 Let's say you're trying to find some solid information about a serious health problem that concerns you, a high blood pressure, diabetes, yet everywhere you look someone's trying to sell you something like vitamins, yoga mats, blenders, drugs, well, breathe a sigh of relief because all we bring you are the facts, welcome to the Nutrition In fact, SpodGast, I'm your host, Dr. Michael Greger, does even thinking about migraines give you a headache? Well, you're not alone. Migraines affecting an estimated 10% of the population worldwide. In our first story, we put plant-based diets to the test for treating migraine disorders. Headaches are one of the top five reasons people end up in emergency rooms and one of the leading reasons for which people see their doctors in general. One of the things you can try to do to prevent them is identify the triggers and avoid them. The common triggers for migraines include stress, smoke, hunger, sleep issues, certain trigger foods like chocolate, cheese, and alcohol, your menstrual cycle, or certain weather patterns. In terms of dietary treatments, the father of modern medicine, William Osler, suggested trying a strict vegetable diet. After all, the nerve inflammation associated with migraines may be reduced by a strictly plant-based diet, as many plant foods are high in anti-inflammatory compounds and antioxidants, and likewise meat products may have pro-inflammatory properties, but it wasn't put to the test for another 117 years. Among those given a placebo supplement, half said they got better, half said they didn't. But when put on a strictly plant-based diet, they did much better, experiencing a significant drop in the severity of their pain. Now it's possible that the pain-reducing effects of the plant-based diet may have at least been in part due to their weight reduction. They lost about 9 more pounds in their vegan month. Even just lowering the fat content of the diet may help. Those placed on a month of consuming less than 30 grams of fat a day, like less than two tablespoons of oil all day, experienced highly significantly decreases in headache frequency, intensity, duration, and the need to take medications. A six-fold decrease in frequency and intensity from three migraine attacks every two weeks down to just one a month. And by low fat, they didn't mean snack wells. They meant more fruits, vegetables, beans. Before the food industry co-opted and corrupted the term, eating the low fat meant like eating an apple, not apple jacks. Now this is a really low-fat diet, like 10% fat for someone eating 2500 calories a day. What about just less than 20% fat compared to a more normal, but still relatively lower fat diet than average? Same significant drops in headache frequency and severity, including a five-fold drop in attacks of severe pain. Since the intervention involved at least having of saturated fat intake, mostly found in meat, dairy, and junk, the researchers concluded that a reduction of saturated fat intake may help control migraine attacks, but it's not necessarily something they're getting less of. There are compounds present in live green real veggies that might bind to a migraine-triggering peptide known as CGRP. Drug companies have been trying to come up with something that binds to it, but the drugs have failed to be effective and are also toxic, a problem you don't see with cabbage. Green vegetables also have magnesium found throughout the food supply, but mostly concentrated in green leafy vegetables, beans, nuts, seeds, and whole grains. It's essentially the central atom to chlorophyll, so you can see how much magnesium foods have in the produce by the intensity of their green color. Magnesium supplements do not appear to decrease migraine severity, but may reduce the number of attacks you get in the first place. You can ask your doctor about starting 600 milligrams of magnesium diacetrate every day, but note magnesium supplements can cause adverse effects such as diarrhea, so I recommend getting it in the way nature intended. Any foods that may particularly help—I've talked about ground ginger—combining caffeine with over-the-counter painkillers like Tylenol, aspirin, and ibuprofen may boost their efficacy of about 130 milligrams for tension-type headaches and 100 milligrams for migraines. What you might expect to get in three cups of tea, though I believe it's just a coincidence that the principal investigator was named Lipton. Note you can overdo it. If you take kids and teens who have headaches drinking one-and-a-half liters of cola a day and cut the cola, you can cure 90% of them, though this may be a Coca-Cola effect rather than a caffeine effect. Did you know that the daily application of capsaicin results in up to an 80% therapeutic response rate for a certain type of headache? Here's the story. It appeared worthwhile to study the effects produced by the topical application of capsaicin in the human nose. It therefore appeared worthwhile because it never had been done before? Okay. So they took some medical students, dripped some in their nose, and they started sneezing, burning, and snotting, and describing the pain as like 8 or 9 on a scale of 1 to 10. No surprise, but here's the interesting part. What do you think happened when they repeated the experiment the next day? You'd think they might be sensitized to it, you know, still all irritated and so it might hurt even worse, but no, it hurt less. When they did it again the next day and the next, by day 5 it hardly hurt at all. They didn't even get a runny nose, no sneezing. Came back the next week, day 10, and still nothing. Sheesh, were they like permanently numbed? No, after a month or so the desensitization wore off and they were back in agony whenever they tried rubbing it in their nose. What the researchers think is happening is that the pain fibers, the nerves that carry pain sensation, dumped so much of the pain neurotransmitter called Substance P that they ran out. Day after day of this, the nerves had exhausted their stores and could no longer transmit pain messages until they made more Substance P from scratch, which takes a couple weeks. This gave researchers an idea. There's a rare headache syndrome called cluster headache. It's been described as one of the worst pains humans experience. Few, if any, medical disorders are more painful. It's nicknamed the Suicide Headache because patients often consider taking or have taken their lives over it. It's thought to be caused by arterial dilation putting pressure on the trigeminal nerve in the face. Treatments involve everything from nerve blocks to Botox to surgery, but hey, that same nerve goes down to the nose. What if we caused the whole nerve to dump all its Substance P? Preventive effect of repeated nasal applications of capsaicin in cluster headache. Same as before, capsaicin in the nose and by day 5 they could hardly feel it anymore. These were cluster headache sufferers, and so what was rated as an 8 or 9 on the pain scale by the wimpy medical students was like maybe a 3 or 4 by those used to the violence of the cluster headache attacks. Having achieved desensitization, what happened to their headaches? Well, cluster headaches are one-sided headaches. You only get pain on one side of your head. So those who had rubbed capsaicin in the opposite nostril on the wrong side of the head, nothing happened. They started out having like 40 attacks a day, and a month later the headaches were still going strong. But those that rubbed the capsaicin in the nostril on the side of the head where the headaches were cut the average number of attacks in half. And in fact, half the patients were cured. The cluster headaches were gone completely. All in all, 80% responded. At least equal, if not better, than all the current therapies out there. Finally, today we discover the power of powdered ginger for migraines. Many successful herbal treatments start like this. Some doctor learns that some plant has been used by some ancient medical tradition, like ginger for headaches. And figures, hey, they've got patients with headaches, and since it's just some safe common spice, advises one of their migraine patients to give it a try. At the first sound of a migraine coming on, the patient mixed a quarter teaspoon of powdered ginger and some water, drank it down, and poofed. Within a half hour, the migraine went away. And it worked every time. No side effects. This is what's called a case report, which is really just a glorified anecdote. But case reports have played an important role in the history of medicine. AIDS was first discovered as a series of case reports. Some young guy walks into a clinic in Los Angeles with a bad case of thrush, and the rest is history. Or reports of an unusual side effect of a failed chest pain drug leading to the billion-dollar blockbuster Viagra. Case reports are maybe the lowest or weakest form of evidence, but they're often the first line of evidence. That's where everything begins. So a report like this isn't helpful in and of itself, but it can inspire researchers to put it to the test. The problem is, who's going to fund it? The market for migraine drugs is worth billions of dollars. A quarter teaspoon of powdered ginger costs about a penny. So who'd fund a study pitting ginger versus the leading migraine drug? No one, until now. A double-blinded randomized controlled clinical trial comparing the efficacy of ginger to Sumitriptan, also known as Imitrex, one of the top-selling billion-dollar drugs in the world in the treatment of migraine headaches. They tried using just one eighth of a teaspoon of powdered ginger versus a good dose of the drug, and they both worked just as well, just as fast. Most started out in moderate or severe pain before, but after the drug or ginger ended up mild or pain-free. The same proportion of migraine sufferers reported satisfaction with the results either way, and so as far as I'm concerned, ginger won. Not only because it's a few billion dollars cheaper, but because there were significantly fewer side effects in the ginger group. On the drug, people reported dizziness, sedative effect, vertigo, and heartburn. The only thing reported for ginger was an upset tummy in about one in 25 people, taking a whole tablespoon of ginger powder at one time on an empty stomach could irritate anyone's tummy, just as a note of caution. Sticking to an eighth of a teaspoon is not only up to 3,000 times cheaper than the drug, but you're probably less likely to end up as a case report yourself of people that have had a heart attack or died after taking the drug. We would love it if you could share with us your stories about reinvention of your health through evidence-based nutrition. Go to nutritionfacts.org slash testimonials, which may be able to share it on social media to help inspire others. If you'd like to see any graphs, charts, graphics, images, or studies mentioned here, go to the Nutrition Facts Podcast landing base. There you'll find all the detailed information you need, plus links to all the sources we cite for each of these topics. My last two books were a How to Survive a Pandemic and my How Not to Diet Cookbook. Get ready this year for the launch of How Not to Age, and of course all the proceeds for the sales of all my books goes directly to charity. NutritionFacts.org is a non-profit science-based public service, where you can sign up for free daily updates on the latest new nutrition research with bite-sized videos and articles uploaded nearly every day. Everything on the website is free, there are no ads, no corporate sponsorships, no kickbacks, it's strictly non-commercial, not selling anything. I just put it up as a public service as a labor of love as a tribute to my grandmother, whose own life was saved with evidence-based nutrition.