A Spoonful of Sugar…
“A Spoonful of Sugar Helps the Medicine go Down” the famous line from the ‘Mary Poppins’ movie.
Taken literally, yes, taking medicine with something sweet such as a yoghurt can make it go down easier, especially the larger tablets. Taken figuratively, as in Mary Poppins, and indeed Snow White, whistling or singing or doing something pleasant to distract yourself while doing a chore or feeling particularly down, in pain and migrainey, can really help!
What we’re speaking about here however is not figurative, it’s … supercalifragilisticexpialidocious
This time of year, food is one of the foremost things on our minds, and most of the foods we buy for the season unfortunately contain copious amounts of sugar. However, it’s not just food, it’s everywhere! On our Christmas Trees (Candy Canes), in our movies (Willy Wonka and Chitty Chitty Bang Bang) and is even in our more traditional yuletide entertainment.
Welcome to the Land of Sweets!
Let me take you to another land – one filled with colour and mystery, with biscuit mountains topped with whipped cream snow, children made of gingerbread, candy canes that dance, and icing sugar floating down from clouds of marshmallow, as the Sugar Plum Fairy flies across her realm making sure all is right with the world!
This fantasy is from Tchaikovsky’s famous Yuletide ballet The Nutcracker, when the heroine, a young girl called Clara is whisked away to the Land of Sweets after defeating the Mouse King. As a celebration of her bravery, the Sugar Plum Fairy treats Clara to dances the Dance of the Sugar Plum Fairy and Clara is lead safely home by The Nutcracker. What do all these wonderful visions have in common? One word… Sugar!
Why do we need Sugar?
First, what exactly is sugar for? Our bodies need one form of sugar to survive – ‘Glucose’. It is the number-one brain food and one of the most important fuel sources for our body. We don’t have to add glucose to our diets because when the body breaks down things like carbs and fats it can make glucose out of them.
The hormone ‘Insulin’ is created in the pancreas to regulate the movement of glucose and allows it to enter blood cells to create energy for the body. When the pancreas can’t produce enough insulin, or the insulin can’t be used properly to create this energy it can cause diabetes.
So, what about Sugar and Migraine?
Sugar is present naturally in many foods and is one of the most difficult things to avoid when trying to watch your diet whether it’s for weight loss, diabetes, or migraine.
One thing to remember is that anything in the list of ingredients on a food product that ends in OSE is a sugar, e.g., fructose, lactose, sucrose, and indeed glucose.
Sugar, like caffeine can be a double-edged sword for migraineurs. On one hand too much can trigger attacks, on the other, a drop in blood sugar can be a massive trigger, especially if meals are skipped or after physical activity like sports, so sugar and migraine can be a complicated relationship.
In his book The End of Migraines- 150 Ways to Stop Your Pain, Dr. Alexander Mauskop says that “three quarters of people with Migraine have” what he calls “reactive hypoglycaemia”[1]. He explains that “blood sugar drops too low after eating” a high carb meal. He also stated that Migraineurs “have a higher incidence of Insulin resistance”[2], which means your cells need more than the normal amount of insulin to regulate the glucose in your blood.
Dr. Mauskop suggests that there is evidence that a Ketogenic Diet may be a good option for migraineurs but cautions the difficulties in keeping to such a diet for more than a month or too.
Four ways Sugar may Trigger Migraine
With thanks to Eileen at Migraine Strong or allowing us to use information from some of their articles. – To read their full article see here https://www.migrainestrong.com/sugar-and-migraines/]
1 Fluctuating Blood Sugar levels.
Our bodies maintain a stable level of sugar in the blood so that it can fuel our brain and organs, allowing them to do what they need to do to keep us alive. People with migraine have a brain more sensitive to changes than people who don’t have migraine, therefore these fluctuations may not even get noticed, but for migraineurs it can be the opposite.
2 Inflammation
Sugar may be an inflammatory[3] food like some other foods such as red meat, white bread, etc. In fact, some scientists believe that the rise in consumption of sugary foods more than coincides the with rise in inflammatory diseases.
3 Other triggers in Food
Sugary foods contain other potential Migraine triggers – foods such as Caffeine, cheese, chocolate, nuts, MSG, red meat have all been implicated in triggering migraine
4 The Migraine Prodrome – Migraine Attacks can come in phases. For more information on the phases of migraine see our article https://migraine.ie/2020/11/the-phases-of-a-migraine-attack/
The first phase of an attack is called the Prodrome and usually occurs hours or days before the headache phase of an attack. Food cravings are one of the most common symptoms of this phase. Most people crave sugary foods, such as chocolate and after eating the bar in the fridge, the headache comes on. They naturally blame the chocolate, but they were already in the migraine when they had the cravings.
So, what can be done?
Figuring out triggers can be a huge help. If you have food triggers, then they can be avoided or at least reduced. The diary – which we are happy to send you – can be very helpful for figuring out these things.
Keeping any eye on your migraine threshold – you might be able to tolerate one or two triggers like a busy day, or skipping one meal, but those combined with a late night may send you over the threshold and trigger or worsen your migraine.
Keep the Pie close by! Sorry what?! Pie, as in cake, dessert, sweet food? Nope, sorry not that kind of pie. I wish!
The pie I’m talking about is again another tool borrowed (with permission) from our colleagues at Migraine Strong.
The Treatment Pie
The Treatment Pie was developed by Migraine Strong to show the need to treat migraine or in their words ‘attack migraine using a multimodal approach’. As you can see the Treatment Pie includes everything that may influence how you live with your migraine.
Medication – Acute and preventative medications are probably the go to treatment for most of us. Knowing when and how to take your meds is important.
Miscellaneous – This slice of the pie covers alternative or complimentary therapies such as massage, acupuncture, dry needling, etc
Hydration – Everyone who is anyone with migraine is probably sick to death of hearing about making sure they drink enough water and keeping hydrated, but dehydration truly is a massive trigger for many migraineurs
Meditation – Using exercises like breathing or mindfulness to look inward and induce calmness, serenity and learning about yourself, can be very relaxing, and in turn reduces stress which as the number 1 trigger for migraine.
Therapy – there are several kinds of therapy that might be helpful, Cognitive Behavioural Therapy (CBT), Biofeedback, Acceptance and Commitment Therapy (ACT), Hypnotherapy are just a few.
Sleep – The importance of good sleep hygiene cannot be stressed enough. A regular routine for sleep is essential to help with migraine. Too much or too little sleep can be detrimental to migraineurs.
Diet – What we eat can have an influence as we can see above. Actual food triggers are only implicated in 20% of migraine cases. Routine mealtimes, not skipping meals, eating foods rich in magnesium and other vitamins and minerals can be helpful.
Movement – Movement makes the headache of migraine worse, strenuous exercise is a known trigger as it can dehydrate you, lower your blood sugar and if it contains a hard physical impact can cause pain. However aerobic exercise and exercise with smooth movements have been shown to benefit migraineurs.
Supplements – The supplements taken most often for migraine include Magnesium, Vitamin B2 (Riboflavin and Co-Enzyme Q 10. Others such as Vitamin D, turmeric and ginger may also be helpful.
One slice or two?
Most people try one thing at a time, but some experts recommend trying multiple treatments together and basically bombard migraine so that the treatments will be more effective. So don’t be afraid to take more than one slice from this particular pie. You won’t OD on sugar or carbs, and it might be good for your health!
Art by Carl Warner – https://en.wikipedia.org/wiki/Carl_Warner supplied by https://abstract.desktopnexus.com/wallpaper/1601621/
The information contained in this article is for information purposes only and not intended to replace medical advice or diagnosis.
[1] Dexter JD, Roberts J, Byer JA. The five hour glucose tolerance test and effect of low sucrose diet in migraine. Headache. 1978 May;18(2):91-4. doi: 10.1111/j.1526-4610.1978.hed1802091.x. PMID: 649385.
[2] Fava A, Pirritano D, Consoli D, Plastino M, Casalinuovo F, Cristofaro S, Colica C, Ermio C, De Bartolo M, Opipari C, Lanzo R, Consoli A, Bosco D. Chronic migraine in women is associated with insulin resistance: a cross-sectional study. Eur J Neurol. 2014 Feb;21(2):267-72. doi: 10.1111/ene.12289. Epub 2013 Nov 15. PMID: 24238370.
[3] Malhotra R. Understanding migraine: Potential role of neurogenic inflammation. Ann Indian Acad Neurol. 2016 Apr-Jun;19(2):175-82. doi: 10.4103/0972-2327.182302. PMID: 27293326; PMCID: PMC4888678.
