Gut Brain Therapy: From the horse's mouth

Non-Pharmacological Treatment "Alternative" Treatments
21

Something to think about, since “migraine” is a hotly debated topic, both here and elsewhere.

I think part of the whole confusion here is that there’s disagreement about what migraine IS.

Some people see migraine as something “curable,” with a definitive origin or cause – and thus a discoverable cure – as it is with most diseases. They have a cause, and generally they have a treatment.

Others, however, hold to a “migraine brain” theory. This theorizes that migraine is not an “illness” or “disorder” but simply that some people are born with an “abnormal”, “hypersensitive” or “differently wired” brain. Basically, they say, “Once a migraineur, always a migraineur.” The idea here is that migraine itself is permanent; the symptoms can come and go, and can be managed, but the underlying disorder or abnormality of the brain is inherent – it’s just the way some brains are wired.

Maybe that idea is true; maybe it’s not. It COULD be that some brains simply are predisposed (especially genetically) to some sort of underlying electrical or chemical abnormality, or that something in the genetic code itself is “awry,” or whatnot.

But I’m not here to argue for one idea or another.

Think of it this way: Is migraine a treatable disorder in and of itself? Or does the term merely DESCRIBE symptoms of an inherent, unchangeable abnormality of some brains (simply “the way they were ‘made’”)?

Does a person born with, say, six fingers on one hand – or some other physical deformity or birth defect – have an “origin” for that problem? Well, yes, in a way, but it’s likely very deep-rooted; to find it, you’d probably have to go deep into the DNA, or the family’s genetic history. (Is the idea of “stopping a migraine” akin to trying to “stop yourself from having six toes”?)

I’m probably “apples and-oranges”-ing myself out onto a limb here, but I’m just saying, perhaps migraine is the same way. Maybe it’s a condition some people are born with that has various symptoms, and can even cause other ones, and they’re all potentially treatable.

I think we – both “we” the forum members and “we” the current realm of science/medicine – have to work toward understanding what migraine really IS. Again, I’m not advocating either theory, but I do think it explains why there’s so much confusion and disagreement. They’re both valid theories – and THEORIES only, until someday someone gets the proof we all want.

22

Hi Tom and George,

Sorry for not being able to respond to you at length Tom but will soon. I have taken up a new job with loads more responsibility. Once I get my head around everything and get things streamlined, I should have more time for the forum again and to respond properly.

George, I wanted to clear one thing up for the moment. Scientific theory is often misunderstood. People think of theory as “just a theory” as though it is full of holes or is not well substantiated or established. The word theory tends to have this meaning when people throw it around in casual conversation. However, it does not mean this at all in science –– and this is where things differ between science-based treatments (where evidence and prior plausibility are essential) and the philisophical approach.

Scientific theory is built upon evidence that mounts over time and “coordinates existing facts and laws”. For example, there is the theory of gravity, Newtonian mechanics, relativity and evolution. No one these days will argue that gravity does not exist nor should they argue against evolution unless they can come up with a better explanation with evidence to back it up. Philosophy is just not good enough and not scientific theory. I will continuously bring this back to the evidence. There has to be something there or at least some plausibility to generate a hypothesis with which we can test. Acupuncture, for example, has been used for thousands of years in China. There is all kinds of philosophy and in depth explanation behind it from chakras to energy meridians etc … but put it to the test, remove confirmation bias and control for the placebo effect, and we get our answer –– no real physiological change; just some temporary altering in the subjective feelings of pain.

This article explains all of this well if you want to follow it up:

ola4.aacc.edu/jsfreeman/TheoryandLaw.htm

Tom – also wanted to thank you for not taking any of this discussion personally. I have come across very few people who do not take criticism about a modality –– especially the ones I question –– very well. It often turns into being told you are “narrow-minded” or “evangelical”, or worse, it erupts into personal attacks being thrown at the person being critical or skeptical.

How can something be the same disease if it is experienced differently by the sufferers. Why is it not possible that it is different diseases?

It’s the norm for people to experience different symptoms from the same disease. This cuts across the entire spectrum of disease. Two people can have the same cold virus and experience different symptoms –– one may have a runny nose and not the other, or it could be affecting one’s throat more than the other. Type 2 diabetes and CVD produce different symptoms in people. Not unusual at all. When we start heading into neurological disease it’s even more unlikely that any two people will experience identical symptoms even though both suffer from migraine (MAV is notorious for no two people being alike), depression, anxiety or epilepsy.

Best … Scott 8)

23

Hi Tom,

Thanks for your response. It is clear to me that you have a genuine interest in migraine and in its treatment, that as well as the time you have been taking to post on this forum is certainly appreciated.

I would like to respond in general terms to your concept of disease, its cause(s) and cure(s).

Firstly, I am not sure that all diseases (or conditions, disorders or whatever other name we wish to apply) can necessarily be cured. While this is a sloppy analogy I think it may illustrate what I mean here. I have flat, pronating feet. This cannot be “cured” but can be successfully managed by wearing orthotics.

Secondly, I’m also not sure that looking for a “cause” is necessarily helpful in managing (let alone curing) certain conditions. If migraine is a brain disease (which I am convinced it is) and genetically based then once you’re born with it, the cause is irrelevant. Another (possibly equally sloppy) example here might be schizophrenia. If you’re born with it that is the way your brain is - you can’t be cured but the condition can be managed.

Why does migraine manifest so differently in different people as well as having different triggers? I think Scott has answered this succinctly but I think the schizophrenia example applies here as well. People can have ‘latent’ schizophrenia which is triggered by something (eg use of recreational drugs) and all schizophrenics, while having certain experiential elements in common will also have unique qualities to their condition.

Having said all the above, I doubt it will surprise you that my answer to your question is

  1. I don’t know what causes the disease and i dont know how to cure it but here is how i am going to manage your symptoms.

In general terms I think all of us look for a cause and a cure. That seems to me to be a perfectly normal and rational way to view the world, we want to know why something has gone wrong and how to fix it. In reality however, I don’t think this is always feasible. If someone is born with a condition, as I said above, the cause is irrelevent. Of course, this assumes that migraine is both genetic and a disorder or ‘hard wiring’ of the brain andI recognise that not everyone agrees with that model.

I would like to comment on one statement you made Tom about trusting one’s own judgement about one’s health - see paragraph below.

I often tell my migraine customers that the best doctor they will ever find is the one they see in the mirror every morning. I have come to believe that we have an intuitive knowledge of our own health and wellness that is superior to anything anyone can learn from a book. This statement will be more acceptable to those of you in you 40s, 50s, and 60s than to those of an earlier age. It has been amazing to me how many of my customers call and tell me that they always knew that their migraines were related to their gut but that their doctors always assured them that that was not the case.

From my own experience this can be the case. On at least two occasions (for non migraine related issues) I have been ignored/dismissed by a GP. In both instances I persisted and got second and third opinions and was vindicated. In one of those cases had I not persisted I would most likely have gone on to develop bowel cancer. I now have a GP who encourages me to listen to my intuition but he ALWAYS conducts numerous tests to discover what is wrong with me. It is this GP that finally led me to my neurologist who diagnosed MAV (after excluding various other possibilities). However, I **seriously **caution against relying on intuition alone. I have suffered for years with undiagnosed MAV, in large part because I repeatedly insisted that what I had was not migraine. I “knew” this wasn’t migraine. Way back in 2002 when I had my first MAV episode (but not confirmed, it could have been viral) ALL the doctors, from the GP, to the neurologist to the optician all suggested migraine but I didn’t agree as the symptoms were so different from my usual migraines. So, intuition is a hit and miss affair and should NEVER be relied on alone when it comes to one’s health. I am sure Tom that you are not advocating self diagnosis rather than seeing medical professionals but I just wanted to make this point in case anyone got the wrong idea. :slight_smile:

Once again, thank you for your ongoing interest and discussion.

Regards
Victoria

24

Hi Tom,

A very enlightening government review has just been released showing clearly that after a decade of research, and 2.5 billion dollars of taxpayer money to fund this stuff, CAM therapies have been shown to have very little use. The review can be found here:

[size=150]$2.5 billion spent, no alternative cures found[/size]
[size=120]Big, government-funded studies show most work no better than placebos[/size]

http://www.msnbc.msn.com/id/31190909/

In summary – the government spent 2.5 billion dollars to determine that unpurified, poorly-controlled drugs (which includes herbs) with generally low doses of active ingredients don’t work very well, that treatments based upon unscientific notions don’t work, and exercise and relaxation make people feel better. Not surprisingly, they found that acupuncture does not work either.

I wanted to address some other points you made earlier.

Darwin, Einstein, Newton, Edison, and many others who are credited with adding tremendous amounts to our scientific knowledge did not rely on double blind placebo controlled studies. Rather it was their careful observations that led to their theories that over time have been accepted as scientific fact.

Double-blinded RCTs are not used to test things such as the Theory of Evolution or when inventing such things as light bulbs; rather, in the context of our discussion, they are best used to test if there is any real effect from a pharmacological treatment (including herbs) beyond the placebo effect. As I have mentioned previously, such trials are necessary to remove confirmation bias and any effect one would expect from placebo. This is critical when assessing any treatment particularly when we are measuring changes in pain (i.e. migraine) which is highly subjective and is notorious for being effected by placebo effect. Even open-labelled trials are not good enough to rule it out. While I commend you for doing this already, you need to go the extra distance to really show that your formula works beyond placebo and does make physiological changes that might help migraine. The point you’ve missed is that such things as the Theory of Evolution (Darwin) are built upon evidence. There is nothing philisophical about this. Yes, Darwin first made observations but he tested his hypothesis. It was the gathering of evidence over time and continued testing of the hypothesis that generated a grounded scientific theory. And over the last 140 years since The Origin of Species was published, copious amounts of evidence has continued to pile up to the point where we can now consider evolution as fact. We can even use the science to predict where fossils can be found based on missing links in evolutionary lineages –– and that’s exactly what scientists do and they have found numerous fossils right where they predicted they would be in various rock layers.

How is it possible to look a women who gets migraines every month at her cycle and a man who gets a migraine every time the barometric pressure drops and conclude they have the same disease? But come on, how can you look at those two people and say they have the same problem?

Because this is the nature of migraine. It is a neurological disorder and it affects different parts of the brain in each sufferer (no two are identical – like finger prints); the triggers differ. A migraine brain likes things to remain in homeostasis; it does not like things to fluctuate else the migraine loop is triggered. Females have monthly hormonal fluctuations which are well known to affect migraine and bring on attacks. Hormonal surges throw homeostasis out for a few days. Some people with migraine are affected by changes in pressure –– both men and women while others are not. To assume it is not the same disease because symptoms are not identical is not correct. The symptoms and triggers of this disease are well known and documented.

How can we observe that certain foods trigger a migraine and dismiss the possibility that the digestive system is playing a role in migraine disease? To me it is an obvious indication that gut function is playing a role.

That does not seem obvious to me at all when you consider that for some people food does not trigger migraine or other things besides food trigger migraine –– pressure changes, hormonal fluctuations, stress, lack of sleep, travel. Why have you not considered that protiens and/or molecules in a particular food (tyramines, nitrates) might enter the bloodstream, head up into the brain, interact with brain physiology and precipitate a migraine attack? Furthermore, the evidence indicates that migraine originating in the brain causes the irritable bowel or the abdominal migraine and not the other way around. There’s just no evidence Tom. I’m still waiting to see something –– anything besides philosophy –– to show that this is primarily a gut issue as you strongly believe and not something originating in the brain.

Biochemical toxins (drugs) are the best way to cure disease. What is the principal behind this belief?

You have made the assumption that all drugs are biochemical toxins. Most anything is toxic if taken in a large enough quantity. You can kill yourself if you drink too much water. When drugs are taken in correct quantities as is teased out in controlled clinical trials they are not toxic. There’s no guarantee it will go down well, however, because of potential side effects, but just like I can feed peanuts to a person with a peanut allergy and kill them does that mean peanuts are toxic? Some drugs actually do cure disease while some do not and enable people to get on with life –– to manage the illness, whatever that may be. Some cancers are very treatable for example. Without treatment I believe the survival rate for Hodgkins Lymphoma is about 5% but with the use of drugs (chemotherapy treatments) it shoots up to 90%. I don’t think you’d come across any doctors who would claim that drugs cure all disease or even a patient who would believe that all drugs are a magic bullet. They definitely aren’t and it’s not a perfect system but at least it’s based on evidence and in most cases either extends life or increases the quality of life significantly.

If someone suffers from both IBS and migraine both the neurologist and the gastroenterologist will assure the patient that the conditions are not related…This myth that every condition is largely independent of every other condition.

I think you’d find that most doctors familiar with the science literature in this area would know that there is a link between migraine and IBS. You say that specialisation might cause oversight. I would agree with that and I’m sure it happens too frequently but ideally two specialists should be communicatiing with each other. I see it happen all the time where I work between specialists. I guess there are good and bad specialists just like there are good and bad mechanics. What I find incredible however, is that you would rather put your trust in a so-called holistic doctor who is trained in “everything” and then treats an illness with CAM therapies, most of which are not supported by evidence or have been shown to be ineffective, instead of a specialist who has spent over a decade studying human disease at a university level –– knowledge that has been built upon for decades, evolving over time and has become more refined whereas nothing ever changes in the world of CAM. It’s always the same thing over and over again and never changes with new evidence. I think I already mentioned before how treaments for HIV are now so much better than they were just 10 years ago. By contrast, homeopathy has been the same nonsense since 1796!

Can anyone show me research that shows taking six or eight medications is beneficial to the human organism?

While I wouldn’t wish having to take a lot of medications on anyone, sometimes it is necessary. For some on this board they have good migraine control on 3 medications with no side effects. Others do well on just one. But the example I want to illustrate to you is cardiovascular disease. Following a first CVD event (e.g. heart attack) a patient must take approximately 5 medications daily to prevent a secondary event –– a statin, aspirin, ACE inhibitor, beta blocker and clopidegral. Without these meds the chances of survival are very low over the following year after an MI.

I do not think that you are willing to acknowledge their limitations. Where has the gold standard of medical research taken us? Do we have a medical paradigm that effectively treats those who suffer from chronic illness?

I never said it was a perfect system. Nothing is perfect but it’s the best we’ve got in terms of trying to evaluate the efficacy of a treatment. Philosophy alone won’t do the job. Where has medical research taken us? I don’t even know where to begin in answering a question like that and I would be writing for days answering it in full. The advances are huge and everywhere. I am stunned frankly that you suggest medical science has taken us to a place that is ineffective in treating chronic disease. Let me at least point out that in the early 20th century, life expectancy was 40. It is now 78. In China, since the recent adoption of medical science and with its availability to the masses on the increase, life expectancy there has gone up dramatically as has the quality of life. Holistic medicine, Chinese herbs and acupuncture was not responsible for any of it.

I often tell my migraine customers that the best doctor they will ever find is the one they see in the mirror every morning. I have come to believe that we have an intuitive knowledge of our own health and wellness that is superior to anything anyone can learn from a book.

I strongly disagree with this. Sure, we know when there’s something that’s not right with our body, when there’s pain where it shouldn’t be etc or we just don’t feel right, but the idea that we all have intuitive knowledge of our own health which is superior to a trained professional’s expertise in treating human disease is delusional. The problem is we are all highly susceptible to being tricked by our own subjective experience. We can all be easily deluded. I think Victoria made this very clear. Unfortunately the vast majority of people just don’t realise that seeing is NOT believing. Remember those people I told you about who swore they felt great on radioactive tonics? Their intuition killed many of them. Intuition cannot be trusted outright.

Tom, after reading through all of this thread again our difference in all of this seems to boil down to one of evidence. You are happy to rely on intuition, philosophy, and faith without the need for requiring any sort of evidence while I am not. The evidence that does exist for CAM therapies is extremely weak or negligible at best. There’s just no getting around evidence when trying to show whether or not something holds water. If the treatment really works it’ll speak for itself in a clinical trial; the research can then move forward, evolve, and become more refined in treating migraine.

Best … Scott 8)

25

Happy Father’s Day!!

I am the proud Dad of 4 wonderful children and I am grateful for the opportunity I have had to guide and teach them and I am equally grateful for the opportunity I have had to be guided and taught by them. Thank you Julia, Lea, Brian and Lillia.

I have been struggling for two weeks to come to grips with how to move this conversation forward…and life has been a bit hectic. I think there is great value in this discussion and would like to see it continue and I will try to be more diligent in not letting so much time pass between my comments and responses.

To that end I want to address two topics and get your feed back. You wrote:

Tom, after reading through all of this thread again our difference in all of this seems to boil down to one of evidence. You are happy to rely on intuition, philosophy, and faith without the need for requiring any sort of evidence while I am not. The evidence that does exist for CAM therapies is extremely weak or negligible at best. There’s just no getting around evidence when trying to show whether or not something holds water. If the treatment really works it’ll speak for itself in a clinical trial; the research can then move forward, evolve, and become more refined in treating migraine.

I must confess to some real frustration with your unwillingness to hear me more clearly. I am not against evidence. At one point in the conversation you asked if there was any other evidence to support my theory that the gut can be playing a role in migraine. This was following my extensive quoting of Dr. Gershon, the gut brain research, the knowledge that neurogastroenterology has added to our understanding of how the human organism works and the evidence acquired via autopsy that lesions indicative of both Parkinson’s and Alzheimer’s show up in the gut brain as well as the head brain. I am not “happy to rely on intuition, philosophy and faith”.

Can you not agree that having a clear philosophical basis for a treatment approach would make scientific sense? You want to make the argument that double blind placebo controlled studies are the only true evidence. You are fairly quick to dismiss the evidence that trained doctors and scientist use to guide their work if it is not supported by blinded studies but yet you and Victoria are convinced that migraine is a brain disorder with a genetic basis. How do you possibly come to that conclusion when there are no blinded studies to support that? Isn’t that conclusion solely based on observation and theory?

Victoria even makes the argument that trying to find the cause is irrelevant. This completely befuddles me. She does explain it in a way I understand in that if you believe that you are born with a migraine brain there is nothing you can do. Have you never seen someone stop getting migraines? I just met a lady yesterday and happened to mention that i work in the migraine field and she said that she used to get them twice a week but they completely stopped when she got divorced. How can that possibly happen within the belief system that says I have a migraine brain and there is nothing i can do?

With all do respect and love I said in the very beginning that i face the challenge of looking at disease in general and migraine in particular in a new way. You keep trying to analyze what i am saying within the belief system you are attached to. You have been defensive of your beliefs without being able to acknowledge any limitations of them.

Let me be specific with one example of my frustration I said:
“Biochemical toxins (drugs) are the best way to cure disease. What is the principal behind this belief?”

Your response was:

You have made the assumption that all drugs are biochemical toxins. Most anything is toxic if taken in a large enough quantity. You can kill yourself if you drink too much water. When drugs are taken in correct quantities as is teased out in controlled clinical trials they are not toxic. There’s no guarantee it will go down well, however, because of potential side effects, but just like I can feed peanuts to a person with a peanut allergy and kill them does that mean peanuts are toxic? Some drugs actually do cure disease while some do not and enable people to get on with life –– to manage the illness, whatever that may be. Some cancers are very treatable for example. Without treatment I believe the survival rate for Hodgkins Lymphoma is about 5% but with the use of drugs (chemotherapy treatments) it shoots up to 90%. I don’t think you’d come across any doctors who would claim that drugs cure all disease or even a patient who would believe that all drugs are a magic bullet. They definitely aren’t and it’s not a perfect system but at least it’s based on evidence and in most cases either extends life or increases the quality of life significantly.

In my world anything unnatural to the organism, something that it cannot use in its normal function and would, if the organism is operating properly, either be removed or not allowed to enter in the first place is a toxin. For you to equate the point I am making to someone drinking too much water or having an out of balance immune system that creates a severe allergic reaction to peanuts is frankly off point and dismissive.

My point was neither that drugs are bad nor good and i have stated earlier that I am not against pharmaceutical medicines because there is no doubt in my mind that they improve the quality of life in many who use them. My point/question was what is the philosophical basis for this approach to treating disease and i would still appreciate you articulating your thoughts on this.

The idea that pharmaceutical medicines are not toxins is completely foreign to me. If they are not toxic then why do they side effects? Why do so many of them create problems with the liver?

I did not want this conversation to be about pharmaceutical medicine vs alternative medicine. Frankly a lot of what i see in natural medicine is more reflective of your paradigm than my belief system in that we study the effect of various herbs, vitamins, minerals etc on the symptoms of some disease. My argument is not that natural medicine products treat diseases more/less effectively than pharmaceutical medicines but rather that maybe the underlying paradigm/philosophy is not sufficient to answer the questions we would all like to be able to answer relative to cause and cure. That is why i am asking you to answer the question what is the philosophical/theoretical basis for the use of drugs to treat/cure disease.

Blessings to all, more to come
Tom

26

Hey Tom,

I really have no idea where this conversation can go anymore. From my perspective, you are just not understanding mine or Victoria’s points. You have your beliefs in the matter and that’s fine but I think we have been over the central points of the discussion a few times now and it feels like we’re just going in circles.

Can you not agree that having a clear philosophical basis for a treatment approach would make scientific sense?

A resounding NO. I have been trying to get this point across to you many times now with examples etc. Having a philosophy about something (a treatment) is NOT scientific. You MUST have evidence to back it up. This is the scientific paradigm and one that has revolutionised medical treatments now since the first rudimentary clinical trial was conducted by a young and smart Scottish naval surgeon named James Lind. He didn’t know it but he used the scientific method to solve a problem that was killing hundreds of thousands of sailors in the mid 1700s –– scurvy. Did you know, for example, that bloodletting was once considered to be a very sound medical practice? It was so strongly upheld among the world’s best medical practioners (and considered a philosophy of the time) that when an enlightened doctor (Willam Cobbett) realised doctors were inadvertently killing their patients, a famous American doctor (Benjamin Rush) was so outraged of his accusations that he sued Cobbett for libel in 1797 –– and he won because it was inconceivable to rule against a man of Rush’s standing yet, in the end, sound evidence ended this crazy practice.

It wasn’t until decades later when clinical trials were used to evaluate bloodletting did people finally realise that it was a useless treatment or caused the death of patients. Previously, however, the accepted philopsophy was that blood needed to be drained because it stagnated and was thus the cause for disease. If you had stated otherwise in those days, you would have been looked upon as an idiot. Bloodletting was what killed George Washington in 1799. Rush was fooled by his respect for ancient ideas and philosophy coupled with the ad hoc reasoning that were invented to justify the use of bloodletting. It would have been easy for Rush to confuse sedation caused by bloodletting for a genuine improvement, unaware that he was literally draining the life out of his patients. He was also probably confused by his own fallible memory, selectively remembering those patients who survived bleeding and got well but conveniently forgetting the ones who died.

You should read the story of Florence Nightingale too. I won’t go into it in detail but she too understood the power in using mathematics (statistics) and the scientific method to make monumental shifts in the wartime hospitals where British war vets were dropping like flies. She was not part of the establishment, had no great reputation then, but the results of her tests and methodical work were so powerful she showed that those in power were just plain wrong. She saved the lives of thousands by observing and then testing her hypothesis that the filth in hospitals of the time were killing soldiers.

you asked if there was any other evidence to support my theory that the gut can be playing a role in migraine. This was following my extensive quoting of Dr. Gershon, the gut brain research, the knowledge …

I revisited the post and reread it and while you quote his work, I still see no evidence or any references to your gut-brain hypothesis. I don’t have the book Tom to make a fair assessment of it but I did have a scan of it on Amazon. I notice that there is no mention of migraine or headache in the index. I cannot see if he has properly referenced any of his work, drawing on the science literature in forming his views. Has he specifically made reference to how the gut-brain relates to migraine? One reviewer comments that the book spends ample time discussing serotonin. However, as I noted to you previously, serotonin manufactured in the gut has no bearing on the needs of the brain and I don’t think you realised that. If migraine is not mentioned in his book, how is it that you’ve made this jump to migraine? On what evidence do you base this?

I just met a lady yesterday and happened to mention that i work in the migraine field and she said that she used to get them twice a week but they completely stopped when she got divorced. How can that possibly happen within the belief system that says I have a migraine brain and there is nothing i can do?

With all due respect Tom, I don’t think you truly understand what migraine is, what the triggers are or how a person’s threshold plays a major role in whether or not migraine symptoms will present themselves. It sounds to me that you are in some way suggesting that this woman had some sort of mysterious imbalance going on because of her marriage, that it was her own unfortunate situation and doing that caused her migraines and had nothing to do with brain pathology (correct me if I’m wrong). You have to understand that at any given point in time, a person has a threshold for which they can withstand migraine triggers. Dr Rauch used the water level in a pool as an excellent analogy. If the threshold is low in a person it takes very little for the migraine process to begin in the brain. Anxiety and stress are both major and potent migraine triggers for such an individual predisposed to migraine. The lady you mention was likely under large stress from living in an unhappy marriage and then having to undergo the divorce process (divorce is ranked very highly on the list of life’s most stress-causing events). Her threshold was rock bottom and so she was symptomatic. She is no longer stressed from the marriage and divorce as it’s behind her now, her threshold is up, and she is now asymptomatic. There’s nothing mysterious about it. She is still a migraineur however. Throw a great big trigger at her again when her threshold happens to be low and she’ll be right back into another cycle.

In my world anything unnatural to the organism, something that it cannot use in its normal function and would, if the organism is operating properly, either be removed or not allowed to enter in the first place is a toxin. For you to equate the point I am making to someone drinking too much water or having an out of balance immune system that creates a severe allergic reaction to peanuts is frankly off point and dismissive.

Tom, you are truly stuck in the belief that natural = good; and you’ve used this all over your website. It’s a classic logical fallacy as I’ve illustrated previously. I’m not being dismissive when I made those points. Suggesting that a “natural” molecule cannot act as a toxin is baseless and not logical. The peanut example is a solid one for this point –– it is “natural”, it is a food for the human body (i.e. used in its normal function), yet given to a person with an allergy to a particular molecule in a peanut, it can be deadly and quite toxic.

I’m not attached to any belief system or faith. I simply know that the scientific method is the best way to arrive at the truth of whether or not a treatment is real or not –- it removes the effect from placebo and removes confirmation bias. If you can show me a better system, I’ll gladly adopt it. Tom, we’ve written pages of dialogue on all of this yet all you’d have to do is run an independent double-blinded study using your treatment on a group of migraineurs and you’d have some solid and robust evidence that would speak volumes. It’s the gold standard –– why not give it a go? I am totally open to all of this yet I’ve still not seen nor heard anything compelling from you and am frankly disappointed as I thought there would be much more to the gut-brain story. I for one, would really be interested to see the results of a solid clinical trial and would hope there was a real effect beyond placebo.

I HIGHLY recommend that you read a book called “Trick or Treatment” by Simon Singh and Edzard Ernst. The latter is the world’s first professor of alternative medicine. Pay particularly close attention to Chapter 1 titled “How Do You Determine The Truth?” There is some excellent history in there and very good discussion on the placebo effect and how it applies to this topic. It’s a great book where the key theme that runs throughout is “truth”. I think you’d really find it to be an eye-opener.

Best … Scott :slight_smile:

27

Hi Tom,

I’m wary of engaging further in this debate as I think we’ve reached a point where the twain shall not meet, however I just want to address a comment you made specifically in response to a post of mine. You say:

Victoria even makes the argument that trying to find the cause is irrelevant. This completely befuddles me. She does explain it in a way I understand in that if you believe that you are born with a migraine brain there is nothing you can do. Have you never seen someone stop getting migraines? I just met a lady yesterday and happened to mention that i work in the migraine field and she said that she used to get them twice a week but they completely stopped when she got divorced. How can that possibly happen within the belief system that says I have a migraine brain and there is nothing i can do?

The cause is irrelevant to me, as a migraineur. It is no doubt of course of interest to the scientists and medicos who do research in this area. What I mean is, that once a migraineur, always a migraineur. That is the way the brain is wired. This is quite separate from the issue of triggers. I do not, nor have I previously in this discussion suggested that triggers do not play a part in migraine. Quite the opposite. Triggers (by definition) trigger a migraine in migraineurs. It is this that treatments try and control. This occurs in two ways. Firstly by reducing the triggers (for each migraineur this is different, with some commonalities) and by increasing the migraineur’s threshold for withstanding migraine, such as by taking preventitive medicines.

The example you provide of a woman who has not had a migraine since her divorce supports the role of triggers, but in no way suggests that this woman’s migraines were “caused” by her marriage and “cured” by her divorce. That would be ludicrous. Logically, as any migraineur would know, a stressful lifestyle (which can be inferred as she ended up getting divorced) is a known trigger for migraine. It is well documented in both the literature and on this forum that triggers play a substantial role in migraine. Managing these triggers helps manage the migraine but the triggers themselves neither cause, nor cure migraine. I note the example makes no mention of the role of a gut brain (which I understand is your hypothesis) so I am unclear of how this particular example supports the existence or role of a gut brain.

Once again Tom I would like to stress that I do not wish to make any attack on you personally nor doubt your sincerity in wanting to help treat migraine. Clearly we will just have to agree to disagree.

Regards,
Victoria

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I don’t think Tom accesses the board any longer and had nothing else to add to support his philosophical point of view on migraine but given the latest findings on Norfolk Island I think the evidence needs to be revisited – particularly the genetic background that went right over his head.

Tom said:

— Begin quote from ____

To further speak to the idea that migraine is as you suggested Scott “entirely a genetic abnormality of the brain” let me ask if anyone can provide any evidence where the identification of genetic markers of any disease has led to a clear understanding of the cause and/or cure of the related disease?

Why is it possible to consider that migraine is simply, as if anything within the human organism can be described as simply, a genetic abnormality of the brain?

You and Victoria are convinced that migraine is a brain disorder with a genetic basis. How do you possibly come to that conclusion when there are no blinded studies to support that?

— End quote

From the author of “Genetic Headache” –– Professor Lyn Griffiths, molecular geneticist.

"70% [of the people from Norfolk Island] are descended from only 21 individuals … it’s a lovely population. It’s isolated. This means that after many generations the genetic variation within the poulation is significantly reduced, making them ideal when it comes to isolating the genetic bases of hereditary disorders like migraine. We found a high prevalence of migraine –– 27% compared to 12% on the Australian mainland.

We’ve identified a new genomic region for migraine… we know where they are in the chromosomes. Their studies have implicated three classes of genes. The first deals with neurotransmitters, affecting things like calcium channel genes in brain neurons as well as dopamine and serotonin. The second influences hormones … there were variations in both oestrogen and progesterone receptor genes that make people more susceptible to developing migraine. The third class of genes relates to blood flow and vascular differences."

Something very interesting they may have uncovered is the targeted use of vitamin B and folate to reduce migraine activity. A large trial is underway to determine whether there’s a difference in response based on the specific gene mutation. This might lead to specific dosing for maximum effect.

Scott 8)

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This is such an interesting post Scott. Maybe this is the reason why some of us may respond to one class of medications while others will respond to a different class. If they can definitely figure out a direct genetic basis, this information could target the medication which could give migrainers a better chance of responding. Maybe shorten the period of trialing different meds… hmmm… wouldn’t that be lovely?
Best,
Lisa

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This is an old thread but I want to share here anyways. Migraine can be related to gut health through too much histamine intake from the food we eat. There can be problems with gut dysbiosis. Dao enzyme deficiency, leaky gut (leaking hisatmine while lowering available DAO enzyme to degrade hisatmine). I have healed my gut using l-glutamine and have gotten rid of my vestibular migraines, cervogenic headaches, cervical vertigo. You need to understand histamine is also a nuerotransmitter and that the gut biome is vast and varies greatly between person to person.

I am still reading through this thread bit it does not mention histamine at all and instead focuses on serotonin. There is sure to be multiple causes of migraines.