triggers Any number of triggers can bring on a migraine, including such different factors as drinking alcohol, experiencing a change in the weather, and not getting enough sleep. Now one researcher has determined that these common migraine triggers and a host of others can produce oxidative stress in the brain. Such stress is marked by a build-up of damaging molecules called free radicals and can lead to pain. In a study published recently in Headache, Jonathan Borkum, PhD, of the University of Maine’s Department of Psychology, evaluated 2,000 studies about migraine triggers published between 1990 and 2014 and found that nearly all common migraine triggers are capable of generating oxidative stress. Based on those findings, he stated he believes oxidative stress can be a unifying principle behind the types of triggers countless migraineurs experience.

Q: I just recently started taking feverfew preventively to lessen my migraines, and I believe it is working. I would like to find out which brands are reputable and how many miligrams are suggested daily. I have so far tried 3 brands: Puritan's Pride feverfew (tanacetum parthenium), 380 mg per capsule; Elusanes Grande Camomille, 200 mg per pill; and Leinersan's Mutterkraut Chrysanthemum parthenium D4, 400 mg per capsule. I live in Switzerland, where the herb is not sold.

By Alexander Mauskop, M.D., FAAN Director, New York Headache Center, New York, NY Parents of kids with headache frequently ask about complementary and alternative approaches, hoping to avoid prescription medications and their associated side effects. As it turns out, scientific studies have shown that many of these alternative treatments can be beneficial in reducing headaches, with very few side effects. Taking these factors into account, the treatments described below are worth trying by most, if not all, headache sufferers. However, before considering any kind of medication, whether conventional or alternative, the first step is to make sure that the child has healthy habits. Parents and children, especially adolescents, should be counseled about the importance of regular and nutritious meals without any caffeine, chocolate or other known dietary migraine triggers. Frequent exercise and regular sleeping patterns are also important factors in decreasing headaches. Stress is a major contributor to headaches, even in young children. One of the best treatments for migraine and tension-type headaches is biofeedback. Many studies have shown that biofeedback works well, with long-lasting benefits. However, similar and less expensive techniques, such as self-taught progressive relaxation and meditation, work equally well. The advantage of biofeedback is that a biofeedback therapist can make the learning process easier and can act as a coach and motivator.

Q. I am 15 weeks pregnant with my first child and have been having severe headaches almost every day throughout my pregnancy. On the two headache-free days I’ve had, my head was tender and sore. I did not experience headaches on a regular basis prior to getting pregnant. The pain is on my left side, often in my left eye, and travels down the left side of my head to the base of my head and neck. Sometimes I wake up with these headaches and they last all day. The headaches start as a very light pain, but the pain quickly increases and can last several hours. Sound, light and even smell, along with motion, intensify the pain. I have looked for triggers for these headaches, but cannot find any obvious ones. These headaches make me very tired and irritable and incapacitate me. I only find any sort of relief by lying perfectly still in a pitch black room with no noise or smells. Concerned by these headaches, I called my OB/GYN and asked for advice. She referred me to a neurologist, who diagnosed me with migraines induced by pregnancy and prescribed Inderal(R). He also scheduled trigger point injections for later this month. Being pregnant, I am concerned about medications and treatments, so I read all I could find on Inderal and discovered that it is a class C pregnancy drug. I am concerned by what I read, but both my neurologist and my OB/GYN told me it is safe for my baby. Should I take Inderal or not? I wonder if other non-drug options exist. Would massage or a chiropractor be safe and helpful? I want to do what is best for my baby, but at the same time I realize I have 25 weeks of pregnancy to go and I am already exhausted and drained from the past 15 weeks of pain. I am honestly not sure I can take it.

By Christopher Hobbs (Excerpted from the National Headache Foundation Newsletter) Feverfew is Tanacetum parthenium, a member of the daisy family. However, it is sometimes obtained under the name of Chrysanthemum parthenium. It is easy to confuse the medicinal variety of feverfew with chrysanthemum or even other varieties of feverfew — though none of these are toxic, so a mistake would not be injurious.