The problem with migraine, as with many chronic diseases, starts
with its definition. Only defining the cause (not a trigger) we can
successfully treat it; hence, the definition should point to the
roots of the disease. Regrettably, the usual definition
of migraine is a headache of a chronic neurological kind and immediately,
a description of the symptoms follows. We get to know what we have
already known through our own experience: that migraine is a
headache (what else?), that it is chronic (of course, if it hits us again and
again), and that it is of neurological kind (what can be more neurological than
the brain where it occurs?). A medical dictionary on line also states:
"For many years, scientists believed that migraines were linked to the
expanding (dilation) and constriction (narrowing) of blood vessels on the
brain's surface". This statement can only prompt several
questions. If they "believed", then what is their opinion
now? What makes the vessels expand and constrict so wildly that it causes
headaches? We are not born with migraine, and may happily live years or decades
not knowing what a headache is. Does it mean that at some point, our vessels
get crazy and start to expand and narrow without any reason? Let's find the
cause for this and try to eradicate it. Science and Reason are inseparable –
this is a maxim, and therefore only true science can help us.
Yet, another puzzle comes. Right after mentioning the vascular
connection, medical sources point out the level of serotonin as
the trigger of a headache. What is serotonin? The dictionaries are very precise
in that: a neurotransmitter (a chemical released by nerve cells) that passes
impulses (messages) from cell to cell and thus, from organ to organ. Thus, we
can make a more precise statement: migraine is a headache related to
the change of vascular tone due to the change of serotonin levels. Simple
logic says that we need to look for the ways of stabilizing the serotonin
levels and thus find the remedy for migraine headache. It turns out that the
drug industry has already found the way to target serotonin. In fact, there is
a whole group of drugs (Sumatriptan) - serotonin agonists. The term
'agonist' means that the medication is SIMILAR to the structure of serotonin.
The majority of the existing drugs are blockers, and many of them have
therefore the prefix ‘anti’ – antihistamines, antibiotics,
antihypertensives, etc. Even if there they do not have this prefix,
the effect of the drug is still to block. The group of
serotonin agonists does not block the pain; these medications work SIMILAR to
serotonin. Please pay attention to that: what causes the headache
is treated with the medications with similar effects!
Strange? No. The
explanation will come later on. For now, please, remember this fact.
To stop the serotonin leakage, we need to know WHY it starts to
pour out of the cells. Medical sources from basic sciences teach: serotonin
levels depend on histamine levels ( Mansfield , I. The role of
antihistamine therapy in vascular headaches. JACI 2001:107:595-601). This means
that histamine, another neurotransmitter, regulates the production of
serotonin. This, actually, makes it superior in the production of migraine. Medical textbooks provide
us with another important fact - histamine regulates the production of
practically all other neurotransmitters. ( Wada H. et al. Is the histaminergic
neuron system a regulatory center for the whole brain activity? Trends in
Neuroscience 1991; 14:415-8; Knigge U. The role of histamine in the.... Acta
Endocrinologica, Copenhagen 1991:124:609-19). Look at the dates of those
publications: at least for two decades, the fact of the histamine's superior
role in the brain activity and in the production of vascular headaches has not
been a secret for a long time, and yet, it is not entered in medical
dictionaries. In fact, this information is much older. In the 50s, the famous
American neurologist Bayard Horton was honored to have his name given to a
vascular headache formerly called "histamine cephalalgia"; the name
comes from Greek roots meaning pain in the head. This old name of a vascular
headache again brings us closer to its origin – histamine.
Basic sciences indirectly prove the leading role of
histamine in the production of headaches by recognizing the prime effect of
histamine upon the vascular tone. Here is an example. An anaphylactic shock is
an allergic reaction. The central substance in any allergy is histamine – the
fact known to every lay person. What is the central symptom of an anaphylactic
shock? Low blood pressure; it happens because the excessive production of
histamine expands the vessels. Thus, descriptions of vascular headaches as the
result of serotonin fluctuation look strange if not unscientific. Science needs
to center on the main phenomena when explaining any process, while the
secondary events should be given as accompanying ones. It is obvious that
serotonin levels and effects are secondary to the effects of histamine.
Questions arise: what is this evil substance - histamine? How
can it be evil if it is “the center of the whole brain activity?” It is of
interest that although dictionaries and various medical sources almost never
mention histamine as the central neurotransmitter "guilty" of
headaches, practically all of them warn against eating foods that provoke
headaches due to their ability to increase the production of histamine in the
body. Medicine often surprises us, and it does not fail to surprise us in the
case of migraine. Strangely, the list of those harmful foods contains the
healthiest ones: fish, red meat, strawberries, citruses, nuts, hard cheeses,
red wine, chocolate, beer, honey ... It does not make sense: the foods, which
are supposed to be a necessary part of our every day diet, do the opposite -
lead to pain and suffering. This raises more questions: why are the effects of
histamine so good for the majority are headache-provoking in others? The answer
will determine what differs the people with migraine from those who do not have
it and thus help find the key to the migraine problem.
All advice on migraine prevention contains suggestions to
avoid histidine-containing foods, and all the above
named foods contain histidine. What is histidine and what is its relation to
histamine? The main building blocks of a live body are proteins, and they are
made of amino acids. 10 of them, including histidine, are called essential
amino acids. They are not produced by the body itself and are
derived from foods that contain their precursors. Histidine is a
precursor of histamine. When histidine gets into the body, it turns into
histamine. Any migraine sufferer can ask a logical question: can I prevent
migraines by completely avoiding those foods? No is the answer. There is no
life without histamine. Its very name starts with 'hista', which means tissue.
Not a single tissue in the body is able to function without histamine; each
cells produces it. As the only source of histamine is histidine-containing
foods, we cannot avoid them. We need them. Bewildering.
As the regulatory neurotransmitter, histamine supervises the
production of others. Vascular tone, muscle tone, production of hormones,
functioning of gastrointestinal system, sleep and awakening, immune processes,
etc. – functioning of all organs, including brain, cannot occur without active,
often governing participation of histamine. Therefore avoidance of
histidine-containing foods is harmful. Histamine is needed for the
body’s vital functions, and this makes unscientific the advice to stay
away from histidine-containing foods.
Nature has played a nasty trick on those with migraine by
creating this paradox: what is supposed to be good for the body works
against it! And, migraine sufferers are not alone in this: the long
list of symptoms that may occur in response to products with high histidine
content includes nasal congested or runny nose, watery/itchy eyes, itch,
agitation or its opposite - sleepiness, stomach pains or discomfort, etc. These
symptoms are often familiar to migraine sufferers. We have come to
the surprising conclusion: something is wrong with the body's handling
histamine and not with the foods. LET US SUMMARIZE: Migraine is a vascular
headache. Vascular tone depends on the regulatory neurotransmitter histamine.
Histamine is produced in the body from histidine. Histidine is a substance
contained in foods. The healthier the food, the more histamine it contains.
Paradox: instead of thriving on the healthiest foods, some people get migraine
and allergy symptoms when consuming them. We cannot deprive ourselves of
histidine-containing food and hence, we need to look for another solution of
migraine problem. We need to try making our body react to such foods
properly. We need the way to curb histamine effects in the
body.
We will discuss it next time.