An Innovative New Treatment for MigraineSeptember 2004
By Dr. Sergey A. Dzugan
Following initial consultation, a baseline lipid profile was taken and levels of pregnenolone, dehydroepiandrosterone sulfate, progesterone, total estrogen, and total testosterone were determined through routine blood testing. Serial determinations were made thereafter during treatment.
All patients then underwent a comprehensive treatment program incorporating the following four components:
It must be stressed that these four components of the program cannot be separated; they are intertwined and work together. For example, by using estrogens and progesterone, we not only restored hormonal balance, but also helped restore a balance between the sympathetic and parasympathetic nervous systems. The same situation is associated with calcium and magnesium: by restoring metabolic integrity, we also restored balance between the sympathetic and parasympathetic nervous systems.
Hormonorestorative therapy includes a formula that is chemically identical to human hormones and is administered in physiological doses according to schedules intended to simulate natural human hormone production. Patients received treatment with oral pregnenolone, DHEA, and dermal applications of triestrogen (estriol 90%, estradiol 7%, estrone 3%), progesterone, and testosterone gels. All patients had steroid hormone deficiencies before beginning hormonorestorative therapy, with deficiencies in pregnenolone most prominent. Recommended doses to different patients varied significantly and were determined by serum hormone levels obtained during serial testing.
We did not use a standard dose, rigid protocol, or traditional design for this study. Doses were individually selected to produce youthful physiological serum levels. We administered hormones in doses sufficient to achieve circulating plasma levels observed in younger healthy adults between the ages of 20 and 30, who register the highest naturally occurring levels of all steroid hormones. These levels are at the high end of the normal range specified by the testing laboratory. Sixteen patients (69.6%) had been taking from one to three steroid hormones before beginning hormonorestorative therapy; none of the 16 reported obtaining any relief from these therapies, and all were still experiencing migraine before starting our program. All agents such as equine conjugated estrogens, medroxyprogesterone acetate, and methyl testosterone were switched to bio-identical hormones during treatment. Estrogens were always used in conjunction with progesterone.
Throughout the period of hormonorestoration, all of our patients were provided with an oral dose of 420 mg of magnesium citrate taken at bedtime. Patients were also given 3-6 mg of melatonin and 100-250 mg of kava root extract at bedtime. Kava has been shown to be effective as an alternative treatment in mild to moderate cases of anxiety. The pharmacological properties of kava are postulated to include blockade of voltage-gated sodium ion channels, enhanced ligand binding to gamma-aminobutyric acid (GABA) type-A receptors, diminished excitatory neurotransmitter release due to calcium ion channel blockade, reduced neuronal reuptake of noradrenaline (norepinephrine), reversible inhibition of monoamine oxidase B, and suppression of the synthesis of the eicosanoid thromboxane A(2), which antagonizes GABA(A) receptor function.78 In this study, kava was used as part of the program without side effects. While kava remains on the market, you may wish to substitute L-theanine because of concerns about kava-induced liver toxicity. For the restoration of healthy natural intestinal flora and improvement of absorption, 3.5 billion of the Lactobacillus group (L. rhamnosus A, L. rhamnosus B, L. acidophilus, L. casei, L. bulgaricus), 1 billion of the Bifidobacterium group (B. longum, B. breve), and 0.5 billion of Streptococcus thermophilus were introduced. Migraine is a recurrent clinical syndrome characterized by combinations of neurological, gastrointestinal, and autonomic manifestations.79 We believe that restoration of natural intestinal flora is a very important element of our program.
Much to our satisfaction, all patients responded to migraine management with this multimodal treatment strategy. None of the patients suffered from migraine after initiating this program (a 100% success rate), indicating that migraine is not only treatable but also curable. Furthermore, the associated symptoms of fibromyalgia, insomnia, depression, and fatigue were resolved entirely.
During the follow-up period, no complications or side effects related to this regimen were cause for concern. Most important, all patients described a significant improvement in their quality of life.