No More Headaches! – Identifying Triggers & Enacting Positive Lifestyle Changes

headaches

No More Headaches! – Identifying Triggers & Enacting Positive Lifestyle Changes

Headaches are one of the most common health concerns that bring new patients to Spark Health.In 2018, the CDC reported that 20% of women and 10% of men experience severe headaches or migraines. Certainly, an even higher percentage of women and men experience headaches that, though milder, still interfere with daily life.  

There are several types of headaches each with varying levels of severity – tension headaches, cluster headaches, and migraine headaches to name a few. Regardless of which type afflicts you, any headache can cause significant disruption to daily activities and lives.   

The bad news is that there is still much we do not know about the specific etiology of headaches. There are so many potential causes and triggers that it can be hard to pinpoint just what is behind the throbbing. The good news is that once you do identify your personal headache triggers it is likely that you will be able to treat them simply by making lifestyle changes – such as increasing daily hydration or practicing better sleep hygiene. That’s why when patients work on health in a holistic, integrative way, headaches usually decrease in frequency and severity as a result.

Keep reading to find out what might be triggering the pounding between your ears, and the lifestyle changes you can enact to rid yourself of those headaches once and for all.

Trigger #1: Posture

Often overlooked as a trigger, posture can play a significant role in headache onset. Chronic poor posture can cause tension to build in the back, shoulders, and neck and as the pain moves up the body a tension headache can soon ensue. It’s no wonder that tension headaches are the most common type of headache globally, with an estimated 2 in 3 US adults experiencing tension headaches regularly.

Especially in the past year with the COVID-19 quarantine, many people are working from home and sitting in the same positions for much longer periods of time which can wreak havoc on the body and promote poor posture. Make sure to pay attention to your posture throughout the day and try to not spend too much time sitting or standing in the same position for too long. Taking regularly scheduled walks to break up the day, purchasing an ergonomic chair for your home office, and incorporating practices like yoga and Pilates into your daily routine are all things you can do to better improve posture over time.

Trigger #2: Food & Drink Sensitivity 

Most people consume foods regularly that they have a sensitivity to.  That’s because, unlike allergies or intolerances, food sensitivities cause a delayed immune response making it very difficult to pinpoint the specific food triggering the response. Unfortunately, headaches are one of the most well documented manifestations of a food sensitivity.

Food sensitivity testing can be helpful in revealing which foods are potential triggers for the inflammation that can cause headaches. Many of the most common food triggers – such as aged cheeses, cured meats, fermented foods, citrus fruits, and chocolate – contain tyramine, an amino acid that plays a role in blood pressure regulation. It is thought to cause the release of norepinephrine in the brain, which could stimulate pain receptors. Following an elimination diet in which you remove all potential food triggers from your diet and then slowly re-introduce them is the best way to identify which specific foods are behind your headaches.    

Trigger # 3: Dehydration 

Headaches are a well-known symptom of dehydration.  It can be a trigger for mild tension headaches and full-blown migraines. Other symptoms of dehydration can include thirst, fatigue, dizziness, decreased urination, and dry mouth, but frequently those symptoms are so mild that a busy person doesn’t notice them until the headache sets in. Rehydrating with water often produces a fast headache cure in mild cases of tension headaches, but using electrolyte or rehydrating solutions can often speed the headache resolution. 

Alcohol as a headache trigger is closely related to dehydration. Although its etiology is not entirely understood, the dehydration that alcohol causes definitely contributes. Fermented alcoholic drinks like beer, red wine, and kombucha are high in migraine-triggering tyramine. But other types of alcohol have additional compounds that may contribute to headaches, even when only a small amount of alcohol is consumed. If you commonly find yourself nursing a headache after a few cold ones, the best cure is to limit or avoid alcohol consumption all together.

Trigger #4: Hormones 

There is at least one obvious reason why women suffer from more severe headaches and migraines than men – hormones.  The biggest headache culprit is estrogen, which fluctuates throughout a woman’s cycle. Estrogen can affect the sensation of pain through its effects on the neurotransmitter serotonin. Estrogen also affects blood vessels, and the irritability or spasm of small blood vessel walls may play a role in triggering migraines. 

Because any estrogen fluctuation can trigger a headache, there are several parts of a woman’s cycle where headaches can happen, including at ovulation, in the days before menses, and during menses. These are all times when estrogen levels are dropping quickly. If you tend to experience headaches around the same times each month, consider using a menses cycle tracker app like Eve or Clue that can help you map symptoms like headaches to your monthly cycle. Knowing when to expect a nasty brain squeeze is half the battle, practicing self-care (think lots of sleep, water, and healthy foods) leading up to these episodes can help you lessen or even avoid their onset.

Trigger #5: Rebound Headaches from Medications 

This is one of the most frustrating causes of headaches, but also one of the best reasons to treat your headaches with integrative medicine, rather than relying on medications.  Any pain reliever that is used regularly (more than a couple of times per week) to treat headaches has the potential to cause a Medication Overuse Headache (MOH).  These headaches start only when you stop taking the medication and typically come on first thing in the morning and can last for several weeks in the worst cases. 

If you are regularly using a pain reliever to combat headaches, consulting with a medical professional can help you transition to a more lifestyle-focused intervention plan while avoiding the onset of MOH. Because naturopathic doctors focus specifically on integrative, wholistic treatment plans, they are a great choice for helping you to navigate this transition.

Trigger #6: Environmental Triggers 

Some headache-sufferers are abnormally sensitive to environmental cues.  Strong smells, and particularly the smell of smoke can trigger headaches. Bright and/or flashing lights can be triggering for some people. And many note that specific weather patterns or weather changes can be a reliable trigger.  One study found that migraines were 28% more likely on days when lightning struck near a person’s home. The thought is the brain could be sensitive to barometric pressure changes that come with storms. 

While these studies are still in the early stages, it is encouraging to see some light shed on the more mysterious triggers of headaches. As more research comes to light, the hope is that the medical field will follow suit with treatment plans and recommendations for offsetting these environmental triggers.

Trigger #7: High Blood Pressure & Other Serious Medical Conditions 

While most headaches are not severe enough to be an emergency, there certainly are a few rare causes of headaches that can signify a serious problem. Headaches can be a sign of very high blood pressure, which can lead to brain and other organ damage if left untreated. As a general guideline, if you have a severe headache like you’ve never had before or have any type of headache that is unusual for you, you should speak with your doctor. Any headaches accompanied by high fever, stiff neck, or neurologic changes like convulsions, confusion, muscle weakness, or changes to speech or vision could be a health emergency and you should head to the emergency room right away. 

If headaches are getting in the way of your daily life, visit Spark Health today for a personalized assessment and treatment plan. Located in Solano Beach in San Diego County, CA, Spark Health Integrated Medicine takes a collaborative approach to natural medicine, partnering with patients to help them achieve their unique health and wellness goals. Give us a call 858-228-4188 or send us an email at Spark@MySparkHealth.com to book a consultation today!

 

Article written by Dr. Jennifer Zeglen, ND

Beat The Bloat

bloat

Can’t Beat the Bloat? There May Be More to Blame Than Diet

Most people have experienced bloating at some point in their life. More often than not it is our own eating habits that are the culprit – overeating, eating too fast, consuming large quantities of salt or fat. But when the occasional bloating turns into weekly or daily episodes, it may be indicative of a much larger systemic issue. 

In our practice, we see three core causes of chronic bloating: hormone imbalance, gastrointestinal disorders, and food sensitivities. Because of the similarities in symptom manifestation, these three conditions are often brushed off as run-of-the-mill bloating and too often go unchecked. If you can’t beat the bloat, read on to see if a systemic disorder may be to blame.

Bloat Trigger #1: Hormonal Imbalance

Women often experience bloating during hormonal changes in their cycles. Typically, this takes place during the second half of the menstruation cycle leading up to menses in which levels of estrogen dramatically shift and progesterone is released. While estrogen increases water retention, progesterone slows down the GI tract resulting in constipation and.. more bloating. And if your go-to PMS craving is an extra glass of wine or a bag of potato chips, that only makes things worse – alcohol consumption and salty foods further increase bloating. Triple whammy!

Problematic is the tendency for women to be told not only to expect but to accept bloating as part of the normal menstruation cycle. However, chronic bloating could point to a hormonal imbalance stemming from either an estrogen dominance or a lack of adequate progesterone (or both).

Estrogen dominance is a common hormonal imbalance that occurs during perimenopause, the 8-10 year period before the onset of menopause. The higher levels of estrogen in comparison to progesterone encourage increased water retention and bloating. Progesterone deficiencies during this time period similarly lead to increased fluid retention as it skews hormone balance to be predominantly estrogen.

If you feel like your bloating occurs during specific times each month then it is a good idea to get your hormones checked. A medical professional can look at your full hormonal cascade along with timing in your cycle to determine if you are perimenopausal. Hormones can be tested via blood, saliva, or urine samples.

The gold standard, and most thorough, for evaluating female hormone levels is the DUTCH test. DUTCH stands for dried urine test for comprehensive hormones. Our Naturopathic Doctors examine your labs through a functional lens to ensure you are not only in the normal range, but the optimal range.

Following proper testing, hormonal imbalances can be addressed with natural therapies like diet, lifestyle, supplementation or bioidentical hormone replacement therapy when needed. Each hormone balancing approach is customized to the patient depending on their symptoms as well as their lab testing.

Bloat Trigger #2: Gastrointestinal Disorders

In contrast to the “puffiness” characteristic of menstrual bloating, GI disorders cause the belly to become distinctly hard and distended. This is due to a buildup in our intestines, either of gas or stool, that pushes against the walls of our abdomen and produces the uncomfortable feeling of bloat.

What causes this gaseous build up to occur? Gastrointestinal Dysbiosis – an overgrowth of bad bacteria in the small intestine. The microbial balance of good and bacteria in our stomach and intestines is incredibly sensitive and dietary changes, alcohol consumption, the introduction of new medications, stress, poor dental hygiene, and unprotected sex can all lead to an imbalance.

Once Gastrointestinal Dysbiosis is present, sensitivities intensify. While common sense tells us to eat healthier foods to counteract discomfort, this often worsens the condition. Foods high in fermentable oligosaccharides (FODMAPs) like apples, garlic, onions, cauliflower, broccoli, avocados are highly fermentable by bacteria, producing more gas and bloating as a consequence. In this case, an apple a day does not keep the doctor away.

The first step to diagnosing your Gut Dysbiosis is identifying whether a Small Intestine Bacteria Overgrowth (SIBO) is present, which can be determined through a simple breath test. If SIBO is ruled out, we often examine the large intestine via a comprehensive stool analysis. This test can tell us the status of your good and bad bacteria, yeast, digestion and absorption markers, immune system function, and if there is any inflammation happening directly in the gut.

Bloating can stem from an overgrowth of pathogenic organisms or a lack of digestive enzymes. It can also come from a lack of proper GI motility or constipation. It is important to identify what may be causing for the proper treatment. This could be adding in the right strains of beneficial bacteria in a probiotic, digestive enzyme support, or botanicals that can eradicate the overgrowth of certain bacteria, yeast, or parasites.

Bloat Trigger #3: Food Sensitivities

The third common trigger of bloating is one that is often misunderstood. Food sensitivities differ from food allergies and intolerances in that they can cause a delayed reaction, such as bloating, hours to days after consumption. And because food sensitivities include a wide range of foods such as gluten, dairy, eggs, soy, alcohol and nuts/seeds, this makes determining the trigger food even more difficult.

So, while the gold standard for determining food sensitivities is an elimination diet, it can be helpful to start with food sensitivity testing to determine which foods to try removing. A food sensitivity test looks is a blood test that examines the IgG response to certain food groups. The IgG response is the delayed immune reaction characteristic of food sensitivities, as opposed to the IgE response of a food allergy that happens within seconds to minutes in the form of hives or anaphylaxis.

If a test comes back with several food sensitivities, then a patient may be experiencing some hyperpermeability of the gut causing them to be at risk for more food sensitivities. We then use a combination of an elimination diet along with gut healing support in order to address food sensitivities. Sometimes, these can resolve over time with a healthier gut lining and may not be a true food sensitivity lifelong.

Bottom line, if you can’t beat the bloat then consulting a medical professional can help. Come see us at Spark Health today – whether it’s hormones, gut dysfunction, or food sensitivities causing your bloat, we will work with you to rid yourself of its discomforts once and for all!

If you are interested in learning more or would like to book an appointment, call us 858-228-4188 or send us an email at Spark@MySparkHealth.com.   

Founded in 2013, Spark Health Integrated Medicine is located in Solana Beach, San Diego County, CA.

 

Article written by Dr. Christina Bradshaw, ND

Everything You Need to Know About SIBO

sibo

What is SIBO?

Small Intestine Bacterial Overgrowth (SIBO) is a chronic bacterial infection of the small intestine. Since these bacteria normally live in the gastrointestinal tract, SIBO occurs as a result of the bacteria colonizing in a place where they do not belong. When there is an abnormally high number of bacteria present in the small intestine, it can cause issues symptomatically as well as internally.

What are the common symptoms of SIBO?

There are countless symptoms associated with SIBO, but the most common symptom is abdominal bloating that worsens as the day goes on. In many cases, people will wake up with a fairly flat abdomen in the morning, which distends throughout the day and usually worsens after meals. Other common symptoms of SIBO include diarrhea, constipation, gas, belching, fatigue, low mood, and skin issues.

It can be challenging to figure out the cause of these symptoms because they are not directly correlated with specific types of food and can improve or worsen every few weeks throughout the course of the bacteria’s lifecycle. Some people will experience symptom relief for a period of time only to notice flare ups without making any dietary changes. This can be frustrating as the root cause is difficult to pinpoint.

Internally, large amounts of bacteria in the small intestine interfere with digestion and block the absorption of nutrients from the food that we eat. The bacteria take the nutrients from the food and use it for their own benefit, rather than the normal process of our cells using those nutrients. This can lead to low levels of vitamin B12 and iron, since the bacteria in the small intestine love to use those for a fuel source. They also use dietary fiber as a fuel source, so high fiber foods in the diet are used for their growth, as well. The high levels of bacteria in the small intestine also decrease fat absorption, which can lead to a decrease in one of our most important fat-soluble vitamins, vitamin D.

Intestinal permeability, commonly referred to as “leaky gut,” is also a side effect or symptom of SIBO, as the bacteria are associated with damage to the lining of the small intestine. When the GI lining is permeable, the tight junctions of that lining have loosened, so that toxins, bacteria and food particles can slip through the cracks and into our blood.

Gas created by the bacteria when they ferment the food we eat is a huge cause of belching, bloating, flatulence, abdominal discomfort and bowel changes. The bacteria also produce different acids and ammonia, which can cause neurological and cognitive issues, such as restless legs, brain fog, difficulty concentrating and poor memory.

How do you test for SIBO?

Lactulose breath testing for SIBO is the gold standard for diagnosis. The bacteria in the small intestine produce both hydrogen and methane gas, which is measured in the breath test. The day before taking the test is a preparation day with a limited diet consisting of mainly animal protein, followed by an overnight fast for 12 hours. The test is performed at home, at least one hour after waking, and takes 2 hours and 15 minutes to complete. Breath samples are collected every 15 minutes to assess the levels of both gases after a lactulose solution is ingested.

 How do you treat SIBO?

Treatment for SIBO is a multi-faceted approach that allows for eradication of the bacteria along with changing the internal GI environment to avoid reinfection and regrowth. There are 5 pillars of SIBO treatment at Spark Health:

1. Anti-bacterial Treatment

Using either antibiotics or natural anti-microbials is the first step towards eliminating the overgrowth of bacteria in the small intestine. In order to begin the process of balancing the bacteria in the digestive system, we first must eradicate the bacteria that should not be present in the small intestine. This gives us a clean slate to start rebuilding a healthy GI environment down the road.

2. Diagnosis-Specific Diet

After completion of antibiotics, it is important to starve the remaining bacteria of their dietary fuel source, and not to allow new growth of bacteria to flourish. This is not a calorie, fat or carbohydrate restricted diet, but it removes all foods that the bacteria are able to ferment.

3. Internal GI Environment

Changing the environment of the digestive tract creates an inhospitable environment for unwanted bacteria to grow and allows beneficial bacteria to colonize in the right areas. This is accomplished with supplements for digestive enzyme support, stomach acid production, bile salts, dietary starch breakdown, biofilm disruption and GI lining support.

4. GI Motility and the Brain-Gut Connection

The muscles that comprise the digestive tract are involuntary, meaning that they need direction from the brain and nervous system to contract to propel contents  downstream. Since we can’t voluntarily control those muscles, valves and sphincters, we need the proper nerve input to tell the GI tract how to mechanically function.

5. Nervous System and Stress Response

In order to have a healthy, happy gut, we need to make sure that our bodies are not caught in a constant state of fight or flight, also known as sympathetic upregulation. We need to be able to switch into parasympathetic mode, which allows for proper digestion. Stress management is a huge part of successful SIBO treatment.

This is a time-consuming and intensive process, but when done correctly under the guidance of an experienced doctor, the results are life-changing, and patients feel better long term.

Can SIBO come back?

Unfortunately, once someone has been treated for SIBO, there is a chance that it could come back. This can happen if:

1. Your original treatment for SIBO was ineffective

Antibiotics alone are sometimes not enough to kill the misplaced bacteria. Sometimes a combination of treatments, such as an antibiotic paired with a motility enhancing and or gut healing supplement will provide the best relief.

 2. Your GI motility is low

If you have ever experienced chronic constipation, type I diabetes, celiac disease, Crohn’s disease, or hypothyroidism, your GI motility could be slower than average. If this is the case, you may need to take specific actions to improve GI motility before being treated again for SIBO.

3. You are not adhering to healthy lifestyle choices

If you decide to go back to being inactive and eating unhealthy foods, you could also experience a recurrence of SIBO.

When you do not move your body, a reduced amount of blood flows to the digestive tract. This, in turn, can slow GI motility. As a result, it will take longer for the small intestine to digest food, leaving plenty of time for bacteria to grow where it shouldn’t.

Eating too often can also affect a person’s chances for getting SIBO again. The migrating motor complex (MMC) is a recurring cycle that clears the food out of your stomach every 90 minutes once the stomach is empty. However, if you are continually snacking, the MMC does not have enough time to do its job and remove the excess food to keep the small intestine clear. This creates the perfect opportunity for SIBO to swoop in.

4. You had a case of food poisoning

There are many bacteria that can be responsible for causing food poisoning, including E. coli, Campylobacter jejuni, Shigella, and Salmonella. The one thing that all of these bacteria have in common is a substance known as cytolethal distending toxin (CDT), which has been shown to damage cells in the intestines. Therefore, if you have prior damage to the intestine, it can be easier to contract SIBO.

The best way to prevent SIBO recurrence is to continue to implement healthy diet and lifestyle choices that support healthy gut function and motility. And working with a team of naturopathic doctors is a great way to ensure that you have access to all the resources you need to achieve your goals.

If you are interested in learning more about optimal gut health and how to prevent and treat SIBO, please reach out to the Spark Health team. We take a collaborative approach to natural medicine, partnering with patients to help them achieve their unique health and wellness goals. Please call us at 858-228-4188 or send us an email at Spark@MySparkHealth.com to schedule an appointment.

Spark Health Integrated Medicine is located in Solana Beach, San Diego County, CA, and was founded in 2013.

 

-Article written by Dr. Aliza Cicerone, NB, FABNO