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LINK BETWEEN ALLERGIES, MIGRAINE IS WEAK

DEAR MAYO CLINIC: Is there an association between allergies and migraine headaches? If so, how is it that allergies contribute to migraine? — Corpus Christi, Texas

ANSWER: Migraine headaches are very common — they affect up to 20 percent of women and nearly 10 percent of men. Allergies are also very common and affect about 10 percent of people. Any time you have two such common medical conditions, there are bound to be many people who suffer from both. It remains uncertain whether or not allergies cause migraine.

Throughout the years, many reports have described small numbers of patients who seem to have migraine headaches triggered by allergies — especially food allergies. A far more common occurrence is the observation that certain substances can trigger a migraine attack. Some triggers — which raise the suspicion of an allergy — are foods and food additives such as alcohol, chocolate, cheese, artificial sweeteners, monosodium glutamate, nitrates, sulfites, artificial food colors, and certain fruits and vegetables. Some environmental factors may also suggest the possibility of allergy (strong chemical smells, moldy odors and smoke).

On the other hand, many migraine triggers do not suggest allergy at all — for example, stress and release from stress, caffeine and caffeine withdrawal, too much and too little sleep, fasting, bright lights, change in the weather, a woman’s menstrual period and a bump on the head. Patients who note that their migraine headaches are triggered by environmental factors do not report symptoms typical of allergy. Conversely, patients with documented allergies do not usually experience headaches, and if they do, their headaches are not typical of migraine.

From the perspectives of an allergist and a neurologist, we think that the evidence of a true association between allergies and migraine headaches is very weak, if one exists at all. We would not recommend allergy vaccine immunotherapy to treat migraine headaches unless there is a coexisting allergy that may benefit from this treatment.

It is very important for people with migraine to look for triggers. Even though the triggers do not provoke migraine on an immunologic basis, avoiding the triggers can help the patient avoid some headaches.

Of course, many migraine triggers (stress, change in the weather, a woman’s menstrual period) are unavoidable. A very helpful strategy is to take an effective medication as soon as possible in the course of an acute migraine attack. If the headaches are bad enough, a doctor may recommend taking medications every day to help reduce the frequency, duration and severity of the migraine attacks.

— Evangelo Frigas, M.D., Department of Allergic Diseases/Infectious Diseases;
J.D. Bartleson, M.D., Department of Neurology,
Mayo Clinic, Rochester, Minn.

Additional Resources:
Treatment of Migraines
Appointment Information
More Information on Migraine Headaches

READERS: There’s no question that being overweight is bad for your health. But being underweight poses health problems, too, especially as you get older, according to Mayo Clinic Women’s HealthSource.

Health problems can include fighting off infection, osteoporosis, decreased muscle strength, trouble regulating body temperature and even increased risk of death.

If you’re thin and your weight has fallen below your usual adult weight, it could indicate a problem. Unintentional weight loss could be caused by:

— Diseases: Many health problems impair how your body absorbs food and uses calories. Among the most common are cancer, inflammatory bowel disease and celiac disease.

— Medications: Drugs, including some antidepressants, blood pressure and osteoporosis medications, can cause decreased appetite. Aspirin and other nonsteriodal anti-inflammatory drugs can cause gastrointestinal side effects.

— Psychological and social factors: Depression and anxiety can cause weight loss. Lack of transportation, limited finances or physical impairments can make it difficult to buy and prepare food.

Be aware of what weight is healthy for you, be alert to changes and ask for help when needed. If you’ve noticed a change in your appetite, have pain while eating or are unintentionally shedding pounds, see your doctor.

Additional Resources:
Staying Healthy

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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.