folate intake and severe headache or migraine. Stratified and sensitivity analyses yielded similar results.
Conclusion
There was a linear negative relationship between dietary folate intake and migraine.
... Albeit around 50% of patients felt unsatisfied with their current migraine treatment with 80% considering other conventional therapies or interventions [8]. neurons relaying pain signals to the brain [12]. One part of this mechanism, which has now been discredited, was inferred to cause increased blood flow in the brain, more specifically arte-rial and vessel dilation in the cranium such as in the dura, arachnoid, pia, and cerebrum. ...
... An-other hypothesized aspect of general migraine experi-ences is mitochondrial dysfunction and inability to properly metabolize oxygen since those who experience migraines have diminished mitochondrial phosphoryla-tion [12]. ...
Migraines are one of the world’s leading disabilities, disproportionally affecting women. Socioeconomic challenges worsen the quality of life for migraine sufferers, many of whom express dissatisfaction with current therapies. Since the vascular theory of migraines has already been disproven, current research investigates neurovascular aspects like cortical spreading depression (CSD) and potentially impaired oxygen metabolism in mitochondria. This review aims to assess the efficacy of bioactive compounds such as red wine, CoQ10, caffeine, magnesium (Mg2+), and riboflavin (B2) in reducing or preventing migraines. A review of current and past literature is used to reach conclusions on these compounds. The goal of researching these compounds is to potentially help decrease cases of excessive medication use or offer complementary options for individuals dissatisfied with their current therapies.The outcomes of studies regarding red wine are not definitively established, and the ambiguous role of caffeine requires further research on controlled intake and dosage. Compounds such as CoQ10, magnesium, and riboflavin exhibit potential as prophylactic supplements for the reduction of migraine occurrences. Evaluation using the functional food product creation guidelines set by the Functional Food Center has allowed CoQ10, magnesium, and riboflavin to be evaluated up to step 10. Future research should aim to refine the information that remains unresolved from these steps, particularly by addressing factors such as dosage, timing, and frequency of consumption. Additionally, efforts could be directed toward identifying a suitable food vehicle that incorporates all the beneficial bioactive compounds.Keywords: Migraine; bioactive compounds; functional food; cortical spreading depression; CoQ10; red wine; caffeine; magnesium; IgG-based elimination diet; dietary approaches to stop hypertension (DASH)
... Birçok migren hastası, baş ağrısını tetikleme korkusuyla alkolden kaçınma eğilimindedir. Bu, alkol ve baş ağrısı ile ilgili anketlerin ve çalışmaların sonuçlarını etkilemektedir (Panconesi, 2008;Sun-Eldestein & Mauskop, 2009;Wöber-Bingol & Wöber, 2011;Krymchantowski & Jevoux, 2014). ...
... Baş ağrıları kafein alımını bıraktıktan sonra 24-48 saat içinde başlamakta ve 1-6 gün sürmektedir. (Rockett, 2012;Sun-Eldestein & Mauskop, 2009). ...
NÖROLOJİK HASTALIKLARDA YUTMA BOZUKLUĞU VE TIBBİ BESLENME TEDAVİSİ
... Birçok migren hastası, baş ağrısını tetikleme korkusuyla alkolden kaçınma eğilimindedir. Bu, alkol ve baş ağrısı ile ilgili anketlerin ve çalışmaların sonuçlarını etkilemektedir (Panconesi, 2008;Sun-Eldestein & Mauskop, 2009;Wöber-Bingol & Wöber, 2011;Krymchantowski & Jevoux, 2014). ...
... Baş ağrıları kafein alımını bıraktıktan sonra 24-48 saat içinde başlamakta ve 1-6 gün sürmektedir. (Rockett, 2012;Sun-Eldestein & Mauskop, 2009). ...
Spor küresel dünyada giderek büyüyen dev bir sektör haline gelmiştir.
Bu sebeple spor kulüplerinden ve sporculardan beklentiler artmıştır. Ülkelerin
ve kulüplerin spordaki başarısının temelinde, sporcunun en iyi performansı
sağlıklı bir şekilde sürdürebilir olması yatmaktadır. Bundan dolayı spor, sağlık
ve sosyal bilimciler, sporun gelişimi için bilimsel ve akademik çalışmaların
sınırlarını genişletmek durumunda kalmışlardır.
Yapılması gereken bir atletik görevin yerine getirilmesi sırasında başarı
için ortaya konulan çabaların bütünü sportif performans olarak tanımlanabilir.
Sporcunun başarısı ve performansının değerlendirilmesinde yarışma ve
antrenman sırasında sonuca etki eden tüm etmenler dikkate alınmak
zorundadır.
Sağlıklı yaşam uygulamalarıyla sportif faaliyetlere katılımın artması
sporcu sayısını arttırmıştır. Sporcuların hem profesyonel hem de amatör
büyük bir kitle haline dönüşmesi sporcu sağlığı konusunun önemini
arttırmaktadır. Sporcularda meydana gelen sağlık sorunları insan bedenini
meydana getiren tüm vücut sistemlerini etkileyebilmektedir
... 44 In contrast, the intensity and frequency of migraine headaches may decrease by certain nutrients such as vitamin D, magnesium, coenzyme Q10, alphalipoic acid (ALA), and eicosapentaenoic acid (EPA). 45,46 Previous studies did not directly investigate the association between migraine and DII score. However, primary evidence showed a significant association between DII and other neurological disorders and brain function. ...
... As mentioned earlier, 28 dietary components were used to compute the DII score. It has been reported previously that some of these components, such as vitamin D, riboflavin, magnesium, omega-3 fatty acids, 45 vitamin A, 59 vitamin E, 60 thiamin, 61 niacin, 62 vitamin B6, folic acid, 63 and zinc 64 may alleviate migraine severity. These nutrients receive a negative value (anti-inflammatory effect) in the calculation of the DII score. ...
Background: Migraine is a neurologic disorder. Although, based on previous evidence, migraine is related with inflammation and oxidative stress, its relationship with the inflammatory potential of the diet is still unknown. Thus, the aim of this study was to show the correlation between Dietary Inflammatory Index (DII) and severity and duration of migraine headache.
Methods: In this cross-sectional study, 266 women who suffered from migraine, were included. Demographic and anthropometric data were collected form all participants. 147-item semiquantitative food frequency questionnaire (FFQ) was collected to assess dietary intake and consequently, DII scores were calculated. Migraine Disability Assessment (MIDAS) questionnaire, Visual Analog Scale (VAS), and a 30-day headache diary were also completed by each participant.
Results: The DII score ranged between -4.22 and 5.19 and its median [interquartile range (IQR)] was 0.003 (-1.48-1.55). There was no meaningful association between age, occupation, physical activity (PA), weight, height, Body Mass Index (BMI), waist circumference (WC), hip circumference, waist-to-hip ratio (WHR) and DII score classifications (P > 0.050). Subjects with more than 20 days of headache had higher DII score compared to those with less than 10 days per month [odds ratio (OR) = 1.60, 95% confidence interval (CI) = 1.12-2.08, P = 0.001]. There was no association between DII and migraine severity (VAS and MIDAS) in the crude and adjusted model of logistic regression. Although there was a significant association between headache duration and DII (P = 0.020), this relationship was not meaningful after adjusting for age, PA, BMI, and job status (OR = 0.53, 95% CI = 0.28-1.00, P = 0.052).
Conclusion: The present study showed a direct association between headache frequency and DII. Nevertheless, any relationship was not found between headache duration or migraine severity and DII score. Future large and prospective studies are needed to explore the effect of inflammatory potential of diet in migraine characteristics.
... Značajno utječe na smanjenje kvalitete života, posebice kod žena koje 2-3 puta češće obolijevaju od migrene nego muškarci (Peters, 2019). Migrena se, prema prisutnosti aure, klinički dijeli na dva osnovna podtipa: migrena bez aure (70-80 %) i migrena s aurom (10-30 %) (Stojić, 2021). Prema frekvenciji napadaja, migrena može biti epizodična (glavobolja prisutna 14 ili manje dana/mjesec) i kronična (glavobolja prisutna 15 ili više dana/mjesec) (IHS, 2018). ...
Cilj ovog rada bio je usporediti raznolikost prehrane eksperimentalne (ispitanici koji boluju od migrene, n=104) i kontrolne skupine (zdravi ispitanici, n=210) pomoću upitnika o kvaliteti prehrane (eng. Diet Quality Questionnaire - DQQ) koristeći bodovanje raznolikosti prehrane (eng. Diet Diversity Score - DDS) i ostale indikatore kvalitete prehrane. DQQ upitnik razvijen je 2021. godine, a predstavlja jednostavni standardizirani alat za procjenu kvalitete prehrane na populacijskoj razini (https://www.dietquality.org/countries/hrv). Dodatno, cilj istraživanja bio je utvrditi postoji li razlika između odgovora dobivenih putem računalnog načina ispunjavanja DQQ upitnika u odnosu na odgovore prikupljene putem intervjua. Istraživanje je provedeno u dvije faze s ukupno 314 hrvatskih ispitanika (16–67 godina, indeks tjelesne mase, ITM=23,58±3,86 kg/m2). Eksperimentalna i kontrolna skupina zadovoljile su minimalne kriterije za raznolikost prehrane (DDS≥5), premda je u usporedbi s kontrolnom, eksperimentalna skupina ostvarila značajno nižu raznolikost prehrane (DDS=5 odnosno 5,7; p<0,001), a pritom su najznačajnije razlike uočene kod konzumacije namirnica životinjskog porijekla (p=0,0016), povrća (p=0,0047) te ultra-prerađenih slanih grickalica, gotovih juha ili brze hrane (p=0,0089). S obzirom na način ispunjavanja (računalno ili intervju), u obje skupine nije utvrđena statistički značajna razlika u rezultatima.
... Tanacetum parthenium was discovered in the 20th century to cope with migraine headaches. Its active ingredients are the sesquiterpene lactone parthenolide [161,162]. ...
Chronic pain, lasting more than three months or persisting after normal healing, is a significant global health issue. As a healthcare system, it's crucial to ensure proper management of chronic pain. Traditional pharmacological and non-pharmacological pain management techniques may not fully meet the evidence requirements of doctors in terms of effectiveness and safety. Therefore, researchers are exploring natural analgesics. Plant-based phytoconstituents show promise in relieving chronic pain associated with various diseases.
This study aims to review the latest advances in discovering natural bioactive compounds that can help alleviate chronic pain. The article discusses the pathways of chronic pain and a multifactorial treatment strategy. It also organizes data on the use of plant-derived substances, such as cannabinoids, terpenoids, phenolics, and crude extracts. Additionally, it delves into the pharmacodynamics of cannabinoids, including their route of administration and elimination. The review presents the results of 22 clinical trials on various cannabinoids for pain relief. It's important to note that opioids and other alkaloids from plants are not covered in this article due to their primary use in controlling acute, rather than chronic, pain.
Keywords: herbal substances, crude extracts, cannabinoids, terpenoids, phenolic compounds, analgesic effect, pain sensation
... A key element of the migraine diet is preventing hunger, which can be achieved by consuming frequent small meals at a regular schedule along with adequate hydration. Additionally, specific foods such as alcohol, chocolate, cheese, and caffeine have been identified as migraine triggers [17,18]. These trigger foods may contain migraine-provoking components such as tyramine and histamine among others [19]. ...
Objective
To evaluate the effectiveness of nortriptyline regimen and migraine dietary/lifestyle modifications on dizziness and stress levels in patients diagnosed with vestibular migraine (VM).
Methods
A total of 35 patients diagnosed with definite VM based on the International Classification of Headache Disorders were included in this intervention study. Patients self‐selected to receive either nortriptyline regimen alone (10–40 mg daily with biweekly escalation) (group A, n = 17) or migraine dietary/lifestyle modifications alone (group B, n = 18). Main outcome measures were dizziness severity and stress level measured by the visual analog scale (VAS).
Results
At 4‐week post‐treatment, dizziness decreased from 6.0 ± 2.5 to 4.2 ± 3.4 ( p = 0.069) in group A and from 8.7 ± 1.5 to 3.6 ± 3.0 ( p < 0.001) in group B. VAS for stress changed from 5.5 ± 1.3 to 5.4 ± 2.9 ( p = 0.93) and from 6.9 ± 3.2 to 5.0 ± 2.7 ( p = 0.025) in groups A and B, respectively. The δ values of the VAS score for dizziness were 1.8 ± 3.7 and 5.1 ± 3.1 and the δ values of the VAS score for stress were 0.06 ± 2.9 and 1.9 ± 3.3 in groups A and B, respectively. Quality of life (QOL) improved in 88% patients in group A and 94% patients in group B.
Conclusions
Nortriptyline, at a maximum dose of 40 mg, effectively alleviates patient symptoms, while a migraine diet and lifestyle modifications notably reduce vertiginous symptoms and stress levels in VM patients in 4 weeks. Both interventions are equally effective in ameliorating the QOL of patients. The ideal treatment for patients would likely need to include both medication and diet/lifestyle changes.
... [ [119][120][121] Tanacetum parthenium (Feverfew) ...
... Dietary triggers are established phenomena in migraines. The most common culprits are alcohol, tyramine-rich foods such as aged cheese or cured meat, artificial sweeteners, and flavor enhancers like monosodium glutamate (MSG) and nitrites and nitrates used as preservatives in plenty of foods [36]. Studies in children have shown that the "elimination" or oligoantigenic diets with witch certain substances are excluded from consumption may be effective in migraine prophylaxis [37]. ...
Headache disorders are a significant global health burden, leading to reduced quality of life. While vast pharmacological treatments are available, they may be associated with adverse effects or inadequate efficacy for some patients, therefore there is a need for exploring alternate treatment strategies. This review gives a brief explanation and evaluation of some established and emerging non-pharmacological approaches for headache management, focusing on nutraceuticals and diet, acupuncture, cognitive behavioral therapy (CBT), biofeedback, relaxation techniques, autogenic training, and neuromodulation. Special consideration is given to psychological interventions as they increase patient self-efficacy and provide strategies for managing chronic pain. Future research should focus on optimizing these therapies, identifying patient-specific factors influencing their effectiveness, and integrating them into holistic headache management strategies.
... Tyramine, an amine compound derived from the amino acid tyrosine, is present in various food items, including aged cheeses, cured meats, smoked fish, beer, fermented foods, and yeast extract, among others [82]. Tyramine has the potential to trigger headaches by promoting the release of norepinephrine and exerting an agonistic influence on αadrenergic receptors [83]. ...
Migraine, a prevalent neurological condition and the third most common disease globally, places a significant economic burden on society. Despite extensive research efforts, the precise underlying mechanism of the disease remains incompletely comprehended. Nevertheless, it is established that the activation and sensitization of the trigeminal system are crucial during migraine attacks, and specific substances have been recognized for their distinct involvement in the pathomechanism of migraine. Recently, an expanding body of data indicates that migraine attacks can be prevented and treated through dietary means. It is important to highlight that the various diets available pose risks for patients without professional guidance. This comprehensive overview explores the connection between migraine, the gut microbiome, and gastrointestinal disorders. It provides insight into migraine-triggering foods, and discusses potential diets to help reduce the frequency and severity of migraine attacks. Additionally, it delves into the benefits of using pre- and probiotics as adjunctive therapy in migraine treatment.
... Due to the myriad side effects of traditional prescription drugs, the demand for "natural" treatments such as vitamins and supplements for common ailments such as headaches is also increasing. Studies examine the evidence for supplements in the treatment of migraine [37]. ...
Phytochemicals affect metabolic changes as well as organ changes. With their effects, they can prevent diseases or, in the case of established disease, affect speeding up conventional treatment. Low-calorie diets and other restrictive diets are challenging to follow for an extended period. As a result, they are less popular than non-restrictive programs that instead encourage good eating habits. In our experiment, we dealt with the health problems of 8 probands with the following health problems: high blood sugar level, overweight, high blood cholesterol level, high blood pressure. Before and after the end of the restrictive diet, we determined changes in the organism. Blood sugar levels, body weight, changes in blood pressure, subjective expression of pain, physiological values in the blood (cholesterol, hemoglobin, white blood cells, glucose, urea, cholesterol, thyroid function and hormones (T3 – triiodothyronine, T4 – thyroxine)) and urine (urine pH, urine proteins, glucose, ketones, urobilinogen, blood in urine and hemoglobin) were determined. As for blood biochemical parameters, positive changes were observed in almost all probands, except for the decreased creatinine level. After completing the restrictive diet, the participants' blood pressure moved towards normal values (120/80). In addition, the participants' body weight decreased by an average of 3-4.5 kg, which led to a change in their BMI (Body Mass Index). During the entire 7-day period of the diet, most of the participants initially reported negative subjective experiences, but at the end of the restrictive diet, they generally felt good.
... Los exámenes complementarios como la TAC y el EEG y la indicación terapéutica fueron establecidos según el juicio del médico tratante. Con relación a los aspectos dietéticos, se hacía una entrevista estructurada sobre la historia nutricional para determinar si existía algún alimento que de manera consistente se asociara a las crisis migrañosas, en cuyo caso se recomendaba evitar su consumo; además, se sugería omitir de la dieta diaria alimentos que se han asociado a las crisis migrañosas tales como chocolate, cítricos, queso blanco, comida china, refrescos, nestee, alimentos que contienen amarillo número 5, entre otros, (28)(29)(30)(31)(32)(33). No se sugirió el empleo de complementos dietéticos. ...
Introducción: la cefalea es común en la infancia y su frecuencia aumenta en la adolescencia; raras veces está relacionada con enfermedades graves, pero sí repercute negativamente en la calidad de vida. Objetivo: determinar las características clínicas y epidemiológicas de la cefalea en una cohorte de niños, clasificarla y evaluar la respuesta al tratamiento profiláctico. Métodos: estudio descriptivo, prospectivo y longitudinal en el que se analizaron las siguientes variables: edad, sexo, antecedentes perinatales y personales, historia familiar de cefalea, características de los episodios, tratamiento recibido y respuesta al mismo. Se clasificaron los casos de acuerdo con los criterios de la Sociedad Internacional de Cefalea y según su patrón temporal. Resultados: el grupo más afectado fueron los escolares y predominaron las niñas. El antecedente familiar de migraña estuvo presente en 64,7%. Predominó la migraña sin aura (63,9%). Recibieron tratamiento profiláctico 88,6% y hubo buena respuesta en 88,2%. Los estudios de neuroimágenes y el EEG hechos de rutina no tuvieron utilidad. Conclusiones: no existen criterios estandarizados para la clasificación de la cefalea en la infancia, pero debe hacerse un seguimiento adecuado de todos los síntomas para validar los criterios diagnósticos y reducir el impacto negativo sobre la calidad de vida.
... 17 Personalised lifestyle medicine, including sleep hygiene, stress management, aerobic exercise and dietary modification as well as nutraceuticals, should be considered in a migraine management plan. 18,19,20 The aim of this narrative review is to explore the clinical evidence for nutritional medicine for migraine, including diet and nutrient-based interventions, from the perspective of personalised or precision nutrition. ...
Chronic migraine headaches are estimated to affect between 1.4% and 2.2% of the population, and have a huge impact on wellbeing and quality of life. A diverse range of therapeutic nutritional options have been explored for migraine headaches, with varying degrees of benefit. Dietary interventions include generally healthy food plans, identification and avoidance of trigger foods, weight-loss diets, low-glycaemic-load diets, ketogenic diets, gluten-free diets, IgG-led elimination diets and a high-omega-3/low-omega-6 diet. Nutritional supplement interventions include riboflavin, niacin, homocysteine-lowering B vitamins, vitamin B12, vitamin E, vitamin D, magnesium, zinc, iron, omega-3 fatty acids, coenzyme Q10 (CoQ10), lipoic acid, soy phytoestrogens, ginger, turmeric, carnitine, 5-hydroxytryptophan (5-HTP), palmitoylethanolamide (PEA), and multi-ingredient formulas. The wide range of therapeutic options may make it challenging to approach nutritional management of migraine in a clinical setting, so a pragmatic model that helps personalise interventions from clinical signs and symptoms and reliable biomarkers would be useful, so-called 'precision nutrition'. The aim of this narrative review is to explore the clinical evidence for nutritional medicine for migraines, including diet and nutrient-based interventions, from the perspective of personalised or precision nutrition.
... For this reason, managing an optimal diet plays a significant role in promoting health in the society [27]. On the other hand, because of the complexity of migraine, as a multidimensional disease, and also the difficulty of establishing studies to investigate how dietary factors can influence migraine [58], inconsistency prevails in the literature, ranging from a limited significance of dietary modification for migraine to some promising effects. Dietetic intervention by using very high-fat, low-carbohydrate ketogenic diet has been proposed conceptually in respect to a possible investment to non-pharmaceutical interventions for migraine patients [59]. ...
Migraine is a prevalent heterogeneous neurological disorder, enumerated as the eighth most disabling neurological disorder by the World Health Organization. The growing advancement in technology and investigation of various facets of cerebral metabolism in migraine has shed light to metabolic mechanisms in migraine pathophysiology. A growing number of clinical research postulates migraine as a reaction to oxidative stress levels that go beyond antioxidant capacity or cerebral energy deficiency. This has become an extremely attractive subject area and over the past years there has also been a sustained research activity in using ketone bodies (KB) as a novel potential migraine prophylaxis. Not much epidemiological research has been conducted to exhibit the efficacy of ketone bodies in abnormal metabolism in migraine pathophysiology. Therefore, a better understanding of ketone bodies in metabolic migraine may provide novel therapeutic opportunities. The goal of this review is to assess present understanding on potential migraine triggers, as well as how ketogenic interventions support metabolic disability in migraines and address the therapeutic importance of ketones in migraine treatment, accenting clinical studies (including neuroimaging and therapeutic studies). This review is intended to demonstrate existing literature on the effects of ketone bodies on metabolic migraine traits to guide the readership through current concepts and foster a perspective for future research.
... The authors concluded that there appears to be a relationship between PEA ingestion and the onset of migraine. There are, however, numerous reports linking dietary PEA to migraine initiation [179,180] through the ingestion of common "migraine triggers" (e.g., chocolate, wine, and cheese) known to contain PEA. However, a preclinical study was performed where PEA was infused into 15 healthy baboons and alterations in the cerebral blood flow was measured [181]. ...
Migraine is a common, debilitating disorder for which attacks typically result in a throbbing, pulsating headache. Although much is known about migraine, its complexity renders understanding the complete etiology currently out of reach. However, two important facts are clear, the brain and the metabolism of the migraineur differ from that of the non-migraineur. This review centers on the altered amino acid metabolism in migraineurs and how it helps define the pathology of migraine.
Graphical abstract
... This can be done with the help of food diaries, which are an inexpensive way to understand which foods and drinks may trigger headache attacks in that individual. 8 It was interesting to observe that half the patients considered that at least one dietary component was a headache trigger. While alcohol ASAA Machado SB, Ares-NC, Scorcine C, Fragoso YD. ...
Objective
To assess food and drink avoidance among patients with headache by means of an online survey.Methods
Individuals with frequent headaches were invited to answer a Google Form questionnaire [https://form.jotformz.com/200233754863656]. The survey included sex, age and characteristics of headache. Dietary habits were assessed as the number of times the individual consumed certain foods, on a daily, weekly, or monthly basis. The participants could state up to three foods that they avoided for fear of headache attacks.Results120 complete forms were received. Alcoholic beverages were the most frequent trigger factor, reported by 26.7% of the patients. 95.5% of the participants did not consume alcohol regularly. Cheese, caffeine and fat were also recognized as potential triggers of headaches. There was no standard profile of dietary triggers and, therefore, everyone has to be personally approached in this subject.Conclusion
The online survey confirmed that individual characteristics of headache were dietary triggers in half the participants. Alcohol was the most frequently mentioned trigger, followed by cheese, fat and caffeine.
... Several previous studies have shown that some dietary components such as processed or fermented foods, chocolate, caffeine, salty foods, dairies, seafoods, citrus fruits, food additives (aspartame, monosodium glutamate, and nitrates), and tyramine-containing foods stimulate migraine attacks (6,9,10). On the other hand, it has been shown that specific nutrients, including magnesium, coenzyme Q10 (CoQ10), vitamin D, and omega-3 fatty acids, may improve the condition of these patients and decrease the severity and frequency of migraine attacks (11). Also, some studies have shown that adherence to vegetarian, low-fat, and elimination diets is effective in reducing the number and severity of migraine attacks, as well as decreasing the visual analog scale (VAS) (12). ...
Background: Migraine is a chronic medical problem and sometimes progressive disorder characterized by recurrent episodes of headache. Nutritional factors can reduce and prevent the severity and frequency of migraine. Objectives: This study aimed to assess the relationship between major dietary patterns and disease severity among migraine patients. Methods: This cross-sectional study included 266 females (18 - 50 years old) who attend neurology clinics of Sina and Khatam Alanbia hospitals, and a professional headache clinic, both in Tehran, Iran, for episodic migraine diagnosis in 2016. The participants’ data was gathered using a general questionnaire and medical history. Dietary intake was assessed using a 147-item semi-quantitative food frequency questionnaire (FFQ). Anthropometric measurements were taken for all cases. visual analog scale (VAS) and migraine disability assessment (MIDAS) questionnaires were used by a neurologist for assessing migraine disability and pain severity, respectively. Also, principal component analysis (PCA) was used to identify major dietary patterns. The association between dietary patterns and disease severity was evaluated using multinomial logistic regression. Results: Using the PCA, two major dietary patterns, including the healthy and unhealthy diet, were identified. More adherence to the healthy dietary pattern (high in fruits, fruit juices, and dried fruits, vegetables, whole grains, liquid oil, brains, beans, low-fat dairy, and white meat) was associated with a lower VAS score after adjusting for energy intake, BMI, water intake, and increased salt intake (OR = 1.82, 95% CI = 0.96 - 3.44, P-trend < 0.005). The intensity of migraine headache increased by 82% in the lowest adherence to this pattern compared to the most adherence. There was no significant association between healthy and unhealthy dietary patterns with MIDAS before and after controlling for confounding variables. Conclusions: This study showed that adherence to a healthy dietary pattern reduces the severity of pain in migraine patients. However, further studies are needed to evaluate the relationship between the unhealthy dietary pattern and the severity of migraine symptoms.
... The efficacy of magnesium as a safe method of alleviation of headaches and migraines has been documented in the literature. 26,27,28,29 Magnesium is utilized in hundreds of chemical pathways in the body and is known to relax tension of any muscle in the body, including that of the heart and blood vessel walls. This may partly explain its positive impact on headaches. ...
Objective: To describe the outcome of Chiropractic Biophysics (CBP) technique along with dietary changes performed on an 8-year old with chronic headaches as well as chronic sore throat, fatigue, dizziness, queasiness, and radiographic diagnosed cervical subluxation.
Clinical Features: An 8-year old male presented with chronic headaches for two years. He also suffered from sore throat, fatigue, queasiness, aches, pains, and dizziness. He had been seen by a neurologist, psychologist and nutritionist with limited health improvements. Radiographs of the cervical spine revealed a cervical spine second harmonic S-shaped neck with upper spine kyphosis and lower spine hyperlordosis.
Interventions and Outcomes: The boy was treated with CBP mirror-image isokinetic exercises, postural adjustments, and cervical spine extension traction. Spinal manipulation, cervical mobilization and hydrotherapy were provided. One
month into care, a food diary analysis prompted dietary modifications along with nutritional supplementation. The child was originally seen on a three times per week schedule as per CBP protocol then progressed to a maintenance schedule
of two times per month, a total of 86. A lateral cervical radiograph taken 6-months after initiating care revealed that his cervical lordosis was improved to near normal for his age.
Conclusion: This case presents the successful outcome in an 8-year old with a variety of health issues as well as headaches. This case and others suggests CBP cervical extension traction as well as manipulation is a safe and effective intervention for the pediatric headache.
... SunEdelstein et al (2009) concluded in his study that it is of utmost importance to make the food diaries in order to identify the food triggers. It serves as the inexpensive method of reducing the migraine headaches [11]. ...
... Current therapeutic measures for migraine included pharmacological therapies, moreover, other therapeutic strategies are represented by dietary supplements, and herbal ingredients, dietary patterns, acupuncture, relaxation techniques, biofeedback, and psychotherapy. [63,64] Therapeutic strategies for the treatment of migraine largely include non-steroidal anti-inflammatory drugs (NSAIDs), COX-2 inhibitors, and triptans. [34] In an early study, Pradalier et al [65] did not find any difference in mean intensity, mean duration of the attacks, and rescue medication use, between the group treated with omega-3 FAs 6 g/ d supplementation for 16 weeks in comparison with placebo. ...
Background:
Omega-3 fatty acids (FAs) can produce several beneficial effects and are commonly used for the treatment of migraine symptoms. Although current therapeutic measures for migraine included pharmacological therapies, dietary supplements, and herbal ingredients, dietary patterns, acupuncture, relaxation techniques, biofeedback, and psychotherapy, omega-3 FAs therapeutic role seems to be obtained through the inhibition or reduction of the release of inflammatory cytokines. The present review aims to provide updated information about the effects of omega-3 FAs in migraine treatment, investigating their clinical effects alone or in combination with other substances.
Methods:
Bibliographic research was conducted by examining scientific literature from January 2000 until January 31, 2020. Ten clinical studies were included in the review. Quality assessment of randomized controlled trials was performed by using the JADAD scale.
Results:
Clinical studies methodology is not always of good quality and results show moderate evidence concerning the therapeutic role of omega-3 FAs in migraine.
Conclusion:
Further clinical trials are necessary to implement the knowledge concerning the use of omega-3 fatty acids in the treatment of migraine.
... It could result in the release of some inflammatory mediators that irritates cranial nerves root, mostly the trigeminal nerve that transmits the sense of face and most of the head. There are some experiments supporting involvement of cortical event in the initiation of headache as well 36 .The aura is thought to be caused by cortical spreading depression, a slowly propagating wave of intense neuronal and glial depolarization progressing over the cortex and followed by a period of inactivity 37 .Mitochondrial dysfunction, which leads to impaired oxygen metabolism, has been speculated to play a role in migraine pathophysiology 38 and this is the basis for the use of supplements that enhance mitochondrial function in the treatment of migraine, such as riboflavin,CoQ10, and alpha lipoic acid 26 .The mechanism by which fasting and skipping meals triggers headaches may be related to alterations in serotonin and norepinephrine in brainstem pathways 39 or the release of stress hormones such as cortisol. ...
Headaches have afflicted man throughout history, and Migraine is a common, but under diagnosed and under treated type of headache that has a strong social impact, influencing both quality of life and work productivity. Stress, food allergies, neuro endocrine imbalances and nutritional deficiencies all may contribute to migraine attacks. Several mechanisms have been implicated in migraine patho physiology including inflammation, mitochondrial dysfunction, abnormal neuronal excitability and vascular events. Drugs from different pharmacological classes are used for migraine prophylaxis and these agents may normalize neuronal excitability by modulating distinct ionic channels and various neurotransmitter systems. They can also block cortical spreading depression; prevent peripheral and/or central pain sensitization. Over the last two decades, the results from clinical studies have provided evidence of the efficacy of allopathic and herbal drugs which have shown considerable relief in complications of migraine yet a lot of pathological mechanisms and resultant sufferings remain unresolved.
... According to them Most patients are sensitive to aspartame, monosodium glutamate, nitrates, nitrites, alcohol, and caffeine. 30 A case control study was conducted by Gludekin B et al. 31 in turkey during 2008. The aim of the study was to evaluate leptin levels in patients with migraine and without it and to investigate its relation to vascular risk factors. ...
Migraine is a major health problem in all over the world in young age especially from age 20-30 years. Migraine is the severe headache especially in female as its prevalence is much higher in females than males. Migraine affected the health of youngster in both developed such as America and US and developing country such as Pakistan, Africa, India and Afghanistan. Prevalence of migraine is higher in middle class people. As, 18% of the migraine patients belong to upper class, 81% of patients belongs to middle class and only 1% patients belongs to lower class. Prevalence of migraine is higher in middle class because people belong to middle socio-economic status take more tension of the life.Factors that can trigger the rate and frequency of migraine are smoking, consumption of alcohol, physical exercise and dietary supplements. To find the determinants of migraine and to reduce the rate of migraine, it was essential to create the awareness among people about health issues.
Keywords: smoking, consumption of alcohol, migraine, dietary supplements,manifestations, probable migraine, chronic migraine
... Diet and Migraine [41][42][43][44] : ...
... In addition, caffeine can determine the increase of intracellular adenosine monophosphate-activated protein kinase, releasing vasoactive amines (e.g., serotonin), causing neurogenic inflammation or vasodilation with impaired vascular permeability and meningeal edema. Signals from the neural inflammation site are transmitted to brainstem nuclei, thalamic nuclei, and the cortex (97). Neuronal disregulation could be related to the adenosine activation of prostaglandin E2 that increases sodium channel sensitivity and astroglyosis. ...
Dark chocolate is not the most popular chocolate; the higher concentration in antioxidants pays tribute to the increment in bitterness. The caloric density of dark chocolate is potentially lower but has a large variability according to recipes and ingredients. Nevertheless, in the last decade, the interest in dark chocolate as a potential functional food has constantly increased. In this review, we present the nutritional composition, factors influencing the bioavailability, and health outcomes of dark chocolate intake. We have extracted pro- and counter-arguments to illustrate these effects from both experimental and clinical studies in an attempt to solve the dilemma. The antioxidative and anti-inflammatory abilities, the cardiovascular and metabolic effects, and influences on central neural functions were selected to substantiate the main positive consequences. Beside the caloric density, we have included reports placing responsibility on chocolate as a migraine trigger or as an inducer of the gastroesophagial reflux in the negative effects section. Despite an extensive literature review, there are not large enough studies specifically dedicated to dark chocolate that took into consideration possible confounders on the health-related effects. Therefore, a definite answer on our initial question is, currently, not available.
Chronic pain lasting more than three months or persisting after normal healing is a significant global health issue. In a healthcare system, it is crucial to ensure proper chronic pain management. Traditional pharmacological and non-pharmacological pain management techniques may not fully meet the requirements of physicians regarding effectiveness and safety. Therefore, researchers are exploring natural analgesics. Plant-based phytoconstituents show promise in relieving chronic pain associated with various diseases. This study aims to review the latest advances in discovering natural bioactive compounds that can help alleviate chronic pain. It discusses the pathways of chronic pain and a multifactorial treatment strategy. It also organizes data on using plant- derived substances, such as cannabinoids, terpenoids, phenolics, and crude extracts. Additionally, it delves into the pharmacodynamics of cannabinoids, including their route of administration and elimination. The review presents the results of 22 clinical trials on various cannabinoids for pain relief. It is important to note that opioids and other alkaloids from plants are not covered in this article due to their primary use in controlling acute rather than chronic pain.
In summary, neurodegenerative diseases are multifactorial disorders marked by the degeneration and eventual death of nerve cells, leading to structural and functional deterioration. Alzheimer’s, Parkinson’s, Huntington’s, Amyotrophic Lateral Sclerosis, and Multiple Sclerosis are notable examples of such diseases, impacting quality of life and often progressing rapidly. While there is currently no definitive cure for these conditions, treatment strategies focus on enhancing quality of life by slowing disease progression. However, chronic use of existing therapeutic interventions and medications can cause serious side effects. This situation has led patients to turn to alternative medicine practices.A prominent approach among complementary medicine practices is the use of medicinal plants with neuroprotective properties. These plants can aid in brain injury recovery and enhance learning and memory functions through the stimulation of new synapse formation. These plants containing phytochemicals may be effective in the developmental mechanisms of neurodegenerative diseases and may favourably affect the prognosis of the disease. Therefore, phytochemical, pharmacological and clinical research on medicinal plants may make promising contributions to the development of naturally derived drugs for neurodegenerative diseases.
The etiopathogenesis of migraine is multifactorial and demands several drugs for its treatment, yet these therapeutic drugs cause various adverse effects. Migraine is a frequent neurovascular disorder affecting women three times more than men. Migraine has a severe impact on the sociocultural, financial, and overall quality of life (QoL) of affected patients as well as hampering their productive life. Migraine is considered one of the leading causes of disability around the globe. Frequent attacks of headaches with sensory and motor aura are hallmarks of migraine. Non-pharmacological approaches as preventive medicine either individually or in combination with conventional pharmacotherapies are emerging for the management of various diseases including migraine. Clinical representation of migraine is affected by dietary practices and food components. Cumulative evidence from preclinical and clinical studies identified several dietary components as migraine triggers. This leads to the emergence of dietary practices that involve the restriction of certain dietary components using elimination diets or ketogenic diets. Alternatively, the concept of comprehensive diets which involve selective use of certain food components or nutrients in the diet for the management of migraine is also proposed. The use of nutrients such as magnesium, Coenzyme Q10, alpha-lipoic acid, L-carnitine, and vitamins are novel approaches to alleviating symptoms of headache in migraine patients; all of which have modest adverse effects. These nutrients improve mitochondrial function, decrease inflammation, and boost antioxidant status, resulting in reduced and less intense migraine episodes. This book chapter emphasizes the role of nutrients and diets in the management of migraine.
Migraine is a recurrent disease of the central nervous system that affects an increasing number of people worldwide causing a continuous increase in the costs of treatment. The mechanisms underlying migraine are still unclear but recent reports show that people with migraine may have an altered composition of the intestinal microbiota. It is well established that the gut-brain axis is involved in many neurological diseases, and probiotic supplementation may be an interesting treatment option for these conditions. This review collects data on the gastrointestinal and oral microbiota in people suffering from migraine and the use of probiotics as a novel therapeutic approach in its treatment.
We investigate consumer preferences for domestically produced white wines compared to foreign wines in Australia. A discrete choice experiment was used to analyze young Australian consumers’ preferences regarding white wine and a latent class model was estimated to take preference heterogeneity into account. We examine the relationship between consumers’ ethnocentrism and preferences for wine from a specific origin. Highly ethnocentric Australian wine consumers are found to strongly prefer Australian wines and to a lesser extent wine from New Zealand compared to otherwise identical French wine, confirming a country-of-origin effect. Carefully considering the information to include on wine labels helps to stimulate consumer demand in certain market segments. Producers can use information regarding consumer preferences for specific wine characteristics to put an attractive and profitable product on the market. For instance, Australian wines might have a domestic advantage over similar foreign wines, if this ‘country of origin’ is brought to the consumers’ attention. Hence, labeling wine as ‘Made in Australia’ is likely to increase the willingness to buy wines amongst a significant subgroup of Australian consumers aged 18–38. Adding other specific labels such as gold or silver medals to the bottle can also attract specific customer segments.
Jihočeská univerzita v Českých Budějovicích, Zdravotně sociální fakulta, katedra radiologie a toxikologie
Summary Energy drinks are soft drinks advertised as boosting energy. Energy drinks usually do not emphasize energy derived from the calories they contain, but rather through a choice of caffeine, taurine, carnitine, vitamins, and different herbal supplements the manufacturer has combined. The central ingredient in most energy drinks is caffeine, the same stimulant found in coffee or tea. Most of these drinks contain between 70 and 200 mg of caffeine, which stimulates the central nervous system giving the body a sense of alertness. It can raise heart rate and blood pressure while dehydrating the body. A lot of people experience side effects above 200 mg, which include sleeplessness, heart palpitations, and headaches. Other common ingredients are for example taurine, L-carnitine, glucuronolactone, vitamins, and various forms of natural anti-oxidants in the form of herbal extracts as guarana, ginseng or Ginkgo biloba. Taurine is an amino acid that helps regulate heartbeat, muscle contractions, and energy levels. Creatine helps with supplying energy to the muscles and is usually found in energy drinks and products that are marketed to body builders. Glucuronolactone occurs naturally in all connective tissue and it is added to energy drinks because is believed to help with glycogen depletion, freeing hormones and other chemicals, and aids in detoxification. L-carnitine, quaternary ammonium compound biosythesized from the amino acids lysine and methionine is required for the transport of fatty acids from the cytosol into the mitochondria during the breakdown of lipids for the generation of metabolic energy. Rare side effects of L-carnitine include nausea, vomiting, abdominal pain, and diarrhea. B-vitamins are essentially the things that help convert food to energy, like sugar which is found in abundance in energy drinks. Energy drinks contain a lot of sugar, for example glucose which is the body's preferred fuel. However, too much sugar intake has been linked to diabetes. Ginseng, an adaptogenic herb, is known to increase energy, has some anti-fatigue components, supposedly relieves stress, and increases memory. A variety of physiological and psychological effects have been attributed to energy drinks and their ingredients. Some studies reported significant improvements in mental and cognitive performance as well as increased subjective alertness. Excess consumption of these drinks may induce euphoria caused by stimulant properties of caffeine. Caffeine also induces agitation, anxiety, irritability, and insomnia. Souhrn Energetické nápoje jsou nealkoholické nápoje, které stimulují organismus a odstraňují únavu. Tyto nápoje obvykle nemají dodávat energii díky kalorické hodnotě živin, které obsahují, ale díky kombinovanému účinku kofeinu, taurinu, karnitinu, vitaminů a dalších rostlinných složek. Ústřední složkou ve většině energetických nápojů je kofein, stejný stimulant, jaký nacházíme PREVENCE ÚRAZŮ, OTRAV A NÁSILÍ 2/2010
The consumption of food products containing the non-caloric sweetener aspartame
has increased since the 80’s, when these products were introduced in the market. Since
then, several pieces of evidence suggest that aspartame may be potentially harmful
to the nervous system, although some controversy on this subject still persists. Some
research suggests an association between aspartame intake and metabolic damage to
the central nervous system (CNS), such as changes in enzyme and neurotransmitter
activities. Considering the possible adverse neuronal actions of aspartame, we consider
it important to study the biological effects of this sweetener on the functional aspects
of the CNS. Objective: To analyze the pertinent literature on important aspects of the
possible neurophysiological alterations associated with aspartame consumption. Methods: We conducted a search for studies, whose strategy was developed for Embase,
Medline, Lilacs and Pubmed databases, according to the descriptors: Aspartame, brain
function and nervous system. We present here a narrative review of the literature over
the period from 1992 to 2012. Conclusion: experimental and clinical studies indicate the
risk of neural adverse reactions, which are associated with the use of aspartame, even
in relatively low doses. This risk might be higher in developing organisms. Because of
such evidence we recommend that the sweetener consumption, if any, should be performed with moderation and caution, under the guidance of a nutritionist or a medical
doctor, in order to avoid aspartame-associated deleterious effects on brain function,
mainly in children.
Background and objectives:
Migraine is a predominant headache condition with frequent, sporadic attacks of moderate to severe pain. Modifying dietary habits have been considered as an appropriate therapeutic approach in these patients. This study was designed to examine the association between dietary diversity score (DDS) and severity, frequency and duration of migraine attacks.
Methods and materials:
The present study was conducted using a cross-sectional design on 256 women aged between 18 and 45 years referred to neurology clinics for the first time. After the diagnosis of migraine by a neurologist the data related to anthropometric measures and dietary intake (147-item semi-quantitative food frequency questionnaire) were collected. To assess migraine severity the Migraine disability assessment questionnaire (MIDAS), visual analog scale (VAS), and a 30-day headache diary were used. Multinomial logistic regression was used to evaluate the association between DDS and migraine severity. The age, physical activity, BMI, and job were considered as confounding variables in regression model. Data were analyzed using SPSS software and P-values <0.05 considered statistically significant.
Results:
Totally, 256 subjects participated in the present study with mean age, height, weight, and BMI of 34.28±7.88 years, 161.78±5.18 cm, 69.25±13.06 kg, 26.46±4.89 kg/m2, respectively. Subjects with higher DDS had a lower waist circumference (P=0.01). There was no association between DDS and other anthropometric measures and demographic characteristics (P>0.05). In the crude model of logistic regression, participants with lower DDS had higher odds of more pain severity (OR=2.30; 95% CI=1.28, 4.12; P=0.005), migraine disability (OR=2.66; 95% CI=1.51, 4.69; P=0.001), and headache duration (OR=2.05; 95% CI=1.17, 3.59; P=0.010) compared to reference group. No association was found between headache frequency and DDS. Adjusting for the effect of confounding variables did not change the significant association.
Conclusion: DDS was inversely associated with migraine disability, pain severity, and headache frequency. Additional studies are needed to replicate these findings and to explore mechanisms that mediate the association between DDS and migraine attacks.
Migraine is a recurrent, primary cause of headache. Although prophylactic vitamin B12 therapy is used on migraine patients, there is a limited number of studies examining the levels of B12 vitamin and folic acid in pediatric patients diagnosed with migraine. The study group (Group 1) included 65 pediatric patients diagnosed with migraine in the Pediatric neurology outpatient clinic, and 87 healthy cases admitted to the general pediatric clinic were included in the control group (Group 2). Complete blood count parameters, vitamin B12, folic acid, ferritin, and 25 OH D vitamin levels of the study and control groups were compared. The mean vitamin B12 level was 196.42 ± 95.54 pg/mL (59–499) in Group 1 and 240 ± 105.24 pg/mL (74–619) in Group 2. The mean folic acid level was 8.85 ± 3.49 pg/mL (3.68–23.70) in Group 1 and 7.24 ± 7.17 pg/mL (1.11–35.50) in Group 2. There was a statistically significant difference between Group 1 and 2 in terms of vitamin B12 and folic acid levels (p = 0.008, p = 0.00). The results of this study indicate the requirement for routine evaluation of vitamin B12 and folic acid levels in pediatric patients diagnosed with migraine.
Thirty-two male Wistar albino rats were chosen to test the possible protective role of antioxidants of the edible seaweed Sargassum vulgare as a functional food additive to alleviate oxidative stress and toxicity associated with consumption of the artificial sweetener ‘aspartame (ASP)’. Biochemical and spleen histopathological analyses of the orally ASP-administrated rats, at a dose of 500 mg/kg for one week daily, showed different apoptotic and inflammatory patterns. Rats treated with ASP and then supplemented orally with the S. vulgare-MeOH extract, at a dose of 150 mg/kg for three consecutive weeks daily, showed significant positive reactions in all investigated assays related to ASP consumption. The protective and immune-stimulant efficacy of S. vulgare-MeOH extract, inferred from combating oxidative stress-induced lipid peroxidation, modulating the low levels of the endogenous antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) and of the thyroid hormones T3 and T4, attenuating the elevated levels of apoptotic CASP-3 and inflammatory biomarkers TNF-α and IL-6, as well as heat shock proteins (Hsp70), can be most likely ascribed to the synergistic effect of its potent antioxidant phenolics (mainly gallic, ferulic, salicylic, and chlorogenic, and p-coumaric acids) and flavonoids (rutin, kaempferol, and hesperidin). Mechanism of action of these natural antioxidants was discussed.
Thirty-two male Wistar albino rats were chosen to test the possible protective role of antioxidants of the edible seaweed Sargassum vulgare as a functional food additive to alleviate oxidative stress and toxicity associated with consumption of the artificial sweetener ‘aspartame (ASP)’. Biochemical and spleen histopathological analyses of the orally ASP-administrated rats, at a dose of 500 mg/kg for one week daily, showed different apoptotic and inflammatory patterns. Rats treated with ASP and then supplemented orally with the S. vulgare-MeOH extract, at a dose of 150 mg/kg for three consecutive weeks daily, showed significant positive reactions in all investigated assays related to ASP consumption. The protective and immune-stimulant efficacy of S. vulgare-MeOH extract, inferred from combating oxidative stress-induced lipid peroxidation, modulating the low levels of the endogenous antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) and of the thyroid hormones T3 and T4, attenuating the elevated levels of apoptotic CASP-3 and inflammatory biomarkers TNF-α and IL-6, as well as heat shock proteins (Hsp70), can be most likely ascribed to the synergistic effect of its potent antioxidant phenolics (mainly gallic, ferulic, salicylic, and chlorogenic, and p-coumaric acids) and flavonoids (rutin, kaempferol, and hesperidin). Mechanism of action of these natural antioxidants was discussed.
Protein misfolding diseases (PMDs) are chronic and progressive, with no effective therapy so far. Aggregation and misfolding of amyloidogenic proteins are closely associated with the onset and progression of PMDs, such as amyloid-β in Alzheimer's disease, α-Synuclein (α-Syn) in Parkinson's disease and human islet amyloid polypeptide (hIAPP) in type 2 diabetes. Inhibiting toxic aggregation of amyloidogenic proteins is regarded as a promising therapeutic approach in PMDs. The past decade has witnessed the rapid progresses of this field, dozens of inhibitors have been screened and verified in vitro and in vivo, demonstrating inhibitory effects against the aggregation and misfolding of amyloidogenic proteins, together with beneficial effects. Natural products are major sources of small molecule amyloid inhibitors, a number of natural derived compounds have been identified with great bioactivities and translational prospects. Here, we review the non-polyphenolic natural inhibitors that potentially applicable for PMDs treatment, along with their working mechanisms. Future directions are proposed for the development and clinical applications of these inhibitors.
To describe the prevalence, sociodemographic profile, and the burden of migraine in the United States in 1999 and to compare results with the original American Migraine Study, a 1989 population-based study employing identical methods.
A validated, self-administered questionnaire was mailed to a sample of 20 000 households in the United States. Each household member with severe headache was asked to respond to questions about symptoms, frequency, and severity of headaches and about headache-related disability. Diagnostic criteria for migraine were based on those of the International Headache Society. This report is restricted to individuals 12 years and older.
Of the 43 527 age-eligible individuals, 29 727 responded to the questionnaire for a 68.3% response rate. The prevalence of migraine was 18.2% among females and 6.5% among males. Approximately 23% of households contained at least one member suffering from migraine. Migraine prevalence was higher in whites than in blacks and was inversely related to household income. Prevalence increased from aged 12 years to about aged 40 years and declined thereafter in both sexes. Fifty-three percent of respondents reported that their severe headaches caused substantial impairment in activities or required bed rest. Approximately 31% missed at least 1 day of work or school in the previous 3 months because of migraine; 51% reported that work or school productivity was reduced by at least 50%.
Two methodologically identical national surveys in the United States conducted 10 years apart show that the prevalence and distribution of migraine have remained stable over the last decade. Migraine-associated disability remains substantial and pervasive. The number of migraineurs has increased from 23.6 million in 1989 to 27.9 million in 1999 commensurate with the growth of the population. Migraine is an important target for public health interventions because it is highly prevalent and disabling.
The importance of magnesium in the pathogenesis of migraine headaches is clearly established by a large number of clinical and experimental studies. However, the precise role of various effects of low magnesium levels in the development of migraines remains to be discovered. Magnesium concentration has an effect on serotonin receptors, nitric oxide synthesis and release, NMDA receptors, and a variety of other migraine related receptors and neurotransmitters. The available evidence suggests that up to 50% of patients during an acute migraine attack have lowered levels of ionized magnesium. Infusion of magnesium results in a rapid and sustained relief of an acute migraine in such patients. Two double-blind studies suggest that chronic oral magnesium supplementation may also reduce the frequency of migraine headaches. Because of an excellent safety profile and low cost and despite the lack of definitive studies, we feel that a trial of oral magnesium supplementation can be recommended to a majority of migraine sufferers. Refractory patients can sometimes benefit from intravenous infusions of magnesium sulfate.
Magnesium is an important intracellular element that is involved in numerous cellular functions. Deficiencies in magnesium may play an important role in the pathogenesis of migraine headaches by promoting cortical spreading depression, alteration of neurotransmitter release and the hyperaggregation of platelets. Given this multifaceted role of magnesium in migraine, the use of magnesium in both acute and preventive headache treatment has been researched as a potentially simple, inexpensive, safe and well-tolerated option. Studies have shown that preventive treatment with oral magnesium and acute headache treatment with intravenous magnesium may be effective, particularly in certain subsets of patients. In this review, the pathogenesis of migraine will be discussed, with an emphasis on the role of magnesium. Studies on the use of intravenous and oral magnesium in migraine treatment will be discussed and recommendations will be made regarding the use of magnesium in treating migraine headaches.
Safety of long-term administration of 75 mg/kg of aspartame per day was evaluated with the use of a randomized, double-blind, placebo-controlled, parallel-group design in 108 male and female volunteers aged 18 to 62 years. Subjects received either aspartame or placebo in capsule form three times daily for 24 weeks. No persistent changes over time were noted in either group in vital signs; body weight; results of standard laboratory tests; fasting blood levels of aspartame's constituent amino acids (aspartic acid and phenylalanine), other amino acids, and methanol; or blood formate levels and 24-hour urinary excretion of formate. There also were no statistically significant differences between groups in the number of subjects experiencing symptoms or in the number of symptoms per subject. These results further document the safety of the long-term consumption of aspartame at doses equivalent to the amount of aspartame in approximately 10 L of beverage per day.
The use of feverfew (Tanacetum parthenium) for migraine prophylaxis was assessed in a randomised, double-blind, placebo-controlled crossover study. After a one-month single-blind placebo run-in, 72 volunteers were randomly allocated to receive either one capsule of dried feverfew leaves a day or matching placebo for four months and then transferred to the other treatment limb for a further four months. Frequency and severity of attacks were determined from diary cards which were issued every two months; efficacy of each treatment was also assessed by visual analogue scores. 60 patients completed the study and full information was available in 59. Treatment with feverfew was associated with a reduction in the mean number and severity of attacks in each two-month period, and in the degree of vomiting; duration of individual attacks was unaltered. Visual analogue scores also indicated a significant improvement with feverfew. There were no serious side-effects.
Nervous connections between the trigeminal ganglia and cerebral blood vessels have recently been identified in experimental animals and have been termed the trigeminovascular system. Existence of this system in humans is inferential. Trigeminovascular neurons and their peripheral unmyelinated nerve fibers contain the neurotransmitter peptide substance P. Most newly synthesized substance P is transported from ganglion cell bodies to afferent nerve fibers, where depolarization-induced release of neurotransmitter into the wall of the cerebral blood vessel occurs. Substance P dilates pial arteries, increases vascular permeability, and activates cells that participate in the inflammatory response. The relationship of trigeminovascular fibers to the pathogenesis of vascular head pain sheds light on possible mechanisms of migraine and other central nervous system conditions associated with headache and inflammation.
We detected a significant decrease in plasma thromboxane B2 (TXB2) and 6-keto-prostaglandin F1α (6-keto-PGF1α) levels together with a significant increase in plasma 6-keto-PGF1α/TXB2 ratio in young healthy non-alcoholic male volunteers after acute ingestion of ethanol (1.5 g/kg). Paradoxically, during ethanol intoxication and the following hangover a significant increase in ADP-induced formation of TXB2 by platelet rich plasma could be observed, which suggests that ethanol intoxication via some unknown mechanism sensitizes platelets to produce TXB2. Whether these observations contribute to the increased risks of subarachnoid haemorrhage or ischaemic brain infarction among occasional heavy drinkers recently described by us remains to be proved.
Seventeen patients who ate fresh leaves of feverfew daily as prophylaxis against migraine participated in a double blind placebo controlled trial of the herb: eight patients received capsules containing freeze dried feverfew powder and nine placebo. Those who received placebo had a significant increase in the frequency and severity of headache, nausea, and vomiting with the emergence of untoward effects during the early months of treatment. The group given capsules of feverfew showed no change in the frequency or severity of symptoms of migraine. This provides evidence that feverfew taken prophylactically prevents attacks of migraine, and confirmatory studies are now indicated, preferably with a formulation controlled for sesquiterpene lactone content, in migraine sufferers who have never treated themselves with this herb.
Sucralose is the active compound of the most commonly sold sweetener in the United States. Different than aspartame, sucralose is not considered to be a migraine trigger. Herein we report a patient with attacks of migraine consistently triggered by sucralose. She also suffers from menstrually related migraine that had been well-controlled for several months since she switched her contraceptive from fixed estrogen to triphasic contraceptive pills. Some attacks triggered by sucralose were preceded by aura, and she had never experienced migraine with aura before. Withdrawal of the compound was associated with complete resolution of the attacks. Single-blind exposure (vs. sugar) triggered the attacks, after an attack-free period.
• Safety of long-term administration of 75 mg/kg of aspartame per day was evaluated with the use of a randomized, double-blind, placebo-controlled, parallel-group design in 108 male and female volunteers aged 18 to 62 years. Subjects received either aspartame or placebo in capsule form three times daily for 24 weeks. No persistent changes over time were noted in either group in vital signs; body weight; results of standard laboratory tests; fasting blood levels of aspartame's constituent amino acids (aspartic acid and phenylalanine), other amino acids, and methanol; or blood formate levels and 24-hour urinary excretion of formate. There also were no statistically significant differences between groups in the number of subjects experiencing symptoms or in the number of symptoms per subject. These results further document the safety of the long-term consumption of aspartame at doses equivalent to the amount of aspartame in approximately 10 L of beverage per day.
(Arch Intern Med. 1989;149:2318-2324)
Despite the ease in inducing hangover, only a few trials have studied treatment of hangover symptoms. Bogin and coworkers (10) compared propranolol with placebo but found no effect. In their crossover study, 10 healthy college students drank enough alcohol to reach a blood alcohol level of at least 0.1 g/dL. On the night the alcohol was consumed, 5 of the students received a long-acting oral preparation of 160 mg of propranolol; the remaining students received placebo. The study was repeated on a second occasion with a switch in treatment assignment. The morning after each night of alcohol consumption, researchers assessed the vital signs of each participant and calculated a score on a hangover severity scale. Objective analysis of hand tremor, blood pressure, and cardiac rate and rhythm showed no significant differences. On a scale of 1 to 5, the mean (±SD) severity of hangover was 2.9 ± 1.1 in participants who received propranolol and 2.8 ± 0.9 in those who received placebo (CI for the mean difference, −0.84 to 1.04). The authors concluded that propranolol does not produce a clinically important benefit in the symptoms of hangover. However, the study's power was only 50% for the hypothesized primary finding, at a two-sided α value of 0.05 (10).
Two trials have investigated the effect of simple carbohydrates on hangover severity. Seppala and colleagues (29) assigned 40 healthy men to receive one of six treatments. Participants received 1.75 g/kg of alcohol from 6:00 p.m. to 9:00 p.m. and an oral glucose or fructose solution (0.5 g/kg or 1 g/kg). The participants in the two control groups received alcohol or glucose but not both. All patients subjectively assessed their hangover severity and underwent psychomotor tests that determined reaction time, coordination, and attention span. Administration of glucose at the time of alcohol ingestion reduced mistakes by 50% on the choice reaction test (which was given 15 hours later) but slightly increased mistakes on the coordination test. Hangover severity was not affected. The study was limited by the small number of participants (n = 5) in each treatment group. Moreover, the statistical analysis did not account for multiple comparisons. Ylikahri and coworkers (37) used a similar design to study 109 healthy men (1.75 g/kg of alcohol administered orally over 3 hours, followed by 1 g/kg of oral glucose or fructose). Patients who received glucose or fructose had lower serum levels of free fatty acids and ketones but no change in subjective or objective hangover symptoms.
A patient who had noted the development of headaches shortly after eating frankfurters agreed to a series of tests aimed at determining whether the nitrites in frankfurters were the cause of his " hot-dog " headaches. He drank odourless and tasteless solutions containing 10 mg. or less of sodium nitrite or solutions identical in appearance containing 10 mg. of sodium bicarbonate. Headaches were provoked eight out of thirteen times after the ingestion of sodium nitrite, but never after the control solution. Headaches were also provoked by the ingestion of solutions containing 100 mg. of tyramine hydrochloride. The mechanism of headache production by these exogenous chemicals is uncertain.
The efficacy of feverfew capsules on migraine prophylaxis was investigated in a randomized double-blind, placebo-controlled crossover study in which 50 patients, who had not used feverfew before, participated. The capsules were filled with a dried alcoholic extract of feverfew on microcristalline cellulose and contained 0.5 mg parthenolide. The patients used one capsule (feverfew or placebo) a day. Fourty four patients completed the 9 month study. Both treatment groups suffered the same number of migraine attacks. A prophylactic effect could not be demonstrated for our feverfew preparation, but the patients seemed to have a tendency to use fever symptomatic drugs during the period they used feverfew. This result was not in accordance with the results from two other studies. The difference may be explained by the fact that both other studies included patients who previously reported positive experiences with feverfew preparations for migraine prophylaxis.
SYNOPSIS
Consumption of monosodium glutamate has long been considered to precipitate headaches in susceptible patients. In this study the direct effects of glutamate and its metabolite, glutamine, on arterial contractility were examined using rings of rabbit aorta. In a high concentration glutamate caused significant concentration‐dependent contractions (EC 50 , 10 ‐1 M; maximum tension, 188.4±33.3 mg wt tension/mg tissue). Agonists and antagonists for a‐adrenergic, histaminergic, serotonergic, cholinergic, and GABA‐nergic receptors as well as inhibition of prostaglandin synthesis failed to influence glutamate contractions. At high concentrations (10 ‐5 M) the calcium channel blocker, verapamil, inhibited the glutamate response. Glutamate and glutamine both exhibited concentration dependent relaxation of norepinephrine (NE), phenylephrine (PE), histamine, serotonin (5‐HT), and prostaglandin F 2a (PGF 2a )‐induced contractions. Kainic acid (10 ‐4 M), an agonist of one subpopulation of central glutamate receptor, potentiated glutamate‐induced vasoconstriction; a higher concentration (10 ‐3 M) produced an irreversible inhibition of glutamate contractility. Only the central glutamate receptor antagonist, ketamine (10 ‐4 ‐10 ‐2 M), induced a reversible, concentration dependent inhibition of glutamate‐induced contractions. Glutamate contractility was not dependent on extracellular calcium, an intact endothelium or neuronal function. These results demonstrate a direct effect of glutamate on peripheral arterial tone. Dietary consumption of large quantities of MSG may represent a serious health hazard to certain individuals with pre‐existing vascular disease.
To assess the effectiveness of feverfew as a prophylactic therapy for migraine, a double-blind placebo controlled cross-over trial was conducted for a period of 4 months. Fifty seven patients who attended an outpatient pain clinic were selected at random and divided into two groups. Both groups were treated with feverfew in the preliminary phase (phase 1), which lasted 2 months. In the second and third phases, which continued for an additional 2 months, a double-blind placebo-controlled cross-over study was conducted.The results showed that feverfew caused a significant reduction in pain intensity compared with the placebo treatment. Moreover, a profound reduction was recorded concerning the severity of the typical symptoms that are usually linked to migraine attacks, such as vomiting, nausea, sensitivity to noise and sensitivity to light. Transferring the feverfew-treated group to the placebo treatment resulted in an augmentation of the pain intensity as well as an increase in the severity of the linked symptoms. In contrast, shifting the placebo group to feverfew therapy resulted in a reduction of the pain intensity as well as in the severity of the linked symptoms. © 1997 John Wiley & Sons, Ltd.
Objective.—A population-based survey was conducted in 1999 to describe the patterns of migraine diagnosis and medication use in a representative sample of the US population and to compare results with a methodologically identical study conducted 10 years earlier.
Methods.—A survey mailed to a panel of 20 000 US households identified 3577 individuals with severe headache meeting a case definition for migraine based on the International Headache Society (IHS) criteria. Those with severe headache answered questions regarding physician diagnosis and use of medications for headache as well as headache-related disability.
Results.—A physician diagnosis of migraine was reported by 48% of survey participants who met IHS criteria for migraine in 1999, compared with 38% in 1989. A total of 41% of IHS-defined migraineurs used prescription drugs for headaches in 1999, compared with 37% in 1989. The proportion of IHS-defined migraineurs using only over-the-counter medications to treat their headaches was 57% in 1999, compared with 59% in 1989. In 1999, 37% of diagnosed and 21% of undiagnosed migraineurs reported 1 to 2 days of activity restriction per episode (P<.001); 38% of diagnosed and 24% of undiagnosed migraineurs missed at least 1 day of work or school in the previous 3 months (P<.001); 57% of diagnosed and 45% of undiagnosed migraineurs experienced at least a 50% reduction in work/school productivity (P<.001).
Conclusions.— Diagnosis of migraine has increased over the past decade. Nonetheless, approximately half of migraineurs remain undiagnosed, and the increased rates of diagnosis of migraine have been accompanied by only a modest increase in the proportion using prescription medicines. Migraine continues to cause significant disability whether or not there has been a physician diagnosis. Given the availability of effective treatments, public health initiatives to improve patterns of care are warranted.
SYNOPSIS
Brain magnesium was measured in migraine patients and control subjects using in vivo 31-Phosphorus Nuclear Magnetic Resonance Spectroscopy. pMg and pH were calculated from the chemical shifts between Pi, PCr and ATP signals. Magnesium levels were low during a migraine attack without changes in pH. We hypothesize that low brain magnesium is an important factor in the mechanism of the migraine attack.
Prospective studies of precipitating factors in migraine are rare. Mig Access is a national control-matched survey conducted to evaluate the access of migraineurs to health care in France. This study allowed us to screen prospectively some precipitating factors of headache in migraineurs and in nonmigraineurs.
Three hundred eighty-five migraineurs (group 1) and 313 nonmigraineurs (group 2) kept a diary for a 3-month period (a total of 35 805 days in group 1 and 29 109 days in group 2). Precipitating factors were reported for each headache period. Headache intensity was self-assessed during each headache period using a visual analog scale of 0 to 100.
Headache was reported on 4274 days (12%) in group 1 and on 602 days (2%) in group 2. Headache intensity was greater in group 1 (39 ± 20 versus 32 ± 19, P<.05). The most frequent precipitating factors (reported at least once by more than 10% of subjects [range 18% to 80%] in both groups) were fatigue and/or sleep, stress, food and/or drinks, menstruation, heat/cold/weather, and infections in both groups. All these factors except infections were reported to cause headache more frequently in migraineurs than in nonmigraineurs. Mean intensity of headache related to fatigue and/or sleep, stress, food and/or drinks, hot/cold weather, and menstruation varied from 37 to 43 in migraineurs and from 29 to 35 in nonmigraineurs. Headache with the highest mean intensity was due to infections in the two groups (47 ± 20 in group 1,45 ± 23 in group 2).
Our results support that endogenous factors are the most frequent triggers of headache in migraineurs. The most frequent precipitating factors of headache appear identical in migraineurs and in nonmigraineurs. Our results suggest that similar triggers could precipitate headache of different type in these two populations.
SYNOPSIS
The effects of oral Magnesium (Mg) pyrrolidone carboxylic acid were evaluated in 20 patients affected by menstrual migraine, in a double‐blind, placebo controlled study. After a two cycles run‐in period, the treatment (360 mg/day of Mg or placebo) started on the 15th day of the cycle and continued till the next menses, for two months. Oral Mg was then supplemented in an open design for the next two months. At the 2nd month, the Pain Total Index was decreased by both Placebo and Mg, with patients receiving active drug showing the lowest values (P<0.03). The number of days with headache was reduced only in the patients on active drug. Mg treatment also improved premenstrual complaints, as demonstrated by the significant reduction of Menstrual Distress Questionnaire (MDQ) scores. The reduction of PTI and MDQ scores was observed also at the 4th month of treatment, when Mg was supplemented in all the patients. Intracellular Mg ⁺⁺ levels in patients with menstrual migraine were reduced compared to controls. During oral Mg treatment, the Mg ⁺⁺ content of Lymphocytes (LC) and Polymorphonucleated cells (PMN) significantly increased, while no changes in plasma or Red Blood Cells were found. An inverse correlation between PTI and Mg ⁺⁺ content in PMN was demonstrated. These data point to magnesium supplementation as a further means for menstrual migraine prophylaxis, and support the possibility that a lower migraine threshold could be related to magnesium deficiency.
SYNOPSIS
Seventy-six percent of patients with daily headaches were found to have a history of episodic migraine in the past, more than half of them hormone dependent headache such as menstrual migraine. Various factors possibly influencing the transformation of episodic migraine into daily headaches were analyzed in a series of 61 patients who presented with daily headaches. Abnormal personality profile, especially neuroticism including depression, excessive stress, excessive use of medications such as caffeine containing analgesics, narcotic analgesics and ergotamine, and development of hypertension were found to be significant in the transformation of episodic migraine into daily headache.
The problem of daily headache is discussed. It is suggested that the majority of daily headaches are a continuum of episodic migraine, influenced and perpetuated by various factors such as neuroticism, excessive medication, stress, and development of hypertension. It is pointed out that diagnosis of tension headache under those circumstances is not justified.
We have confirmed our earlier finding that most red wines are able to bring about 5-hydroxytryptamine (5-HT, serotonin) release from platelets in vitro. Platelets from individual subjects manifested varying degrees of releasing ability but responded to different wines with a similar rank ordering. There was a high correlation (r = 0.87) between the effect of red wine and that of reserpine in different individuals. Some types of red wine caused a consistently higher release of 5-HT than others in all subjects; one red wine in particular resulted in neglible release. When several brands of this ·low-releasing” red wine were further examined, they all showed a lower activity than all the brands of a ‘high-releasing’ red wine type. This variation in releasing power was not related to intensity of red colour. Partial purification of red wine was achieved by column chromatography and showed releasing activity to be associated with a low molecular weight orange fraction. Preliminary studies, using solid phase extraction methods, showed that the active components lie mainly in a subgroup of the flavonoid fraction. If any of the adverse effects of red wine, such as headache induction, derive from this 5-HT releasing ability, then it may be possible to prepare red wines free from the chemical substances responsible.
The aim of this study was to evaluate and define the triggers of the acute migraine attack. Patients rated triggers on a 0-3 scale for the average headache. Demographics, prodrome, aura, headache characteristics, postdrome, medication responsiveness, acute and chronic disability, sleep characteristics and social and personal characteristics were also recorded. One thousand two hundred and seven International Classification of Headache Disorders-2 (1.1-1.2, and 1.5.1) patients were evaluated, of whom 75.9% reported triggers (40.4% infrequently, 26.7% frequently and 8.8% very frequently). The trigger frequencies were stress (79.7%), hormones in women (65.1%), not eating (57.3%), weather (53.2%), sleep disturbance (49.8%), perfume or odour (43.7%), neck pain (38.4%), light(s) (38.1%), alcohol (37.8%), smoke (35.7%), sleeping late (32.0%), heat (30.3%), food (26.9%), exercise (22.1%) and sexual activity (5.2%). Triggers were more likely to be associated with a more florid acute migraine attack. Differences were seen between women and men, aura and no aura, episodic and chronic migraine, and between migraine and probable migraine.
The gastric epithelium is renewed from stem cells in the isthmus of the gastric glands. We describe that the two neuroendocrine peptides gastrin and somatostatin are coexpressed by isthmic stem cells. Bromodeoxyuridine labeling indicates that the coexpressing cells divide and differentiate into gastrin and somatostatin cells, which remain in paracrine contact during most of their migration down into the gland. The coexpressing cells display nuclear immunoreactivity for the transcription factors Isl-1 and CREB, which have been implicated in somatostatin gene expression. Differentiated gastrin cells lack Isl-1 reactivity and show variable staining for CREB while differentiated somatostatin cells display Isl-1 and CREB reactivity.
SYNOPSIS
Seventy-four patients were evaluated who suffered from migraine and associated their attacks to the mid-morning or mid-afternoon fasting state. These seventy-four patients underwent a standard five hour, 100 gram glucose tolerance test. The glucose tolerance curves of six of the patients were classified diabetic and fifty-six patients exhibited a curve consistent with degrees of reactive hypoglycemia, i.e., serum glucose of less than 65 mg% or a drop of 75 mg% within one hour. Following dietary therapy with a low sucrose, six meal regimen, all patients who demonstrated a diabetic glucose tolerance curve showed an improvement of greater than 75%, and three have been headache free. Of the fifty-six patients who showed reactive hypoglycemia curves, forty-three returned for follow-up after dietary instruction. Of those forty-three patients 27, (63%) showed greater than 75% improvement, 17 (40%) showed 50 to 75% improvement and 4 (9%) showed 25 to 50% improvement.
Endogenous glutamate is thought to be a major neurotransmitter. After binding to a cell membrane receptor there can be a stimulation of what can be called the nitric oxide (NO)-mediated neurotransmission pathway (NO-MNP). The activity of the enzyme that produces NO from arginine, NO synthase, and the level of NO become elevated. NO has little activity within the cell in which it is produced, but it rapidly leaks out of that cell and produces effects in neighboring cells. The NO-MNP can be activated to release NO in endothelial cells which in turn acts on neighboring vascular smooth muscle cells to induce vasodilation. Therefore, we suggest that exogenous, ingested glutamate, like endogenous glutamate, can lead to the same stimulation of the NO-MNP in sensitive individuals which would then cause the symptoms of the Chinese restaurant syndrome and/or glutamate-induced asthma. Further, since ingested nitrite and related compounds can be metabolized to NO, NO may more directly cause the symptoms of 'hot dog headache'. In addition, it has been suggested that NO production can also be controlled in endothelial cells by fluid forces that stimulate pressure receptors. Therefore, elevations of NO and stimulation of the NO-MNP may occur due to sudden, local, alterations of blood pressure during pugilistic activities and play a role in the symptoms of pugilistic Alzheimer's disease. If these ideas are correct, then inhibitors of the NO-MNP and/or temporary reduction of the plasma level of arginine may be useful in preventing at least some of the symptoms of these disorders.
One of the features of inflammation is increased oxygenation of arachidonic acid which is metabolized by two enzymic pathways--the cyclooxygenase (CO) and the 5-lipoxygenase (5-LO)--leading to the production of prostaglandins and leukotrienes respectively. Amongst the CO products, PGE2 and amongst the 5-LO products, LTB4 are considered important mediators of inflammation. More than 200 potential drugs ranging from non-steroidal anti-inflammatory drugs, corticosteroids, gold salts, disease modifying anti-rheumatic drugs, methotrexate, cyclosporine are being tested. None of the drugs has been found safe; all are known to produce from mild to serious side-effects. Ginger is described in Ayurvedic and Tibb systems of medicine to be useful in inflammation and rheumatism. In all 56 patients (28 with rheumatoid arthritis, 18 with osteoarthritis and 10 with muscular discomfort) used powdered ginger against their afflictions. Amongst the arthritis patients more than three-quarters experienced, to varying degrees, relief in pain and swelling. All the patients with muscular discomfort experienced relief in pain. None of the patients reported adverse effects during the period of ginger consumption which ranged from 3 months to 2.5 years. It is suggested that at least one of the mechanisms by which ginger shows its ameliorative effects could be related to inhibition of prostaglandin and leukotriene biosynthesis, i.e. it works as a dual inhibitor of eicosanoid biosynthesis.
A 40-year-old female suffering from recurrent migrainous strokes is reported. She did not show any muscle weakness or wasting. Ragged red and cytochrome c oxidase negative fibers were present in the muscle biopsy. Muscle mitochondrial DNA analysis showed a 5 kb deletion, without a point mutation at nucleotide pair 3243 in the mitochondrial tRNALeu(UUR) gene. Phosphorus nuclear magnetic resonance spectroscopy of brain and gastrocnemius muscle showed a defective energy metabolism in both organs. An increased inorganic phosphate to phosphocreatine ratio due to a decreased phosphocreatine content was found in the occipital lobes, while an abnormal work-energy cost transfer function and a low rate of phosphocreatine post-exercise recovery were found in the muscle.
Consumption of monosodium glutamate has long been considered to precipitate headaches in susceptible patients. In this study the direct effects of glutamate and its metabolite, glutamine, on arterial contractility were examined using rings of rabbit aorta. In a high concentration glutamate caused significant concentration-dependent contractions (EC50, 10(-1)M; maximum tension, 188.4 +/- 33.3 mg wt tension/mg tissue). Agonists and antagonists for alpha-adrenergic, histaminergic, serotonergic, cholinergic, and GABA-nergic receptors as well as inhibition of prostaglandin synthesis failed to influence glutamate contractions. At high concentrations (10(-5)M) the calcium channel blocker, verapamil, inhibited the glutamate response. Glutamate and glutamine both exhibited concentration dependent relaxation of norepinephrine (NE), phenylephrine (PE), histamine, serotonin (5-HT), and prostaglandin F2 alpha (PGF2 alpha)-induced contractions. Kainic acid (10(-4)M), an agonist of one subpopulation of central glutamate receptor, potentiated glutamate-induced vasoconstriction; a higher concentration (10(-3)M) produced an irreversible inhibition of glutamate contractility. Only the central glutamate receptor antagonist, ketamine (10(-4)-10(-2)M), induced a reversible, concentration dependent inhibition of glutamate-induced contractions. Glutamate contractility was not dependent on extracellular calcium, an intact endothelium or neuronal function. These results demonstrate a direct effect of glutamate on peripheral arterial tone. Dietary consumption of large quantities of MSG may represent a serious health hazard to certain individuals with pre-existing vascular disease.
The pathogenesis of eclamptic convulsions is unknown. A review of the world literature indicates considerable controversy regarding the ideal anticonvulsant to prevent or control these convulsions. Parenteral magnesium sulfate is the drug of choice to control eclamptic convulsions in North America, but it is rarely used for this purpose overseas. The efficacy and safety of magnesium sulfate in the treatment of preeclampsia-eclampsia have been well documented during the past 60 years. During the same time period, numerous anticonvulsant drugs have been used overseas; however, the ideal drug is yet to be found. Recently phenytoin has been recommended as an alternative for magnesium sulfate; however, comprehensive data regarding its safety and efficacy are lacking. The evidence in the literature indicates that magnesium sulfate is the ideal anticonvulsant in preeclampsia-eclampsia.
Brain magnesium was measured in migraine patients and control subjects using in vivo 31-Phosphorus Nuclear Magnetic Resonance Spectroscopy. pMg and pH were calculated from the chemical shifts between Pi, PCr and ATP signals. Magnesium levels were low during a migraine attack without changes in pH. We hypothesize that low brain magnesium is an important factor in the mechanism of the migraine attack.
Extracts of feverfew (Tanacetum parthenium) inhibited secretory activity in blood platelets and polymorphonuclear leucocytes (PMNs). Release of serotonin from platelets induced by various aggregating agents (adenosine diphosphate, adrenaline, sodium arachidonate, collagen, and U46619) was inhibited. Platelet aggregation was consistently inhibited but thromboxane synthesis was not. Feverfew also inhibited release of vitamin B12-binding protein from PMNs induced by the secretagogues formyl-methionyl-leucyl-phenylalanine, sodium arachidonate, and zymosan-activated serum. Feverfew did not inhibit the secretion induced in platelets or PMNs by the calcium ionophore A23187. The pattern of the effects of the feverfew extracts on platelets is different from that obtained with other inhibitors of platelet aggregation and the effect on PMNs is more pronounced than has been obtained with very high concentrations of non-steroidal anti-inflammatory agents.
It has been suggested that extracts of feverfew may inhibit platelet behaviour via effects on platelet sulphydryl groups. In the present study we have obtained evidence for such a mode of action. Compounds that contain sulphydryl groups such as cysteine and N-(2-mercaptopropionyl)glycine prevented the inhibition of platelet behaviour by feverfew. Feverfew and parthenolide (one of the active components of feverfew) dramatically reduced the number of acid-soluble sulphydryl groups in platelets. This effect occurred at concentrations similar to those that inhibited platelet secretory activity. Feverfew itself did not induce the formation of disulphide-linked protein polymers in platelets but polymer formation occurred when aggregating agents were added to feverfew-treated platelets. Feverfew evoked changes in the metabolism of arachidonic acid that were similar to those observed in glutathione-depleted platelets.
The IC50 values for the in-vitro inhibition of the prostaglandin synthetase (bovine seminal vesicle mitochondrial fraction) mediated PGE2 production from arachidonic acid by parthenolide, michefuscalide and chrysanthenyl acetate were 11.0 +/- 0.44, 12.1 +/- 0.51 and 14.2 +/- 0.58 microM (mean +/- 95% confidence limits), respectively.
SYNOPSIS
Recently, three pilot studies have proposed that the addition of products containing aspartame to thediets of migraine headache sufferers may produce a significant increase in the frequency of theirmigraines. The present study was a controlled thirteen‐week, double‐blind, randomized cross‐over studycomparing the effect of aspartame to that of a matched placebo on the frequency and intensity of migraineheadache. The results of this study indicated that the ingestion of aspartame by migraineurs caused asignificant increase in headache frequency for some subjects. The implications of these findings andsuggestions for further research are discussed.
Contractility of all types of invertebrate and vertebrate muscle is dependent upon the actions and interactions of two divalent cations, viz, calcium (Ca2+) and magnesium (Mg2+) ions. The data presented and reviewed herein contrast the actions of several organic Ca2+ channel blockers with the natural, physiologic (inorganic) Ca2+ antagonist, Mg2+, on microvascular and macrovascular smooth muscles. Both direct in vivo studies on microscopic arteriolar and venular smooth muscles and in vitro studies on different types of blood vessels are presented. It is clear from the studies done so far that of all Ca2+ antagonists examined, only Mg2+ has the capability to inhibit myogenic, basal, and hormonal-induced vascular tone in all types of vascular smooth muscle. Data obtained with verapamil, nimopidine, nitrendipine, and nisoldipine on the microvasculature are suggestive of the probability that a heterogeneity of Ca2+ channels, and of Ca2+ binding sites, exists in different microvascular smooth muscles; although some appear to be voltage operated and others, receptor operated, they are probably heterogeneous in composition from one vascular region to another. Mg2+ appears to act on voltage-, receptor-, and leak-operated membrane channels in vascular smooth muscle. The organic Ca2+ channel blockers do not have this uniform capability; they demonstrate a selectivity when compared with Mg2+. Mg2+ appears to be a special kind of Ca2+ channel antagonist in vascular smooth muscle. At vascular membranes it can (i) block Ca2+ entry and exit, (ii) lower peripheral and cerebral vascular resistance, (iii) relieve cerebral, coronary, and peripheral vasospasm, and (iv) lower arterial blood pressure. At micromolar concentrations (i.e., 10-100 microM). Mg2+ can cause significant vasodilatation of intact arterioles and venules in all regional vasculatures so far examined. Although Mg2+ is three to five orders of magnitude less potent than the organic Ca2+ channel blockers, it possesses unique and potentially useful Ca2+ antagonistic properties.
SYNOPSIS
630 (39%) of 1600 patients seen in a Headache Clinic over a three year period had chronic daily headaches (CDH). In 78% of these CDH patients, the daily headaches evolved out of a prior history of episodic migraine; these patients we designate as having “transformed” or “evolutive” migraine. The other 12% had migraine headaches which were daily from the start.
Patients with transformed migraine, in contrast to those with daily headaches from the start, have a significantly higher incidence of positive family history of migraine, menstrual aggravation of migraine, identifiable trigger factors, associated G.I. and neurological symptoms, and early morning awakening with headache.
The CDH group in general over-used symptomatic medication and exhibited abnormalities on behavioral scale testing. Withdrawal of daily symptomatic medication, institution of a low tyramine low caffeine diet, initiation of prophylactic anti-migraine therapy, and biofeedback and behavioral therapy, gave worthwhile improvement in 76% of chronic daily headache patients.
Factors which promote “evolution” of migraine from intermittent to chronic daily occurrence are not well-defined but may include medication abuse, medication withdrawal, and psychiatric disturbances.
We performed a double-blind crossover trial of challenges with 30 mg of aspartame per kilogram of body weight or placebo in 40 subjects who reported having headaches repeatedly after consuming products containing aspartame. The incidence rate of headache after aspartame (35 percent) was not significantly different from that after placebo (45 percent) (P less than 0.50). No serious reactions were observed, and the incidence of symptoms other than headache following aspartame was also equivalent to that after placebo. No treatment-related effects were detected in vital signs, blood pressure, or plasma concentrations of cortisol, insulin, glucagon, histamine, epinephrine, or norepinephrine. Most of the subjects were well educated and overweight and had a family or personal history of allergic reactions. The subjects who had headaches had lower plasma concentrations of norepinephrine (P less than 0.0002) and epinephrine (P less than 0.02) just before the development of headache. We conclude that in this population, aspartame is no more likely to produce headache than placebo.
The turnover of 5‐hydroxytryptamine (5‐HT) in the whole brain and different brain regions was studied in rats fasted for 24 h. These rats showed an increased tissue concentration of the amine in the whole brain and of its metabolite 5‐hydroxyindoleacetic acid (5‐HIAA) in the whole brain, the striatum, the combined pons‐medulla and the cerebral cortex.
The accumulation of 5‐HIAA after probenecid was increased by fasting in the regions mentioned above except for the striatum. The effect of probenecid was also increased by fasting in the midbrain, the hypothalamus and the hippocampus.
In the striatum, the administration of probenecid produced a smaller increase in 5‐HIAA concentration in fasted than in fed rats.
The decay of 5‐HT following p‐chlorophenylalanine (PCPA) was increased in the hypothalamus of fasted rats at 16 h, but not at 4 h, after the intraperitoneal administration of the inhibitor. In the midbrain, the striatum and the combined pons‐medulla, food deprivation did not modify the decrease induced by PCPA. However, the inhibitor induced a reduction of food consumption in the fed group, which made this group rather similar to the fasted one and complicated the interpretation of the results in these last three cerebral areas.
Our results confirm that food deprivation increases the turnover of brain 5‐HT and point out that the increase probably occurs in all brain areas. This increased tunover appears to be accompanied, in the hypothalamus, by an increased neuronal release of the amine. In the striatum, fasting probably blocks the active transport system which removes acid metabolites from the brain.
An 8-month-old boy with severe lactic acidosis was found to have lipoamide dehydrogenase deficiency. Treatment with thiamine, biotin, bicarbonate, protein restriction, and ketogenic diet failed to alleviate the lactic acidosis. Oral administration of lipoic acid 25 to 50 mg/kg produced dramatic improvement in lactic and pyruvic acidemia, which has continued for 2 years and which has been accompanied by clinical improvement.
Nineteen percent of about 490 patients with classical or common migraine reported that headaches can be precipitated by chocolate, 18% by cheese and 11% by citrus fruit, and a highly significant majority of these patients were sensitive to all three foods. Twenty-nine percent of the patients reported sensitivity to alcohol; again this was significantly associated with sensitivity to the three food stuffs, though a substantial number of patients were sensitive to alcohol but not foods. Thirty-one percent of 331 female patients believed that oral contraceptives precipitated headaches, but this could not be related to any dietary response. Patients with affected relatives were significantly more likely to report sensitivity to alcohol and chocolate; sensitivity to cheese and citrus fruit was less strongly related, and there was no relationship at all for oral contraceptives. These correlations suggest that food induced headaches are mediated by chemical constituents common to these foods.
Two groups of normal volunteers had regional cerebral blood flow (rCBF) measured, by the 133Xenon inhalation technique, before and 30 minutes after 250 mg or 500 mg caffeine given orally. rCBF was measured in a third group of subjects, twice, at a similar interval under identical laboratory conditions. Subjects who received caffeine showed significant decreases in rCBF while the others showed no rCBF change from the first to the second measurement. However, the two caffeine groups did not differ in degrees of rCBF reduction. There were no regional variations in the post-caffeine decrease in cerebral blood flow. The three groups did not show significant changes in end-tidal carbon dioxide, pulse rate, blood pressure, forehead skin temperature and respiratory rate.
Feverfew has been used since antiquity to treat fevers and other inflammatory conditions. Feverfew extracts were found to inhibit ADP, thrombin, or collagen-induced aggregation of human platelets, but significantly, did not affect aggregation induced by arachidonic acid. Synthesis of thromboxane B2 from exogenous 14C-arachidonic acid was also not inhibited. Washed platelets prelabelled with 14C-AA responded normally to thrombin by releasing 14C-TXB2. This was completely blocked by feverfew. A purified platelet phospholipase A2 was inhibited by the material with an I50 of 0.1 antiplatelet units. The pharmacological properties of feverfew may thus be due to an inhibitor of cellular phospholipases, which prevents release of arachidonic acid in response to appropriate physiological stimuli.
We detected a significant decrease in plasma thromboxane B2 (TXB2) and 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) levels together with a significant increase in plasma 6-keto-PGF1 alpha/TXB2 ratio in young healthy non-alcoholic male volunteers after acute ingestion of ethanol (1.5 g/kg). Paradoxically, during ethanol intoxication and the following hangover a significant increase in ADP-induced formation of TXB2 by the platelet rich plasma could be observed, which suggests that ethanol intoxication via some unknown mechanism sensitized platelets to produce TXB2. Whether these observations contribute to the increased risks of subarachnoid haemorrhage or ischaemic brain infarction among occasional heavy drinkers recently described by us remains to be proved.