Tag: headaches

Don’t Forget Your Back

Most of us spend a large portion of the day hunched forward.  Think about when you are working on the computer, cooking, driving or even relaxing.  Your typical posture during these activities is head and neck forward, shoulders rounded forward, back curved and hips flexed.    When you remain in this position for an extended period of time, the muscles in the front of the body tend to shorten or contract, while the muscles in the back of the body tend to weaken.    This can be a set up for back, neck and shoulder problems and in addition, tends to make you look shorter, heavier and less confident.

Stretching before and after exercise as well as during the day is often overlooked in the rush to “get your workout in”.   Stretching however, has numerous benefits.   According to a study published in the Annals of Physical Medicine and Rehabilitation Medicine in September 2016, by I Fekhfekh, et al, dynamic muscle stretching of the knee musculature actually resulted in an increase strength gain in those muscles.  Interestingly, this study also found a decrease in the postural stability of the knee after stretching.    In English, it appears that stretching helps your to build strength, but may decrease the stability of the muscles you stretch at least temporarily.

In general, stretching helps to improve flexibility, joint range of motion, and usually is helpful for injury prevention.    Stretching helps by increasing blood flow to the muscles stretched.  This increased blood flow carries important nutrients to your muscles to allow for muscle growth and repair.  In addition, the increased blood flow helps to wash away muscle “waste” which leads to decreased soreness and inflammation of the muscle.

If allowed to remain in a contracted position for a prolonged period of time, our muscles will shorten.  For example if you spend a large portion of your day sitting in a chair or driving, the muscles in the front of the hips, your hip flexors will shorten.  These muscles have a direct effect on both your posture and your back health.

 

So what should you do?

It is important to stretch the muscles in the front of the body at least daily.

Exercises that focus on the hip flexors:

-Kneeling hip flexor stretch  – in the position of a lunge, allow your back knee to touch the floor and drive the hip of your front leg forward.  This will stretch the hip flexor of the knee on the floor

–Pigeon stretch – extend your right leg straight back and bring the heel of your left leg underneath your right hip.  Then drive your hips forward towards the ground.  Stretch and repeat on the other side.

– Yoga poses such as: low lunge, crescent lunge, upward facing dog, and revolving side angle pose

 

Stretches that focus on the chest muscles and prevent rounded shoulders:

– Door Frame stretch- stand in a doorway or at the corner of a room with your arms up like you were going to stop traffic.  Line your arms up from the elbow to the hand with the doorframe or in the corners of the wall.   Step towards the door and you should feel a stretch in your chest (pectoralis “pec” muscles) and hold for 20-30 seconds.

– Wall slides – stand with your back to the wall and keep your shoulders against the wall.  Walk forward 1-2 steps and slide your arms up and down the wall and squeeze your shoulder blades together.  You should feel a stretch in your upper chest muscles.

–Shoulder squeeze stretch –  clasp your hands together behind your back and slowly try to lift your hands.  Squeeze your shoulder blades together to stretch out the chest wall.

– Yoga poses include : bridge pose, camel pose, cobra pose and cow face pose

 

Stretches for your neck:

– Chin Tucks (Neck Retraction) – keep your shoulders back and your head in a neutral position (eyes facing forwards, chin level) slowly move your head backwards until you feel a slight stretch in the back of your neck.  Hold for 10-20 seconds and repeat.  If needed you can apply a gentle pressure on your chin with your fingertips to press your chin backwards and deepen the stretch.

Incorporating these exercises into your daily routine will help to prevent shortening of the muscles in the front of the body which leads to poor posture and often pain of the neck and back.  As always, if you are having pain which persists you should be evaluated by a certified health care professional to ensure that these exercises are safe for you.

This week we primarily discussed stretching exercises to prevent muscle contraction, and next week we will discuss the importance of strengthening the back muscles to further combat the issues of a hunched posture.

Fermented Foods

The gastrointestinal tract is the barrier between the outside world and the inside of our bodies.  Pretty much anything that we put into our mouth either gets digested and absorbed to be utilized or stored by our body, or gets excreted as either solid or liquid waste.

Research has shown that our GI (gastrointestinal tracts) contain between 2-6 pounds of gut flora (bacteria, viruses, fungi, parasites, etc).  These microbes (also called flora, or living organisms) can be helpful, harmful or neutral.  Due to necessary and sometimes unnecessary use of antibiotics to treat illness, environmental chemical exposures, and use of antibiotics in our food sources, the population of flora in our GI tract can be greatly altered.

If the balance between the good and bad flora shifts, this can lead to significant issues; such as improper digestion of foods, malabsorption of nutrients, overabsorption of nutrients leading to weight gain, and possibly a breakdown in the gut barrier.    This breakdown in the gut barrier theoretically can enable toxic substances and possibly microbes to enter into the bloodstream.   Our bodies have multiple ways to defend against bacteria and toxins transiently entering our body and bloodstream.   However sometimes these defense mechanisms may not work properly and illness can ensue.

The process of fermenting foods increases the beneficial bacteria count in the foods, and makes nutrients more bioavailable or easier for the body to absorb.    Eating fermented foods, seems to help better regulate the immune system.   Fermented foods can contain a wide variety of beneficial bacteria and the levels found in these foods far exceeds the level of beneficial bacteria found in over-the-counter supplements.  Consuming probiotic supplements alone though, hasn’t really been shown to increase the levels of beneficial bacteria in the gut.   Adding  prebiotics found in fermentable fibers (chicory root, Jerusalem artichoke, yams, dandelion greens, leeks, onion, garlic and banana) have been shown to stimulate the grown of beneficial bacteria in the gut.  Therefore it is recommended to consume both prebiotics and probiotics.

It is crucial to introduce fermented foods, such as sauerkraut, kimchi and kombuchi very slowly into the diet.  This is because fermented foods can have high levels of histamine and aldehydes.  Histamine is substance that causes a local immune response such as hives, rashes, nausea etc.   Some people have decreased ability to break down histamine or aldehyde quickly and therefore can be intolerant to higher levels of these substances.  If you notice that when you eat fermented foods, you develop headaches, abdominal pain and bloating, hives, rashes or nausea it may be due to the high histamine or aldehyde load.    In this case, one would require an individualized assessment to determine the safety of consuming such foods.

Raw fermented foods are becoming more readily available for purchase.  In addition, there are more kits available to ferment foods at home.  It is important to realize that when commercially purchased, fermented foods are often pasteurized or preserved for safety.  This kills the beneficial bacteria.  In addition, commercially available foods often contain high amounts of refined sugar and processed dairy.     Therefore, the benefit of foods such as kefir and yogurt, that have a high concentration of probiotics, is offset by the amount of sugar and processed dairy.   As was discussed last week, pasteurized dairy can have many unwanted side effects.

If possible it is best to select foods such as sauerkraut, kombuchi and kimchi rather then milk based products such as yogurt and kefir.  When eating yogurt and kefir it is recommended that you select full fat products without any additional sweeteners or sugars added.

Currently, there is a fair amount of debate in the literature regarding prebiotics, probiotics and fermented foods.  Just remember no one specific food or supplement is best for everyone.   We all have different genetic make ups and environmental factors that influence our responses to food and supplements.

Hope this helps to bring some light onto the subject of probiotics and fermented foods!

What’s the Deal with Aspartame and Diet Soda?

I suffered from chronic daily headaches for about 8 years. The headaches were never terrible nor debilitating, but always present. It was as if I was in a constant state of fogginess. During medical school, I drank about 1 liter of diet soda every day while I studied. In residency, I switched to Crystal Light Iced Tea because I decided I needed to cut down on my soda intake. During one particularly busy week in residency, I ran out of my iced tea and was unable to make it to the grocery store. I didn’t realize it at first, but over the course of the week my ever-present headaches disappeared. By the end of the week, I was noticeably better and my fogginess had lifted completed. I wasn’t sure the reason, but I was certainly thrilled. Fast-forward to the next week when I was able to get to the grocery store, and all of a sudden my headaches returned.

It took me a while to make the association, but I ultimately figured out that 8 years of suffering, in my case, was due to aspartame consumption. I now avoid it like the plague and have had a negligible number of headaches over the last 12 years. That’s not to say that I don’t get headaches here or there but many of them I can trace back to eating foods, sweets or drinks which I didn’t realize at the time, contained aspartame.

Aspartame is one of the artificial sweeteners found in many diet sodas but is also being utilized as a sweetener in many foods such as:

  • Powdered drinks
  • Flavoring syrups for coffee
  • Sweetened iced teas
  • Fruit and vegetable juices
  • Flavored waters
  • Gums
  • Candies
  • Yogurt
  • Certain condiments and desserts
  • Meal replacement bars

Why is this an issue?

Aspartame is broken down by enzymes in our body into phenylalanine, aspartic acid, diketopiperzine, and methanol. These breakdown products can have significant effects of on our bodily functions and metabolism.

According to a review article published in the European Journal of Clinical Nutrition in 2009, aspartame can:

  • Disturb amino acid metabolism
  • Disturb protein structure and metabolism
  • Impair neuron functioning
  • Cause endocrine imbalances
  • Change the concentration of neurotransmitters in the brain
  • Cause excessive nerve firing in the brain
  • Compromise the function of the blood brain barrier
  • Affect fertility

In certain individuals, a byproduct of aspartame breakdown, methanol, can cause a toxicity that mimics fibromyalgia. Symptoms can include spasms, shooting pains, numbness in legs, cramps, vertigo, dizziness, headaches, tinnitus, joint pain, depression, anxiety, slurred speech, blurry vision and memory loss.

It is very important to prevent toxic substances from entering into our brain where they can cause inflammation and damage neurons. This is the role of the blood brain barrier. This barrier has transporters that allow important amino acids to cross into our brains to be used to make needed substances called neurotransmitters. These neurotransmitters are chemicals that allow communication between brain cells to control everything from our moods, and emotions to our sleep-wake cycles.

Essentially, what happens is that when we eat and drink foods with aspartame our bodies digest the aspartame into its components. The high levels of these breakdown products (particularly phenylalanine) can flood or overload the transporters in the brain and allow too much phenylalanine to get into the brain and prevent other needed amino acids from entering. This can lead to too much of certain neurotransmitters being produced while inhibiting the formation of others. These imbalances may influence or worsen diseases such as Parkinson’s, Multiple Sclerosis, and Epilepsy.

In addition to the neurological effects described above, multiple studies have shown that daily consumption of diet soda results in an increased risk of metabolic syndrome (a group of symptoms such as abdominal obesity, elevated blood pressure, elevated fasting blood sugar levels which raise your risk for heart disease) as well as type II diabetes. Specifically, a study done collectively by Columbia University and the University of Miami, published in the Journal of General Internal Medicine in Sept 2012, followed diet soft drink consumption over 10 yearsand found that daily diet soft drink consumption led to an increase of vascular events such as stroke, heart attack or vascular disease. There was however, no increased risk seen with regular soda consumption or infrequent diet soda consumption.

Therefore, the take home message is that very infrequent diet soda and artificial sweetener consumption is probably okay unless you are like me and can’t tolerate even small amounts. If you suffer from chronic daily headaches, seizures, chronic fatigue, chronic pain, infertility, neurological diseases, or even autoimmune diseases, consumption of artificial sweeteners may be exacerbating your conditions. A trial of elimination of all artificial sweeteners may help to alleviate or even in some cases eliminate some of your symptoms.

Some Common Causes of Headaches

Last week we discussed the importance of avoiding aspartame and artificial sweeteners due to the numerous deleterious effects on our bodies. One of the issues we addressed was the potential for headaches due to the use of aspartame. However, this is only one of the myriad of triggers for headaches.

When addressing headaches, it is important to determine the characteristics of your headaches. It is crucial to understand dangerous vs. safe headaches. I use safe as a relative term, because all headaches are painful and significantly impact our quality of life, but not all headaches are indications that a serious issue is going on. Headaches have been classified by the most common constellation of symptoms that occur with each type.

To begin, we will discuss the headaches that require emergent attention.

HEADACHES DUE TO BLEEDING IN THE BRAIN
A sudden onset of a severe headache, often described as the worst headache of my life is concerning for possible bleeding in the brain. These headaches can be associated with nausea, vomiting, visual changes, neurological changes and/or changes in consciousness. Especially if these headaches occur after a trauma or head injury, it is imperative to go directly to the emergency room for imaging studies to evaluate for any bleeding in the head. In addition, if you have a family history of individuals having bleeding strokes, you should be evaluated promptly.

Another headache that, if chronic, requires attention is a headache that presents upon waking up. Infrequent morning headaches are not generally worrisome especially if you have a cause, like a sinus headache, significant tension/stress, or an illness. However, if you have chronic morning headaches, which actually get better throughout the day it is a good idea to have these headaches evaluated by a health care professional. Especially if the headaches are associated with progressive neurological symptoms such as, but not limited too, numbness, tingling, weakness, word finding difficulties, visual changes, balance issues, and decreased coordination.

Finally, any headaches associated with fever, chills, light sensitivity, and neck pain should be evaluated promptly as these can be indications of infections in the brain and/or spinal cord.

TENSION HEADACHES
The most common type of benign headaches are TENSION HEADACHES. These headaches can be described as band-like in nature. Typically, there is dull aching pain around the temples. Often there is tightness or pressure in the forehead, sides or back of the head. In addition, you may have tenderness in the shoulder and neck muscles and even the scalp. Generally these headaches are brought on by stress and alleviated with stress reduction and relaxation. Exercise can be helpful to relieve tension headaches.

CLUSTER HEADACHES
These headaches are much less common and not very well understood. It is hypothesized that they are related to blood flow in the brain. These headaches by definition occur in groups or clusters. These headaches are always located only on 1 side of the face. Usually, they present around the eye but can radiate to the jaw, temporal region or forehead. They can be associated with symptoms on the side of the headache, such as eye tearing, nasal congestion, sweating, eyelid drooping, and pupil changes. These headaches can be worsened by alcohol consumption during the time when they are occurring. In addition, cluster headaches are associated with heavy smoking. These headaches tend to occur in groups (ranging from 1 time every other day, up to 8 times per day, by definition) and there can be periods of remission. Cluster headaches are more difficult to treat and require physician supervision for treatment and prevention.

MIGRAINE HEADACHES
Migraine headaches can also be described as the worst headache of ones life and therefore can be confused with headaches due to bleeding in the brain. Typically, migraine suffers have had a series of migraines and are able to tell the difference. In general, migraines can occur with or without an aura. An aura is a constellation of symptoms which presents before the actually headache ensues. For example, an aura can be visual changes, sensory changes (such as smells, strange lights,) or hallucinations (confusing thoughts). Migraines can be associated with nausea, vomiting, visual changes and even neurological symptoms. In addition, migraines can be associated with hormonal changes. Like Cluster headaches, Migraine headaches should be managed by your health care professional.

SINUS HEADACHES
These headaches are associated with sinusitis, or an infection/inflammation of your sinuses. Typically these headaches are associated with facial pressure, pressure above your teeth, congestion, and post-nasal drip. Treatment of these headaches should be focused on treating the sinusitis.

So what can you do to help alleviate your headache intensity and frequency?

Monitor your diet, because often headache triggers include foods. The most common offender is dairy. This can be because dairy leads to sinus congestion. However, other foods, such as alcohol, gluten, chocolate, bananas, sugar and artificial sweeteners can be implicated causes for headaches.

If you suffer from chronic daily headaches, keep a food diary and rotate your foods. Sometimes, headaches can occur even 1-2 days after eating the offending food. Try to eliminate foods and then re-introduce one food at a time every 2-3 days to determine if your headaches return.

Daily exercise also helps to alleviate most headaches, though you can get an exercised induced headache if you do heavy lifting, heavy exertion, or especially if you are dehydrated.

A few tips for preventing headaches:

  • Stay hydrated – drink lots of water and eat foods with a high water content such as cucumbers and watermelon
  • Coffee can help with headaches, however, caffeine withdrawal headaches are often a common cause of headaches
  • Foods rich in B vitamins, or the addition of a B complex vitamin to your diet can help prevent headaches. Both vitamin B2 and B3 deficiencies have been implicated in contributing to headaches
  • Foods rich in omega-3 fatty acids help prevent headaches (salmon, flax seed)
  • Bananas and foods rich in potassium are helpful for headache treatment and prevention
  • Magnesium containing foods or supplements are helpful in treatment and prevention of headaches (quinoa, spinach)
  • Co-Enzyme Q10 and Selenium have also been useful for treating headaches (speak to your doctor first before beginning these supplements).

As always, if you suffer from chronic daily headaches, address these with your healthcare provider for optimal treatment and prevention.