Magnesium is an incredibly important supplement in our bodies, especially if we have migraine. Many studies have found that taking daily magnesium can help reduce migraine attack frequency and intensity. Typically the dose is 400-500mg/day for prevention, and then more for an acute dose if you’re trying to stave off an attack.
Types of Magnesium for Migraine
Magnesium Oxide
Magnesium oxide is the most common form of magnesium found in most stores, and if you pick up most drug store magnesium, it will likely be oxide. This is an affordable option and it’s in Class A of supplements, meaning it’s safe during pregnancy.
Magnesium Glycinate
Magnesium glycinate is the slightly less common form of magnesium, however its still easily accessible and does not cause the stomach upset that oxide does!
Magnesium Threonate
AKA CogniMag is something that many in the Vestibular Migraine community swear by for grain fog! IT’s a slightly different make up of magnesium and helps with improving cognition.
Magnesium in Foods
Many common foods are high in magnesium, and if you’d rather just try to eat enough throughout your day, you are welcome to try. The most common foods with high magnesium are beans/legumes, nuts and seeds, fiber-rich whole grains, dairy products, and many leafy greens. Although it’s entirely possible to get enough magnesium in your diet this way, it’s unlikely enough for a person with vestibular migraine, as a person with VM is typically low in magnesium, even if they eat a well-rounded diet.
Magnesium Spray
Magnesium spray is a topical form of magnesium that can help get magnesium into your bloodstream, without ingesting it orally. Because so many people are sensitive to magnesium in their gastrointestinal system, it’s not always an option to take it orally, even if you want to. A great place to start, other than your diet, are topical options! 4 sprays of this, on your skin, provides 66mg of magnesium! Although it’s a ways to get up to 400, it’s an excellent place to start!
Magnesium Lotion
Magnesium lotion, similarly to spray, is another topical option for you. This way, you won’t have gastrointestinal upset, but will still be able to increase the amount of magnesium your bloodstream absorbs. Additionally, it is a great way to practice self-massage on your neck. Take some of this cream, dab it on your neck, and rub your neck and shoulders for a neck-pain-relieving massage.
Magnesium Bath Soak
Sometimes when you are having a high pain migraine day, there’s nothing better than a warm bath. Pop this magnesium bath and foot soak in a bath of warm water and relax!
Magnesium Roller
The last option for non-oral magnesium is a roller. You can roll this anywhere on your body, it can sometimes help with sleep when put on your temples, or head pain relief!
Receiving a new diagnosis, one that you understand you have to live with forever, is jarring news; news that you likely never thought you were going to get. Accepting that you are now living with a chronic illness is not something easy to do.
As you probably know by now, I treat vestibular disorders but I do not have a vestibular disorder. However, I do want you to know that I write this post from a place of learning acceptance as well. Although I am not dizzy, I do have a chronic illness, Hashimoto’s Disease. It is a fairly common condition that affects your thyroid gland, and, similarly to Vestibular Migraine, affects 1-2% of the population annually. Learning to cope with a chronic illness is a process – it is not one that happens overnight, sometimes it can take years.
For instance, it can be really difficult to distinguish between life fatigue and fatigue that happens because of your diagnosis. It can be hard to learn your food triggers, because it may be something you’ve been eating your entire life and haven’t thought twice about it. And, largely, it can be hard to make a change when you’re so used to living with something that may have been left untreated for a long time. Accepting that you have a diagnosis is the first step in many senses, especially when it comes to living with a vestibular disorder.
Receiving an Accurate Vestibular Diagnosis
Vestibular specialists are hard to come by and when you finally find one, it’s likely that you have seen many other practitioners beforehand that have told you that you’re ‘totally normal’ or that ‘it’s all anxiety.’ The most common vestibular diagnoses are Benign Paroxysmal Positional Vertigo, Vestibular Neuritis, Vestibular Migraine, and Meniere’s Disease. There are many others, but they’re much less common.
Remember that vertigo is not a diagnosis, it’s a symptom. So, if you’re receiving the diagnosis of vertigo from your provider, either ask for another diagnosis or find a different provider.
When you receive a diagnosis, read up on it to make sure you fit the profile. For example, if you receive the diagnosis of BPPV, but your vertigo isn’t positional, try to seek another diagnosis. If your diagnosis does seem like you, congratulations on finding out the WHY of it all, even though it means you have to now deal with this new thing, it does not define you and it means you can start working to manage your symptoms.
Learning about your diagnosis
Every vestibular disorder is different. There are different symptoms, protocols, dietary needs, and lifestyle changes that are required for each one. Luckily, there has never been more research on vestibular disorders and their needs than there is right now. A great starting point for learning about your diagnosis is right here on this website. Under the “Dizziness” tab you can find the name of most vestibular diagnoses and definitions, treatments, and more. Before you make any changes, it’s best to learn what will actually help.
Because no two people are the same, it may be ineffective to ask others who have the same diagnosis and copy them exactly. Some people may be gluten sensitivity, while others are not. It’s important to keep in mind that your vestibular diagnosis is your own and that although others may be similar, no one else has the same treatment plan as you do.
How to Best Use Support Groups
Support groups can be the best and the worst tool at the same time. It’s vital to find community, relate to others, and ask for advice from others who know, and for that, I absolutely love a good support group. However, spending too much time in a support group, especially one where things may not be too positive, can be really frustrating. Know when you need to take a step back from the group if it feels like it’s becoming overwhelming or negatively affecting your psyche. You are more than your diagnosis, and although it’s important for you to have a community around you, it’s equally important that you are able to focus on non-vestibular aspects of your life.
Asking for Help (& Accepting It!)
You are not a burden on anyone. When you receive a diagnosis, your mind, body, and soul will go through many changes. You may not be able to do as much as you were able to, and accepting that new reality, having to do less throughout your day, and you may need to ask for help. As humans, we want to be as independent as well can, and do everything by ourselves – that starts when we are about 2 years old and never really stops. Asking for someone else to go out of their way to do you a favor, or to take on more than their normal load can be difficult. However, I’d like you to think of this backward.
If your best friend, neighbor, partner, child, or family member got sick or was going through something new and difficult, what would your initial thought be? Take a second and think about that.
I’m willing to bet the first thought that came to your mind was that you would want to help, right?
As much as we want to be independent, we also want to help. We are not as individual as we want to believe that we are. The “it takes a village” mentality is very real, and even when it’s hardest to admit, we do need help and people LOVE to help. If you find that by the end of the day you’re absolutely exhausted, you cannot manage to do anymore, but you still need to make dinner, ask for help then – but only the first time. I say this not because you shouldn’t ask for help making dinner, but because you should ask for help before you think you need the assistance.
We cannot give from an empty glass. You get one full glass a day, and prior to chronic illness, it’s likely that your cup was much bigger than it is now. Everything can take from your cup, doing laundry, walking the dog, getting your kids ready for school, brushing your teeth, eating, working out, and more. Every single thing you do takes energy. What things can you ask for help with? Can someone else walk the dog and make breakfast? Can you meal prep one meal so it makes it easier for you during the day?
Try making a list of all the little things you do throughout the day. Eating, cooking, laundry, dishes, and other small tasks – ask for help with those throughout the day so you’re able to make it to bedtime. Quit while you’re ahead, and your body will thank you for it later.
When you have a new diagnosis, managing the news, your new routine and your body’s needs might be enough to run your cup out of energy, however, there are ways to create a bigger cup, over time.
- Taking help, especially at first, with any task that seems daunting.
- Prioritizing movement – exercise can, over time, increase the size of your cup through strengthening and cardio.
- Find triggers for you – food, weather, stress, and hormones are big ones to be careful of
Remember, other people like to help. Good friends want to be there for you. Your partner can pick up some extra slack.
Setting Boundaries
It seems like the last few years everyone has really started to talk about boundaries, what they are, why they’re important, and how to ask for one. And, whoever these people are who created this term, are right – boundaries are really important. They’re important with family, romantic relationships, friendships, pets, and with yourself. A boundary is a limit that you set for yourself within a relationship. A person who has healthy boundaries is able to delve into intimate relationships and new experiences when they want to but also knows themselves well enough to set a limit for when they want to say no.
I want you to consider your own boundaries. Do you have them within your friendships or with family members? Do you have boundaries set when it comes to experiences, like you would never go skydiving? Are you able to open yourself up to others to ask for help when you need it? Do other people in your life have healthy boundaries? If you are sure you have healthy boundaries, that’s great! You are able to say no to a friend or family member if they ask you to go to a crowded gala where you are not comfortable, for example.
However, if you find yourself thinking that you may not have boundaries for yourself, try and think of a few that may help you. These do not have to be perfect or concrete the first time. These can fluctuate over time, and that is okay and normal. Start small, and try to be consistent. Boundaries can become habitual if they are repeated many times.
For more information on setting better boundaries, read this article.
Changing What You Can Control
When you ask for help and set a few boundaries, you have made an active change – that is excellent. You can only control yourself. Your actions, your emotions, your choices. It’s important to remember this because other people may be at the source of your symptoms, but you can choose who to be around, within reason. Choose yourself first.
If you notice that really big box stores are a trigger for your symptoms, you know you cannot control the fluorescent lighting and tall aisles. However, you can choose to wear a hat, Migraine Shields, and earplugs. You can also ask if someone else can go to the store for you, or use a store’s storefront pick-up or delivery options. Small changes in these actions will both use less of your cup and simultaneously relieve the stress of another errand that may make you increasingly symptomatic.
Focus on what you can do, instead of what you cannot control.
Although you cannot be in control of others, you can control you. If large crowded areas where people are darting across one another are problematic, avoid the mall during peak hours. Talk to your family about screaming and yelling in the house – little kids may seem like they don’t understand, but they do listen, and most of them want to be treated like an adult. Talk to them individually, or as a family, and share with them what’s going on with you, and why their parent needs a little extra help or quiet time sometimes.
Accepting What is Out of Your Control
Not everything is in your control, we learn this from a young age. As much as we may enjoy micromanaging and trying to get everyone on our page, it’s just impossible. There is always going to be crazy carpet at hotels and in airports, airplanes are going to his turbulence, and the car in front of you may unexpectedly slam on their breaks. All of these may be triggers for you. Remember to stay calm, and breathe through the moment. Moments like these are always going to happen, and stressing out about what might make you dizzy or otherwise symptomatic will bring on your symptoms more than the event itself. Being stressed out can cause dizziness, and increasing that anxiety can only make things worse.
Here are a few tips to help you get through moments of chaos
- Take a step outside. You do not need to be present in these moments, people understand that you may need to leave. And if you do not feel comfortable explaining, excuse yourself to the restroom.
- Practice grounding standing up. Root your feet into the floor, breathe in through your nose, hold, breathe out, hold. Each should be for 4 seconds, for a total of 16 seconds per breath.
- Block time on your work calendar throughout the day, 15-30 minutes, to take time for yourself if needed.
- Take a walk alone, or with a friend, to clear your head.
Vestibular Migraine, as I’m sure you know by now, can be incredibly challenging to manage. Between weather changes, hormone changes, food triggers, and decreasing your caffeine intake, ‘a challenge’ doesn’t even begin to describe it. There’s a new study that I wanted to bring your attention towards, Dietary alteration of n-3 and n-6 fatty acids for headache reduction in adults with migraine: randomized controlled trial.
This article is interesting because instead of taking another thing out of your diet, it talks about something you can and should eat more of – finally!
What Food Group is Great for Vestibular Migraine?
This new study from the British Medical Journal shows that increasing Omega-3 Fatty acids, and without decreasing Omega-6’s can help decrease migraine pain, days, attacks, and other migraine-related symptoms.
The research shows that altering Omega-63s without changing Omega-6’s can decrease pain severity and frequency of attacks. However, the research did not find that there was a significant difference in quality of life.
What’s the Science between Omega-3’s and (Vestibular) Migraine?
Vestibular Migraine occurs due to a complex cascade of events that begins in the brain stem and trigeminal nerve, impacts the trigeminocervical complex, and then impacts the vestibular system. This cascade of events is what causes both pain (trigeminal nerve) and dizziness (vestibular nerve) in those with vestibular migraine. Omega-3’s are protective against that response.
As human beings, we are great at many things, however, synthesizing our own Omega-3 and 6’s is not one of them. Therefore, we can alter the number of fatty acids we have at any given time with our diet and/or supplements. And, it just so happens that these fatty acids are essential to the migraine cascade – in fact, they have a big role in pain regulation.
The nerve endings of the trigeminal nerve (the one that causes pain in migraine) are regulated by these same fatty acids, called lipid mediators. These mediators and together known as oxylipin receptors, and they’re enriched at the end of the trigeminal nerves. They regular sensitization and the release of the headache-related neuropeptide calcitonin gene-related peptide (1). This fact implies that there is a link between omega-6 & 3 fatty acids and headache etiology.
The oxylipins that come from Omega-6’s have been found to “sensitize the trigeminal nerve endings, and evoke behavioral pain responses;” this means Omega-6’s can increase pain severity and migraine frequency (1). However, the oxylipins that are derived from Omega-3’s are found to have antinociceptive properties, meaning that they reduce pain (1).
Where do I Find Omega-6’s, and Should they be Avoided?
Omega-6, the kind of fatty acid that is found mostly in the typical American diet, in fact, there is research to show that most people who eat a Western diet eat significantly more Omega-6s than Omega-3’s. Omega-6’s do play a role in our body’s function, so you should not completely get rid of this kind of fat. However, because we eat so much Omega-6, and want to try to fit in more Omega-3, it’s important to know where they come from.
- Vegetable oils
- Soybeans
- Corn/corn oil
- Eggs
- Some meat and fish
Where Do I Find Omega-3’s?
Omega 3’s are to kind of fatty acids we don’t get enough of in the Standard American Diet. It’si’mportant we get more of these than Omega-6’s so we can desensitize the trigeminal nerve, decrease pain severity, and decrease pain days overall. Although it may be easier for you to take them as a supplement, it is better to get them in your food, and more affordable. However, if you do not like any of these foods, it is typically recommended to get them in supplement form (aka Fish oil). Ask your doctor before you change or start a new supplement.
- Salmon, mackerel, or other fatty fish
- Seaweed and algae
- Chia and hemp seeds
- Walnuts
- Edamame
- Oysters & shrimp
- Spinach & Brussels
- Supplements
Source:
Ramsden, C. E., Zamora, D., Faurot, K. R., MacIntosh, B., Horowitz, M., Keyes, G. S., Yuan, Z.-X., Miller, V., Lynch, C., Honvoh, G., Park, J., Levy, R., Domenichiello, A. F., Johnston, A., Majchrzak-Hong, S., Hibbeln, J. R., Barrow, D. A., Loewke, J., Davis, J. M., … Mann, J. D. (2021, July 1). Dietary alteration of N-3 and N-6 fatty acids for headache reduction in adults with migraine: Randomized controlled trial. The BMJ. Retrieved October 5, 2021, from https://www.bmj.com/content/374/bmj.n1448.
Your journey with Migraine is complex, changing, and can be confusing. There are so many things you can try, many of which I may not have even heard of – it truly take a well rounded healthcare team to treat Migraine, and in this case, Vestibular Migraine. Exercise, even for just 30-40 minutes, can help prevent and treat Migraine attacks. It is difficult because in the moment exercise may sound like the most impossible thing to do with your body. But, if you start slowly, even during a Migraine Attack, you can help cut down the time or prevent the attack entirely.
Why Exercise?
We all know, tucked away somewhere in the back of our brains, that exercise is good for us. It has many health benefits from stress relief to heart health. National College of Sports Medicine recommends 150 minutes of moderate intensity exercise/week, which can be broken up into smaller sections of your choice, to meet that guideline. This guideline, combined with the Migraine-prophylaxis guideline, is a great place to start for overall health and wellbeing.
Migraine attacks can be prevented with light, moderate, or high intensity exercise. Any form of exercise that you enjoy counts – yes, even walking, barre, and Pilates count! The best part about exercise, is that just about any form of movement is helpful.
Exercise is so effective in preventing migraine, that this study from 2011 found that exercise, regular meditation/relaxation, and topiramate were equally effective in stopping a migraine attack. In this study, those who were in the exercise group were to exercise with a physical therapist for 40 minutes, three times a week. This exercise program had a 15 minute warm-up, 20 minute workout time, and 5 minute cool down. There were absolutely no adverse effects in the exercise group, however the topiramate group had 8 participants with adverse effects – just another reason to utilize exercise as a treatment and preventative!
Exercise can also help your symptoms to improve more quickly during Vestibular Rehabilitation Therapy. If you have Vestibular Migraine, Vestibular Rehabilitation Therapy is hopefully a part of your plan for recovery! Vestibular Rehabilitation Therapy is the exercise program used to habituate, or teach, your brain how to respond to irritating stimuli. This process is most effective when patients and clients are encouraged to exercise as a piece of their rehabilitation.
Where Do I Begin?
Beginning to exercise again can be a difficult step – that’s why we created Vestibular Fit! Vestibular Fit is the custom exercise program built for those with vestibular disorders. Returning to exercise after diagnosis, treatment, and management of a vestibular disorder can feel daunting. Sign up for Vestibular Fit and we will get your workouts customized to you in the next 48 hours!
There are few things as good for your body, and soul, as physical activity. the best kind of exercise is the kind that you will do. I mean that – if you like to jog, let’s make that happen. If you love to go to Barre, let’s get you back to class!
Sources:
(1 )Amin FM, Aristeidou S, Baraldi C, et al. The association between migraine and physical exercise. J Headache Pain. 2018;19(1):83. Published 2018 Sep 10. doi:10.1186/s10194-018-0902-y
(2) Penney, S. (n.d.). Fitness. how much activity is enough? NASM. https://blog.nasm.org/fitness/fitness-how-much-activity-is-enough.
Vestibular Rehabilitation Therapy is the process of improving your imbalance, dizziness, vertigo, and other vestibular symptoms through exercise. To read more about the process of Vestibular Rehabilitation Therapy and how it works, click here.
How to Test Your Vestibular System
Your vestibular system can be tested in multiple ways, but there are a few tests and measures that I use most frequently in the clinic. These are the four most common tests that I find make people mildly symptomatic, and provide solid objective measurers that I can treat through Vestibular Rehabilitation Therapy.
The first measure I use is the Dizziness Handicap Inventory. This is a standardized scale that consists of 24 questions regarding your functional, physical, and emotional limitations surrounding dizziness and vertigo. It provides me as a Vestibular Physical Therapist an objective way to measure and track patient progress.
Next, I screen all of my patients’ ocular motor skills. I test visual tracking, visual range of motion, end range nystagmus, convergence, saccades, and for spontaneous nystagmus with and without fixation.
The Vestibular Function testing comes last in this order, as I need to be sure I check for central dysfunction before peripheral vestibular dysfunction. The next tests can check laterality of a vestibular lesion in some situation, gaze instability and use of Vestibulo-ocoular reflex, and your ability to cancel our your Vestibulo-ocular reflex.
1: Head Thrust Test (Head Impulse Test): this test can tell laterality of a vestibular lesion, usually after a Vestibular Neuritis, if the loss is 40% or more on one side. Ask the patient to stare at your nose, and quickly move your patient’s head left and right. If their gaze slips off their nose and you see a catch up saccade, that is the side of the vestibular lesion.
2: Dynamic Visual Acuity (DVA) Test: this test screens for gaze instability. You should start by reading an eye chart, the lowest line you can read comfortably. Next, your Vestibular Physical Therapist will shake your head right and left at 240 BPM in approximately a 60 degree motion. While your head is moving, you should read the chart again. This is scored by the number of lines between your static and dynamic head positions. A difference of three or more is clinically significant for gaze instability.
3: Vestibulo-ocular Cancellation (VORcX): this is a test for visual motion sensitivity via the cerebellum’s ability to inhibit the Vestibulo-ocular reflex. Standing, clasp your hands in front of you and place your thumbs up and together. Stare at your thumbs and swing your whole body and hands right and left, keeping your eyes on your thumbs the whole time. Repeat 10 times .While you are performing this motion, your PT should watch your eyes for saccadic eye movement, which indicates a positive test. Additionally, a positive test is if this makes you symptomatic.
4: Dix-Hallpike & Horizontal Roll Testing: these tests are for Posterior and Horizontal Canal BPPV. I only test for BPPV when my patients have a subjective history of rotary vertigo with position changes, or have other risk factors that make me curious. Because it’s easy to treat, and a quick test, I find it is usually worth my time to test most patients.
Best Vestibular Rehabilitation Therapy Exercises
The best Vestibular Rehabilitation Exercises will make you slightly dizzy, but not so dizzy that you feel faint, dizzy, or ill the rest of the day. Your symptoms should last a few seconds to minutes, and you should then be able to bring those symptoms back down to your baseline level.
Prescribing exercises for Vestibular Rehabilitation Therapy completely depends on what makes you dizzy. Your Vestibular Physical Therapist should perform a few objective measures, and also consider the subjective actions that make you dizzy.
Positive DVA Testing tells me as the clinician that you should begin VORx1 exercises (Vestibulo-ocular Reflex Times One). This will help with gaze stability. Other cues you may need VORx1 are: you have difficulty keeping your eyes focused in one place, you have the sensation that things “bounce” when you’re walking, or that you feel like you have a “lag” when you move your head.
- Stare at the pineapple in the center of the chart, and shake your head horizontally (the “no” direction) in a quick, small movement
- Perform this movement for 15 seconds as quickly as you can without allowing the pineapple to go out of focus or jump around.
- Stop, let your symptoms dissipate. Before repeating, your symptoms should return to your baseline (the level of dizziness you had prior to beginning this exercise).
- Repeat 3 times, resting completely back to baseline in between each set.
A positive VOR Cancellation Test means you should practice VOR Cancellation (VORcX) and/or being other visually stimulating environments. You can do this by performing VORcX as an exercise until you’re symptomatic and then performing grounding in between sets, or to simulate a stimulating environment you can walk into a busy environment, or watch something on a screen.
VOR Cancellation Instructions:
- Standing, clasp your hands in front of you and place your thumbs up and together.
- Stare at your thumbs and swing your whole body and hands right and left, keeping your eyes on your thumbs the whole time.
- Repeat until you are mildly-moderately symptomatic.
The Importance of Your Baseline
In between each repetition of a vestibular exercise, you need to return back to your baseline.
When your brain is already dizzy, and you’re performing an exercise to make yourself (briefly) dizzier, your fight or flight system is stimulated. We need to remind your brain that you are in a safe environment, that you can feel relaxed and calm in the face of dizziness. Because our brains are ‘plastic’, meaning we can teach ourselves anything, we can teach our brains to be stronger against dizzying stimuli.
Grounding is the answer to this in many ways. Grounding is the act is the act of feeling your stillness. Feeling your feel on the floor, your back in the chair, your arms on the armrests, and so on. Then, sit and breathe slowly, completely, and deeply. Be mindful of your surrounding and your stillness. This is a practice that can be meditative.
Return back down to your baseline dizziness level between each repetition. This is actually the most important part of vestibular exercises. Before restarting your exercises you should be absolutely sure that you’re feeling back to where you started!
Here’s a good rule of thumb for Vestibular Rehabilitation Therapy: no more than 5/10 symptoms over baseline, and for no more than 5 minutes at a time.
How to Dose Vestibular Exercises
Vestibular Exercises should be scaled, graded, and dosed based on your exact needs. Your Vestibular Physical Therapist should perform a test or provocative movement, and then see if you become symptomatic.
If you are symptomatic, stop, perform grounding, and then begin again when you’re feeling ready.
For VORx1 Exercises, I typically ask my patients to perform them 3 times a day for 15 seconds at a time. These can be all back to back 15s, grounding, 15s, grounding, 15s. Or, you can do one set each at breakfast, lunch, and dinner.
This is a good rule of thumb however no everyone can tolerate 15s, so if that is the case, I find a number my patient can tolerate and work up from there.
The same thing goes for all vestibular exercises. Find a level of movement that is difficult but tolerable, perform grounding, and then begin again.
Migraine and Vestibular Migraine can be reduced and managed naturally with vitamins, minerals, diet, and exercise! People often ask me which vitamin deficiencies cause migraine and if you should be tested. Although your doctor can test you, that’s not a requirement as most people with migraine do have issues with these deficiencies in most research. These vitamins include Magnesium, CoQ10, D3, Riiboflavin (B2), and Omegas!
Natural migraine treatments can be paired with your medical treatment, however, be sure you tell your doctor what you’re taking as some vitamins for migraine can have an impact on your prescription medication – there are always options, so its best to be safe!. Some people use natural migraine treatment alone, without the need for Here’s a list of vitamins and other accessible over-the-counter treatments you can try. As always, ask your doctor before you change or add anything to your treatment plan!
The most common supplements for Vestibular Migraineurs are CoQ10, Magnesium, and Riboflavin (B2). Some supplements, like Migralief have all 3 combined, which makes remembering to take it easier. However, sometimes just because it’s easier doesn’t mean it’s better – some of my patients have been very successful with taking Migralief, but others have needed to take each one separately for multiple reasons.
Magnesium for Migraine
Magnesium has so many purposes in our bodies. It helps with mental clarity, digestion, nerve function, blood sugar, and more! Taking keeping magnesium available in your body for use is called bioavailability. Different kinds of magnesium supplements help with different difficulties you may have related to migraine
Magnesium Glycinate
Magnesium glycinate is used for mental clarity and digestive health, without causing digestive issues or a crash at the end of the day. Glycinate is an amino acid that your body uses to fight inflammation and improve sleep. Magnesium glycinate also occurs in foods such as meat, dairy, and legumes. Since those on a Migraine Diet or Heal Your Headache diet may be avoiding most dairy and some legumes, glycinate may be lacking in your diet. It’s important we have all the necessary amino acids in our diets, so a magnesium glycinate supplement may be a great idea for you!
Magnesium Threonate
Magnesium L-Threonate is when we combine threonic acid and magnesium. This form of magnesium is a formed to be easily digestible and is great for mental clarity. Studies have shown that it helped promote learning and memory, and helped prevent memory decline. Threonate is already present in some level in our cerebrospinal fluid, and the presence of extra in neuronal cultures “increased functional synapse density” (2). Really good Magnesium Threonate, like the kind form Pure Encapsulations, is really hard to come by. If you can’t find it from Pure Encapsulations on Amazon, they have another show online here.
Magnesium Citrate
Magnesium Citrate is often used for treating digestive issues, such as constipation. Magnesium citrate is the most available form of magnesium – this is the kind of magnesium that you find generically in stores. This form of magnesium is also commonly found in powder form. If you have trouble with the bathroom in general and are a person who deals with chronic constipation it might be good to take Magnesium Citrate. However, if you do not, be more cautious about this – you might spend a little extra time in the bathroom than you had intended if you take Magnesium Citrate.
For more into on forms of migraine, you can take, click here!
Coenzyme Q10
Coenzyme Q10, or CoQ10, for migraine is used for preventing oxidative change in your brain. Migraine Brains hate change – so preventing large changes in oxidative stressors within your brain will help decrease the number of migraines in your life. CoQ10 helps support mitochondria by creating adenosine triphosphate, which helps us with energy (3, 4). Some studies have shown that CoQ10 can help with episodic migraine prevention up to 15 episodes per month. CoQ10 is made by Pure Encapsulations, like Magnesium, in pill form which is of high quality. It is also in chewable gummies made by NOW Supplements which patients have reported is effective as well.
Riboflavin (B2)
Riboflavin, which is a form of B2 vitamin, is effective in preventing migraine (5). Migraineurs are frequently B2 deficient, so supplementing your body this vitamin can be incredibly helpful in migraine prevention. Riboflavin is generally well tolerated, affordable, and will likely make you feel better. In the study, of people who took Riboflavin for the 3 month trial, 59% reported decrease in migraine symptoms by at least 50%. Riboflavin is useful in brain function, skin cell production, gut/digestive lining, and more. People who have migraine are typically deficient in B2, so it’s a good idea to supplement it into your diet. B2 can be found in eggs, milk, meat, nuts, enriched flour, and more If you do not tolerate these foods well, especially if you’re on a strict migraine diet, it could be a good idea to supplement it in vitamin form instead of trying to eat enough throughout your day. The typical dose is 400mg/day for at least 3 months, but as always, ask your doctor for more information!
It is significant, however, that riboflavin has been shown to interact with some medications like antidepressants and some cancer drugs, so be sure to check with your doctor first!
Omega-3 For Vestibular Migraine
A new study found that having more omega-3’s than omega-6’s is helpful for preventing pain and migraine frequency/days. We have two main forms of Omega-fatty-acids in our bodies. The first is Omega-6 and the second is Omega-3. Omega-3 has long been known to be healthier and better to have more of in your body. You can find it in avocados, fatty fish, and other nutrient-rich foods. Its other form is Omega-6, and is known not to be as healthy. This study found that increasing the number of Omega-3’s a person had, without doing any alteration of Omega-6, decreased headache frequency. Both Omege-3 and -6 are not synthesized internally, meaning that we have to eat them to get them in our bodies, or we have to supplement them or eat them!
Melatonin for Vestibular Migraine
New research shows that melatonin could be very helpful in treating vestibular dysfunction. MT1 receptors interact with melatonin, and are found all over the same parts of the brain that the vestibular system is! This study says “melatonin has been proposed as a prophylactic agent in the prevention of migraine attacks, a condition that can be associated with vertigo” (8). This study also states that in animal models melatonin has been found that it can be otoprotective (protective for the ear). 3mg was taken daily during this study, and it should be taken at night before you go to bed. This way you can not feel extra sleepy during the day.
Vitamin D3 for Vestibular Migraine
Vitamin D3 can be helpful in preventing vestibular migraine, but the mechanism is not clear. There is not a lot of evidence to recommend it to all patients with migraine or vestibular migraine, but it’s great to ask your doctor if it’s a good fit for you. Many people are vitamin D3 deficient, especially with migraine. There is some evidence to show that there is a decrease in migraine frequency and pain when vitamin D3 is supplemented. This is especially important when it is not sunny outside, or if you live in a particularly foggy place! We get D3 via UV waves, but if we don’t live in a sunny place, or you live in a house/apartment without a lot of light, it’s important to find a way to get it in. Supplementation is frequently the answer here!
Sources:
(1) https://www.healthline.com/nutrition/magnesium-types
(2) https://pubmed.ncbi.nlm.nih.gov/27178134/
(3) https://www.verywellhealth.com/coenzyme-q10-migraine-prevention-1719853
(4) https://www.migrainetrust.org/living-with-migraine/treatments/supplements-and-herbs/
(5) Schoenen J, Jacquy J, Lenaerts M. Effectiveness of high-dose riboflavin in migraine prophylaxis. A randomized controlled trial. Neurology. 1998 Feb;50(2):466-70. doi: 10.1212/wnl.50.2.466. PMID: 9484373
(6)Wolff, A. (2020, April 5). The Best Magnesium Supplements for Migraine. The Dizzy Cook. https://thedizzycook.com/magnesium-supplements-explained-which-one-is-best-for-vestibular-migraine/
Learning to live with Vestibular Migraine is a life-long process, but tips and tricks from those with Vestibular or other forms Migraine can be so helpful. However, it is sometimes hard to find an all inclusive list of things that people have found helpful in the past. This is a list, which will be continually updated, containing items that patients have found to be helpful!
Lifestyle:
Allay Lamp
The Allay lamp’s intention is to decrease migraine triggers by emitting a calming green light that is proven to decrease photophobia, anxiety, and stress. We know that there are many wavelengths of light, which make up the whole world of colors, but for those with Migraine most of those lights are intolerable. Wearing migraine glasses is one solution, but another is to use this lamp. This lamp triggers small electrical responses in your brain, instead of large electrical signals that most bands of light cause. You can dim it, place a shade on one side for decreased light overall, or change it to a whiter light that is still soothing.
Migraine Glasses
There are so many pairs of glasses my patients have found to be helpful. Migraine glasses are intended to block blue light, in addition to yellow and other waves of light. Blue light ranges from 400-750nanometers. Because it is such a wide range, different kinds of blue lights are more and less problematic for your migraine and related symptoms. Some blue light glasses block only some parts of the blue light spectrum, even the parts that are good for you. Blue light around 460-500nm is actually healthy – we use blue light to monitor our melatonin levels, which affects our sleep-wake-cycle. Blue light can even be used to treat Seasonal Affective disorder. Blue light below 430nm is the “bad” blue light. The intention for a good pair of blue light blocking glasses is to block the blue light under 430nm. Special migraine glasses, like Theraspecs and Migraine Shields, and AxonOptics glasses do just that!
TheraSpecs
Theraspecs are the pair of glasses I let patients use in the clinic. I really like them as the pink hue from the FL-41 glasses are soothing for many of my patients, and they were created by a person in the Migraine Community. According to their website, TheraSpecs wearers experience 74% fewer migraine attacks on average per month, which for people with photophobia (light sensitivity) will make a huge difference. Even if you aren’t sensitive to light, Theraspecs will make a difference!
Theraspecs work to block the harmful blue light waves, provide wrap around protection of your eyes, and focus on blocking blue light the most at 480nm, the most aggravating wavelength for those with Migraine.
Migraine Shields
Migraine Shields are the best pair of glasses if you don’t want any color distortion in your vision. Most migraine glasses have FL-41 lenses, which are tinted pink – Migraine Shields uses a slightly different technology and aren’t tinted pink. These are great for work environments, using the computer, or choosing anything where color might be important. Migraine Shields do not come in a large enough size to fit over other glasses if you have a prescription! However, Migraine Shields have just released readers. These readers come in many shapes, sizes, and are so much cuter than the ones you find at the drugstore – these really multitask and are SO helpful!
AxonOptics
AxonOptics are also a great option for Migraine relief. They are not too pink, lightweight, and come in three different tints. AxonOptics glasses have three tints for three intentions: indoor, outdoor, and transitional. Transitional lenses take a little longer to make, and they are a little more expensive. However, if you are going to purchase 2 pairs anyway, it may be worth it.
Research has found that FL-41 lenses need to be specifically made for people with light sensitivity. AxonOptics creased their specific glasses for Migraine by crafting a lens that is consistent, effective, and a nice color. Additionally AxonOptics has a plethora of frames you can choose from, and an option for contact lenses.
These can also be in the form of prescription eye glasses – if you’d like them to fill your prescription they can do that so you can still be working with these on!
Why Not Just Wear Sunglasses?
Sunglasses, while they may provide relief for your migraine in the moment, block too much light. If light is a trigger for you already, you don’t want to make it an even bigger trigger than it is already. When you wear sunglasses all day, inside and outside, it blocks many wavelengths of light, not just those in the blue light spectrum which work to block the provocative forms of blue light. If you block many kinds of light, not just the ones that typically affect migraine, you may end up sensitizing yourself too all light, making your triggers worse!
Headache Hat:
The headache hat is a tool you can use to soothe the headache part of your Vestibular Migraine, if you have them. I have found that patients in the middle of an attack will get their headache hat from the freezer, and feel at lease some relief. I would put the entire thing in the freezer, so you don’t have to deal with putting it together when you’re in the middle of a Migraine attack. It’s an easy, natural, way to give yourself a little relief.
Food and Beverages for Vestibular Migraine:
Imperfect Foods Subscription:
Imperfect Foods is a weekly delivery of produce, meat, dairy, and snacks that is completely customized to your liking. You can choose what you’d like to go into the box, and they’ll deliver it to you on a set day for your whole neighborhood. I love Imperfect Foods, as they deliver the food that would normally be thrown out by grocery stores – your produce sometimes looks funny or misshapen, but is perfectly consumable!
They have options for organic or non-organic, and many other fun products that will make your life easier for when you really don’t want to go to the grocery store!
Click the link above, or here, for $20 toward your first week!
Ritual Zero Proof:
Ritual Zero Proof is a whiskey, tequila, or gin alternative that tastes like the real thing, but without the alcohol! It really does taste like the real thing, but has no alcohol, no hangover, and no migraine! This was started by three people who do drink but wanted an additional way to enjoy a cocktail that wouldn’t give them the tipsy feeling. Although not intended for a vestibular migraine diet, it fits perfectly into your lifestyle!
PureWine Wands: Sulfite Removers
Sulfites and histamines can be part of your trigger load. Because wine, and other food & beverage categories, can contain quite a few sulfites finding ways to avoid, or remove, the sulfites is helpful! PureWine Wands remove the sulfites from the wine, which are produced by the grape skins during fermentation, and naturally occur in almost all, if not all wines. Removing these will help, but make sure you follow the directions as they do have to sit for a while to be effective.
You can use the wands, for a glass of wine
Or the wave for an entire bottle!
Books for Vestibular Migraine:
There are a few books that Migraine patients should read, whether you have Vestibular Migraine or another kind of migraine. These will all help you understand Migraine and how to manage your symptoms
Victory Over Vestibular Migraine:
This book is by well-known neuro-otologist, Dr. Shin Beh. He goes through the steps from finding out you have Vestibular Migraine to learning what to do next in order to manage your Vestibular Migraine symptoms. This is an absolute must-read for all vestibular migraine patients – either if you have a new diagnosis or you’ve been managing your symptoms for a long time.
The Migraine Brain:
This was the first Migraine book I read when I started treating patients with Migraine. It really helped me understand the vastness of triggers a person can have, how to manage the symptoms, and what a migraine actually is. It’s around 300 pages, but it’s a quick read and it has charts in the back to help you analyze your migraine!
Heal Your Headache (The 1-2-3 Program for Taking Charge of Your Headaches)
This book will give you a step-by-step guide for dietary recommendations for migraine and vestibular migraine. It will take you through the elimination and reintroduction of foods into your diet for a successful migraine lifestyle!
This is a short list of many Vestibular Migraine Hacks that will help make your lives easier! Check back soon for more helpful products and tips as this list grows!
Wake up, drink coffee, go to work. That’s how most people start the day, many even prioritizing coffee over breakfast! But what happens if your doctor says that coffee, specifically caffeine, is problematic for you?
For those with vestibular disorders this is incredibly common. Caffeine is amongst the many triggers for dizziness, headache, and lightheadedness. Therefore, one of the first changes after being diagnosed with a vestibular condition are dietary restrictions. A Migraine or Ménière’s Disease Diet is not always easy, but good replacements can improve your day to day! There is alcohol-free beer & 0% ABV spirits that can be replacements for happy hour, and there is Swiss Water Process decaf coffee for continuity in your morning routine. Those with Vestibular Migraine, Secondary Endolymphatic Hydrops, and Ménière’s Disease will benefit most from dietary changes, especially those who are frequently or chronically dizzy. Caffeine and dizziness are partners in crime. Any small amount of caffeine, even a sip or two, can cause a dizzy-attack.
Caffeine is the ingredient that makes coffee dangerous for those with vestibular dysfunction. So, it would seem like decaf is a great alternative if you’re in need of caffeine-free-coffee. However the vestibular system is highly sensitive to caffeine, including in tea, chocolate, and the small amount in decaf coffee. The decaffeination process removes approximately 97% of all caffeine in a cup of coffee, which still leaves about 7mg per 8-ounce cup of coffee. Unfortunately, this small amount of caffeine is enough to cause you to have a dizzy episode.
In order to avoid even the 7mg of caffeine in decaf coffee, Swiss Water Processed coffee is the safest option. Additionally it avoids the use of Ethyl Acetate, the chemical used to take the caffeine out of the beans before they are roasted. Instead the Swiss Water Decaffeination process uses just hot water and time to keep the flavor of coffee, while ridding the beans of caffeine!
No matter how you make coffee, whether it’s a Nespresso or Keurig machine, a French Press, or drip coffee, there are options for you! The list below compiles the best coffee you can buy for a Vestibular Migraine Diet, Ménière’s Disease Diet, or if you’re avoiding caffeine for any other reason!
Organic Gorilla Swiss Water Process Decaf Coffee
This decaf coffee is excellent for those who need K-cup compatible decaf coffee. These pods are compostable, and are 99.99% caffeine free. Simply pop the pod into your Keurig Machine and you will have a fresh cup of coffee your brain and the environment will thank you for!
Stone Street Swiss Water Process Decaf
This cup of jo will have you convinced you’re drinking caffeinated coffee! Stone Street Coffee is roasted locally in Brooklyn, NY, but can be shipped anywhere you’d like! They sell through Amazon, their website, and have a tasting room in Brooklyn. Each batch of beans is sourced through fair trade from small family farms in Africa. Then, it is carefully processed and roasted for a consistent taste and tone! This Swiss Water Processed Coffee company sets itself apart with its excellent flavor and quality.
Kicking Horse Coffee
Living true to its mission and slogan, this coffee will help you wake up, and kick ass. It is free of caffeine, herbicides, and pesticides. It is sustainable, organic, and fair trade. They hold themselves to the highest standards when it comes to recycling, composting and being sustainable. In fact, Kicking Horse is so sustainable, they will not sell single-serve coffee in a pod as it is not sustainable, however they do provide ground and whole bean options. Kicking Horse Coffee is determined to make you feel good about yourself while drinking excellent coffee, and their mission is maintained through their Swiss Water Decaf Coffee.
Verena Street Swiss Water Process Decaf Coffee
Offered in whole beans and ground coffee, this Swiss Water Processed Decaf Coffee can be found anywhere you shop, and has a fantastic medium roast. Verena Street sources its beans sustainably through Rainforest Alliance Certified farms to insure the highest quality of beans that support local, family owned farms.
Allegro Swiss Water Process Decaf
If you like a dark roasted coffee that is also sweet and smooth, Allegro’s Swiss Water Decaf Coffee is the one for you! It is one of the only companies that produces Swiss Water Processed Decaf Coffee in multiple roasts. It comes in French Roast, Italian Roast, and Sumatra. Additionally, it is also one of the most affordable brands of decaffeinated coffee, making it easier on your pocket to order more than one bag!
Trader Joe’s Decaf Coffee
For those of us who can’t get enough Trader Joe’s, you can add another win to the list of things you love about it! According to FAQ’s pages, their decaf coffee is Swiss water processed, making it ideal for a caffeine-dizziness problem! Trader Joe’s Decaf Coffee is a staple for many as it is easy to drink, affordable, and free of pesticides! It is easier to purchase in stores, as most Trader Joe’s items are, but is available on Amazon as well.
Source:
All information regarding how Swiss Water Process Decaf Coffee is made:
Best Decaffeinated Coffee: The Process. (2019, August 14). Retrieved January 05, 2021, from https://www.swisswater.com/our-process/
Restarting your exercise routine can be difficult, and whether you do it inside a gym, or at your house, you may be in need of some new products. Below, I have listed my top 10 favorite exercise products. Some are for balance, others are for strengthening or stability. Any and all of them would be great additions to a home gym, or as something to bring to your gym with you depending on what you have access to!
Kettle Bell
These kettlebells are coated in rubber, which is a nice feature for protecting your floor, and making them quieter to place down! I love kettlebells, they’re one of the most versatile pieces of equipment; you can do kettlebell swings, single leg deadlifts, or overhead presses with them. A quick Google Search of “kettlebell workout” will get you millions of web results and workout options!
Hand Weights
Hand weights are other great pieces of equipment! In my opinion, these can always be put to god use, and if you don’t have any, here’s an option from Amazon that has many different weights to choose from. Be sure to get a weight that seems challenging for one hand, but nothing so heavy you can’t lift it up!
Reebok Step
One of my FAVORITE exercises to give to people are step ups. They challenge dynamic balance, use single leg stance, and can functionally strengthen your legs! This Reebok Step is adjustable, so you can always make it higher if you so choose. It is a great options for step ups, elevated lunges, supported single leg stance, and toe taps!
Balance Pad or Balance Board
Challenging your balance every day is incredibly important to reduce risk of falls. Balance exercises are frequently overlooked in exercise routines. Challenge your balance by standing on a balance board at your desk during the day, or use it just for workouts. Balance pads and balance boards challenge different balance systems, but are both really useful.
Loop bands
Loop bands are great for around your ankles during lateral crab walks, or around your knees when you’re doing squats to challenge your gluteus muscles! There are endless possibilities for loop bands, and I use them for both my vestibular and orthopedic patients all the time.
Resistance Bands
An addition, or an alternative, to looped bands are resistance bands. These can be hung from doorways or used independently to strengthen your core, arms, and legs, or added to balance exercises for an extra challenge.
Yoga Mat
A staple in any home workout area, or to bring to your gym, is a yoga mat. They provide a more comfortable option to workout than the floor, and make clean up after easier. This mat has two different options for thickness and colors!
A thicker yoga mat could also be very beneficial. Here’s a link to a more comfortable one.
Yoga Ball
A yoga ball is popular for improving your posture while sitting at a desk. However it can also be used for working out. You can do sit ups on it for a dynamic challenge, lifted dynamic bridges, or ab roll outs!
Water Bottle
Staying hydrated is so IMPORTANT! Everyone knows this, but many people forget to bring water with them. This water bottle will remind you to drink water, and is insulated, so it will keep your tea hot, and your water cold!
Foam Roller
Rest and recovery is just as important as exercising! You should stretch and roll out your muscles after your workout, and on your recovery days. This foam roller is small enough to fit in your apartment, and firm enough to help your muscles recover and leave you feeling refreshed.
Meal prep is the concept of preparing your meals ahead of time to save you time in the future. Most people meal prep one or two days a week. Although it will take up some time, it saves time, energy, and so much thinking, in the long run.
If you have specific dietary needs, or if you find you don’t have time to cook meals during the week, this is a fantastic way to keep a healthy diet, save money, and save time.
Personally, I like to meal prep on Sundays and Wednesdays. That way, I can keep my meals fresh and I don’t have to eat the same thing all week (which is a common complaint I hear).
LET’S MAKE THIS SIMPLE
You can plan to prep parts of your meals to put together later, or full meals all at once. Personally, I like to do both. I chop some of my vegetables (think greens, potatoes, peppers, and onions) to be used later in easy egg scrambles. Then, I prepare my snacks by separately boxing and bagging foods like carrots, hummus, gluten free pretzels, and trail mix. Lastly, I boil pasta or rice, or roast a squash that I can use with one or multiple meals. Some of these I keep in separate containers, and others I put together to form a meal.
PREPPING TO PREP
I always go into the week with a game plan. This begins with thinking of breakfast, lunches, and dinners and prepping a menu. I like to start with breakfast; my favorites are overnight oats, or egg muffins. I think of the ingredients I need for these, and I add them to my list. Next, I think of what I would like for lunch: usually a big salad with vegetables, protein, and my favorite low-sodium dressing. Lastly, think of a few dinners you may want, and repeat.
An important factor is to consider how many times you eat out during the week. Don’t lie to yourself about this, because you’ll end up wasting food and spending extra money.
Additionally, invest in good cooking equipment, and quality storage containers. I always recommend stainless steel or glass instead of plastic to avoid chemicals leaching into your foods. And great nonstick pans, sharp knives, and a crockpot or slow cooker are always amazing additions to your kitchen.
HEADING TO THE GROCERY STORE
Any grocery store is a great choice, something familiar is always helpful. Personally, I get my produce delivered via Imperfect Foods. I use this service to deliver me discounted food that would have normally been thrown away, which is great for me and for the environment! I do my in person shopping at Trader Joes, Safeway, or H-E-B.
Regardless of if you use a grocery delivery service, go to the grocery store yourself, or do a combination you will need a list. You will probably find that you already have a lot of what you need at home in your pantry, like the staples that you buy in bulk. Be sure to look and see what you already have before making a list and shopping!
When you’ve written your list head to the grocery store to shop for your groceries.
GOING GROCERY SHOPPING
Many people decide on a singular day of the week to meal prep, while others do it twice a week in order to ensure freshness and to decrease food boredom. This totally depends on you, and both options are perfect. It all depends on you, your habits, and your schedule. Even if you prep more than once a week, you can absolutely only go to the store one time if you choose.
Regardless of the option you choose, you should be sure that it is consistent every week. If you choose Sunday and Wednesday, make sure you stick to this so that you consistently have food every day. However, if you find one plan isn’t working for you, try changing it up, there is no wrong way to do this. Also, if you choose the twice a week option, this does not mean you need to shop more than once a week – buy everything in one fell swoop!
When you are at the grocery store, be sure you are looking at the labels. Reading a nutrition label may be new for you, and that is totally fine! Because you may be new to eating a low or controlled sodium diet, what you need to look for is the section that says “Sodium”. Sometimes it is on the front of the package, and other times it is only on the back.
Once you locate the label, find the word “Sodium”, and look at how many milligrams are in each serving. This can be anywhere from 0mg to thousands. A good way to figure out if something is high or low, is to look at the “%DV”, or Percent of Daily Value. Anything higher than 20% is considered high for your daily value in one serving. But, just because something may be high, doesn’t mean you can’t use or purchase the item. Be wary that you can use part of a serving, or combine it with something lower in sodium, to prepare a meal with a normal or lower amount of sodium.
PREPPING YOUR MEALS
Once you finish making your list, checking your cabinets, and grocery shopping, you are ready to start cooking!
You can do the cooking all at once, or in steps, but regardless of how you’re going to do it preparing, portioning, and storing your food is important.
Once you’ve prepared your food, portion and place the meals into containers and reusable snack bags, you are ready for the week!
Maybe you’ve done this for one meal, maybe you’ve done it for all 3. The important thing about meal prepping is consistency, cooking foods you actually like, and adhering to your personal dietary needs. If you need low sodium, don’t add salt, and season your foods with sodium-free seasonings!
Comment below what’s on your menu this week!