From Web MD

In a nifty piece of detective work, doctors at Catholic and La Sapienza universities, Rome, identified a hidden gut problem as a potential cause of migraine headaches. The gut problem is called celiac disease or gluten intolerance. Celiac disease can cause severe symptoms — but sometimes the symptoms are hard to detect. Even in people with no obvious symptoms, it has been associated with many kinds of nerve and brain problems. Might celiac disease also cause migraine? Maurizio Gabrielli, MD, and colleagues compared 90 migraine patients with 236 healthy blood donors. They found that the migraine sufferers were 10 times more likely to have celiac disease than the healthy donors.

“Our results suggest that a significant proportion of patients with migraine may have celiac disease,” Gabrielli and colleagues write in the March issue of The American Journal of Gastroenterology. The cause of celiac disease is sensitivity to gluten. Gluten is the protein in grains that lets bread rise. A gluten-free diet cures the disease. Could it cure migraine? Of the 90 migraine patients in the study, four had previously undiagnosed celiac disease. All four went on a gluten-free diet. It cured migraines in one patient. The other three had fewer headaches — and when they got migraines they were shorter and less intense. This might have been the famous placebo effect. But Gabrielli’s team used SPECT scans to look at the patients’ brains blood flow. The gluten-free diet improved blood flow in the brains of all four patients. If larger trials confirm these preliminary findings, the researchers suggest, people with migraines should be tested for celiac disease. For those found to have the problem, it may be a cause of their migraines and a gluten-free diet could help — or even cure — them.

Dr. Perlmutter’s comment:

Simply stated, all headache patients should have a simple blood test, antigliadin antibody, to check for gluten sensitivity.

From

ScienceDaily

It may be worthwhile to consider how much wheat you eat if you suffer from headaches or lack of coordination and have gluten sensitivity.

Researchers found that removing or cutting back on gluten a protein in wheat and other grains –in the diet greatly reduced these symptoms among a middle-aged study group.

The study was reported in the latest issue of Neurology, the scientific journal of the American Academy of Neurology. The study reported 10 patients with gluten sensitivity whose MRI (Magnetic Resonance Imaging) tests suggested inflammation of the central nervous system. All had experienced occasional headaches and some suffered from unsteadiness and failure of muscle coordination. After removing gluten from their diets, nine of the 10 patients in the study found full or partial relief. One patient would not try the diet.

In one of the cases, a 50-year-old man developed headaches and nausea along with confusion and agitation. He had experienced episodic headache for four years but then the attacks progressed in frequency and severity. After starting a gluten-free diet his balance improved rapidly and his headaches cleared completely. After a relaxation of the gluten-free diet, his intermittent headaches returned.

In a similar case reported elsewhere, said study author and neurologist Marios Hadjivassiliou, M.D., a 45-year-old man had suffered from migraine since childhood, and that over time his attacks had become more severe and resistant to treatment. Following the diagnosis of gluten sensitivity and introduction of the gluten-free diet, his headaches were resolved.

“Removing the trigger factor, in this case gluten, may be a therapeutic intervention for some patients with gluten sensitivity and headache,” said Hadjivassiliou.

The diagnosis of gluten sensitivity and gluten-related neurological dysfunction relies on the presence of antibodies. In addition, certain genes make some individuals more susceptible to gluten sensitivity.

From Medscape Medical News

The antioxidant CoQ10, or ubiquinone, wards off migraine attacks in patients, according to research presented here at the American Academy of Neurology annual meeting.

“Coenzyme Q10 proved to have a significant effect in reducing migraine propensity and had an extremely favorable side-effect profile,” lead author Peter S. Sandor, MD, research fellow in the neurology department at University Hospitals in Zurich, Switzerland, said during a presentation.

Dr. Sandor theorized that migraine may be caused by a decrease in mitochondrial energy reserve, and that CoQ10 serves as an energy boost in the brain. The substance was found useful in a previous open-label study in 2002, he said.

The researchers conducted a double-blind, placebo-controlled study of 42 people who suffered an average of 4.4 migraine attacks per month, with or without aura. No other form of migraine prophylaxis was allowed during the study.

After a month of a baseline placebo, patients randomly assigned to the treatment group received 100 mg of CoQ10 three times a day, while the remaining patients continued to receive placebo. A liquid, water-soluble form of CoQ10 was used for better diffusion into the cells, Dr. Sandor said.

Approximately 48% of those who took CoQ10 had a 50% response rate during the three-month study, while this occurred in about 14% of those taking a placebo. “That is a 33% therapeutic gain,” Dr. Sandor said. “You would need to treat three patients to have one successful.”

The number of migraine attacks per month was reduced in the treatment group from 4.4 to 3.2, with no change in the placebo group.

In addition, participants receiving CoQ10 also had fewer days with a headache and fewer days with nausea.

Adverse effects were minimal, although one patient developed an allergic skin rash and withdrew from the study. However, these effects are mild compared with those of other medications to prevent migraine such as beta blockers, Dr. Sandor pointed out. “This is an extremely important point,” he said, “How often do we treat young females? We do not want to give substances which may be teratogenic.”

The study was well conducted and had a solid methodology, noted David Dodick, MD, an associate professor of neurology at the Mayo Clinic in Scottsdale, Arizona, who moderated the session.

“It seemed to have a robust, statistically significant effect over placebo,” he told Medscape.

If the findings can be replicated in a larger clinical trial, CoQ10 may provide an alternative to migraine sufferers who do not like taking prescription medications and would prefer a natural alternative, Dr. Dodick said.

However, the researchers used a liquid formulation not equivalent to what is currently available in the U.S. “The data is not generalizable to what a patient would buy in a pharmacy,” Dr. Dodick noted. “You can’t just buy the tablets and get an effect.”