The key to making a migraine friendly spicy rub for fish or meat is just that...make it yourself.  Many store bought rubs and spices come with some ingredients that we migrainuers can do without--namely MSG.  Why would they add MSG to their seasoning mixes?  Well, for a number of reasons.  The first being that it adds depth and fullness to the flavoring.  It is thought to intensify or enhance salty and sour tastes.  What these manufacturers don't realize is even though it may be tasty it causes lots of us to experience adverse symptoms as a result of adding this flavor enhancing migraine trigger.  Remember MSG has a lot of aliases: hydrolyzed protein, autolyzed yeast, and sodium caseinate to name a few.

Here are the ingredients for my Dry Spicy Rub:

4 tablespoons paprika
1 tablespoon cayenne
2 tablespoons ground black pepper
3 tablespoons garlic powder
3 tablespoons salt
1 tablespoon dried oregano
1 tablespoon dried thyme

Combine all of this in a small dish and mix them together.  This may be stored with your seasonings in an airtight container for up to 3 months.  Make sure to date your container.

How I use my Dry Spicy Rub:
I use this rub to season fish and meat before grilling or cooking.  I also like adding it for some spicy flavor to soups, stews, gumbo, etc. (you get the point).  I sprinkle the rub onto the meat and "rub" it in covering the entire meat.  I try to add this about 30 minutes prior to cooking or grilling.  It can be left on up to 24 hours before cooking.  I also have been known to put a few dashed of this in my chicken noodle soup after it is prepared and just before I eat it.

A recent study may have found a biomarker for migraines!  What does this mean to the migrainuer?  Well, let's just start with the physiology behind this biomarker (CGRP)...

During a migraine, trigeminal (the largest cranial nerve) activation leads to a release of a nueropeptide called CGRP.  The release of this nueropeptide leads to peripheral inflammatory and vasodilatory responses that trigger nuerons involved in pain transmission. These events cause the stereotypical throbbing pain experienced during a migraine.  I don't know if you read my post about estrogen and migraine.  In it I mention the nueropeptide, CGRP which is released with a drop in serotonin causing vasodilation.  A new study showed levels of CGRP are elevated in the peripheral blood of women with chronic migraine.  These elevated levels were found in the absence of both migraine attacks and medication.

For this study they were able to round up 103 chronic migraine sufferers (women with 15 or more headache days a month for at least 3 months).  The control groups were 43 matched women with episodic migraine,  and 31 matched healthy women without a headache history, along with a series of patients with 14 episodic cluster headache matched for age in a pain-free period.  They drew blood on migraine-free days where no symptomatic medication was taken the day before the blood draw.  Patients were allowed to take daily preventive medication.

The study authors concluded that elevated levels of CGRP in the absence of a migraine could be a biomarker for patients with Chronic Migraine.

So what does that mean to the chronic migrainuer?  Maybe your illness will no longer be invisible.  There will be scientific proof that your throbbing pain does exist and it is real.  CGRP levels could be drawn to confirm the diagnosis of chronic migraine.  It also makes me wonder if treatment research will be aimed at decreasing CGRP as therapy for the migrainuer.

If you like shrimp, asparagus, and pasta...you will love this pasta dish!

Ingredients:
1/2 cup of Olive Oil
4 cloves of garlic peeled and diced
2 shallots finely chopped (shallots replace onions for most of my migraine-friendly recipes.  Onions are too high in tyramine for this migrainuer)
1 tsp. salt
Freshly ground black pepper
1 Tbsp. dried tarragon
1 pound large peeled and deveined shrimp
A package of almost any pasta will work with this dish

Start by buying shrimp that has no preservatives (see previous post related to migraine induced by sodium tripolyphosphate). See example below of shrimp without preservatives or antibiotics.  The only ingredients should be shrimp as far as I'm concerned.

 

Once you have purchased you migraine-friendly shrimp, you can start peeling and deveining them.

Next I start boiling water for the pasta of choice (I usually prefer a gluten-free angel hair).  Any pasta will work for this dish. I just prepare per the package instructions and then set aside.

For ease and because I was feeling lazy, I dumped the shallots and garlic into my food processor and pulsed them together.

In my pan I heated the oil at a medium heat and tossed in the shallots and garlic

While those are cooking I prep the asparagus, and then toss them in with the shallots and garlic.  I add in both the tarragon and the black pepper.

And at last, I toss the prepared shrimp in with the asparagus and cook until the shrimp are completely pink.  When the shrimp are completely cooked I toss in the cooked pasta to soak up the oil and flavors.  Then I serve it into a bowl straight from the pan.  The tarragon and black pepper give this dish a really nice flavor.  ENJOY without a migraine!

I just wanted to take time to share a "favorite" with fellow migrainuers today.  We all know how difficult it is to find migraine friendly foods and granola can be especially difficult due to nuts, preserved dried fruits, and coconut.  I have found a product that is delicious and migraine friendly and so I feel obligated to share this treasure.  The brand is "Kind" and they make multiple flavors of granola (some of which contain coconut and nuts so beware of those flavors).  The flavor is "Maple Quinoa and Chia Seeds".

The brand "Kind" highlights that their products contain ingredients that you can see and pronounce, which is vital to the migrainuer.  This product is also gluten-free.  Gluten can be a migraine trigger for some people and more and more people are switching to a gluten-free lifestyle.  They also state this is a non GMO product.  I can rest assured I am not eating franken oats:).

Here is what Kind says about their products and I happen to agree with them:

Not all of their products are migraine-friendly (they contain nuts, coconut, chocolate, etc.).  Maple Quinoa Clusters with Chia Seeds is a granola that is delicious when eaten as a cereal with milk.  I add some fresh blueberries to mine in the morning.  I have also been known to munch on it dry for a afternoon snack.  I must disclose that I am not receiving any incentive for plugging this product.  I just happen to be overly excited about a store-bought product that is migraine-friendly and yummy too!

Here is a link to Kind's website if you want to check them out.  In my research of their site I also learned you can't purchase this product directly from them, but you can get it from Swansonvitamins.com.  I am not sure why it is unavailable from the manufacturer, but my local grocer is carrying it.  It appears the manufacturer's site does offer another flavor of migraine-friendly granola: "Cinnamon Oat Clusters with Flax Seeds".  I haven't sampled this flavor, but would give it a try if my favorite becomes unavailable at my local store.

If you are a woman experiencing migraines it is almost certain that like me, you have noticed some sort of correlation between your cycle and your migraines.   Although chronic migraine may make it difficult to identify estrogen cycle fluctuations as your trigger due to migraine frequency.  So what about our cycles makes us susceptible to migraines at specific times versus others?  There have been numerous studies suggesting a connection to estrogen.

If we take a look specifically at estrogen during a female cycle, this is what happens:
1. Menstruation: estrogen typically measures at a low of <50 pg/ml (first 7 days of graph)
2. Follicular development: estrogen increases during follicular development and peaks at about 200 pg/ml (peak pictured in graph)
3. Ovulation: estrogen drops briefly during ovulation (around day 16 pictured in graph)
4. Luteal phase: estrogen rises again for a second peak (roughly days 20-24 pictured in graph)
5. End of Luteal phase: estrogen level drop to their menstrual levels (assuming we aren't pregnant)

For me personally I tend to "struggle" around (1.) menstruation and (3.) ovulation.  These are both times in the female cycle where estrogen is dropping.  Estrogen related migraines usually are due to a drop in circulating estrogen after exposure to higher levels of estrogen for a few days (this is referred to as estrogen priming).  This "priming" happens naturally at the beginning of menstruation or immediately after giving birth (and lucky me, after delivering both of my beautiful children I had a tremendous migraine).

Other instances that can cause a change in estrogen levels include:
1.  A purposeful withdrawal from an estrogen containing product (birth control) during the hormone-free week or interruptions in estrogen therapy.
2. Unintentional withdrawal from estrogen by missing doses of pills or as a result of drug interactions that may reduce estrogen availability.

This made me wonder exactly how and why does this drop in estrogen trigger a migraine? 
While investigating I came across a connection between estrogen and serotonin.  Estrogen may also impact migraines by affecting other chemical mediators like nitric oxide, magnesium, and prostaglandins which help keep balance between
excitatory and inhibitory neurotransmission.  However I find the estrogen-serotonin connection particularly interesting.  If you are familiar with migraine medications then you know that one of the most effective abortive medications for migraine are a class of drugs called triptans.  These drugs are serotonin receptor agonists (meaning they bind to the specific receptors in the brain that bind to serotonin).  They work because once they bind that receptor on cranial vessels they cause vasoconstriction (shrinking of the vessels) as well as a decrease the release of a neuropeptide that causes inflammation.  Estrogen impacts the central nervous systems in a number of ways.  When estrogen levels drop, serotonin levels fall and there is also an increase in the rate of serotonin elimination.  With the drop in serotonin two things happen that could impact a migraine: a release of calcitonin gene-related peptide (which is a potent vasodilator or vessel expander that is produced in both peripheral and central neurons) and a release of substance P (which is associated with pain and inflammation) from trigeminal nerves.  To sum it all up, this drop in estrogen has begun a process that leads to vasodilation of cranial blood vessels and pain and inflammation via the trigeminal nerve.

**My graph of the female hormones during cycle was made available thanks to Wikipedia
 

If you are looking for a vegetarian migraine-friendly recipe...this may be what you need.  My 5 year old daughter loves these artichokes, which is evidence that an adult palette is not required for this meal.

Artichokes
2 whole artichokes
Minced garlic
black pepper
salt

I prepared the quinoa per the package instructions... making enough to yield 3 cooked cups of quinoa.  Basically I brought it to a boil and then let it sit there.

To prep the artichokes I cut off the pointed end with a serrated knife and placed them in a pan to boil.  I made sure they cooked at a boil for 15 minutes.  At the same time I preheated the oven to 400 degrees (I will put the artichokes in the oven once they are seasoned later in recipe).

I chopped up the produce:
1. Sliced the green onion thin
2. Diced the green and red bell pepper
3. Chopped the pear into bite size or smaller pieces
4. Diced the celery into thin pieces

I added all of these wonderful things into the cooked quinoa.  Then I added the 1/2 cup of sunflower seeds, 1/2 tsp. crushed red pepper flakes, 3 tsp. agave nectar, and 1 tsp. of salt (I usually add more salt) and mixed it all together.  This quinoa pilaf is ready to eat!

Back to the Artichokes:
Once the artichokes are finished boiling, I removed them from the water and placed them on a cutting board. I cut them in half with a serrated knife.  Then I put them on sheet pan with their hearts exposed.   While exposed I misted them with olive oil with my "Misto" then I seasoned them by sprinkling minced garlic, fresh ground black pepper, and sea salt on them (If you don't have a "Misto" just brush them in olive oil).  Then I placed them in the preheated oven (400 degrees) for 15 minutes.  I left my oven light on to make sure they didn't get too crispy.

If you thought I was done grooming this four little "chokes" you were wrong.  I removed them from the oven and then gave them all a cute little hair cut.  If you have never prepared or eaten an artichoke this is how I do it.  I take a regular spoon from my cutlery drawer and spoon out/off all of their hair being very careful not to take a piece of their sweet little hearts off with their hair.  Then I remove all the "crispier" leaves leaving only the yummy ones with a little heart on them (pictured). 

If you have never eaten an artichoke prepared this way, you pull each leaf off and eat the tender white heart off each leaf (as in the one pictured) one at a time until you have no leaves left.  At this time it will be just you and the heart--the best
part.  You can eat all the heart you want.  It's a very sad ending for the artichoke but a wonderful experience for the eater.  And to quote my now seven year old son, who was 3 at the time of the quote, "Lehman's aren't quitters, we are eaters"! 

I served these artichokes on top of the pilaf for a vegetarian and migraine-friendly dinner. 

**This pilaf goes great with both fish and meats as well.

Mayo is spread I use on sandwiches and  in tuna salad, deviled eggs, and is the base for many salad dressings.  My migraine experience has introduced me to very strenuous label reading.  Store bought mayo has a number of ingredients that concern me both as a migrainuer and a consumer.

Ingredients of concern: natural flavor, calcium disodium EDTA, lemon juice, and dried onions.

Natural flavor is an ingredient that food companies can put on a label and neglect to disclose the chemicals that are used to create the flavor.  The flavor can be the result of combining hundreds of unique chemicals.  As a migrainuer I like to know exactly what chemicals I am ingesting.  These flavors can be made through several methods including drying, roasting, or fermenting.  Remember glutamate (MSG) occurs naturally in many foods.  These flavorings come from natural sources, but are highly processed taking "natural" to a whole new meaning.

Calcium Disodium EDTA is made from ethylenediamine, formaldehyde (a known carcinogen), and sodium cyanide (cyanide should make us all question this ingredient).  EDTA is used to treat heavy metal (lead) poisoning because it binds many metals and causes your body to expel them.  A side effect of chelation therapy (heavy metal removal) with EDTA is malabsorption or low levels of vitamin C and various B vitamins.  Migrainuers are commonly low in B vitamins and Magnesium.

lemon juice  and onion are of concern for me because they are on my elimination list.

So, here is a recipe for Migraine-free Mayo that I can use to dress up salads and sandwiches:

2 egg yolks
1/4 cup distilled white vinegar
1 tablespoon Dijon Mustard (mine had horseradish)
1 1/2 cups canola oil
salt
 

I combine the egg yolks, vinegar, and mustard in a food processor.

I could use a whisk...but, I am lazy.

I realize the definition on this photo is not ideal, but I ensure my mustard doesn't have any strange ingredients either.

Gradually I add in the oil a little at a time until it is the thickness you I desire.

Then I add in a little salt.

It's just that simple.

Here is my "left-over salad" using my Mayo with  a little ground black pepper as a dressing!

I used last night's grilled chicken and sautéed green beans with spinach and red bell peppers.  I topped it with the Mayo, ground black pepper, and pumpkin seeds and served myself lunch.

I just completed two weekends of tennis tournaments without a migraine!  I realize not every migrainuer plays tennis.  Whether you want to run, bike, hike a mountain, or do whatever form of activity you love, avoiding a migraine means you must properly prepare.

Before beginning my migraine plan I spent tournament weekends overusing triptans and caffeine in an attempt to just make it through the weekend.  Then I would spend days trying to recover from the weekend in a dark room with ice wrapped around my head.  I am now able to make it through my tournament weekend through proper preparation.

The difficulty playing in tennis tournaments (and many other sports or activities) for the migrainuer lies in the high temperatures (1), the change in activity level (2), and possible dehydration (3).  All three of these factors are physical stressors and require proper preparation in order to overcome them.

1.  High Temperatures:  The weather in Oklahoma did not reach 100 degrees until a week before the tournaments began.  Although the beautiful 80 degree weather up until now provided many comfortable days of tennis it did not give me the opportunity to acclimate to the 100 degree weather I encountered for the tournaments.  Another important temperature fact about tennis is that you add 10-15 degrees to the temperature when playing on hard court surfaces (which I did this past weekend).  Since I spend most my days in a well shaded air-conditioned room, preparing for the tournament means I needed to start acclimating to a sunny 110 degree environment.  Most of the time as a migrainuer I avoid heat and exercise because it is a migraine trigger.  However tournament officials don't appear to care about my migraine brain so at least one of my match times will be in the middle of the day and at peak heat.  Since no one has invented a weather machine yet, I must acclimate to this hot environment.  The experts say that it takes about 7-14 days to acclimate to temperature changes.  My acclimation plan started with adding a walk into my routine at the hottest possible time (around 5 p.m.).  I gradually increased the length of my walks in the heat in order to slowly acclimate and avoid an exertion level that would trigger a migraine.

2.  Change in Activity Level:  Any change for a migrainuer can be a trigger.  Stressing our bodies to do something that they aren't accustomed to whether it is staying awake too long or skipping meals can put us over the edge.  Tennis tournaments mean an unpredictable amount of activity.  A highly competitive third set match could possibly mean I am on the court for over two hours.  Since we play two matches a day, I may be playing four hours of tennis a day.  Trust me when I say that I never play four hours of tennis a day.  What I can do is make sure my body is well-conditioned.  I get on my treadmill or bike whenever I can squeeze in an extra 45 minutes of cardio in order to prepare my body physically.  Only one Saturday before the tournaments began was I able to play tennis twice in one day.

3.  Possible Dehydration:  Properly hydrating is extremely important for exercising in the heat.  Headaches are a main symptom of heat exhaustion.  Heat exhaustion is brought on by high temperatures, humidity and overexertion.  Body water is what keeps us cool.  If you allow your body to dehydrate you can't sweat enough to keep from overheating.  I start hydrating the week before the tournament.  My goal is to never be thirsty and to pee clear.  The day of the tournament I wake up drinking water.  I drink two full 16 oz. waters before I get to the courts.  The Sport Medical Advisory Committee recommends you drink another 8 to 16 oz. of water 15 minutes prior to your event.  They also recommend drinking 4 to 8
oz. of fluid every 15 to 20 minutes during your event.  I drink as much as possible at every change over.  Their recommendation for after events is to drink 16 to 20 oz. of water for every pound lost before the next competition (I will not be weighing myself at the courts). I plan to drink as much water as possible and seek shade  (if I can find some) between and during matches.  The recommendation regarding sports drinks is that they may provide additional benefits with "prolonged continuous or intermittent activity of greater than 45 minutes, continuous or repeated exertion, and in warm-to-hot and humid conditions".  The problem with sports drinks for the migrainuer is that the ingredients are many times migraine triggers.  The idea behind sports drinks is to give an athlete both carbohydrate along with electrolyte replacement during the event.  This migrainuer  will stock some cherry juice in my cooler to sip on if I need some carbohydrate and carry a salty snack for sodium replacement.

Happy Hot Exercising--I hope my experience will help better prepare another migrainuer for exercising in the heat.

My latest dietary experimentation resulted in the seed bar.  Attempts to find a suitable migraine-friendly energy bar/snack bar have left me troubled by the endless products on the market with either nuts or chocolate in them (two very common migraine triggers). If there isn't a nut or chocolate in the bars to ruin them for me,  usually there ends up being another ingredient that ruins it for me as a migrainuer (see my food elimination list).  It is also nice to know that as a result of preparing the bar myself I can guarantee there will not be any of the extra unpronounceable preservative ingredients hiding in my food as a potential migraine trigger as well.

Seed Bar Ingredients:
1 cup oats
1/3 cup sunflower seeds (an excellent source of vitamin E, which contains antioxidant and anti-inflammatory properties)
1/3 cup pumpkin seeds
1/4 cup flax seeds (a great source of omega-3 fatty acids, which are heart healthy as well as a great fiber source)
2 cups puffed rice cereal

caramel sauce:
2/3 cups dark brown sugar
1/2 cup honey
4 tbsp. unsalted butter
1/2 tsp. salt
2 tsp. pure vanilla extract

I preheated the oven to 350 degrees. I lined a baking sheet with parchment paper and spread the cup of oats, 1/3 cup of sunflower seeds, 1/3 cup of pumpkin seeds, and 1/4 cup of flax seeds on the baking sheet and bake it for 8 minutes.

While those were baking I started on the caramel sauce: I combined the 2/3 cup of sugar, 1/2 cup of honey, 4 tbsp. of butter, and 1/2 a tsp. of salt in a saucepan on medium heat and stirred it until I had a smooth caramel sauce.
 
I removed the caramel sauce from the heat and then added the 2 tsp. vanilla.

In a large bowl I combined the oats, seeds and 2 cups of puffed rice cereal and then stirred in the caramel sauce until evenly coated.

Then I lined an 8-inch square baking dish with parchment paper and emptied the cereal mixture into the dish.  I pressed the mixture into the dish to distribute it evenly and then let it sit for 2 hours.  I then lifted the parchment paper out of the dish and transferred it to a cutting board where I sliced up some bars.

I snacked on these for breakfast and used them as energy bars until they were gone.  In fact, I made a second batch yesterday to have on hand for my tennis tournament this weekend.

Near the beginning of my chronic migraine story I attempted a migraine elimination diet unsuccessfully.  I was given a list of foods at the Houston Headache Clinic to avoid.  I stuck with the diet for about three months without any change in the frequency or severity of my migraines.   This diet can be pretty restrictive, and when there weren't any visible results
it was quite maddening.  I don't really know why I felt it was worth trying again, but I am certainly glad now that I did.  Why is my elimination plan working now when it didn't before?  This is a great question.  I thought it was worth evaluating further.

The reason dietary triggers aren't fully recognized by all sufferers is complicated. Sometimes food triggers have an almost immediate impact on migraine and sometimes they take up to days before an impact is felt.  This leads people to believe that a particular food is not a trigger because it is hard to see a direct correlation between the two events.  It may be that the food was a trigger but the individuals overall "migraine threshold" was not reached with the ingestion of that dietary item. Most migrainuers will tell you that migraine triggers are cumulative, stackable, or add up. As I encounter migraine triggers, at some point a so-called "migraine threshold" is reached and the great migraine is set in motion. Where exactly my "migraine trigger threshold" sits, is still a great mystery, but I have a sense of when it is about to be reached these days and work to lower it.  The years I spent in a chronic state of migraine made it difficult to tell specifically what was a trigger and what wasn't.  It seemed everything was a trigger at that time in my life.  How do you figure out your triggers?  Another really good question.  I eliminated as many of the known controllable migraine triggers as I possibly could.  It sounds extreme to many, but the result of being migraine-free is worth the dietary sacrifices I make.

Here is a list of somewhat unavoidable triggers:
1. barometric pressure changes
2. hormonal changes
3. strong odors
4. bright lights
5. aerobic exercise
7. sex
8. dehydration
9. sleep deprivation
10. stress

And here is a list of avoidable triggers (triggers dependent on the consumption of them):
1. food
2. beverages
3. drugs
4. tobacco (kind of a drug)

Diet is just a piece of the migraine pie.  There are a bunch of other ingredients needed to create the perfect recipe for
migraine.  If I look back at the differences between my two attempts at elimination diets there are some differences between the two:

1. My job stress was decreased during my successful attempt.
2.  A number of the medications I was taking for migraine prevention (Topamax, Depakote, Pristiq, and Seroquel) were no
longer part of my regimen during the successful attempt.
3. I was no longer sleep deprived (as a result of the preventive medications) during the successful attempt.
4. I quit taking hormonal contraception in order to reduce another (stackable) trigger during the successful attempt.
5. I quit taking my triptans (due to their rebound potential) during my successful attempt.
6. I eliminated caffeine completely...I had been told to limit it to 8 oz. a day in my first attempt.

My point here is that an elimination diet is not a cure, but just a part of my migraine plan in an effort to reduce many of the
stackable or cumulative avoidable triggers that are present in my life.  I believe as a result of keeping all my triggers to a minimum I have my life back.  I know I am still migraine sensitive because at times I am still affected by the unavoidable triggers.  During those times, I live a little more carefully.  For example, I hydrate well and get to bed on time.  And now, if I need to take an aspirin, naproxen, or ibuprofen...they actually work as intended.

We can still hope and work towards a "migraine cure", but I am so grateful I am currently able to manage my migraines successfully.  It is my wish others achieve this same success in managing theirs.