What Supplements Should Migraineurs Take?

The world of supplements is confusing and overwhelming. 

In this episode, Dr. T breaks down how to cut through the confusion, and covers what supplements are particularly relevant to the migraine brain. 

Full Episode with Transcript

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All right, welcome to another episode of the Migraine Miracle Moment. So in this episode, I’m going to tackle a topic that I know many of you are interested in and one that is really challenging to figure out. And that is what supplements should you be taking and specifically what supplements should a migrant or be taking? And there are a couple of different ways you might think about the role of supplements, which I’ll discuss. I’m one of those being something that you would take for kind of general health. And then something that you might take for its therapeutic value. And so we’ll be covering those two different kinds of indications. First off, as a reminder, we are about to start our annual holiday challenge inside of Migrai-Neverland. That’s where we help our members navigate the issues that emerge around the holidays, around food and and social interactions and parties and so forth. And it’s an especially helpful challenge, I think, for those who are still relatively new to the migrant miracle plan. After you’ve done a few holidays in a row, you kind of establish some new habits and routines and it feels easier and easier. But when you’re first getting started, it can kind of be a difficult time. So the holiday challenges, but really helpful for that.

We’ve done it the past few years. We’re also in the midst of our November month of gratitude in our Facebook group, our big Facebook group. So each day we’ve been posting a prompt about something to be grateful for. And people are getting, you know, writing their responses in the comments. And the responses so far has been really amazing. So thank you to all of you who’ve been participating and commenting and sharing your bits of gratitude. It’s really been a lot of fun and such an important thing to do and helpful in a lot of ways. So if you’re not part of our Facebook group, please join us and we’ll be continuing this month of gratitude through the end of November. And once again, if you want to become part of the holiday challenge and if you want to become part of our Migrante Neverland family, you can join sign up at our Web site. And you can learn more about all that, the resources that we have inside of migrant land by going to my migration miracle dot com and just clicking on the resources tab at the on the top menu. Also, I will be sending out a guide to supplementation for the migrant or to the folks who are on our e-mail list.

And it will summarize what I’ve talked about here and it will include links to the supplements that I talk about here. So if you get the Magary Miracle newsletter, then look out for that. If you’re not already subscribed, you can go to my library miracle dot com and sign up there from the home page. OK, so now onto the topic of supplements, so I’m definitely, definitely sympathetic to anyone who is trying to make sense of the world of nutritional supplements and trying to make an informed decision on this topic. It is not easy. And really, the situation here is, is not that all not that different than with pharmaceuticals, where there are just so many forces that are at work that obscure the truth. So, first of all, there’s just the amount of money involved. So this is an industry that’s over 100 billion dollars in value. And I think that becomes an even more, more remarkable figure when you consider just how little of of this stuff has been proven to work and more importantly, how much has actually been shown not to work, which I’ll touch on in a bit. Of course, we could say the same for the pharmaceutical industry. So that’s over a trillion dollar industry.

And they’re we’re spending most of that money on drugs that are either very weak, useless and that are also fraught with risks.

And in both instances, with the both the supplement and the drug industry, a lot of this is because the money involved is such a distorting influence and it makes it really hard to make informed decisions. In some ways, the supplement industry is worse since it’s unregulated. So whereas a drug company has to at least provide evidence that supports the claims they’re making. You know, we can debate the quality of that evidence. But the same requirement is not placed on supplement makers. They don’t actually have to provide any scientific data that supports a claim that they’d make about a supplement. And furthermore, there’s actually no requirements that it contains. What it said to contain and many different analysis have revealed lots of variability from one supplement to the next in terms of whether or not it actually contains what’s what it’s said to contain. And sometimes in some cases, it contains none of what it said to to contain. So, again, the fact that it’s not regulated raises some additional issues that you don’t have to contend with with pharmaceuticals. So I mentioned earlier that there haven’t been a lot of studies on supplements, especially compared to pharmaceuticals, especially kind of large scale scale controlled studies that we’d want. And the ones that have been done certainly give us reason for pause. So there was a 2009 study on multi-vitamin supplementation. So they took a little over 160000 post-menopausal women.

And this was part of the Women’s Health Initiative study. And they looked at the impact of taking a multivitamin and they found, quote, convincing evidence that multivitamin use has little or no influence on the risk of common cancers, cardiovascular disease or total mortality. So, again, taking a multivitamin today, a day had no impact on the primary outcomes that you’d care about, the reason that you take a multivitamin to begin with. And then there was another big study that made a big splash several years ago looking at the impact of taking antioxidants. And so antioxidants were all the rage for a while after research in the in that area, in that field of aging and elsewhere, show showed the role that oxidative injury had in the aging process. And in related diseases. So people began taking antioxidants to try to help prevent oxidative damage and theory to hopefully slow the aging process and potentially prevent a host of age related diseases. And then in 2007, a large meta analysis in the Journal of the American Medical Association showed that not only were antioxidants not helpful, but that actually supplementing with with vitamin A, vitamin E and beta carotene, which are all considered antioxidants that supplementing with those look to increase mortality.

So, in other words, taking these increased the risk of death. And of course, before these trials came out, it seemed reasonable to take a multivitamin a day. You know, it seemed like you could hedge your bets if you didn’t know if you were getting your full complement of vitamins, nutrients from the diet, you could just take a pop, a multivitamin and make sure you’re getting what you needed. Turns out that’s not true. And then the idea of taking antioxidants seemed kind of reasonable as well. So if these are molecules in our body that can help prevent oxidative damage to ourselves, then ingesting them to make sure that we have enough of them floating around seems like it should be a good idea. But it turns out that it’s not. And this gets to kind of some flawed thinking that we commonly have about how how the body works. And that fuels a lot of the decisions around taking supplements.

So why do we keep making this kind of mistake where so many people willing to shell out money?

On something that’s unproven and unregulated, and one thing, as I mentioned, is because of the amount of money that’s involved and and the marketing behind these things. So most of the promotion of these sorts of things is being done by those with a vested interest in whether you buy it. So, you know, people have been selling other people’s stuff that doesn’t actually work. Since ancient times. And this is something that will continue.

And so, you know, good science education, access to good, unbiased information is our best of best defense against being taken advantage of in this way. Another reason is that there’s a perception that supplements are somehow safer. Which is false. And it’s often referred to as the naturalistic fallacy, which is the belief that something that’s natural is inherently better for you. And of course, you only need to demonstrate the effects of something like like snake venom on the human body to prove that notion to be false. But nonetheless, it’s a powerful bias. And how commonly see people over the years in my practice who refuse prescription medications of any kind, but we’ll bring in a list of 20 different supplements that they take. Again, reflecting usually that naturalistic fallacy. Another trap that I think we fall into is in thinking that more is better. So we kind of have this natural bias towards thinking that if a little of something is good for us, then a lot of it must be better. But the truth is that virtually everything in biology has what we call a U-shaped curve or or a reverse U-shaped curve where, you know, at the at the if you can imagine the x axis being the amount of something we do or consume and the Y axis being the benefit, you know, at the very low levels, we start getting an increase in benefit and then it hits a plateau.

You know, once we reached kind of the ideal amount and then if we have too much, that benefit starts going down. That’s where you get the other side of the you. And that’s true of so many things. It’s true of water and it’s true of every vitamin and mineral. So, too, both too little and too much can be a bad thing. And there’s typically a kind of Goldilocks zone between those extremes that’s optimal. This is also true of exercise, but a place where a lot you’ll make mistakes. People are often astonished when they hear about marathoners dropping dead of a heart attack. But we know that there is too much of a good thing, including exercise. And at some point it becomes a stressor and a net negative. And so the two areas of health where this mistake is probably made the most are in the areas of supplementation and exercise and thinking that, you know, more is better. Another reason is I think that the idea of supplements plays into our desire towards looking for the magic bullet. So that’s the story in medicine. In the last century or so is really the story of a searching for these elusive magic bullets.

So looking for a drug that will save us and we’ve kind of accepted as an established truth that such a thing is even possible, rarely even questioning whether it’s reasonable to think that we should be able to find magic bullets. But we continue to look for them when we hope against reason that such a thing exists. And then another reason maybe is that they can offer a shortcut of of of sorts. So in the case of something like a multivitamin, you know, it seems easier to just pop a pill rather than to kind of assess the whole scope of our diet and make sure we’re getting the nutrients that we need. So supplements can sometimes be seen as a helpful shortcut sorts. And I think all in all, the sort of mistakes that we’ve made in these areas are emblematic of the general absence of holistic thinking when it comes to health, which I think more than anything else explains our failure in finding effective treatments for the last several decades for virtually any chronic disease and why we continue to pursue the same dead end strategies of trying to find a magic drug or a or a magic supplement that will fix things.

And moving away from these biases and starting to think holistically and implementing a holistic approach is really the best thing that any of us can do for our health. And when it comes to supplements, I think there are a few things that we can learn about the story so far. One is that it’s clearly there’s clearly a difference between getting something that is in an isolated supplement form and getting it from food. If we take the evolutionary view, you know, our ancestors never would have eaten constituents’ of food in isolation.

It was always coming, bundled with everything else in the food that we were eating. And it turns out that that matters a whole heck of a lot. There are a whole host of reasons why it matters, some of which we understand, some of which we still don’t. But we know that it’s far more beneficial for us to. Consumes something, a vitamin or mineral, whatever part of food rather than isolation. So the take home message from that is that whenever possible, we should be getting our nutrients from food and that supplements are likely to be less effective and have more potential for harm than obtaining the same things from food. So getting our full complement of nutrients from food should always be our top priority. So let’s reframe this question about what potential supplements we still might consider in terms of what are the particular nutrients that are of special importance to the migrant or and that might be deficient in a typical person’s diet. So let’s start that with considering the macronutrients, which our carbohydrates, protein and fat. Now, as some of you probably know, we don’t actually need any carbohydrates in the diet. So nobody is suffering from any carbohydrate deficiencies or and do not do not need to supplement in that domain with respect to protein. The brain primarily needs proteins for their role in chemical reactions. So as enzymes for chemical reactions, as precursors for new neurotransmitters, which are the signaling molecules that nerve cells use and less so for structure, as is the case for our muscles and connective tissue that are built of protein.

So if you’re eating an ancestral diet or the migrant miracle plan, then you should be getting enough quality protein in your diet as meat of any kind or eggs will give you the full complement of amino acids that your body needs. Those who are eating a plant based diet must ensure that they’re getting the full complement of essential amino acids. So that covers carbs and fat. I mean carbs and protein. And that leaves fat, which is probably the macro noot nutrient of most importance for the brain as it is since it’s comprised mostly of fat and the ones that are probably most important for the micro nerves are EPA and DHEA, which are a class at work which are part of the omega 3 fats. And those are found in most abundantly in fish, especially the fish skin. They’re also found in eggs. And this is one of the main reasons that I personally eat sardines at least once a week to make sure I’m getting plenty of EPA and DHEA. Sardines are a great source, lots of fish, good sources of wild salmon is a good one. Oysters are a great source. And again, a lot of it’s concentrated in the fish skin. So make sure to eat the skin if you’re trying to get your omega 3s.

And again, you can also get these from eggs and some eggs are actually fortified or have extra amounts in these. And that usually says that on the box. So once again, this is an area where it’s super important to get it from food wherever you can. However, if you can’t do that for whatever reason, then cod liver oil is a good option as it’s also high and some other things like vitamin A. But once again, these fats are essential for brain function and so are doubly critical for the migrant. Or it’s also why you want to avoid vegetable and seed oils as the fats that you eat get incorporated into your cell membranes and forever alter their structure and function. So if you’re eating plant oils that are not appropriate for humans, then they will become a permanent resident in your cell membranes, which we don’t really want. All right. So those are the macronutrients. Now let’s talk about the micronutrients that are of particular importance to the brain and that may be deficient in a lot of people’s diets. So the first one we’ll talk about is vitamin A, critical for many things, including the function of the brain and the nervous system. And it’s a common deficiency because it is found in highest quality quantities in organ meats and especially in liver. So, you know, getting enough of this was not a problem for our ancestors who valued organ meats typically above all else.

So clearly on some level, they recognized that they were nutritional powerhouses. Also, I think some folks are under the impression that you can get this from certain vegetables like carrots. And it is true that carrots and some other vegetables have beta carotene, which is a precursor to vitamin A. But only about 3 percent of the beta carotene that we eat gets conferred. It can be converted into retinol, which is the active form of vitamin A. And then there’s a significant portion of the population that actually can’t convert beta carotene to retinol at all. And so in order to get the same amount of vitamin A that you’d get in a single three ounce serving of liver, you have to eat 40 pounds of raw carrots or you’d have to eat. 50 cups of cooked kale. So obviously those are completely impractical. So I personally eat liverwurst at least once a week. I get it from U.S. Wellness Meats, which is really good. There’s also a place you can order online called nose to tail, which sells ground beef with organ meat mixed in. So if you don’t like the taste, um, it’s disguises it pretty well. And then I would consider the next best option to be desiccated liver. So there is a supplement company called ancestral supplements that so that makes dried organ meats, including dried liver.

So my kids actually take this because I’m still working on getting them to incorporate liver in their diet. Another good source, as I mentioned before, is cod liver oil. So that’s vitamin A. Then there are the B vitamins. So the B vitamins are a class of eight different water soluble vitamins that have many different functions. Several of them are critical for the function and operation of the mitochondria, which is the part of our cells that generates an energy. And there is an emerging theory that migraines may be related to impaired mitochondrial function, at least in some part. Now, if you’re eating and ancestral diet, then you should be getting plenty of B vitamins as they are again found most abundantly and in high concentrations in animal foods. The one that you might need to still be mindful of is choline, which is found most abundantly in egg yolks and also in liver. So ensuring that you’re getting one or the other of those things and Colleen, as you may know, is the precursor to the neurotransmitter acetylcholine which is found throughout the brain. And is important for things like memory and attention focused and so forth. So that was the B vitamins. Next is magnesium. So magnesium is one of the most common mineral deficiencies for people eating a typical Western diet. And there are links between migraines, deficiency and migraines, which I’ll talk about some in the next episode.

One reason why it may be more of an issue now is that in addition to people generally consuming less magnesium rich foods in the diet, soil depletion has also reduced the content of certain foods that would typically be high in magnesium. Overall, the best dietary sources are leafy greens. So things like collard greens, mustard greens, spinach, that’s where I try to get get it primarily from. Nuts are also a good source, but it’s easy to overdo the nuts. So something best consumed in moderation. The same is not true of greens, which are essentially self-limiting. Another good source are mineral water. So there are certain certain mineral waters that are particularly high in magnesium and you can usually find that on their labels and in the last one is sunlight. So I was going to say vitamin D at first, but I think it’s better to think of sunlight as being the vitamin. They were not that many of us are not getting enough of. First of all, because sunlight is how we generate vitamin D as the active form of it is synthesized when the sun hits our skin. And we know that a lot of people are deficient in vitamin D because of sunlight deficiency. But I think it’s a mistake to think that vitamin D is the only reason for getting sunlight. I think sunlight deficiency is a huge problem and one that we’ve only just begun to understand.

The health consequences of one of those is clearly mediated through reduced production of vitamin D. But there are likely many other effects that we still don’t even understand. So I think we should think of the sun itself as a vitamin and being absolutely vital to health. And so it’s super important to get sunlight on the scan every day and sunlight on our eyes. So getting outside within 30 minutes of waking for a dose of sunlight in our eyes to serve as a cue that morning has arrived is usually helpful for a lot of things, including keeping circadian rhythms aligned, improving sleep and so forth, and then aiming for at least 30 minutes of sun on the scan a day. It’s probably a bare minimum now. Yes, it’s possible that too much sun can cause harm. Remember we talked earlier about everything has a use it U-shaped curve, including sunlight. But most of us are on the deficient side of that curve. And really it’s clear that what we want to avoid in terms of too much sun is sunburns. So as long as you’re enjoying avoiding sunburns, the more sun you can get, the merrier. All right. So those are the big ones in terms of the nutrients that we might consider of supplementing, given that they. Are not unlikely to be deficient in a typical person’s diet, though much less likely if you are following the micro miracle plan and that are also of extra importance to the brain.

And so to summarize what we’ve said so far. First of all, diet and lifestyle changes are going to be many orders of magnitude greater in their impact than any supplement. And the best place to obtain what you need is from a nutrient dense, species appropriate diet along with a healthy lifestyle that attends to things like sleep and physical activity and stress. And if you’re eating a nutrient dense Whole Foods diet that includes things like organ meats, especially liver egg yolks and whole fish like sardines, then you have gone a long way towards ensuring that your body has what it needs to thrive and to repair and recover and to solve its own problems. And so supplementing without attending to those things first. It’s kind of like putting a spoiler on a car with no engine. And supplementation should be reserved primarily for cases where you can’t get an adequate amount in the diet for whatever reason. Now, as I mentioned, there are kind of two different reasons why we might consider supplementing one being if we’re not getting enough of a particular nutrient for whatever reason. But the other being what you might call therapeutic supplementation. So taking a supplement kind of as you would a pharmaceutical for a particular benefit for us, a specific issue or problem.

So some of you may be aware that there are certain supplements that have at least some evidence for benefit and migraines. So in the next episode, which will be part two of this series on supplements, I’m going to be covering the different supplements that people have tested and taken for migraine prevention. And we’ll discussed what the evidence is for those and which which ones of those, if any, that folks should consider as part of their migraine prevention strategy. Okay, that’s it for this episode. As I said in the beginning, I’m going to be sending out a guide to supplementation to those who are on our email newsletter list. So if you’re not a part of that. Be sure to do so. You can go to my micro miracle dot com and you’ll find a place to sign up for that right there on the home page. All right. Thanks so much for listening. Remember to subscribe to the podcast on iTunes or whatever podcast player you use. You listen to if you haven’t already, to make sure you stay up with current episodes. And if you enjoy this podcast, it would be awesome if you let if you left a rating and review in i-Tunes, it really helps other people to find it. OK. Thank you so much for listening. And I will see you in the next episode.

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Migraine Miracle Facebook group (come take part in our month of gratitude!) : https://www.facebook.com/groups/899131986822364

The 9 Primary Migraine Miracle RESOURCESmymigrainemiracle.com/how-we-can-help/

MIGRAI-NEVERLAND, our premier resource for those who want to find their pill free path to migraine freedom (including the Beast Slayer Training Academy): mymigrainemiracle.com/endofmigraine

The Beast Slayer Training Academy

The 2019 Schedule of Migrai-Neverland Challenges: https://www.mymigrainemiracle.com/schedule

The book that started it all – The Migraine Miracle: https://www.amazon.com/Migraine-Miracle-Sugar-Free-Gluten-Free-Inflammation/dp/1608828751