Chronic Migraine, Diet, Treatment, Triggers

Rotation Diet for Migraine or Headaches

The cauliflower debacle never really resolved. Even after I stopped eating cauliflower, I began reacting to other “safe” foods I’ve restricted my diet to the last six months. Despair was knocking, so I did what I always do when I need a sense of control — I began to research. Rotation diets were my target.

Rotation diets have come up frequently in my reading on dietary histamine. The idea, as I was introduced to it, is that you don’t eat the same food more than every four days. That’s the preschool version of rotation diets. A true rotation diet involves rotating food “families” every four days. Food families are either botanical families (for fruit, vegetables, grains, oils and herbs) or animal families (fish, bovines, swine, etc.).

The quickest way to understand how this works is this four-day rotation guide (page 7 of the PDF). The belief is that it takes four days for a food to completely clear your system, so that’s why you need to wait. Also, if someone reacts to multiple foods in the same family, they should consider eliminating the whole group (no goosefoot for me). The science behind rotation diets is slim, but I know what’s working for me.

I started it 10 days ago and am thrilled with the progress so far. My migraines are far less frequent and disabling than they’ve been the last couple months (and they’re easy to abort with triptans and/or Midrin). My diet is way more varied than it has been in the last 18 months. I have’t thrown caution to the wind — I reference lists of foods that contain histamine, tyramine and benzoates (the best lists I’ve found are in Dealing with Food Allergies by Janice Joneja). Instead of avoiding those foods completely, I choose carefully which ones I test.

The rotation diet is allowing me to eat foods that were never a regular part of my diet (mangoes, dandelion greens, persimmons, pomegranates). It’s helping me identify more definite migraine triggers (nuts, cabbage, quinoa, beets). I’m also figuring out how frequently I can eat a food and in what quantity without a reaction.

Wondering why I’m so excited about this strict diet? Here’s a recap of the past 18 months: Failsafe; chicken, white rice and oatmeal; feeding tube formula; six to 10 fruit and veg that I ate every single day. I don’t know how many different foods I’m able to eat now — that’s major progress!

Some people are on rotation diets indefinitely. I’m hopeful I’ll be able to figure out what my thresholds are for certain foods and not have to follow the diet rigidly for long. It doesn’t feel like a permanent change to me, more like another part of the diagnostic process. I’m more optimistic about this diet than I have been since I started my current migraine diet journey in January 2012.

Want to learn more? Here are the resources I’ve found most helpful:

I included migraine and headaches in the title because I’m using it for migraine, but I’ve read that it can help with chronic non-migraine headaches as well.

7/17/14: If you have true food allergies, please seek the guidance of a health professional before reintroducing foods in a rotation diet! I only have food intolerances/sensitivities (not allergies) and am not at risk of a life-threatening food reaction.

Diet, Symptoms, Triggers

A Cold? Nope, Migraine.

You know that cold that gave me brain fog and fatigue as bad as with my worst migraine attacks? It was migraine. While the mild cold lasted only a few days, I simultaneously developed a reaction to one of my “safe” foods (likely cauliflower). It was triggering migraines that were lower on the pain scale than usual since I’d restarted Ritalin as a preventive. Since I ate cauliflower daily, sometimes multiple times a day, I was in a pretty much perpetual migraine.

I’m getting it sorted out, but am also pushing to introduce new foods to my diet so this doesn’t happen again (it has also happened with coconut and butternut squash). That means more migraines as I find out what’s OK and what’s not and what rotation schedule my foods need to be on. It’s annoying and frustrating, but I’ve got a good plan in place and trust that if I’ve figured this out before, I can do it again.

I’ll probably be quieter than usual for a bit, since my mind isn’t cooperating with this writing thing right now. I am reading a ton, including lots of health-related non-fiction that I’m eager to tell you about. Take care of yourselves. I’ll be back soon.

Coping, Diet

A Mindfulness Intensive

I’m on day 11 of a cold that has my brain fog and fatigue at levels equal to my very worst migraine days. The other symptoms aren’t too bad, but I can’t think and I can barely move. The longer it goes on the more tempted I am to freak out —

What’s going on? Is this my new normal? Will this ever go away? Are these migraine symptoms resurfacing? Is the DAO not working as well as it did? Was what I thought was a minor cold the start of chronic fatigue syndrome? Could I have fibromyalgia?

Letting these worries spiral out of control isn’t improving my physical symptoms and it certainly isn’t calming my anxieties. I’m working hard to stay mindful and in the moment. All I know is what I feel right now. I don’t know how I’ll feel next week, tomorrow or even an hour from now.

When the fears take hold, I close my eyes, take a few deep breaths and ask myself what I know: I have fatigue and brain fog right now and for the past 10 days. I have a cold. My head pain and nausea are minimal. I feel better today than I did a few days ago. That’s what I know, everything else is just speculation.

Speculation cannot help me know the future. It cannot, in fact, help me know anything. Rumination is a powerful habit that masquerades as useful and helpful. Instead of being fooled by that deception and getting bogged down by thoughts, I’m practicing being right here, right now. It’s tough. It’s also a tiny bit liberating.

( I hope this unedited missive makes sense. I’ve used all my mental ability to draft this and don’t want to wait to publish it.)

Diet, Patient Education, Treatment, Triggers

Testing if Your DAO Level is Low

Yes, there’s a test that measures diamine oxidase (DAO) levels in the blood. No, it’s probably not worth your time or money to get it done. (Wondering what DAO is? Start reading here and follow the links at the bottom of that post for more information.)

There are two issues. The first is there’s no well-established range of DAO levels. There’s speculation and you’ll find ranges listed, but they aren’t yet backed by solid science. Also, it’s not known whether the amount of DAO in your blood is indicative of how much is in your gut, which is where it really matters.

Genetic testing can show if you have mutations in the genes related to DAO production, but not how much you actually produce. While the test confirmed that I probably make insufficient amounts of DAO, dietary research, an elimination diet and testing DAO supplements were more informative.

The best way to find out if you’re low in DAO is to try taking the supplement. You can get small a bottle of the highest strength DAO for about $30. If you’re going for a high dose, use Histamine Block rather than Histame. (The Amazon link defaults to the more expensive 60 capsule bottle. Click on “30 Easy-To-Swallow Vegetarian Capsules” in the box below the “in stock” notice to choose the less expensive bottle).

It took about a month of playing with the amount of DAO I took and how long before meals to take it before I hit on the right set up for me. The label recommends taking two no more than 15 minutes before every meal. I’ve found each capsule covers about 400 calories, though I take more if I’m eating a high-histamine food, like fish. I currently take it about 8 minutes before eating (or even drinking coffee or herbal tea) and am sure to finish eating within 45 minutes. As you’ve read, the change was drastic once I hit on the right combination.

This was while eating a low-histamine diet, which I recommend trying. Even if you don’t, read the list of high-histamine foods and take extra DAO when you eat them. (Some of those foods are also high in tyramine, which has long thought to be a migraine trigger. DAO does not help process tyramine and there is no digestive enzyme that claims to.)

The capsules are expensive (about $1 each), so I initially felt a lot of pressure to take no more than I absolutely needed. For the sake of dietary variety, I’ve relaxed a bit and now err on the side of too much with foods I’m uncertain about. Other than pocketbook pain, I have no noticeable side effects. I thought heartburn was an issue for a while, but that has resolved (it was likely due to reintroducing fat after going so many months on a very low fat diet). I’ve been reassured that DAO is safe and that any that’s unused gets flushed right out. That’s why you have to take it before every time you eat — it doesn’t stick around.

I know many of you are hoping that DAO will help you as much as it has me. If you do decide to try it, play around with dosing and when you take it. If you get any relief from it, it might be another addition to your treatment plan. Every little bit adds up.

Still have questions? Please ask them in the comments or email me at kerrie[at]thedailyheadache[dot]com and I’ll try to answer them.

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Diet, Meds & Supplements, Treatment, Triggers

Diamine Oxidase (DAO) is Why I’m Doing Better

The Amazing Feat of a Normal Life prompted a lot of questions about why I’m feeling so much better. It’s still the digestive enzyme, diamine oxidase (DAO), that I started in January. (To learn more, read The Post I Never Thought I’d Get to Write and follow the links at the end for more details. If you want to try DAO yourself, you can get it through Amazon. Even though it’s called Histamine Block, it isn’t an antihistamine and doesn’t block histamine.)

I continue to follow a restricted diet, though that’s more about wanting to reintroduce foods slowly and methodically rather than any particular food being a problem. As long as I take DAO, I’m doing great with nearly every food I try (even dairy and wheat). I’ve even tried a few high-histamine foods (with a little extra DAO) and have done fine.

The other dietary change is that I’m eating most foods on a rotating schedule, leaving two or three days between each time I eat a particular food. I began this when I developed an intolerance to coconut after eating it multiple times a day for months without a problem. This has been a very effective way to vary my diet.

It’s a slow process, but I’m getting almost complete nutrition from the foods I eat (I’m still a little low on calcium). I eat mostly vegetables, though I have salmon a couple times a week and am currently testing eggs and milk.

That’s it. I’m past the three-month placebo window and continue to feel better than I ever thought possible. I know DAO is an unconventional migraine treatment. I know the science behind it is weak. I also know it’s working better for me than anything else I’ve ever tried.

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