*Last edited: May 2021 by Eric Chan, ND

Headaches are a very common complaint amongst patients, and are a large source of both lost income and lost time.  While many patients medicate with over-the-counter drugs such as ibuprofen and tylenol, many look for alternatives that have less associated risks on the gut, kidney, and liver with frequent use.

While some natural medicines such as the herb Feverfew can often be used as a trial as a replacement for over-the-counter type headache medications, a good work-up for underlying causes can be much more effective.

 COMMON TYPES OF HEADACHES 

Tension headaches are the most common type of headache.  It is associated with pain that is usually dull or squeezing, and can be described as a general ache. The tension is usually found by having stiff, sore muscles in the upper back, shoulders, and neck muscles. Often times, the base of the back of the skull (occiput) is tender, with pressure reproducing pain.

Conventional treatment is usually limited to ibuprofen, tylenol, and other over the counter pain medications. While excellent for occasional pain, if used for any great frequency (more than twice a month), the below options are best.

Naturopathic work-up and treatments for headaches: 

The two most common causes are related to problems with maintaining stable blood sugar and problems with chronic muscular spasm. Treatment for the blood sugar component is typically with diet and ozone therapy. The chronic muscular spasm often does not require any special laboratory testing. It is very effectively treated in my experience with injections into the muscle, and with acupuncture.

 Migraine headaches are less common than tension headaches, but often more debilitating.  Patients with migraine headaches who come to me have often been diagnosed with this condition elsewhere. 

The most common symptoms associated with this type of headache include nausea and sensitivity to sound or light. Some patients describe visual changes (aura) that precede the headache, while others simply wake up with the pain.

Conventional medication can be useful if a patient is responding to preventative "triptan" type drugs or low-dose beta blockers. If these are well-tolerated, they may be a good option for this debilitating pain. If a patient is not responding well to the preventative drugs and is still having more than one attack a month, the below natural treatments and naturopathic work-up for migraine headaches should be considered. 

Migraine Headache Naturopathic work-up and treatments: 

involve a work-up for food sensitivities and mineral stores in the body. In my experience, many patients experience significant relief after identification of food sensitivities through a blood test, and elimination of those foods is done.  Re-challenging of eliminated foods can help to isolate which foods may be potentially aggravating specific symptoms. Mineral levels, of magnesium in particular, can be low. If an acute migraine attack is occurring,  IV vitamin/mineral high in magnesium are often very effective in my experience at reducing pain or aborting the attack.  A short treatment course of Modified Myer's injections can often be effective, in my experience, at reducing the frequency of attack as well.  All IV treatments are individualized to patient case specifics.

Cluster headaches:

These are less frequent than other forms. They are characterized by one-sided pain, usually around the eye. Occasionally symptoms of blood vessel involvement such as a runny nose may be present. Congestion and pressure can also be present. The headaches are more common in men, and may often be associated with stressful periods.

Alcohol avoidance is important in my experience in reducing the frequency of these headaches.

Naturopathic work-up and treatments for cluster and migraine headaches: this type of headache usually does not require a conventional work-up to find an appropriate treatment plan. However, in many patients food sensitivity testing can also be useful. Chemical sensitivities and food exposures are often in my experience triggers for this type of headache. In patients who experience this headache in increased frequency during periods of stress, an adrenal stress index to measure salivary cortisol at 4 times during the day may be useful. The cortisol pattern, if abnormal, may be corrected to restore normal hormone secretion.

Depending on the results, treatments can help to normalize the imbalances found. For example, simple trigger avoidance can be useful if a few food sensitivities are found, whereas if multiple sensitivities are present investigating and treating any gastrointestinal flora or barrier compromise that may be leading to these sensitivities often is needed. Optimizing micronutrients important for both cellular energy production (vitamins and minerals) as well as those nutrients useful in migraine prevention (such as magnesium, riboflavin) is important.

Detoxification, both chemical as well as metal, if such toxins are found may help as part of the treatment protocol as well.

These treatments can form part of a comprehensive, but individualized treatment plan. One single treatment will not work for every patient. Further investigations such as detailed above can help to identify those that are likely to benefit.

 Labs:  Baseline bloodwork is run prior to any intravenous injection therapy, including by not limited to, kidney function (creatinine), liver enzymes, red/white blood cells, and other blood labs depending on the case.  Thyroid hormone (blood TSH, T4, T3, reverse T3, TPO), adrenal (AM blood cortisol, 4 point salivary cortisol) and/or other lab testing may be recommended as per case history and physical exam findings, to better help elucidate attributing factors to chief concerns and presenting symptoms.

Detoxification: a combination of treatments for either metal toxicities (or increased body burden) or organic toxins depending on levels found on testing. This can involve treatments such as sauna, liver support, lymphatic support, as well as in-office treatments.

 Ozone therapy safety (major autohemotherapy): A survey done in Germany of close to 5 million ozone treatments showed an accident rate of 7 serious incidents, all associated with direct IV injection of the gas (not done in our clinic).  There is a slight possibility of allergy to heparin, though this is a commonly used blood thinner. Some patients do not like the site of their own blood, but they quickly become accustomed to this.

In our experience, the most frequently seen (but still rare) side effect is dizziness/vasovagal/fainting reaction due not at all to the volume of the blood, but rather the needle experience as well as seeing the blood. Possible but extremely rare complications may include soft tissue infection (as with any injection / blood draw), or vein inflammation and clots.

One recent case study has been published on ozone therapy where a single patient with kidney failure had high blood potassium and subsequent arrhythmia. The authors had concluded that the ozone therapy (which looked to be done 9 days in a row) was to blame, but this is not at all clear. The authors did not think that red cell breakdown was responsible for the high blood potassium, but that is the only mechanism that would make sense if the ozone was done daily. Theoretically low grade red cell breakdown would release potassium, and if the treatment is overdone and the kidneys can not excrete this could accumulate.

Photoluminescence therapy (ultraviolet blood irradiation) was used extensively in the 30's to 40's before the advent of antibiotics and the vaccine for polio.  It has an extensive safety and efficacy record. For a great summary of this treatment, buy the book "Into the Light" at www.drdouglass.com.  An online article also available is “The Cure that time forgot” which summarizes much of the published experience.  Potential side effects of ultraviolet blood irradiation are similar to those mentioned above for ozone therapy/major autohemotherapy.

References: Myers’, Intravenous vitamin/mineral injections

Gaby AR. 2002. Intravenous nutrient therapy: the "Myers' cocktail". Altern Med Rev. 2002 Oct;7(5):389-403.

Ali A, Njike VY, Northrup V, Sabina AB, Williams AL, Liberti LS, Perlman AI, Adelson H, Katz DL. 2009. Intravenous micronutrient therapy (Myers' Cocktail) for fibromyalgia: a placebo-controlled pilot study. J Altern Complement Med. 2009 Mar;15(3):247-57.

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Rowe BH, Bretzlaff JA, Bourdon C, Bota GW, Camargo CA Jr. 2000.  Magnesium sulfate for treating exacerbations of acute asthma in the emergency department. Cochrane Database Syst Rev. 2000;(2):CD001490.

Sydow M, Crozier TA, Zielmann S, Radke J, Burchardi H. 1993. High-dose intravenous magnesium sulfate in the management of life-threatening status asthmaticus. Intensive Care Med. 1993;19(8):467-71.

Harakeh S, Jariwalla RJ, Pauling L. 1990. Suppression of human immunodeficiency virus replication by ascorbate in chronically and acutely infected cells. Proc Natl Acad Sci U S A. 1990 Sep;87(18):7245-9.

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Hagel AF, Layritz CM, Hagel WH, Hagel HJ, Hagel E, Dauth W, Kressel J, Regnet T, Rosenberg A, Neurath MF, Molderings GJ, Raithel M. 2013. Intravenous infusion of ascorbic acid decreases serum histamine concentrations in patients with allergic and non-allergic diseases. Naunyn Schmiedebergs Arch Pharmacol. 2013 Sep;386(9):789-93.

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Sharma SK, Bhargava A, Pande JN. 1994. Effect of parenteral magnesium sulfate on pulmonary functions in bronchial asthma. J Asthma. 1994;31(2):109-15.

References: Ozone and Diabetes

Bocci V, Zanardi I, Huijberts MS, Travagli V. 2011.  Diabetes and chronic oxidative stress. A perspective based on the possible usefulness of ozone therapy. Diabetes Metab Syndr. 2011 Jan-Mar;5(1):45-9.

Bocci V, Zanardi I1, Huijberts MS, Travagli V. 2014. It is time to integrate conventional therapy by ozone therapy in type-2 diabetes patients. Ann Transl Med. 2014 Dec;2(12):117.

Bocci V, Zanardi I, Huijberts MS, Travagli V4. 2014. Diabetes Metab Syndr. 2014 An integrated medical treatment for type-2 diabetes.  Jan-Mar;8(1):57-61.

de Monte A, van der Zee H, Bocci V. 2005. Major ozonated autohemotherapy in chronic limb ischemia with ulcerations. J Altern Complement Med. 2005 Apr;11(2):363-7.

Braidy N, Izadi M, Sureda A, Jonaidi-Jafari N, Banki A, Nabavi SF, Nabavi SM5. 2018. Therapeutic relevance of ozone therapy in degenerative diseases: Focus on diabetes and spinal pain. J Cell Physiol. 2018 Apr;233(4):2705-2714.

References: Ozone

Bocci V, Zanardia I, Valacchi G, Borrelli E, Travagli V. 2015. Validity of Oxygen-Ozone Therapy as Integrated Medication Form in Chronic Inflammatory Diseases. Cardiovasc Hematol Disord Drug Targets. 2015;15(2):127-38.

Giunta R, Coppola A, Luongo C, Sammartino A, Guastafierro S, Grassia A, Giunta L, Mascolo L, Tirelli A, Coppola L. 2001. Ozonized autohemotransfusion improves hemorheological parameters and oxygen delivery to tissues in patients with peripheral occlusive arterial disease. Ann Hematol. 2001 Dec;80(12):745-8.

Valacchi G, Bocci V. 2000. Studies on the biological effects of ozone: 11. Release of factors from human endothelial cells. Mediators Inflamm. 2000;9(6):271-6.

Inal M, Dokumacioglu A, Özcelik E, Ucar O. 2011. The effects of ozone therapy and coenzyme Q₁₀ combination on oxidative stress markers in healthy subjects. Ir J Med Sci. 2011 Sep;180(3):703-7.

Wu XN, Zhang T, Wang J, Liu XY, Li ZS, Xiang W, Du WQ, Yang HJ, Xiong TG, Deng WT, Peng KR, Pan SY. 2016. Magnetic resonance diffusion tensor imaging following major ozonated autohemotherapy for treatment of acute cerebral infarction. Neural Regen Res. 2016 Jul;11(7):1115-21.

Smith NL, Wilson AL, Gandhi J, Vatsia S, Khan SA. 2017. Ozone therapy: an overview of pharmacodynamics, current research, and clinical utility. Med Gas Res. 2017 Oct 17;7(3):212-219.

Molinari F, Simonetti V, Franzini M, Pandolfi S, Vaiano F, Valdenassi L, Liboni W. 2014. Ozone autohemotherapy induces long-term cerebral metabolic changes in multiple sclerosis patients. Int J Immunopathol Pharmacol. 2014 Jul-Sep;27(3):379-89.

References: Ultraviolet Blood Irradiation

Hamblin MR. 2017. Ultraviolet Irradiation of Blood: "The Cure That Time Forgot"? Adv Exp Med Biol. 2017;996:295-309.

Wu X, Hu X, Hamblin MR. 2016. Ultraviolet blood irradiation: Is it time to remember "the cure that time forgot"? J Photochem Photobiol B. 2016 Apr;157:89-96.

Kuenstner JT, Mukherjee S, Weg S, Landry T, Petrie T. 2015. The treatment of infectious disease with a medical device: results of a clinical trial of ultraviolet blood irradiation (UVBI) in patients with hepatitis C infection. Int J Infect Dis. 2015 Aug;37:58-63.

References: Acupuncture for Headaches, Pain

Mayrink WC1, Garcia JBS2, Dos Santos AM2, Nunes JKVRS3, Mendonça THN2.2018. 2018. Effectiveness of Acupuncture as Auxiliary Treatment for Chronic Headache. J Acupunct Meridian Stud. 2018 Oct;11(5):296-302.

 Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Shin BC, Vickers A, White AR. 2016. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev. 2016 Apr 19;4:CD007587.

Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Vertosick EA, Vickers A, White AR. 2016. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016 Jun 28;(6):CD001218. 

Nielsen A. 2017. Acupuncture for the Prevention of Tension-Type Headache (2016). Explore (NY). 2017 May - Jun;13(3):228-231.

Yin C, Buchheit TE, Park JJ. 2017. Acupuncture for chronic pain: an update and critical overview. Curr Opin Anaesthesiol. 2017 Oct;30(5):583-592. 

Lin YC, Wan L, Jamison RN. 2017. Using Integrative Medicine in Pain Management: An Evaluation of Current Evidence. Anesth Analg. 2017 Dec;125(6):2081-2093.