Jean Monro, MD, of Herefordshire, England, formerly operated a migraine headache clinic at the National Hospital for Nervous Diseases and has participated in several headache studies. In this interview with NOHA former president, Marjorie Hurt Jones, RN, done in Lake Tahoe, Nevada, at the Twenty-third Annual Meeting of the American Academy of Environmental Medicine (AAEM) in October 1988, Dr. Monro focuses on a study she conducted with 300 patients. The interview is reprinted from Mastering Food Allergies, No. 31, December-January 1989, with permission of the publisher, Mast Enterprises, Inc., 1500 North Wilmot Road, Deerfield, Illinois 60015, and the editor, Marjorie Jones.

JM Yes. Without exception if we investigated long enough, and extensively enough, we found foods that triggered symptoms. We couldn’t always accomplish that if the patient elected to drop out of treatment. But with those who completed testing, our results were excellent.

In a group of 300 patients with severe migraine headaches, 18 dropped out of the study for various reasons. But ALL of the remaining 282 patients were found to have food allergies. 100 percent!

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Over 200 [patients] were sensitive to wheat or dairy products, or both. Other fairly common offenders were tea, oranges, apples, onions, pork, and beef.

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JM Everything – skin testing with neutralization, dietary manipulation, radioallergosorbent test (RAST), and so on. Over 200 were sensitive to wheat or dairy products, or both. Other fairly common offenders were tea, oranges, apples, onions, pork, and beef.

We found that the foods mentioned, which were usually eaten daily (and sometimes several times a day), had a stronger causative role than the traditional "big three" of migraine: chocolate, alcohol, and cheeses. Those last three foods are usually ingested irregularly rather than daily, and the testing simply didn’t point to them as important triggers.

JM Often they did react to related foods. One of the most important factors in determining the extent of their sensitivities was the degree to which they had cleaned up their environment. If they were extremely reactive to molds, for example, and did nothing to rid their home of molds, their food allergies were more extensive.

On the other hand, if they had minimized their chemical and other exposures by getting rid of the gas in their home, discarding house plants, perhaps installing a dehumidifier, making their bedroom into an oasis (without carpet and drapes), and cleaning often, there was usually less of a spreading phenomenon.

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In a group of 300 patients with severe migraine headaches, 18 dropped out of the study for various reasons. But ALL of the remaining 282 patients were found to have food allergies. 100 percent!

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JM Very often that’s true, because such a high percentage of migraines are triggered by foods. But migraines can also be triggered by smelling perfume, gasoline, cigarette smoke, and other fumes.

JM Generally, reducing patients’ "total load" by manipulating their diet (eliminating a few worst offenders and rotating other foods*) and cleaning up their home environment was enough to reduce their reactivity. But we often neutralized them for their worst offenders, too – dust and other inhalants; foods; and chemicals. We let the patient select the mode of neutralization they preferred, either injections or drops. Either way, we prepared serum that was free of glycerine and phenol.

JM Yes. First you must understand that a migraine is a body sensitivity that manifests itself in the blood vessels. In other words, one person will respond to an irritant with a sneeze, and another will develop severe head pain.

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. . . a high percentage of migraines are triggered by foods. But migraines can also be triggered by smelling perfume, gasoline, cigarette smoke, and other fumes.

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We think that vascular problems are among the early signals of sensitivity. So we theorize that we can prevent further organ damage and other manifestations of the sensitivity – rheumatoid arthritis, eczema, asthma, and so on – by taking the migraine seriously and treating it aggressively.

The first type of headache is a classical one. It starts with a visual disturbance – perhaps flashing lights – that precedes the pain. It usually involves half of the head and often includes vomiting. The pain may be severe and typically lasts 1-2 days. The classical migraine is the number one cause of absence from work in Britain.

The second type is similar, but has no aura (the flashing lights or other warning signs that precede the pain). We call this a common migraine. It may or may not include vomiting. In this type, the pain often starts on one side and extends to the other.

The third type, basilar migraine, is very frightening. Here the vascular area affected is the main blood vessel going up the back of the head into a vascular circle. Then the vessels branch out to all parts of the brain. Patients feel panicky, often with an overwhelming sense of doom. They think they are going to die. They describe a sensation of "pins and needles" around the mouth, nausea, tingling hands, and generalized headache.

Motor migraines are a variation of the basilar type. They include hemiplegic migraines, in which half of the body feels weak, and ophthamoplegic migraines, which affect the muscles of the eyes, distorting vision. Both of these may be quite severe.

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The classical migraine is the number one cause of absence from work in Britain.

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All migraines represent some kind of vascular event in which the blood vessels go into spasm or "twitch." Symptoms depend on the area affected.

JM I’ll summarize what’s going on physiologically in a few words. A vascular spasm causes "ischemia" followed by "edema." And the swelling of the tissues causes pain. [MJ’s note: Ischemia is an absence of blood, like a hand that turns pale, then blue, when a tourniquet is applied to the arm. But in this case, it results from the constriction of the blood vessels.] When the spasm is over, the body rushes blood into the deprived area, and basically it overcompensates. Too much fluid collects in the tissue (edema), causing the sensation of throbbing. The bottom line is pain, often severe.

JM Actually, I believe those headaches represent vascular events, too. Whether one labels a headache as "migraine" or not probably depends on its severity. In any case, the focal point of treatment should be to decrease vascular irritability – to find and remove the irritants – rather than simply search for pills to numb the pain.

JM Yes, we suggest a few actions that may, with varying degrees of success, abort the full-blown migraine:

JM There’s no doubt that many people have been successful using biofeedback to help them manage their migraines. It can be quite effective. However, biofeedback is a control measure, not a cure. It doesn’t address the issue of what’s causing the pattern of headaches to occur.

MJ Will you summarize your approach to treating migraine headaches?

JM First, minimize your total load by cleaning up your environment. Rotate your foods, omitting your worst offenders.* And commit yourself to adequate allergy testing to discover your own personal causes and triggers.

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Whether one labels a headache as "migraine" or not probably depends on its severity. In any case, the focal point of treatment should be to decrease vascular irritability – to find and remove the irritants – rather than simply search for pills to numb the pain.

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I feel strongly that migraine patients should do the lifestyle examination I’ve mentioned, and make the few changes necessary. In many ways, their health is in their own hands! I’ve seen severely ill patients improve dramatically when they were cooperative and motivated enough to follow instructions.

We’ve observed that migraine sufferers are often overexposed to these three things: electromagnetism, molds, and chemicals. Electromagnetism, which we haven’t discussed, is all around us; people have magnetic fields, every electric wire or appliance has a field, and so on. But the people who get into trouble with this may live under (or close to) high-tension wires. The strong fields create a state of instability in the body, causing already-compromised people to become more vulnerable.

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* NOHA publishes a rotation diet how-to booklet, Enjoy Nutritious Variety: Rotation Diet. Contact NOHA at 847-604-3258 or at P.O. Box 380, Winnetka, IL 60093; to obtain copy(s) at the current price.

** MJ’s note: "Alkaline salts" means something like Bi-Carb by Klaire Labs, from a health food store, or Alka-Seltzer "Gold" (without aspirin) from a drug store. Or improvise by mixing 2 tablespoons baking soda with 1 tablespoon potassium bicarbonate (available from pharmacies) in a pint of water and drinking it. People with high blood pressure, or heart or kidney problems, or on a low salt diet can use 2 tablespoons of milk of magnesia instead. Source: Type1/Type2 Allergy Relief Program by Alan Levin, MD, and Martha Zelerbach.