Headaches

Introduction

Headaches have been the bane of my life, actually, right since my teens. There’s a big difference between headaches that are occasional and respond to painkillers, and chronic headaches that sometimes don’t. Functional medicine is not really going to help you with acute headaches, but is great at chronic headache strategy, thankfully.

There are, in fact, over 200 types of headache formally listed. But 90% of them are tension type headaches or migraines. We’ll focus on headaches on this page. Check the Migraine factsheet out for those – a whole different ball game!

Before we start, let’s just get some red flags out of the way. Any of these, and you should be talking to your doctors pronto, please:

Red Flags

Most headaches are actually a form of tension-type headache. These are the ones that feel like a ‘band around the head’, a tight, pressure-like feeling, often with tight muscles in the neck and face too. They’re not so much pulsating or throbbing, but can feel pretty intense. They usually respond well to painkillers and to massaging the neck, shoulders and temples.

Is it migraine? If your headache is more on one side of the head, you have an increased sense of smell, light or sound is getting to you, you feel nauseous or are having visual symptoms, like an aura, it’s much more likely a migraine. Even more so if it is limiting your ability to work or live as you would normally.

The most common type is termed ‘episodic’ headaches – ad hoc ones. If you are having this kind of headache more than 15 days a month for 3 months consecutively, though, it is termed ‘chronic‘.

What causes headaches?

There’s no lab test for headaches as such, although there are plenty to help you try and find the triggers and causes.

Most people think headaches are caused by stress, but that’s not always the case at all; it’s more often metabolic. The most common causes are emotional stress, of course, but also food sensitivity (I see this A LOT), dehydration, low blood sugar (again, A LOT), exertion or exercise, electrolyte imbalance, too much alcohol or caffeine and lack of sleep.

If they’ve gone chronic, this is where you really need to find a likely metabolic cause – are your adrenals or kidneys struggling and throwing your electrolyte balances out, how’s your insulin and glucose control, is there an inflammatory process going on somewhere – often the gut?

Sadly, there is a likely genetic/familial element to this, too, which makes some people much more prone to getting head pain. We’ve not yet isolated which genes, but the Migraine Trust reckons:

Genetics play a big role in migraine. This means that it is often inherited in families. It is estimated that up to 60% of the reason people get migraine is because of their genes. These genes make people more sensitive to changes in their environment such as lifestyle factors and triggers that can bring on an attack.

So I’m betting genes are also heavily involved in headaches too.

The trick with chronic headaches is to address those factors above, and to find and reduce any triggers. Most often, I have found a blood sugar drop, dehydration, hormone change or food/chemical/environmental sensitivity is involved somewhere, so start there. Assess which could be a factor for you and then test, ticking things on or off like a checklist.

You can see all key lab tests here. Read the text on the pages where I explain about tests and follow links to more info. Just ask me if you get stuck.

The Fascia

Another, more physical cause can be the fascia tightening – hence the tight feeling. Think of the fascia as a bit like a web of very thin connective tissue or thin muscle which goes from the top of your head to the soles of your feet, covering and weaving through every muscle and area in your body. If someone took the top of the fascia on your scalp, pulled it tight and made a knot on the top of your head, that’s essentially what happens! That’s exactly what it feels like, isn’t it?! The trick with this is to work out why the fascia is tightening and help soften it. More on that below.

Natural Headache Treatment

Most people with an acute headache will respond well to the normal headache painkillers like aspirin, paracetamol and ibuprofen. Caffeine can also help because it promotes blood flow, and so does a hot, steamy shower. Acupuncture has quite a good history too. In severe cases, sometimes muscle relaxants and even antidepressants are used.

In terms of natural painkillers, white willow works similarly to aspirin, so could be worth a try. Also, look at DLPA and CBD. Magnesium spray massaged on my head used to help a lot, if not that attractive! Peppermint balm helped too. I used to make a headache balm similar to this (use code phc if ordering).

Lower the trigger threshold

For chronic headaches, the trick really is to find and deal with as many variables and factors as you can to bring yourself down from the so-called ‘trigger threshold’. Just keep working on them and eventually, you should see a reduction in frequency, duration and/or severity, hopefully all three. It is going to take time – months, maybe years if it is really chronically-entrenched. Chronic headaches are always multi-factorial and you sort of have to unwind the build up, layer by layer. The classic peeling the onion approach.

Don’t focus at first on getting rid of the headaches, although wouldn’t that be nice?! Focus on reducing any or all three of those progress parameters: frequency, severity, duration. Before you start anything, it’s best to note those three parameters down as you will never remember and it will always feel like you’ve not made any progress when you really have. It can help give you hope and impetus. A great way is to use an app like Migraine Buddy or HeadApp (that’s the Google link but they do an Apple one too). Or you could use a diary, or my simple symptom checklist here.

Fascial release

Consider myofascial trigger point type therapy, which you can get done with a specialist, an osteopath, a remedial therapist (I trained with LCSP and you’ll always find good people there), or you can do it yourself.

Basically, it is finding the sore points in your head, neck, jaw or face and pressing into the muscle until it releases or the pain eases. Having said that, because the fascia covers every muscle, you could find the trigger point that causes your headaches is somewhere else entirely! The trick is to find it/them and release. Note, too, that often pressing the trigger point can even bring the headache on initially, and that’s often a clue that you’ve found the culprit. Keep pressing or squeezing the muscle until it releases. Don’t do this with a migraine, though, as that’s an entirely different cause and could make it worse.

Here’s a good explanation and some simple stretches to help release fascia:

And here’s one showing how to work on trigger points – there are loads if you look but it’s best to see someone really, at least to start with.

If trigger points do seem to be your issue, then work with your specialist to find what could be causing them. Think: repetitive movements (always turning your neck one way, for example), being sedentary can really cause the fascia to tighten over time – it needs consistent movement, being dehydrated – water and fats – it can’t slide over muscles. Injuries like whiplash? Could it be your TMJ (temperomandibular joint) in your jaw causing problems – are you grinding your teeth, had dental work, stress making you hold your jaw tight? Are your masseter muscles tight – is there a trigger point there? How about your trapezium muscles from constantly sitting at a computer?

You might find that your headaches or trigger points get worse as you get older. If that’s the case: are you not moving about as much, sitting around more? Are you drinking more alcohol or caffeine but not as much water, are your hormone drops causing increased inflammation (a biggie, that one), is arthritis starting somewhere?

Nutrient-wise, there’s often a lack of Vitamin D – see the factsheet here – it’s hardly ever ‘normal’ when I look at results from my point of view, note! Magnesium is very often low, which actually causes calcium to go up and be stored in muscles and connective tissue, making them stiffer and less flexible. Zinc, B12, folate and antioxidants are often useful if myofascial pain is involved.

Summary of natural treatment for chronic headaches

OK, I know that’s a lot to go through, so let’s summarise for tension-type and myofascial type headaches. This is what I would look at:

Hormones* (see more on this below)

Hydration – easily remedied, but also think of essential fatty acid levels, which affect hydration

Blood sugar and insulin control* – do the Metabolic test.

Stress – see the vagus factsheet especially, but also Stress here.

Nutrient deficiencies/imbalances* – mostly magnesium, Vitamin D, potassium, sodium

Sleep – see the Insomnia factsheet

Movement and exercise – keep that fascia soft! Check the 10 Minute Exercise book out.

Anti-inflammatory diet – lots of diet plans here. Give yourself at least a wheat and dairy free holiday. Gluten is a really common trigger too.

Improve tolerance to foods and chemicals* – gut testing for foods, neuroinflammation techniques for chemicals

Not in any particular order as they could all be important and a factor in your case, but I’ve starred the ones I see a lot of.

Other Types of Headache

Ok, so we know that most headaches are the tension type as above, but it can be useful to at least know a bit about other types, just in case.

TBI Headaches

This is where an accident maybe from years ago, where you may have lost consciousness for even a few seconds, can come back much later and cause headaches. It’s neuroinflammation and you can read much more about that on my Brain factsheet here.

The way to recognise it is if your headache seems to be triggered by something that affects the brain – so extreme reactions to food causing brain fog or depression, for example. Brain fog, brain tiring easily, lack of stamina ie. not being able to do things as much as you used to like read as much, watch the TV, listen to loud music, talk to friends, cope in crowds or noisy environments, tinnitus etc, are all clues to increasing neuroinflammation. It might be better some days than others. It might be triggered by something ‘weird’ like being in a car, looking at numbers, you can’t find the right words, you feel dizzy. If you are having headaches of any type, even migraines, with any of that at the same time as the headache, it could well be a TBI inflammatory type headache. See the factsheet for a core protocol to start helping.

A key here is to manage what is termed the allostatic load – to keep yourself from building up stuff that affects the brain and remaining under the threshold of where a headache would trigger. Like limiting sensory input, stress, blood sugar drops etc. Then you combine that with specific brain exercises to rebuild neuronal capacity in the affected areas of the brain. It’s complicated. Get some help if this sounds like you.

Sinus Headaches

The nasty feeling of sinuses being inflamed – across the bridge of your nose and face, frontal headache, pressure behind your eyes. It’s usually an immune reaction to something like pollen, a food, a virus, bacteria, mould etc which then causes the sinus tissue to inflame and swell, putting pressure on nerves, causing pain. The trick is to find the trigger(s) and control the mucus with eg. mucolytic compounds like NAC – best I’ve ever found – avoiding dehydration, improve air quality with humidifiers and steam , no allergens to breathe in. Massage and nasal irrigation can also really help. This NAC nasal spray is a good choice, especially if you suspect infection or allergy is involved. More info on the Sinusitis factsheet.

Hypothyroid Headache

Often a dull ache, just there all the time, or very frequent. Not pulsing or throbbing. You may not have any other thyroid symptoms, but your TSH could suggest you are most likely suboptimal – not necessarily full-hypothyroid. Look for raised TSH and normal or low-normal T3 and/or T4. See thyroid testing here.

The trick is to trial meds and, if it is that, it should resolve the headaches quite quickly, within 6 weeks, often much less. If no meds, then you could try boosting thyroid function naturally, which can often be enough for sub-optimal thyroid. Just remember to regularly test – you can overstimulate the thyroid, of course. More info on the Thyroid factsheet.

Hormonal Headache

Hypothyroid above is, of course, a hormonal type headache, but here I’m thinking menstrual, menopausal or andropausal (male menopause). Any time when oestrogen drops, you are more vulnerable to tension type headaches and migraines.

Think: just after ovulation, right at the end of your menstrual cycle, perimenopause, surgical menopause, early menopause, even the uneven hormone cycles of PCOS. It can happen in men too when male oestrogen or testosterone drops. I also think a lot of this comes from a lack of progesterone, so it’s all about the balance between hormones. In the oestrogen and testosterone drop, essentially a whole inflammatory cascade can start and we release CGRP, which is one of the main peptides that causes a flare up.

Check the hormone with testing (men’s here), and the various factsheets on hormones in the A-Z on this site.

High Blood Pressure Hypertensive Headache

If you know you get headaches when your blood pressure is higher than normal, then obviously see your health practitioners to get checked for cardiovascular issues and raised blood pressure causes. Sometimes, blood pressure doesn’t even need to be that high to trigger a headache, but the clue is that it’s more raised than usual and the headache goes when the blood pressure drops back to normal. Maybe use a blood pressure monitor with your GP’s support and guidance. More on blood pressure here.

Quick tip: garlic is the best blood pressure reducer I’ve ever come across. Eat more and take a good supplement. Berberine also works well and would be a great choice if you want all-round heart and blood glucose support. Check with your GP, obviously.

Cluster Headaches

These are nasty and thankfully pretty rare. Much more common in men (which makes a change!). Usually on one side and intense pain around the eye. It can last a few minutes or 20 minutes. Any minutes are too many for these, frankly. Eyes tear, you might sweat or flush, nose and eyelids can swell. They can last for months, then go away, then return. Get some help from your doctors, obviously. Try to find any triggers, and follow a sort of migraine approach as both are classed as ‘autonomic’ headaches.

Medication Overuse Headache

The irony of these, honestly! You can start to get rebound/overuse headaches from headache meds, especially opioids. If you start a different type of headache than the one you have been taking the meds for and it’s there most of the time, that’s a clue. The aim is to try and find the causes of the original headache and reduce dosage as much as you can, with GP support.

OK, lots to help you there! My head is now mush, so I’m off for a lie down in a darkened room with some peppermint oil on my temples!

IMPORTANT. Obviously, these are my thoughts and ideas. You are not my patient and I don’t have your full case, so please do discuss this with your chosen health professionals. These ideas are for your consideration only.

Sharing all the knowledge and good stuff after 30 years in-clinic with thousands of patients just like you. If using Natural Dispensary, please use Micki Rose during registration when prompted, or via Amrita, use 4Y2AE7. If you become a newsletter subscriber, you will get a list of discount codes to use too, cos I’m nice like that 🙂

Books and Shop are here.

Follow me here.