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Paying attention to what you eat and drink may help prevent headache or migraine attacks.

What to Eat and What to Avoid If You Get Migraine Headaches

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Migraines are far more than just a bad headache. Experts believe migraine headaches are caused by abnormal brain activity, including dilation and constriction of the blood vessels within the brain. An attack can last from several hours to several days and affects a person’s ability to function at home and at work. A migraine can generate feelings of nausea, vomiting, sensitivity to light and sound, throbbing head pain, aura, and visual distortion, causing a person to want to withdraw and seek immediate relief. If you have never experienced a migraine headache, consider yourself lucky, but for those who do, finding a way to manage the pain and lessen the frequency is a top priority.

Knowing what triggers your migraine headaches is the best defense in avoiding them, especially since triggers can be cumulative. While there are a number of potential causes of a migraine – including hormones, stress, weather, medications, and environmental factors – for many, dietary triggers are a major contributor. Keeping a detailed journal for several weeks may sound tedious, but the effort you put in will be well worth it. With some careful recording, a pattern should be detected. Doing this, along with a thorough physical exam to look for possible nutritional deficiencies (migraine sufferers tend to be deficient in magnesium, vitamin B (riboflavin), vitamin D, and CoQ10), and a detailed discussion with your physician or migraine specialist will put you well on your way to regaining the quality of life you have lost.

When considering how you can reshape your diet to improve migraine symptoms, the bottom line is to eat fresh, not processed, food. The more work that goes into preparing foods for the consumer, the more likely it is that it will have an additive that may be a trigger for you. In general, the following food guidelines will benefit most migraine sufferers.

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What to Eat

Halibut, mackerel, and salmon

Opt for the fattier fishes at the grocery store to make sure you are getting enough omega-3 fatty acids. Diets high in omega-3s and low in omega-6s have been found to lessen the frequency and occurrence of migraine headaches,

Cashews, almonds, and pumpkin seeds

Because of their high magnesium content, cashews, almonds, and pumpkin seeds are the nuts to turn to if you suffer from migraines. Aim for 1 ounce per day.

Steel-cut oatmeal

Drops in blood sugar can be a trigger for many migraine sufferers. To maintain steady blood-sugar levels, eat foods with a low-glycemic index, like steel-cut oatmeal and oat bran.

Spinach

Popeye ate it for energy and iron, but migraine sufferers will appreciate spinach for its high folic acid (B9) content. A 2024 study folate’s relationship with the frequency of migraine found that participants who increased their intake of folic acid experienced an improvement in their migraine symptoms. A review of 11 studies regarding the role of vitamin-B supplementation to treat migraines found it to be an effective treatment for adults, with few side effects. Other dietary sources of vitamin B include mushrooms, asparagus, and eggs.

Incidentally, spinach is also high in magnesium, doubling its migraine-fighting properties. Whether it’s steamed, fresh, or sautéed, try adding a spinach dish to the menu once a week!

Water

Staying hydrated is one of the most important things you can do for your body in general, and you’ll see that it will help with migraines too. Eight glasses of water each day is recommended, but if you consistently miss that mark make sure to snack on foods with high water content, like cucumbers, apples, and pears!

What to Avoid

Alcoholic beverages

Red wine, beer, and whiskey, in particular, have been cited in numerous studies to be triggers for migraines. Alcohol is the most frequently reported trigger by those suffering from migraines, with most studies finding a prevalence rate between 29 and 36 percent.

Baked goods

Wheat flour, found in most traditional baked goods, contains the protein gluten. If you are sensitive to gluten (approximately 6 percent of the population is) or if you have the autoimmune disorder celiac disease (it is suspected that there are more people with undiagnosed celiac disease than diagnosed), even small amounts of gluten can set off an inflammatory response in your body. While celiac disease can be diagnosed through specialized testing by your physician, there are no specific tests for gluten intolerance. Eliminating all gluten from your diet for at least two weeks and monitoring your symptoms is the only reliable way to make the diagnosis of gluten-sensitivity at this time. Along with intestinal problems, neurological presentations—including migraines—are common to both diseases. If you think gluten may be the cause of your migraine, talk to your physician before you adopt a gluten-free diet for a better understanding of how it will affect your overall health.

Processed meats

In order to maximize the shelf life and flavor of processed meats and fish, such as hot dogs, sausages, bacon, deli meats, and smoked fish, manufacturers add the food preservatives sodium nitrate and sodium nitrite. When we consume foods with nitrates and nitrites the result is an increase in nitric oxide, which has been linked to an increase in the occurrence of migraine headaches. Furthermore, a very interesting study found that people whose intestinal microbiome contained a higher level of particular bacteria that facilitates the breakdown of nitrates were more likely to suffer a migraine attack after eating food that contained them.

Aged cheeses

Cheese lovers, beware! Certain aged cheeses, such as blue, Brie, cheddar, provolone, Gorgonzola, and Parmesan all contain tyramine, a naturally occurring substance found in aged and fermented foods that have long been linked to an increase in migraine headaches.

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MSG

It’s not just in your Chinese food! Monosodium glutamate, which has a long, proven history of causing headaches and migraines, is a flavor enhancer that can be found in food items from marinades and salad dressings to chips, seasonings, even canned tuna! It has so many aliases – natural flavoring, hydrolyzed plant protein, komu extract – that unless you are an expert in food labels, it’s hard to know if you’re eating it or not. The bottom line—if you eat a lot of processed, packaged, or restaurant foods, you’re likely eating a good amount of MSG.

Artificial sweeteners

They are found in beverages, baked goods, candies, and scores of other processed foods, and for many, artificial sweeteners such as aspartame are a migraine trigger.

Citrus fruits

It may surprise you to see citrus fruits on this list, but octopamine, a chemical compound found in certain citrus fruits, can cause migraines with aura for those who are sensitive.

Bottom line

The only way to improve the frequency of migraines is to understand what is causing them. Our providers have years of experience treating patients with chronic migraines and we can help you uncover the root cause of your pain. To speak to an experienced nurse today, please give us a call at 703-532-4892.

Watch now: Dr. Lisa Lilienfield on “The Mystery of Migraines”

Praise for Dr. Kaplan’s book – Why You Are Still Sick: How Infections Can Break Your Immune System & How You Can Recover

“Gary Kaplan is not only a pioneer in his field, he’s a badass who is changing the face of medicine. This book holds everything I wish I knew twenty years ago about autoimmunity. It’s an incredible resource for anyone with chronic pain and illness. It will bring hope and health to so many people.”

– Dave Asprey, founder, Bulletproof 360

References

Finocchi C, Sivori G. Food as trigger and aggravating factor of migraine. Neurol Sci. 2012 May;33 Suppl 1:S77-80. doi: 10.1007/s10072-012-1046-5. PMID: 22644176.

Sun-Edelstein C, Mauskop A. Foods and supplements in the management of migraine headaches. Clin J Pain. 2009 Jun;25(5):446-52. doi: 10.1097/AJP.0b013e31819a6f65. PMID: 19454881.

Haghdoost F, Togha M. Migraine management: Non-pharmacological points for patients and health care professionals. Open Med (Wars). 2022 Nov 23;17(1):1869-1882. doi: 10.1515/med-2022-0598. PMID: 36475060; PMCID: PMC9691984.

Saedisomeolia A, Ashoori M. Riboflavin in Human Health: A Review of Current Evidences. Adv Food Nutr Res. 2018;83:57-81. doi: 10.1016/bs.afnr.2017.11.002. Epub 2018 Feb 2. PMID: 29477226.

Razeghi Jahromi S, Ghorbani Z, Martelletti P, Lampl C, Togha M; School of Advanced Studies of the European Headache Federation (EHF-SAS). Association of diet and headache. J Headache Pain. 2019 Nov 14;20(1):106. doi: 10.1186/s10194-019-1057-1. PMID: 31726975; PMCID: PMC6854770.

Chen YS, Lee HF, Tsai CH, Hsu YY, Fang CJ, Chen CJ, Hung YH, Hu FW. Effect of Vitamin B2 supplementation on migraine prophylaxis: a systematic review and meta-analysis. Nutr Neurosci. 2022 Sep;25(9):1801-1812. doi: 10.1080/1028415X.2021.1904542. Epub 2021 Mar 29. PMID: 33779525.

Tian S, Yu X, Wu L, Zheng H, Zhong X, Xie Y, Wu W. Vitamin B6 and folate intake are associated with lower risk of severe headache or migraine in adults: An analysis based on NHANES 1999-2004. Nutr Res. 2024 Jan;121:51-60. doi: 10.1016/j.nutres.2023.11.008. Epub 2023 Nov 15. PMID: 38042023.

Zaeem, Z., Zhou, L. & Dilli, E. Headaches: a Review of the Role of Dietary Factors. Curr Neurol Neurosci Rep 16, 101 (2016). https://doi.org/10.1007/s11910-016-0702-1

Bagdy G, Riba P, Kecskeméti V, Chase D, Juhász G. Headache-type adverse effects of NO donors: vasodilation and beyond. Br J Pharmacol. 2010 May;160(1):20-35. doi: 10.1111/j.1476-5381.2010.00643.x. Epub 2010 Mar 19. PMID: 20331608; PMCID: PMC2860203.

D’Andrea G, Gucciardi A, Leon A. Elusive amines: migraine depends on biochemical abnormalities. Neurol Sci. 2022 Nov;43(11):6299-6304. doi: 10.1007/s10072-022-06241-2. Epub 2022 Jul 16. PMID: 35840874.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

This article was originally published in March, 2017. It was reviewed and updated in Jan 2024.

Treating GERD with Natural Remedies

Natural Remedies for Treating GERD

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It is not uncommon to occasionally experience acid reflux, but when it occurs repeatedly you may have Gastrointestinal Reflux Disease (GERD). Treating GERD is important because over time stomach acids can cause damage to your esophagus, pharynx, or respiratory tract.

Causes

GERD is the condition in which stomach acid frequently leaks upward into the esophagus, usually the result of a relaxed lower esophageal sphincter (LES). The LES is a ring of muscle that relaxes to let food pass through, and tightens to keep it from flowing back upward. When the muscle is weakened or malfunctions, symptoms of GERD may start to appear.

Certain foods may aggravate symptoms, such as spicy, greasy, or fried foods, peppermint, citrus, dairy, tomatoes, grains containing gluten, as well as caffeine and alcohol. Medications such as non-steroidal anti-inflammatories (NSAIDs), birth control pills, and some heart medications may also aggravate the symptoms. NSAIDs can also lead to bleeding and ulceration in the stomach or small intestine. In some cases, GERD is a result of a hiatal hernia or a bacterial infection called Helicobacter Pylori.

For successful long-term results, it is essential to first pinpoint the root cause of your reflux.

Symptoms

The most common symptom of GERD is frequent heartburn, but other common symptoms include cough, hoarseness, sore throat, bad breath, wheezing, difficulty swallowing, and indigestion.

If your symptoms are persistent or severe, give us a call today at 703-532-4892 to make an appointment. Our providers can customize a holistic treatment plan to address not just your GERD symptoms, but any other underlying factors that are keeping you from feeling better


 

Treatment options for GERD

When GERD symptoms are mild, natural remedies can be a safe and effective option for managing GERD. Recommendations may include one or a combination of the following.

  1. Lifestyle modifications: Try to adjust your routine to eat smaller meals more frequently throughout the day. If possible, elevate your head while sleeping, and don’t eat too close to your bedtime so you have more time to digest your food before lying down. Lying on your left side when sleeping may also help with digestion.
  2. Dietary modifications: Nutritionally, start by eliminating inflammatory foods. Keeping a food diary may sound tedious, however, it is a great way to identify possible triggers. Once they are identified, dietary modifications can help reduce the severity of symptoms. Certain diets have also been found to be helpful as well – such as paleo and/or low FODMAP diets.
  3. Weight loss: Losing weight may improve, or for some, eliminate symptoms. Carrying extra weight can add pressure on your stomach which leads to stomach acids traveling to the esophagus.
  4. Quit smoking: If you are a smoker, stop smoking. Among the many other negative health effects, smoking weakens the esophageal sphincter which in turn increases acid reflux symptoms.
  5. Herbal remedies/nutritional supplements: There are a variety of herbal remedies and supplements that can ease GERD symptoms because of their anti-inflammatory and antioxidant capabilities as well as their ability to support the microbiome. Based on a patient’s health profile, we may recommend one of the following: DGL (deglycyrrhizinated licorice root), marshmallow root, slippery elm, aloe vera juice that has been fractionally distilled, digestive enzymes, ginger, Betain with HCL, magnesium, and turmeric, apple cider vinegar, chamomile tea, probiotics. (Check with your provider before taking any supplement.)
  6. Acupuncture: Acupuncture promotes relaxation, can improve gastrointestinal motility, and can restore balance to the microbiome.
  7. Meditation/relaxation practice: Perhaps the simplest change you can make is practicing meditation. Mindfulness-based Stress Reduction (MBSR) practice can help GERD symptoms by reducing stress and anxiety – both of which can aggravate symptoms.

 

Depending on how severe your GERD symptoms are, your provider may prescribe medication. Acid blockers may be necessary for severe gastritis, ulcer, or Barrett’s esophagus, which is a precancerous condition. However, prolonged use can lead to calcium and magnesium deficiency, and achlorhydria (absence of hydrochloride acid) leading to an overgrowth of bacteria in the small intestine (SIBO). This condition and H. Pylori are diagnosed by a breath test and both are treated with different antibiotics or supplements, like garlic and Candibactin. Research has also confirmed that the long-term use of certain types of acid blockers – PPIs – can increase the risk of a cardiac event and also increase the risk of dementia, so it’s extremely important to speak to your provider about the risks, benefits, and length of use.

If you have GERD, a holistic treatment plan that includes medication, lifestyle changes, and alternative therapies can provide significant relief from your symptoms. We can help. Please call us at 703-532-4892 to make an appointment.

References

https://www.sciencedirect.com/science/article/pii/S0254627215301515?via%3Dihub

https://www.sciencedirect.com/science/article/pii/S027153171931187X

https://pubmed.ncbi.nlm.nih.gov/33351048/

https://pubmed.ncbi.nlm.nih.gov/30864012/

https://pubmed.ncbi.nlm.nih.gov/35148031/

https://www.frontiersin.org/articles/10.3389/fcvm.2022.767987/full

Additional resources

For more information on how to treat acid reflux symptoms while staying heart healthy, click here.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

This article was originally published in January 2016. It was reviewed and updated in December 2023.

gluten free options

When Going Gluten-free Makes Sense

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Gluten is a general name for the family of proteins found in the grains wheat, barley, and rye. Glutenin and gliadin, the 2 main proteins in gluten, are responsible for giving dough its characteristic elasticity and glue-like structure before the baking process and its wonderful texture and rise when baked.

Most people can eat gluten without any problem. However, for some, even the smallest amount of gluten can trigger a wide array of inflammatory reactions in the body when consumed, with symptoms sometimes lasting for months. Sensitivity to gluten presents across a spectrum, sometimes being the primary factor that is making a patient ill, but more often it exacerbates an existing pain condition.

Gluten is directly correlated with 3 major gastrointestinal disorders: Celiac disease (CD), non-celiac gluten sensitivity (NCGS), and wheat allergy.

Celiac disease

Celiac disease is an autoimmune disorder that is triggered by eating foods that contain gluten. Even miniscule amounts can trigger a reaction. Celiac disease is characterized by the damage and atrophy of the villi of the intestinal cell lining. The villi are finger-like extensions that extend from the wall of the small intestine into the lumen. The primary role of these villi is to absorb nutrients from the foods we consume. This damage leads to an increase in the space between cells, allowing food particles to enter the bloodstream (also referred to as intestinal permeability or “leaky gut”), and triggers an inflammatory immune response.  CD can directly cause atopic problems, nutritional deficiencies, and anemias. Research also confirms that individuals with CD have a higher risk of developing other autoimmune disorders, such as Type 1 Diabetes, Sjogren’s Syndrome, Rheumatoid Arthritis, and Hashimoto’s thyroiditis.

Celiac disease is also genetically linked, thus, anyone with a relative who has CD is at higher risk to develop it themselves. You can be tested for celiac disease just as you can be tested for food allergies and food sensitivities.

If you have been diagnosed with Celiac disease, going gluten-free is a must. Usually, after following a gluten-free diet (GFD) for just one month the health of patients with celiac disease improves dramatically.

Non-celiac gluten sensitivity

People with non-celiac gluten sensitivity share many of the symptoms common to celiac disease but do not test positive for CD. Once gluten is eliminated from one’s diet, patients with NCGS will quickly see an improvement in several symptoms.

Wheat allergy

Wheat allergy is an allergic reaction to any number of the proteins found in wheat, not necessarily gluten. A person diagnosed with a wheat allergy must avoid eating any form of wheat to avoid triggering an immune reaction but can tolerate eating gluten found barley and rye.

Symptoms of celiac disease & non-celiac gluten sensitivity

The most common symptoms of celiac disease and gluten sensitivity are listed below. Individuals with these conditions can experience a combination of any number of symptoms and some people with CD report having no symptoms at all.

Gastrointestinal:

  • Chronic diarrhea and/ or constipation
  • Chronic indigestion
  • Dehydration
  • Irritable Bowel Syndrome
  • Flatulence
  • Sores or ulcers inside the mouth
  • Poor appetite and lactose intolerance
  • Recurring abdominal bloating, cramping, distention or pain and vomiting

Extra-intestinal:

  • Anxiety and Depression
  • Extremely itchy skin rash called dermatitis herpetiformis (DH)
  • Fatigue
  • Fluid retention
  • Hair loss
  • Joint pain, muscle weakness or cramping
  • Migraine headaches
  • Peripheral Neuropathy (tingling and numbness in hands and feet)
  • Vitamin deficiencies, especially Vitamin D
  • Weight loss
  • Cognitive impairment

The following foods usually or often contain gluten:

  • Breading, coating, Panko (Japanese breadcrumbs) (wheat)
  • Cakes, pastries, cookies, pies, etc. (wheat)
  • Broth, soup bases (barley)
  • Brown rice syrup (barley)
  • Candy, for example, licorice (wheat) and some chocolates (barley)
  • Croutons (wheat)
  • Breakfast cereals (wheat, barley)
  • Imitation bacon (wheat)
  • Imitation seafood (wheat)
  • Processed lunchmeat, sausages, frankfurters (wheat)
  • Marinades (wheat, barley)
  • Pasta (wheat)
  • Sauces, gravies (wheat)
  • Self-basting poultry (wheat)
  • Soy sauce or soy sauce solids (wheat, barley)
  • Stuffing, dressing (wheat)
  • Thickeners (roux) (wheat)
  • Communion wafers (wheat)
  • Herbal supplements (wheat)
  • Drugs and over-the-counter medications (wheat)
  • Nutritional supplements, Vitamins, and mineral supplements (wheat)
  • Play-Doh (wheat)
  • Beer, ale, porter, stout, malt liquor (wheat)

Behind the label

In the last several years, we have seen tremendous growth in gluten-free products available in grocery stores and restaurants, and the number of gluten-free cookbooks has grown exponentially. In 2013, the FDA required that food manufacturers who wished to use a “gluten-free” label on their products had to limit its gluten content to 20 parts per million or less. The FDA chose this standard based on evidence that suggests that most individuals with celiac disease can tolerate “variable trace amounts and concentrations of gluten in foods (including levels that are less than 20 ppm gluten) without causing adverse health effects.”

In 2020, “gluten-free” labeling requirements extended to fermented or hydrolyzed foods. The FDA’s rule requires that manufacturers themselves keep records to support the “gluten free” claim.

Going gluten-free can be tricky; federal law requires wheat and the other top food allergens (milk, eggs, fish, Crustacean shellfish, tree nuts, peanuts, wheat, sesame, and soybeans) to be clearly identified on food labels, but there are no regulations regarding barley, rye, and oats. For example, if you see a label that lists malt extract, malt vinegar, malt flavoring, or brewer’s yeast, that product will contain some barley. Learning what to look for on a food label is essential!

Do oats contain gluten?

Strictly speaking, no, but oats have been found to be at risk of contamination with gluten during its production process. Gluten-free oats are available and should be labeled as such. Many people with CD can eat a small amount of gluten-free oats without a problem. A percentage of people with CD react the same way to the protein in oats as they do to gluten.

Should you go gluten-free without a diagnosis or symptoms?

Important to note is that implementing a gluten-free diet without a Celiac diagnosis or without any symptoms of sensitivity does not come without some risk. A review published in Clinical Nutrition in 2016 found people who follow a gluten-free diet are at higher risk of developing nutritional deficiencies. The reason? Many processed gluten-free foods on the market are lower in vitamins and minerals, such as Vitamin B12, Vitamin D, folate, magnesium, iron, and calcium, than their non-gluten-free counterparts.

What can you eat on a gluten-free diet?

Plenty! In addition to all of the processed gluten-free products on the market, fruits, vegetables, meat and poultry, fish and seafood, dairy, beans, legumes, and nuts are all part of a healthy, gluten-free diet.

The following grains do NOT contain gluten: rice, corn (maize), millet, quinoa, sorghum, buckwheat, amaranth, teff, flax, chia, and nut flours.

In sum, a gluten-free diet is necessary for all patients with celiac disease and highly recommended for patients with a commonly associated autoimmune disorder (Sjogren’s disease, Hashimoto’s thyroiditis). Our experience at the Kaplan Center has also shown that patients with non-Celiac, inflammatory conditions, such as arthritis, chronic muscle pain, chronic fatigue, and fibromyalgia, also see great improvements in their health when implementing a gluten-free diet.

Learning how to dissect food labels and understanding what ingredients indicate the presence of gluten is the key to staying gluten-free! By eliminating your exposure, a GFD can provide a clean slate to curb the cycle of inflammation.

If you are experiencing some of the symptoms above and have not been able to find resolution, please give us a call and make an appointment. We’re here to help you get to the root cause of your symptoms so healing can begin. Call 703-532-4892.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

overlooked causes of migraines

5 Overlooked Causes Of Migraine Headaches

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With migraine headaches, it’s important to look beyond the symptom to target the disease.

Lindsay was 23 years old, fresh out of college, and working at her dream job in Washington, D.C., as a congressional aid. Working in Congress, 10-hour days are the norm and for Lindsey, typically the first to arrive in the morning and last to leave in the evening – that was a short day.

She was in charge not only of the Senator’s schedule but also required to be at his side taking notes at all his meetings, as well as keeping him informed as to who he was meeting with and why.

Young, energetic, with an excellent memory and a gift for attention to detail, Lindsay was a rapidly rising star in the highly competitive world of Capitol Hill. When we met, Lindsay was clearly intelligent, completely charming, and terrified that everything she had achieved could be completely undone by progressively crippling migraines.

She had suffered from migraines since she was 16 and had seen several physicians, including neurologists. Yet despite trials of numerous medications, the headaches had become more frequent and debilitating within the last year.

According to the American Migraine Foundation, 1 billion Americans of all ages suffer from migraines. Women are disproportionately affected, impacting approximately 1 in 5 American women versus 1 in 16 men.

For most migraine sufferers, the attacks occur one to two times a month or less, but about 4 million people agonize with a migraine 15 days or more a month. Migraine headaches are regarded as one of the top 20 of the world’s most debilitating medical illnesses.

Most physicians treat migraines as a disease, when in fact, they may be a symptom. By this, I mean that if you go to your doctor complaining of headaches that are diagnosed as migraines, the appointment typically ends with a prescription for medications to either prevent the occurrence of the headache or treat the acute headache, with little if any testing.

It’s rare for any consideration to be given to why you get the headaches. But, if you can find the underlying cause, you have a much better chance of finding the cure.

Questions? Give Us a Call!

703-532-4892 x2

Here are five frequently overlooked causes of migraine headaches:

1. Celiac disease and gluten intolerance

Celiac disease is an autoimmune disease to gluten, a protein found in the grains wheat, barley, and rye. About 1% of the population suffers from Celiac disease and unfortunately, it’s estimated that over 80% of the people with Celiac disease are undiagnosed.

Gluten intolerance (GI) affects about 6% of the American population. GI, while not associated with the damage to the lining of the small intestines as seen in Celiac disease, can make you almost as sick as Celiac disease.

Because eating grains causes Celiac disease and GI, we tend to think that this is an intestinal problem and expect to see people complaining of abdominal symptoms such as bloating, diarrhea and abdominal pain. In fact, both these diseases can present with minimal or no gastrointestinal symptoms and a large number of other symptoms including migraines, peripheral nerve damage, seizures, anxiety disorders, depression, and even schizophrenia. This was documented in an excellent review published in 2012.

You can screen for Celiac disease with a simple blood test, but we do not have any reliable testing for GI as of yet. Treatment for both conditions is the elimination of all gluten-containing foods from your diet.

Questions? Give Us a Call!

703-532-4892 x2

2. Magnesium deficiency

This may play a role in the occurrence of migraines in up to 50% of the people who suffer from this condition. (An excellent summary of this research was published in 2012.)

Magnesium is essential for a wide range of functions in the body and unfortunately, it’s easy to become deficient in magnesium and difficult to measure with a blood test.

Low nutritional intake, excess consumption of coffee, sodas, and alcohol, chronic stress, chronic illness, and intestinal problems (such as Celiac disease creating problems with absorption of magnesium) can all lead to deficiency.

The foods highest in magnesium, such as halibut, mackerel, boiled spinach, bran breakfast cereal, and nuts such as almonds, cashews, and pumpkin seeds, are not foods that typically make up much of our diets.

I encourage my patients suffering from migraines to make the necessary dietary changes and to supplement with between 250 and 500mg of magnesium a day.

One of the side effects of taking magnesium is diarrhea. If you develop diarrhea while taking magnesium, decrease the dose or try switching the type of magnesium you are taking.

We also treat many of our migraine patients with IV magnesium.

3. TMJ disorder

The temporal mandibular joint (TMJ) is the joint where your jaw connects with your skull. The joints are located in front of your ears on either side of your face. If your teeth are misaligned or you grind your teeth, a condition called bruxism, you can develop dysfunction and pain at the TMJ.

Symptoms of TMJ dysfunction include popping of the joint, pain at the joint, difficulty opening your mouth, and headaches. Proper diagnosis and treatment require that you see a dentist familiar with this condition. The headaches caused by TMJ can be misdiagnosed as migraines and TMJ can be a trigger for migraines.

4. Thyroid disease

Both low and high thyroid levels can cause headaches. Thyroid disease, usually associated with fatigue, dry skin, and hair loss when thyroid levels are low, and rapid heart rate and anxiety when thyroid levels are high, may present with migraine as the only significant symptom. This so-called subclinical presentation of thyroid disease can also be seen in adults and children.

Diagnosis can be made with a simple blood test.

5. Mold toxicity

This is highly controversial, but in my experience, mold toxicity is a significant cause of many diseases, including migraines. Molds can produce allergic reactions when inhaled, but the bigger concern is the toxins called mycotoxins that are chemical toxins present within or on the surface of the mold.

Mold toxins can affect almost every organ in the body, but the brain is almost always affected, resulting in neurotoxicity. People with mold toxicity have complaints that vary from mild cognitive impairment to symptoms that look like multiple sclerosis.

Headaches are a common complaint of people suffering from mold toxicity. Mold toxicity should be considered in anyone who has migraines and a history of exposure to water-damaged buildings where mold grows. Unfortunately, very few doctors know about this condition or how to evaluate a patient for the problem. For more information on mold toxicity, see the Biotoxicity and Neurotoxicity page on this website or visit Dr. Shoemaker’s website SurvivingMold.com.

As it turns out, Lindsay’s migraines were a result of being gluten intolerant and having low magnesium levels. Once she eliminated all gluten from her diet and improved her magnesium levels with magnesium IVs, her migraines dramatically improved.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

"What Gluten Does"  An Excerpt from Total Recovery

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The following is the third in a series of excerpts on gut health from Dr. Gary Kaplan’s book “Total Recovery: A Revolutionary New Approach to Breaking the Cycle of Pain and Depression.”

“Leaky gut has been implicated in the growing number of food and environmental sensitivities affecting almost 25 percent of American adults. These are not food allergies, but delayed hypersensitivity reactions.1

As many as 40 percent of Americans are sensitive to gluten. One in 100 of those has a severe reaction in the form of an autoimmune disease, celiac disease.2

“Imagine gluten ingestion on a spectrum,” says Dr. Allesio Fasano, head of research at the University of Maryland Celiac Research Center. “At one end, you have people with celiac disease, who cannot tolerate one crumb of gluten in their diet. At the other end, you have the lucky people who can eat pizza, beer, pasta, and cookies – and have no ill effects whatsoever. In the middle, there is this murky area of gluten reactions, including gluten sensitivity or intolerance. This is where we are looking for answers.”3

Most doctors don’t know the difference. Some are unaware that gluten sensitivity can genuinely contribute to hundreds of diseases and that the symptoms may not manifest in the gut, but in other parts of the body.4

Years ago, we believed that celiac disease was a rare childhood syndrome. Today the average age of diagnosis is in individuals between ages 40 and 60. Celiac disease affects more than 2 million Americans – 1 in 133 people.5 Researchers have already confirmed that the dramatic rise in figures is not due to greater awareness. By testing old blood samples, they have shown that, in the last 50 years, the rate of celiac disease has increased fourfold.

Gluten intolerance is now estimated to affect 6 to 9 percent of the American population. Furthermore, people in their seventies, who have eaten gluten without problems their entire lives, are now experiencing gluten sensitivity.6

Unfortunately, gluten intolerance is sometimes viewed with skepticism. When the tests come back negative for celiac disease, many doctors dismiss their patients’ complaints rather than investigating further. Part of the problem is that, like allergy tests, gluten intolerance tests are not consistently reliable. While gluten intolerance is not an allergy to gluten, we have not yet found a definitive means of identifying it in the blood.

The only absolute way to determine gluten intolerance is to completely remove gluten from the diet for 6 weeks and see if the symptoms improve. It can be hard to tell. If there are other food intolerances and nutritional deficiencies at play, removing gluten may only eliminate some of the symptoms.

Peter Green, MD, director of the Celiac Disease Center, estimates that research into gluten intolerance is about 30 years behind celiac research.7 Without better research, patients are too often told it’s “all in their heads.” With a burgeoning series of product lines of gluten-free foods, estimated at $2.6 billion in sales last year alone, it is easy to assume that gluten intolerance is nothing more than a fad.8

It’s widely known that agricultural changes in wheat production over the past decades have altered wheat significantly and raised both its protein and gluten content.9 Some ascribe gluten sensitivity to the increase in our consumption of wheat. Gluten can now be found in everything from bread and canned goods to hand lotion and makeup.10 But the evidence is inconsistent. And the cause may lie in the bacteria in the gut itself. We’re beginning to suspect that gut bacteria determine whether the immune system treats gluten as food or as a deadly invader.11

In his studies of celiac disease, Dr. Fasano made an important discovery. He studied 47 newborns who were genetically at-risk for developing celiac disease. By the time they were 2 years old, these children had a fairly impoverished and unstable community of intestinal bacteria.12 As he continued to monitor their bacterial levels, the levels of lactobacilli declined in two children.

Both developed autoimmune diseases. One got celiac disease, and the other type 1 diabetes (which has a genetic proclivity similar to that of celiac disease).13

Dr. Fasano and his colleagues were excited. “Imagine what would be the unbelievable consequences of this finding,” he said. “Keep the lactobacilli high enough in the guts of these kids, and you prevent autoimmunity.”14

The questions is, was it the chicken or the egg? Which came first, the imbalance of bacteria or the autoimmune disease? Some studies show that intestinal inflammation accommodates bacteria that keep the inflammation going.15 As we’ve already observed, bacteria learn and fight hard to survive.

It’s a living system, where different choices can be made at any stage. Our genetics help determine our bacteria, but the bacteria can change us – turning genes off and on, adapting as they go. According to Bana Jabri, director of research at the University of Chicago Celiac Disease Center, even if the chicken comes first, the egg can contribute. “You have the same endpoint,” she says, “but how you get there may be variable.” Such complexity both confounds notions of one-way causality and suggests different paths to the same disease.16″

1 Lipski, Digestive Wellness
2 A. Fasano, “Zonulin and Its Regulation of Intestinal Barrier Function: The Biological Door to Inflammation, Autoimmunity, and Cancer,” Physiological Review 91, no. 1 (January 2011): 151–75, www.ncbi.nlm.nih.gov/pubmed/21248165.
3 Ibid.
4 Ibid.
5 A. Fasano et al., “Prevalence of Celiac Disease in At-Risk and Not-At-Risk Groups in the United States,” Archives of Internal Medicine 163, no. 3 (February 20, 2003): 286–92, www.ncbi.nlm.nih.gov/pubmed/12578508.
6 Melinda Beck, “Clues to Gluten Sensitivity,” Wall Street Journal, March 15, 2011, http://online.wsj.com/news/articles/SB10001424052748704893604576200393522456636.
7 Ibid.
8 Ibid.
9 Ibid.
10 Moises Velasquez-Manoff, “Who Has the Guts for Gluten?” New York Times, February 23, 2013, www.nytimes.com/2013/02/24/opinion/sunday/what-really-causesceliac-disease.html.
11 Ibid.
12 Ibid.
13 Ibid.
14 Ibid.
15 Ibid.
16 Ibid.

Reprinted from Total Recovery: A Revolutionary New Approach to Breaking the Cycle of Pain and Depression by Gary Kaplan, D.O., with permission from Rodale Books. Copyright (c) 2014 by Gary Kaplan, D.O..

To read Part 1 of this series, “Gut Feelings,” click here.
To read Part 2 of this series, “Hidden Immune System,” click here.

gut microbiome

“Gut Feelings”: An Excerpt From Total Recovery

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The following is the first in a series of excerpts on gut health from Dr. Gary Kaplan’s book “Total Recovery: A Revolutionary New Approach to Breaking the Cycle of Pain and Depression.”


“We now know that our intestinal tract has 100 million nerves – more than our spinal cords or peripheral nervous systems. With this radically new understanding, scientists have tentatively begun to refer to it as the body’s second brain.

As Michael Gershon, MD, explains in his book The Second Brain, the intestinal tract is far more independent than anyone had realized. It is even equipped with its own senses and reflexes.1

Surprisingly enough, our digestive systems manufacture just as many neurotransmitters as our brains. With the advent of “designer drugs” – such as selective serotonin reuptake inhibitors (SSRIs) – we have come to think of depression, anxiety, and insomnia in relation to the amount of serotonin circulating in the brain. Only recently has it become apparent that 95 percent of the body’s serotonin is manufactured not in the brain, but in the gut.2

Now it makes sense that the side effects of SSRIs often include intestinal problems.

In America more than two million people have irritable bowel syndrome (IBS), which may be caused, in part, from too much serotonin in the intestinal tract. As Adam Hadhazy points out in Scientific American, this means IBS – like other diseases caused by an imbalance of neurotransmitters in the gut – could almost be considered “mental illnesses” of the second brain.3

IBS may also signal an inflammatory process in the spinal cord or brain itself. An emergent theory on the cause of IBS is that it is a form of central sensitization. Inflammation in the spine increases sensitivity of the nerves controlling the muscles that line the intestinal tract and ensure the smooth flow of food throughout our digestive system. When the nerve signals from the spinal cord and brain to the intestines are disrupted, it can cause the intestinal muscles to spasm, resulting in pain and cramping. The muscles respond by becoming overactive (diarrhea) or underactive (constipation).4

As researchers have turned their attention to serotonin levels in the gut instead of in the brain, it has led to even more surprises. In a study of rodents at Columbia University Medical Center, scientists found that when they gave rodents with osteoporosis a drug that inhibited the release of serotonin in the gut, the disease disappeared. Gerard Karsenty, MD, lead author of the study and chair of the Department of Genetics and Development at Columbia, admitted, “It was totally unexpected that the gut would regulate bone mass to the extent that one could use this regulation to cure – at least in rodents – osteoporosis.”5

Dr. Gershon says, “We have never systematically looked at [the intestinal tract] in relating lesions in it to diseases like we have for the [central nervous system].”6 Once we have had time to investigate the implications of the second brain, important connections to diseases will be linked to the state of our gut.

We know that problems in the intestinal tract can go much further than heartburn and indigestion or constipation. Crohn’s disease, IBS, and ulcerative colitis also arise from imbalances in the gut.7 Early studies have suggested that imbalances in intestinal bacteria can cause “arthritis, diarrhea, autoimmune illness, B12 deficiency, chronic fatigue syndrome, cystic acne, colon and breast cancer, eczema, food allergy or sensitivity, inflammatory bowel disease, irritable bowel syndrome, psoriasis, and steatorrhea.” None of these conditions were previously recognized as being related to gut bacteria.8

Gradually, physicians reading the latest research are becoming aware that migraines are frequently triggered by food sensitivities that inflame the gut.9

Diseases like chronic fatigue syndrome, asthma, and fibromyalgia have a significant relationship to the intestinal tract. When balance is restored, the symptoms are often resolved. Any improvement in the health of our intestinal tract increases the effectiveness of our immune systems.

The question currently being investigated by researchers is: Can we analyze the stool to create a map of all the different types and amounts of bacteria in the gut and use it to predict illness? We’re hoping it can be done.”

1 Michael D. Gershon, MD, The Second Brain (New York, HarperCollins, 1998).
2 Lipski, Digestive Wellness.
3 Hadhazy, “Think Twice.”
4 Ibid.
5 Ibid.
6 Ibid.
7 Lipski, Digestive Wellness.
8 Ibid.
9 Ibid.

Reprinted from Total Recovery: A Revolutionary New Approach to Breaking the Cycle of Pain and Depression by Gary Kaplan, D.O., with permission from Rodale Books. Copyright (c) 2014 by Gary Kaplan, D.O.

To read Part 2 of this series, “Hidden Immune System,” click here.