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Re: Migraines and suchJuly 6, 2010

For those of you bored by talk of migraines, I give you my almost-annual reminder that Salt and Vinegar potato salad is AMAZING. Enjoy. Now for the other six of you still reading:

A reader pointed out to me that I owed you all an update on how the migraine diet was going.

Uh. It's not. I made it about two weeks of eating AIR, and gave it up. I found it almost impossible to avoid everything that particular diet wanted me to.

BUT: I switched daily meds (to Nortriptyline) and I've started eating 1oz of dark chocolate every day. I know. Rather than treating it as a trigger, I'm using it as medicine. This makes MUCH more sense, no? This is on advice from my friend Theresa, for whom the practice has really worked -- perhaps she will chime in in the comments with a little bit about what she told me? Basically, you eat it on an empty stomach when you first wake up. Nothing to eat for the next hour. The dark chocolate has to be very simple, and include four ingredients: cocoa, cocoa powder, vanilla, and sugar. Absolutely no milk or protein of any kind (no nuts, etc.); the protein leaches away the . . . (help me out here, Theresa) the good stuff, the phytochemicals. I know you're BLOWN AWAY with how much I know. Oh, stop.

I buy the 100 calorie packs of dark chocolate from TJ's -- one and a half bars is about 1oz, but most days I just have one bar.

The chocolate, I swear to God, seems to be helping. In the last three months, I've had only one migraine, and it was mild and easily treatable by medicine (and it was totally my fault, because I felt it threatening and had a glass of red wine anyway. Dummy).

And get this: The other night I felt one coming on, and I realized it had been a few hours since I ate, so I had a relatively empty stomach. I ate an ounce of dark chocolate. Within 45 minutes, I was fine. People. Whoa. I don't usually GET fine. I usually circle the drain.

Oh, I also gave up caffeine (except for what I get in chocolate). No coffee, no green or black tea. Let's not talk about it. Wah! But honestly, giving it up wasn't as hard as I thought it would be, not at all. Not sure why. Maybe it's just what my body wanted.

Also, THIS IS BIG: I gave up all the meds I was used to taking for headaches. For two and a half months, I restricted myself to Tylenol and Advil -- no rebound drugs (see this NYT article-- includes anything with caffeine, like Exedrin,and my prescription meds like Fioricet). If you take pills for headaches more than twice a week, you might be at risk for rebound headaches. Right after I wrote here about my migraines, I decided to try this. I was popping Exedrin Migraine easily three or four times a week to push back headaches that waxed and waned. As soon as I stopped taking them, I had a 48 hour migraine that was so bad I was halfway convinced I would die. No joke. Every thing I'd read said you have to NOT take your meds for at least two or three months so your body gets over the rebound effect that keeps headaches going. However, going through that migraine was pretty awful. I felt like a junkie: all I could think about was how close my meds were to me -- I could just take one...

But I didn't. And I didn't die. Now, theoretically, my medicine should be useful to me if I take it only when needed (less than once a month, hopefully). And when I did pop a pill for that last migraine, it worked that way. The pain lasted for less than six hours, and it was relatively mild.

To sum up: YEEHAW!

*obviously, I'm not a doctor, nor do I play one on TV. Consult with your doctor before doing anything different or weird.


you have done a great job of explaining rebound headache strategy to folks! and as for the dark chocolate...well, we ALL know how good it is for you...nothing voodoo karma there....glad things are going so well fo ryou in the migraine dept....and yes, your book did make it to Alaska..and yes, I did buy it and read it and thoroughly enjoyed it and passed it on to another and bragged..yeah...I KNOW her! whoot! (I have a pic of me with said book to prove it too!) so...do tell, salt and vinegar potato salad?

I am so glad that you are doing better. I wish I had had this information before as I suffered from incapacitating migraines for decades. The trick for me was to become a recluse and menopause. I still get the occasional one if I get too much people stimulation.

I wish I could send your post to a blogger I adore who has had a headache for close to two years but she has said no advise and
I have to respect that. Rats!

Regarding your book, I borrowed it from the library (sorry but I am flat broke all the time) and thoroughly enjoyed it, even the sexy scenes, which I usually skip. Can't wait for the next one.

Chocolate is medicine! I SO knew that all along... (seriously, great news. That's a strategy I can approve of.)

Rachael, this is great news! I'm so glad you found something that works for you.

Now a question re: "the 100 calorie packs of dark chocolate from TJ's" - what's TJ's and is it local or nationwide? I could handle an ounce of dark chocolate every morning as medicine ~ (big grins, but seriously intrigued)

Sorry, TJ's = Trader Joe's! :)

Wishing you all the best. I have had migraines since I was 11 or 12 I am now 41. As a result I have had numerous TIAs and 2 major strokes. Foods are not a trigger for me, neither are hormones. I have a rare form added with a congenital defect with an artery in my brain.

You are absolutely correct about rebound migraines, however not all meds cause them. I for one cannot go without caffeine. It is the only thing that helps me and that is not saying much. I no longer can recall a time I was pain free. I have seen specialist in 5 states, so for me my only hope is a surgery, which is experimental and I refuse, so I live in pain.

Most migraine meds do not work for me and I refuse all narcotic pain relievers. Decades have, if nothing else, given me a high pain tolerance.

There are so many types of migraines and I do wish you all the best.

I've read your blog for a while but never commented -- I also get migraines and went to a neurologist. Since at the time I was trying to get pregnant I couldn't take any rx medicine or even ibubrofen and she said a study had recently been done showing high doses of magnesium and riboflavin (b2) had a prophylactic effect on migraines. 200 mg mag and 400 mg ribo every day and after a few weeks: no more migraines. And this totally works for me, better than medication, which works but it feels like the headache is just in the background. Taking magnesium makes the headache disappear.

Anyway -- it may not work for you, and you might want to check with your doctor about taking such high doses of the two, but just thought I'd mention it.

I'm very glad to hear you've found some migraine strategies that are working! What wonderful news!

The rebound headache thing makes sense. I don't get migraines (thank God!) but do get 'regular' headaches a lot, and for several months was basically addicted to Tylenol--when my last dose wore off, I would get a headache again. Silly that I never put it together that it was about rebounding until I went to the doc to ask about the headaches and he suggested giving up the Tylenol cold turkey...by golly, it worked! Now I am much more careful about how often I consume painkillers, even (especially) over the counter ones!

I'm glad this worked for you. I would just like to add that when I worked at a chocolate store they told us chocolate has tons of magnesium. So maybe that's one of the reasons it helps?

My 8 yr old daughter (Clara) had a headache and told me, "I think I might die." I said, "Oh sweetie, you have a migraine." It's horrible to know I passed them down to her. Unfortunately, she doesn't like dark chocolate.

Eating air just isn't good enough. And then you get a headache from low blood sugar (or I do, anyway).

Hey! I stopped caffeine too! Except for those two days with little coffees last week. And the bits of chocolate I eat. And the green tea I'm drinking right now. Other than that, it's been just over a month! Hmm, maybe I'm not really off caffeine. Just much much lower and sporadic instead of every single morning.

Hurray!! So glad to hear you're getting major relief from the migraines. Life is so much better when you're not in pain, or anticipating the pain, or worried that what you're eating/doing/breathing could bring on the pain. And very neat that it's chocolate which helped -- a prescription I wouldn't mind taking!

Chocolate was my miracle cure. No doubt about it. I get menstrual migraines, and after speaking to a woman who wrote a book about the history of chocolate (tough gig, right?), I investigated some of her claims a little more closely. What I heard and read was so promising that I thought it was worth a try, and I'm so glad I took the chance on it.

I have 1 ounce of 70% (or higher) dark chocolate every morning, first thing on an empty stomach. It's very important that the chocolate doesn't contain any milk proteins because they interfere with the absorption of the phytochemicals. Otherwise, Rachael explained it well.

I haven't taken anything stronger than tylenol or advil since starting the chocolate, and that's going on two years. The only migraine I've had in that time period came when I was trying to cut calories and so started skipping the chocolate. I went right back on the chocolate and it worked right away. The only other things I do -- I avoid salt and eat more chocolate at the time when I would normally get a migraine.

My migraines were debilitating. Now they're gone. I doubt whether this would work on other than menstrual migraines, because what the chocolate is doing is toning your hormones a bit. Taking the finger off the trigger, you might say.

Anyway, Rachael, I know I came over like some kind of demented chocolate evangelist when I was explaining all this to you in April, but I'm very glad it's working for you. Here's hoping your head continues to be pain-free! ((hugs))

I'm so happy for you! I may have to try this myself. A world without migraines is a wonderful thing.

I don't actually like dark chocolate, but I'm definitely going to try this! I'm a little nervous about going without the caffeine, though. :-)

I'm also going to ask my doctor about the Nortriptyline meds. I gave up on rescue drugs a long time ago because of the rebound headaches. But the only preventative drugs I knew about were beta blockers (which I hated) and anti-seizure meds (which sounded a little scary).

Thank you so much for giving us your updates!

I'm so glad you found something that works. Menopause cured my migraines but it was a long to time to wait for a cure.

Glad it's working!!!

I buy the bulk pro packages of 99% and of Natural Cocoa Powder from Scharffenberger. I have a ziploc of 99% 5-gram squares here next to the computer. About 1.5 grams will take the edge off and a really bad headache requires about a quart of strong cocoa (just a bit of hot water, 2 T. cocoa powder, stir to mix, add milk, heat) and 15 grams of 99%. No sugar needed.

I'm dealing with recurring meningitis-like fevers and inflammation due to cracks in my skull -- since my teens -- plus conventional migraines and ocular ones due to the cancer tumor. Biofeedback and acupressure are amazingly helpful, too.

The chocolate is way more effective if you hydrate seriously after eating it.

Magnesium citrate, B complex, CoQ10, fish oil, D3, K2, and potassium all can help.

Dark chocolate can raise your HDL (good!) and, if you take vitamin C with it, the iron in the chocolate can be a good thing if you're anemic but a bad thing if you have too high an iron level. Keep an eye on your serum iron just in case. Have your ferritin checked, too, to make sure it's okay to be ingesting a bit more iron than usual.

You getting any exercise?

I'm happy to hear that you finally found something that works for you! It sounds like it has been so frustrating and painful for so long.

Although this involves drugs, I thought I'd share. I've suffered from migraines for about 18 years - pain almost always on the right side of my head/neck. They've lessened with age/perimenopause, but still too many. Back in March I had an urgent care appointment and saw a different doctor in my group. When he heard I'd had a headache for three days, he looked up my nose and saw the right side was inflamed - prescibed antibiotics and a nightly Zyrtec. Said low level allergies may have led to chronic, low level infection. So I took the 5 day dose of antibiotic and have been taking a nightly Zyrtec and have had only one headache in the last 4 months. Amazing for me. I've even been able to start having the occassional glass of red wine without penalty. I'm kind of pissed that after all this time, the remedy seems to have been such a simple one, but more than that, I am grateful to be pretty reliably pain free!

Not eating sugar and increasing magnesium has worked for me with migraines. "Circling the drain" - I like that expression. Never heard it before. Have you read the Oliver Sacks book on migraines called: Migraine. I haven't but it is supposed to be good. I'm glad that you are feeling better.

Oh my gosh--I'm SO glad for you! What a great thing, to have found something that works on your migraines.

Interesting, too--my periods have been getting milder as I move into menopause, but this past time, I had no cramps whatsoever. And was eating a fair amount of dark chocolate. Coincidence?

FWIW, I went through the rebound withdrawal almost 10 years ago. At this point, the "rules" that work for me are: Excedrin no more than twice a week, and NOT two days in a row, and I had to give up the Fioricet altogether. On a betablocker and Effexor as daily prevention...Imitrex or the like as needed.

Glad to hear your migraines are more under control. Mine seem to have flared up this summer (I get weather-related ones, as well as hormone-related ones), so I started up with my B2 supplements again, but I might add in the dark chocolate as I'm curious if it'll help too. I don't like to take meds if I can avoid it, but sometimes you just gotta.

So YAY to chocolate helping with something! :-)

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Rachael loves it when book clubs read her work! She's happy to attend book clubs that read her books either in person or via Skype. Contact her at rachael@rachaelherron.com to make arrangements.


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