AHSNZ Wanaka: a taste of what you missed

ICYMI, the second Ancestral Health Society of New Zealand symposium took place over Labour weekend, giving me a great excuse to head down to the South Island and reconnect with the geographical region I’ve spent much of my time over the years, and with the people who are part of my ‘tribe.’ I love love love the South Island and particularly Central Otago. It was so great to reconnect with fellow Ancestral Health New Zealand crew, meet up with old Dunedin friends and meet other like-minded people.

I am not going to give a detailed account of each presentation – in fact, I don’t need to as the presenters are each writing up a post that summarises their talks – two of which   I am sharing today so you can get a taste of what you missed. As a brief overview, there were a mixture of practitioners and advocates of evolutionary health – touching on topics from sustainable farming to endurance training to perceptions of body size ideals. While our first symposium had more of a focus on nutrition, this conference extended well beyond that.

The programme from the conference can be found here, and below are two posts already written up by Kate and Andrew. Read, ponder, and definitely keep an eye out for details of our next symposium looking to be held in the first quarter of next year.

Kate, the Holistic Nutritionist, an Australian import, did a detailed talk on the importance of the gut microbiome in determining our health

Dr Andrew Dickson (from Massey University), self-proclaimed Clydesdale and lover of trail running spoke about body mass and endurance athletes: perception via psycho-sociology

The day ended with a movement session that didn’t involve exercise; Max Bell (from MovNat New Zealand), Aaron Callaghan (Peak 40) and James Murphy (of Synergy Health) took us through movement and activity patterns that challenged the uncoordinated amongst us (i.e. me) but was suitable for all levels. This enabled pretty much all of the conference attendees to take part. Check out some of the pictures from this (and the conference in general) on the AHSNZ Facebook page here.

Overall – it was a brilliant day and a taste of things to come over the coming year. Along with the  one-day symposiums in the pipeline, we have our first international event planned for Queenstown next Labour weekend – with Melissa and Dallas Hartwig (Whole 9) and Dr Emily Deans already booked to present. I’m already counting down the days to this one – it’s 346 sleeps away.

Not tonight, honey. I’m exhausted.

Have you heard the term ‘ironman widow’? Where someone’s husband (or wife) is basically invisible for the better part of 12 weeks as they prepare for an upcoming race. This not only relates to being physically present (which is diminished when the training time is upwards of 15-20h a week) but also ‘present’ when at home. Often exhaustion sets in, particularly nearer the end of the week or after a heavy training day, where the mere thought of moving from the couch is akin to another 6h ride. Sex? Don’t even go there. It’s a fairly common (yet usually unspoken) phenomenon that rolling around in the sack is off the agenda in the lead up to the event. And I’m not talking about the day before an event; it’s more like as a general rule because they are too damn tired. Does this sound familiar? Yes, being tired is a natural (and expected) part of the training cycle – however, much as we talk about adrenal fatigue and hormonal imbalance in women – this is not an uncommon occurrence in men. It’s just not often talked about.

When we talk hormones, I know that I’m guilty of just addressing women. You know – the stress hormones, thyroid hormones and sex hormones. However men are not exempt from the debilitating effects of overdoing it. Just as a ‘rushed’ lifestyle can affect the thyroid and sex hormones in women (including testosterone), men who undertake endurance sport are at risk of poor testosterone status.

Testosterone: a sex hormone (also present in women too) is a chemical messenger. It declines as we age, and some studies have found a that testosterone levels for a male in their late 30s are down by as much as 50 % on the levels that were present in their 20s. Just as oestrogen is controlled by the hypothalamus, it is the same for testosterone; when the hypothalamus detects a deficiency of testosterone in the blood, it secretes a hormone called gonadotrophin-releasing hormone (GRH). This is detected by the pituitary gland that in response starts producing follicle stimulating hormone (FSH) and luteinizing hormone (LH). These travel to the testes where testosterone is produced from cholesterol by the leydig cells with just a small amount produced by the adrenal glands. It’s then sent back into the blood stream and either attaches to sex hormone binding protein (SHBG) and becomes biologically inert, or remains free in the bloodstream.  Normal levels are between 300 ng/dl – 1200 ng/dl (10.41)-41.64 ng/dL. The three types of testosterone you might see reported are:

  • Total testosterone- As the name implies, it’s how much testosterone available and is the sum of free and bound testosterone.
  • Free testosterone is the most biologically active form of testosterone. Free but low biologically active test and therefore still have signs/symptoms of overall low testosterone.
  • Bound testosterone-This is the testosterone bound to the protein Sex Hormone Binding Protein (or Globulin) (SHBP/SHBG). A high amount of SHBG will usually indicate a low free testosterone.

Testosterone is not just important for reproduction and sex drive – it has a number of other roles including supporting bone mass, regulating fat distribution, muscle size and strength and red blood cell production. If you are a typical endurance athlete who tends to push themselves and have had stress fractures that can’t be put down to a lack of calcium, it could well be that low testosterone is a contributing factor. As we know, testosterone increases during training and contributes to overall energy levels; a low production of testosterone contributes to the fatigue that can be felt under a heavy training load, making someone feel worse than they should. It’s difficult though, to know what is a normal byproduct of a heavy training load (because, let’s face it, endurance sport requires longer and harder training than, say, golf). Below are some common signs and symptoms of low testosterone.

  • Decreased/absent early morning erection
  • Reduced sex drive
  • Erectile dysfunction
  • Loss of facial or pubic hair
  • Testicular atrophy
  • Low bone mineral density/fractures
  • Night sweats

Phew! That’s not you? Well, you may not be out of the woods just yet. Less specific (or earlier signs) include:

  • Decreased energy or motivation
  • Poor concentration and memory
  • Disrupted sleeping patterns
  • Moody
  • Reduce muscle/increased fat mass
  • Reduced performance

You can see that the early signs of a reduced testosterone level could be summed up by being a bit ‘tired’ and are fairly non-specific. The best way to know what is going on with your testosterone is to get it tested through your doctor (noting that the free testosterone is the important measure).

Thankfully there is plenty you can do with your diet to ensure you’re optimising your ability to produce testosterone without getting a prescription for the pharmaceutical type. Unsurprisingly, these come down to pretty much what I write about on a weekly basis:

  • Ensure adequate vitamin D – this is involved in the production of the corticosteroid hormones and it’s important we have enough available to support the production of our thyroid, stress and sex hormones. Food sources are full fat dairy products, a small amount in butter, liver, animal protein and fatty fish such as salmon, sardines and mackerel. Taking a supplement (that also contains vitamin K2) is warranted for a large part of the year in New Zealand, but particularly as we come out of winter and into spring, where the UVB rays are diminished and we’ve been spending the vast majority of time inside on the windtrainer to dodge the weather.
  • Ensure adequate zinc intake (through oysters and animal protein, and brazil nuts too) – a note here is that iron can reduce our overall ability to absorb zinc, and this may need to be looked at if you’re taking an iron supplement.
  • Ensure adequate selenium intake (seafood, Brazil nuts) and vitamin A (full fat dairy products, liver, eggs, animal protein)
  • Saturated and monounsaturated fat: Again, most of the foods mentioned above are good sources of saturated fat in the diet, and monounsaturated fat is found predominantly in olive oil, eggs, avocado and raw nuts. The reality is, all fats contain the range of fatty acids we need, and are labelled ‘saturated’ or ‘monounsaturated’ fats due largely to the amount they contain. Coconut oil (which has had some bad press of late, despite a lack of evidence of a relationship to heart disease) is particularly rich in saturated fat.
  • Cholesterol: another important co-factor in the creation of the sex hormones, and forms the backbone of these. Foods of animal origin help supply dietary cholesterol for this role. If you’re someone who has followed a low fat diet or vegetarian diet and has a low cholesterol level, then potentially your testosterone could be lower than ideal.
  • Ensure adequate B vitamins and magnesium also (present in the foods mentioned above and in abundance in vegetables).

Finally – on the life side of things: sleep more, ensure adequate recovery from training and have more sex. That will increase your testosterone.

Susan’s ketogenic experiment

Now for something different: Susan came to me this week wanting some support as she embarked on a ketogenic diet. As a woman who is both an avid consumer of information and investigative, she’s done a lot of reading about it but hadn’t come across a much information on the effects of a ketogenic diet on a woman of her age.  So she’s undertaking an n=1, and wanted to document it. She will undoubtedly start her own blog but right now, she’s starting the journey here.

I’m Susan, a 50 year old woman and 1.53m tall, originally from the US, married to an awesome man (but sadly childless), an ‘enthusiastic participant’ of most all things outdoors and lifting weights. I was really lucky to have been raised in a very loving family, working class, suburban, incredibly ‘normal’. My mum certainly did her best where food was concerned, or at least to the understanding she had at the time – iceberg lettuce salad with dressing to start, things like meatloaf or pork chops, spaghetti and meat sauce, tinned veg, and ice cream for dessert. We normally had fast food as a treat maybe once a week – McDonalds, KFC, Fish & Chips. We were normal suburban kids, out on our bikes or in the cul-de-sac until dark, running around, walking to school, and I reckon I was normal weight until…the microwave oven!!!!!!

Both my parents worked, and when the microwave arrived, so did the easy, processed, and addictive after school treats. Hot Dogs! Burritos! Pizza! Hot Pockets! Basically, we’d get home from school and have another complete meal. Still, until I was 16, my weight was pretty much fine. I was never an athlete, but I loved my tramping and my outdoor pursuits, and was an avid girl guide. I lived my last year of high school on Grape Nuts Cereal and Diet Coke. And Snickers. And voila, the spiral into something I never imagined, not just for myself, but never imagined existed. A metabolic nightmare that ensued for the next ten years. By the time I was 19, I had gone from a regular menstrual cycle to having maybe 3 or 4 per year. I went looking for help, and what was the doctor’s solution? You got it, birth control.

When I was 21 I met the man who was to be my first husband, I remember that preparing for the wedding, when I was 23, I went on a crash diet which involved 2 shakes per day and not a lot else, and I managed to get down to about 53kg, which was the lowest I’d been since I was 15 years old. Slowly the weight crept back up, but by then I felt like I had all of the tools to understand what it took to keep me in a relatively small state (mainly, don’t eat!). I also went off birth control, as we wanted to have a child. I did manage to fall pregnant quite quickly, only to miscarry at 12 weeks. Following that, once again my periods pretty much stopped, and eventually I went to another doctor to try to figure out why. I had massively polycystic ovaries (PCOS). The doctor was emphatic that the only solution was a ‘wedgectomy’ and massive doses of clomiphene to force ovulation. I declined.

Fast forward 5 or 6 years, I’m out of my first marriage and in bliss with my current partner and living in the UK. I was still having irregular periods and turned to IVF – which involved three unsuccessful attempts, and difficult recoveries from each. About this time I started having some major anxiety issues. Looking back on it, this was really the turning point for me and my health. It was suggested that acupuncture might help, and thanks to an amazing 5-element practitioner, I was brought back to some semblance of physical and emotional balance. This experience led me to start reading and exploring alternative approaches to health and well being. Some worked for me, the acupuncture and cranio-sacral therapy, and some didn’t and felt like a waste of money, like reflexology and kinesiology. I was  OK with that – I felt that it was OK to try things even if there is a chance that they won’t work .

My weight was not good. My lovely man is (was) a vegetarian when we met, and naturally I joined him. Lots of pasta, rice, soy, bread. You can guess what happened. Then we went on the macrobiotic diet, and that made things worse, especially for me with mood swings and ‘hanger’… By the millennium, I weighed 68kg. Technically obese for my frame. But why? Wasn’t I doing all the right things? Eating purely? Being aware? Clearly not, but then, another voila moment.

My cousin’s daughter had been diagnosed with PCOS, and prescribed a drug called Metformin. My ears pricked up – there is another treatment besides a wedgectomy??? I went straight to the doctor, who kindly but firmly explained that in the UK he couldn’t possibly prescribe Metformin for anything other than Type II Diabetes. However, the universe (and science) had turned. Literally a few weeks after that I read in the Sunday Times about a doctor in Harley Street, London, who had been successfully treating women with PCOS. I make a booking immediately.

When I walked out of his clinic an hour after I’d walked in, my life had changed forever. Dr. Carey knew about the connection of insulin to PCOS, the condition of hyperinsulinanemia, and was fairly confident that changing my diet to exclude wheat and processed sugar, and 1/2 hour of light walking in the morning would work wonders. I can still see the little graph he showed me about what happened to my blood sugar when I ate carbs, how my metabolism had become broken so that regardless of the amount of insulin I secreted it wasn’t effective at clearing the glucose, and that my PCOS was a manifestation of those elevated levels of insulin.

I got my period the next month. And I have had one EVERY MONTH SINCE. And the weight started to melt off. I accelerated this through buying Dr. Robert Atkins book, and adopting the low carb principles. Throughout the week I would eat low-carb bars, nuts and protein.   On the weekend I would eat ice cream and drink red wine. I spent my last few years in the UK quite happily hovering at between 60-62kg. Not lean, but certainly nowhere near obese. We emigrated to Aotearoa in 2003. Joined the gym, took up snowboarding in the winter, kitesurfing in the summer and tramping regularly; we’d found our ‘place’ for sure.

At the start of 2007, I had started getting serious about my weight lifting and potentially body building.  I decided to find a trainer who ‘got me’ and I wound up working under the tutelage of a Sydney based body building enthusiast (female) for the next 4 years. Over those years, I broke innumerate personal records for lifting heavy things, for testing myself beyond my wildest imagination. That was the good part. The not so good part was the dieting! For those 4 years and beyond, I weighed and measured every morsel that went into my mouth. Within 15 months I went from 60kg and 27% body fat to 52kg and 13% body fat (tested in hydrostatic tank) I looked amazing, but my wonderful husband nearly left me! There is a very, very thin line between commitment and obsession.

Without knowing it, those 4 years set me up for another, even worse metabolic nightmare, but again, one that no one could have predicted or imagined. I was fit, lean (a little bit miserable) and seemingly unstoppable.

Then the earth moved.

I was in Southern Cross Hospital on Bealey Avenue at 12:51 on 22nd February. I was getting ready to be prepped for my procedure, when I was thrown out of my chair and watched the building twist and shift. As anybody who was there knows, that was just the beginning.

Everyone had a different emotional and physical reaction to the earthquakes – some left, some got ill straight away, some got depressed. I just went harder. Action, movement, gotta keep going, gotta help, can’t stop. By July I noticed that I was losing whole chunks of time – it was like I’d suddenly ‘snap back’ to reality, having no idea where I was, what I was doing. This was particularly scary when it happened whilst driving! Then one fateful day I was going hard in Bottle Lake Forest on my mountain bike, and my legs stopped working. I wish I could adequately describe the sensation – it wasn’t cardiovascular in nature, but literally, I could not push my legs around on those pedals. I have no idea how I got home.

I had been avoiding going to the doctor for the other symptoms quite simply because I didn’t have a doctor, as mine was tragically killed in the CTV Building. But I now knew I had to do something, so I contacted a wonderful doctor at the Helios Integrative Medical Centre. Thanks to her, I managed to bring myself back to health over the next 18 months through supplementation (including whole thyroid), relaxed, intuitive eating, and much, much less exercise. My physical journey back to health was celebrated by completing the Oxfam 100km in April 2012.

Post Traumatic Stress is a very real thing, whether or not you label it adrenal collapse. I think that through my experience I had instinctively begun to recognise the power of food as medicine, or at least much more powerful than we give it credit for. It sounds obvious now, but I hadn’t really thought of food as anything but pleasure or fuel. What about as true, deep nourishment?

My real food journey included finding the work of Weston A. Price, and the wonderfulness of Raw Milk. We joined a herd share and started our own fermentation bench – whole milk kefir and yogurt – yum! Having been wheat and gluten free (also corn, which is actually the worst for me) since 2000, I made the further step to becoming grain free in November 2012. I will have sushi as a treat, or the occasional slice of gluten free bread with eggs bennie for brunch out, but overall eliminating grains have been super easy for me.

For the past 18-months or so, my focus has been on real food. I made another discovery – I love lambs liver! I’d never had liver of any description, but now we eat it once a week. I buy organic meat or from the butcher whenever possible, and have so enjoyed the nourishment that meat brings to our bodies. I also make bone broth, kombucha and sauerkraut.

I feel great, healthy, balanced, calm, focused, and as an avid consumer of information I have come across the ketogenic diet but cannot find a lot of information out there for the peri-menopausal woman. Hence, I’m enlisting Mikki’s help for my own great Ketogenic experiment. Given where my health is at now (i.e. not a metabolic mess) it is a good time to try it. (Ketogenic: 80% calories coming from fat; 10-15% protein, 5-10% carbohydrate).

I have just received  a Ketonix electronic breath ketone-measuring device from Sweden to measure ketones (a sign that you are burning fat as your prefential fuel, and not glucose), and my overall goals are:

  • To be in ketosis for these 30 days, as measured by my Ketonix, noting anything and everything about the state and its effect on mood, sleep, energy, etc.
  • To be confident enough at the end of these 30 days to STOP weighing/measuring (the most difficult part of this experiment has been getting my head round going back to that practice)
  • To not lose strength in the gym
  • To become metabolically flexible enough to complete a 4-5 hour endurance training session for a multsport race I’m doing, with no carbs and no ill effects (this is the long term goal; and it isn’t ‘no fuel’ it is ‘no carbs’ – this is a long term goal)

I have not weighed myself at the beginning of this month, but I do have a ‘number’ in mind that I would like to see at the end of it, and I’m really interested to see what happens to my blood cholesterol levels (which were tested in June and will be retested in 8 weeks’ time).

Thanks for reading, and I’d love it if you would follow me on this journey. Mikki will be posting updates regularly on my progress.

Gallstones and your gall bladder 101: what, why, who (and generally speaking) what to do?

Until this week I had no idea how prevalent gall bladder inflammation (cholecystitis) and gallstones were. And in who. A lovely client of mine had experienced cholecystitis for years. She was actually none the wiser as equally suffered from irritable bowel syndrome too so had lumped the symptoms (upper abdominal pain, particularly after a fatty meal) into the same category as ‘digestive issues’ which we had been working on (and she had been having success with) over the last few months. It wasn’t until this week that she called me to say she was diagnosed with gallstones and was going in for emergency surgery to remove it that I thought – hmm, is that unusual? Turns out it’s not.

The gall bladder is required to store the bile that is required for fat digestion. If a person is experiencing inflammation (systemic or local) this can irritate the gallbladder and cause significant abdominal pain after eating which usually subsides in the hours that follow. Gallstones are a result of reduced gallbladder function, where the bile isn’t released as it should be and can become thick and sticky, forming stones that can be the size of pebbles to the size of golf balls. There are three types of stones; black pigment stones (related to cirrhosis – scar tissue build up in the liver – or haemolytic disorders – breakdown of red blood cells); brown pigment stones (related to an infection in the gall bladder) but overwhelmingly in the western world, the prevalence of the third type of stone – a cholesterol rich one – is increasing, accounting for around 70% of gallstones. Pain occurs if one of these get stuck in the bile duct – this may also subside. However if you experience continual pain, or begin to have more frequent attacks, then it is generally recommended that something needs to be done.

I had always associated gallstones with people of an older age bracket, but that was just because I’d never had a reason to look into it at all. In fact, this week I was bombarded by young, fit women who responded to a post I put on my Facebook page related to cholecystitis and gallstones that had all experienced problems and subsequently had their gallbladders removed. Now not all people suffering from cholecystitis have gallstones, and not everybody with gallstones experience pain – indeed some remain asymptomatic for most of the time. However, there is a surprisingly high number of people that experience problems with either condition and in New Zealand it’s estimated that 20% of people aged 30y – 75y will be affected. Now that is a LOT of people who may be having problems with either cholecystitis or gallstones and potentially not even know it. The pain experienced in an attack may be in isolation of other symptoms, or put down to ‘normal digestive issues’.

The formation of gallstones and cholecystitis is (like most things) possibly due to an interaction between both genetic and environmental factors. Genetically, a mutation in a protein that may be responsible for the delivery of phospholipids and bile from the liver will increase the risk, as will having a genetic predisposition – the latter increasing your risk four-fold. In addition – and this is what sparked my attention from the Facebook posts – the presence of an autoimmune disorder (Crohns disease, celiac disease) or even a sensitivity to gluten increases risk. The first possible reason for this could be from increased inflammation due to the nutrient malabsorption, or a defect in the gallbladder ability to empty – both resulting in a reduction in gallbladder function. Alternatively, it could be that the gallbladder disease is the result of the same immune system attacks that occur with an autoimmune condition. Regardless of the mechanism, there is a very real relationship here.

Other factors that increase the risk of gallstones are taking an oral contraceptive pill, being pregnant, or having had multiple pregnancies. The increased oestrogen levels affect gallbladder motility (delaying bile release from the gallbladder) and increase cholesterol saturation of bile (cholesterol is the backbone of our sex hormones). A high carbohydrate intake in pregnant women (particularly fructose) is also associated with increased incidence, and there is a link between pregnancy, pancreatitis and gallstone risk. Weight loss, weight cycling or fasting can also increase risk of gallstones as fat is being rapidly broken down and there is increased secretion of cholesterol into bile. With these factors in mind, it is no wonder women are at greater risk (two-thirds of those in the US with gallbladder disease are women). Equally a diet that is higher in processed refined food and calories increases the risk with higher circulating insulin and triglycerides as a consequence of the standard western diet. People who are overweight or obese, or have risk factors associated with the metabolic syndrome are at an increased risk – now this may well be due to the previous point, however this has also been found independent of diet; those with a fat deposition around the middle are more likely to experience problems. Indeed this type of fat patterning is related to reduced function of the liver (and non-alcoholic fatty liver disease) which may result in fat build up and cirrhosis also related to gallbladder function.

A question that arose on my Facebook page was whether athletes were at greater risk compared to the general population.I had a good look around the literature and only came across a couple of studies that related a high training load to problems with the gallbladder. As athletes we place ourselves under a lot of training stress – chronically this leads to increased inflammation. Haemolysis can also occur in susceptible athletes who heavily exert themselves which again impacts on inflammatory pathways. This inflammation is in the absence of gallstones but may well lead to gallstone formation as it reduces gallbladder function. If you combine this with an intolerance to certain food (as a number of endurance athletes also experience), then there are certainly links between the two despite an absence of academic literature out there. Changes to liver enzymes after an extreme endurance event may place an athlete at risk, and interestingly, this case study illustrated how inflammation due to higher intensity training led to a thickening of the gallbladder tissue and an increased tension in the absence of stones or bile buildup (‘sludge’). The removal of the gallbladder stopped this tension and the athlete was pain-free. In this instance, surgery was potentially the only route as it wasn’t related to stones. But if you do suffer from gallbladder problems with or without gallstones and don’t want to go down the surgical route, what are your other options?

For those with problematic gallstones, a first approach may be sound wave therapy to break down stones so they can move down the intestine and be excreted without the risk of getting stuck. Similarly, ingesting a naturally occurring bile (in the form of ursodeoxycholic acid) may also gradually break down the stones. However many people continue to suffer symptoms associated with gallstone attacks after these treatments. Though not in the academic/medical literature, I’ve read a lot of people do an olive oil/lemon juice protocol which (it appears) involves fasting/apple juice/anywhere from 1 cup to 3 cups olive oil and lemon juice/sleeping then warm water. I’ve actually just lumped a lot of different components of these protocols to give you an idea of what you can find if you can go searching… not to recommend you try it (it’s not my place to do that!)

For those with problems related to inflammation of the gallbladder, or with gallstones that are symptomatic, an anti-inflammatory diet is the way to go – removal of grains, dairy, legumes, refined processed food and a focus on fruits, vegetables and animal protein. These foods are rich sources of antioxidants and are not going to cause stress on the digestive system, thereby they are your best line of defense. For some, following an auto-immune protocol that also removes eggs, nightshade vegetables, nuts and seeds initially may be required, with further supplementation to help heal the gut. If you have neither of the above and are currently losing weight, research suggests that following a higher fat diet for weight loss is protective against developing gallstones when compared to a lower fat diet. Further, there is limited research that vitamin C supplementation can prevent gallstones by promoting the conversion of cholesterol to bile salts in the gall bladder.

And what if you have the surgery to remove your gallbladder? Is it low fat foods from here on in? This seems to vary a LOT from person to person. Some people can continue to include good amounts of healthy fat in their diet with no noticeable digestive issues. While some notice a vast improvement with the addition of digestive enzymes, others don’t notice any change. It’s best not to drink fluid around meals so you don’t dilute your stomach acid and obviously try to eat as ‘clean’ as possible –following a paleo approach will ensure nutrient intake is optimal.

Got a headache?

Ever get a headache?  I would say that most people I talk to have experienced a headache in the last couple of weeks. Indeed, a 2014 telephone survey found that headaches were one of the top five symptoms reported on a weekly basis, with over one-third of those questioned experiencing an episode. Increasingly, it is more than an infrequent occurrence that can be put down to an occasional late night (lack of sleep), being dehydrated or too much alcohol the night before. In fact, I think that headaches have come to the point where we’ve normalised them so much we barely see any reason to pay them much credence. Everyone gets a headache – what’s the point in worrying about it? Nothing ibuprofen can’t fix.

In my opinion, this normalisation of pain is how we’ve addressed (or not) the chronic stress, tiredness, bloating, inability to wake up properly or the slight malaise we might feel on a day to day basis. For a lot of people what I’ve described is just ‘life’. There’s no point complaining because this is what everyone is experiencing so we may as well buck up and get on with it. Like all of the conditions I’ve mentioned above, frequent and recurring headaches impact massively on quality of life. While obviously migraines are a type of pain that would cause more disruption to everyday life, a headache shouldn’t just be dismissed either. It’s a sign that something is out of balance in your life that you should probably address. That said, a closer look at your diet might reveal elements which could be changed or optimised to reduce the likelihood ot these occurring, Specifically, there are nutrients which have been found (in addition to an awesome diet) to be useful for reducing severity and frequency of headaches or migraines occurring. While the jury is out on both omega 3 fatty acids, and vitamin D (with some research suggesting that too much vitamin D may have the opposite effect), there is fairly good evidence to suggest that these may be useful:

Magnesium: in powder form, along with a citric acid or as an amino chelate – up to 600mg per day over three months (this might equate to 2.5g – 5g of powder from a brand such as Bioceuticals Ultraeaze). Studies have shown that many experience a reduction of attacks by up to 41%. Now that is significant.

CoQ 10: not just as part of face cream, in doses of up to 300mg/day (which is fairly substantial) has been found to reduce frequency of attacks and also symptoms of nausea associated with headaches.

Riboflavin: this amino acid in doses of 400mg/day over four months have also been found to reduce severity and frequency of attacks – people of European background are more likely to respond than others due to genetic differences.

A well balanced whole food/paleo diet contain substantial amounts of these nutrients. Magnesium is abundant in vegetables, animal products and fruit; CoQ 10 present in salmon, sardines, red meat, nuts such as almonds, and seeds such as sesame   seeds; and riboflavin is found in substantial amounts in cheese, beef, pork, eggs and oily fish. However if you are consuming such a diet and not experiencing relief, it might be worth considering supplementing in addition to this.

Now people who experience migraines are likely to know which foods trigger an attack. A well studied group of amino acids have been found to trigger headaches and migraines in susceptible people: tyramines, histidines and arginine.

  1. Tyramines: are found in fermented foods (such as sauerkraut, kimchi), blue cheese, broad beans, beer and sulphate-containing wine, dried fruit, grapes, cured meat and fish (not a complete list). Some people lack the enzymes to inactivate these and it can lead to a build up in the blood, causing temporary nausea, increase in blood pressure, sweating and migraine headaches. Tyramines are found in fermented foods (sauerkraut, kimchi, yoghurts), blue cheese, broad beans, in beer, wine that contains sulphates, other sulphur-based dried fruits, grapes, cured meat and fish.
  2. Histamines: are a result of the conversion of an amino acid histidine by two enzymes diamine oxidase and histamine N-methltransferase. People who have low levels of these enzymes have a build up of histamine in the body as they are unable to metabolise it. Histamines, like Tyramines are found in fermented based foods, along with all alcohol and vinegars. Other sources are fruits such as strawberries, avocado, and bananas, vegetables (tomatoes, spinach, eggplant) and nuts including walnuts, peanuts and cashews.
  3. Arginine: is an amino acid that causes vasodilation of the blood vessels by increasing the amount of nitric oxide in the blood. Great if you’re an athlete wanting to go at higher intensities, not so great if it causes pain through vasodilation and expansion of the cranial blood vessels. Avoiding these foods can minimise this, and nuts and chocolate have the highest amount of arginine in them. (As a side note, people who might experience break outs in the herpes virus have been recommended minimising these foods in their diet).

Not all of these groups of food are going to affect everyone, and not all foods within the different groups are going to trigger a migraine or tension headache, but it’s a process of figuring out which ones do by eliminating them from the diet for one to three months to see if there is respite from frequent migraine headaches, then reintroducing them (as you would any food).

There are many things which affect frequency and severity of headaches and migraines. Like other stressors, the effects of these (or anything) that might trigger an attack can be made worse depending on overall stress load. If you are lacking in sleep, relying on sugar or coffee for energy, have a lot on your plate at work, drinking too much alcohol (etc) then you may well experience more of an effect compared to other times where you feel a little more on top of things. So while you can remove certain foods from your diet and optimise others to minimise attacks in the short term, looking at the root cause of what is causing the headaches is clearly the best option long term.