Case Report: Migraine SolutionAugust 2004
|LE Magazine August 2004|
|Case Report: Migraine Solution |
By Dr. Sergey A. Dzugan
Diagnosis and Treatment
The lab report numbers were as follows: total testosterone was 187 ng/dL (standard range is 241-827), pregnenolone was less than 10 ng/dL (standard range is 10-200), and DHEA sulfate was 199 ug/dL (standard range is 280-640). Progesterone, at 1.6 ng/mL, was slightly higher than the maximum standard level (standard range is 0.3-1.2). Estradiol was within the standard range, at 18 pg/dL (standard range is 0-53).
Patient’s initial program included:
We discussed with CH the necessity of replacing all three deficient hormones (pregnenolone, DHEA, and testosterone), but he preferred to stay with this initial program without testosterone for a couple of weeks.
About a week later, patient began to experience night sweats and his body temperature soared from 95.6 to 102.7 degrees F. His doctor prescribed an antibiotic, and a week or so later the symptoms ceased. Based on his very low testosterone level, we sent him to a urologist for further tests and a testosterone prescription. The urologist ordered a CT scan of his pelvis and head, which apparently showed nothing abnormal. The urologist said he thought CH’s testosterone levels might be low as a result of his vasectomy years ago. He also said he was unaware of any correlation between testosterone levels and migraine incidence.
On April 15, 2004, the urologist prescribed TestimTM 1% testosterone gel. Patient began using the gel daily. As of today, CH reports he is completely migraine free. He has also experienced an improvement in sexual function and energy levels, without any negative side effects.
Prophylactic treatment of migraine patients is desirable because the currently prescribed prescription drugs are not always effective in all patients and allow recurrence of headaches in a high percentage of patients, occasionally with severe adverse side effects.
It has been previously reported that sex hormones play an important role in the creation and regulation of migraine.10 Significantly low plasma testosterone levels were found in active cluster headache patients.11 CH’s case shows that hormonal restoration is a key element of any program recommended for the management of migraine.
Several studies have shown that magnesium and melatonin can provide relief from migraine.12-15 We recommend that both agents be included in treatment programs that aim to eliminate migraine.
Because major depression is approximately three times more common in persons with migraine16 and fatigue likewise is common in migraine patients,17 we must stress the importance of the association between hormonal therapy and kava root extract, which may represent an excellent therapeutic tool for treating migraine, particularly for those suffering from anxiety and depression. Kava kava therapy accelerates the resolution of psychological symptoms without diminishing the therapeutic action of hormones.
Restoration of natural intestinal flora, from our point of view, is also extremely important in treating migraine, because migraine patients usually take different drugs over the years that change intestinal flora and diminish intestinal absorption.
We recommended our program to CH to restore youthful levels of hormones, rebalance the autonomic nervous system (sympathetic and parasympathetic systems), improve the calcium:magnesium ratio, and enhance intestinal absorption. Because CH’s migraines and concomitant symptoms have disappeared, we believe that this case report suggests that similar treatment methodologies may have a wider application in patients with migraine.
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