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Answer by Steven Fowkes:

Metabolic therapy. I’ll start this answer by linking to a previous answer: Is there any possibility to cure migraines?

Migraine is a side effect of a natural defense mechanism of the body. The prostaglandin defense system uses polyunsaturated fatty acids (PUFAs) to sense oxygen, which if overly active (i.e., the presence of oxidative stress) causes the fatty acids to oxidize, and other enzymes convert them to prostaglandin hormones, cell-signaling factors which coordinate (1) inflammatory process involved in tissue-level and cellular-level immune response, and (2) vasodilation and vasoconstriction. Too much vasodilation of blood vessels in the brain causes the migraine headache.

I’ve never experienced this myself. Two of my siblings have. I once experienced a retinal migraine (sparkles, full-blown tunnel vision), but was spared the headache. But since this happened only once, I’ve never been able to treat it personally. But I have assisted many people, some as clients, to (1) drastically reduce their migraines, (2) abort migraines in their earliest stages, and (3) get rid of their migraines for years and decades of time.

There is an “easy” way involving normalization of metabolic rate. This can be done with hormone replacement therapy (some combination of thyroid, adrenal, testosterone and/or progesterone (depending on sex) and estrogen control (e.g., estriol supplementation, or aromatase downregulation). Basically, people with low basal metabolic rate (BMR) with symptoms of low body temperature, cold hands and feet, low pulse rate, phase-retarded circadian rhythm (night owls), low blood pressure (until it goes high), sleep disorder, borderline depression, slow wound healing, etc. are at risk, and raising metabolism towards normal decreases this cause of migraines. Hormone replacement is a primary therapy for people with low hormones or hormone resistance, and a secondary therapy for people with inflammation and/or constitutional toxicities (heavy metals, chemical residues, etc.). I call this “easy” because it over-rides the system on a top-down basis and bypasses the need to bio-hack complex problems like food allergies, toxicities, gut permeability, chronic infection and psychological orientation towards emotional traumas (and life).

The harder, biohacking approach is to study urine pH patterns. Low metabolic rate causes alkaline stress to the blood, which the kidneys defend by dumping the stress into the urine. So urine is more alkaline than usual. When prostaglandins are triggered, the blood becomes acid stressed from the prostaglandin cascade and the urine goes extremely acidic. This happens in roughly 10-20 minutes. It is very sudden. If the urine is always acidic, then the prostaglandin system is in an always-on state and urine pH is useless for biohacking purposes.

If you see alkaline urine, then you can watch the urine alkalinization process and inflammatory urine acidification with the onset of a migraine. If migraines are frequent, this is not so bad.  You may only have to do sequential urine pH testing for a few days to see this “in action.” But if you have migraines rarely, this is a major investment of your time and attention. You have to be testing your urine well before the migraine onset, and once after, to see this pattern, which means continuous testing. Every time you pee. Even in the middle of the night, at work, on vacation, on a date, at the music concert; you get the picture. Testing itself involves carrying a small plastic dispensor, a pen and a piece of paper or notebook. Before peeing, pull out a short strip of paper, touch the fresh tip of the paper to the stream of urine, and match the color to the color chart on the dispenser. Then write it down; pH reading, time, date, and whatever else you are tracking (where you are, what you are eating and drinking, what you are doing, how you feel, your body temperature, what symptoms are you noticing, etc.

Once you see “the pattern,” you will have an early warning system. You’ll learn what the prodromal symptoms are, which when you first feel them give you a few minutes to quickly “acidify” your system to abort the migraine.

But more importantly, you’ll get information about your personal alkaline threshold, which you can avoid in the future by biohacking your pH and changing your lifestyle to encourage a more acidic pH pattern, a more balanced pH pattern, or a more circadian-synchronized pH pattern. You can see what drugs do to your pattern, what dietary supplements do, what exercise does, what eating different foods do, what meditation does, what dancing does, what drinking wine does, what eating chocolate does, what partial fasting does, or what drinking decaffeinated coffee does.

There is not a lot of information out there about this therapy for migraines, but the macrobiotic people have good information about the pH effects of foods. Jan Johnson’s Metabolic Balancing Workbook is an excellent resource, if you can find it.

What has been your most effective migraine relief?

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