Dr. Maupin: This is episode 33 of the BioBalance
Healthcast. I’m Dr. Kathy Maupin. Dr. Newcomb: And I’m Brett Newcomb and today
we’re going to talk about headaches. We’re going to talk about all different kinds of
headaches, but our focus is going to be on migraine headaches and their connection to
hormone imbalances. Dr. Maupin: I have a vested interest in this
because when I was 35, 36, I began having migraines and they were not timed with periods
or anything and they got worse and worse until I had my hysterectomy at 47. They were carrying
me out of my office throwing up and nauseated and I had to go home, and cancel patients.
It was horrible. I have patients that come to me like that now. But when I got to 47,
I thought “Oh I’m going to have my ovaries out, this is going to fix it”. But it didn’t,
it made it worse. And I had headaches all the time then. But when I found the pellets
and the testosterone, I tried all the different hormones. Nothing worked. All the other bio-identicals
didn’t work. But when I tried pellets with testosterone I never had another headache.
And I haven’t had another migraine in nine and a half years. That’s a miracle to me.
Dr. Newcomb: Wow. Well it’s impressive. Fortunately I’ve never suffered from headaches.
I cause them but I don’t get them. Or seldom get them. But I’ve had lots of clients through
the years with severe migraine problems who have to go lay down in a dark place, who have
to stay very still for hours at a time. I’ve even had a couple that literally had to go
to the emergency room and there’s some sort of shot that they give them.
Dr. Maupin: They give them a narcotic. Dr. Newcomb: Is that what it is?
Dr. Maupin: A narcotic is the only thing. It’s really for the symptom for the pain.
It doesn’t really fix the headache, they just know the headache is going to go away
soon. But really what a migraine is is not a muscle spasm. It is actually a swelling
of the vessels in your head. Your head can’t stretch. I mean your head is fixed after you’re
a baby and all of the plates of your head fuse; you can’t stretch your head. So when
the veins get bigger there’s no space to go, so it aches. As the veins get really big,
you get your headache and it causes you to throw up, and it causes you to see an aura
sometimes, and have light sensitivity. Dr. Newcomb: That’s what people tell me.
And it’s hard if you’ve never experienced anything like that, to really, not to have
empathy for it, but to understand it. And you work on things like relaxation, meditation,
calming exercises. Sometimes they help and sometimes they don’t.
Dr. Maupin: If it’s a [headache caused by a] hormonal reason it’s not going to help
that. Dr. Newcomb: People will say I’m trying
all these things and they’re not making any difference. I had one client, poor lady,
she was almost going to lose her job, her marriage was in trouble, because she literally
had migraines so excessively and she was so limited and the doctors couldn’t find an
answer. Dr. Maupin: The medicines didn’t work.
Dr. Newcomb: No. Dr. Maupin: I have several neurologists who
are in St. Louis who now send me their patients that are over 40 who have migraine headaches
and they’ve tried everything. They’ve done the work-up, which you should always
do. You should always have your headaches worked up. Get an MRI. Make sure you see a
neurologist, or a headache specialist and make sure the headache doesn’t mean you
have a brain tumor or an abnormality in the vessels in your head, because God forbid we
treat that with hormones. That’s not what we’re doing. We wait until someone has had
their work-up. Or we send them for a work-up. But we work with the neurologist. And now
there are articles in the neurologic literature that talk about giving testosterone to stop
headaches. And of course it was first in men. Because men have testosterone and they noticed
when they did blood tests they had low testosterone. And they had all these horrible headache,
and when they replaced it, they went away. Dr. Newcomb: They didn’t have it.
Dr. Maupin: Then they started looking at women. And now Dr. Banks here in St. Louis is amazing.
He sends me patients. After he’s worked them up and he’s treated them the way he
treats them and they can’t get better, he sends them to me and I get them better. And
I send my patients to him for the work-up. Dr. Newcomb: Right.
Dr. Maupin: So it all works out. But you should have the work-up first if this is one of your
problems. And I had the MRI as well, when I had the headaches to make sure I wasn’t
going to have a stroke. That’s very important. then after you go through the work-up and
if it doesn’t work, then hormonal replacement in some cases works for migraines.
Dr. Newcomb: I’m not medically gifted so you have repeat things for me and clarify
things for me. Help me understand what the difference is that makes a headache a migraine
as opposed to just a bad headache, because you can have a bad headache and not have it
be a migraine. Dr. Maupin: I always have my patients describe
their migraines or headaches because they sometimes think they have a migraine headache
because it comes on all the time. But a migraine is specifically a throbbing headache that
has an aura or some kind of light flashes or kind of an aura around whatever you’re
looking at. Dr. Newcomb: You see those externally or you
experience them internally? Dr. Maupin: Well, they happen inside your
brain but you see them as if they were in front of you and these little lights that
happen. Dr. Newcomb: So pressure on the optic nerve.
Dr. Maupin: That’s exactly right – from the pressure of the swelling vessels.
Dr. Newcomb: So pressure from the brain swells. Dr. Maupin: So you get that first. You may
not have pain yet. Some people say they have pain immediately. Then there’s a nausea
and a there’s a light sensitivity. You see people walking around the office with their
sunglasses on and a horrible look on their face.
Dr. Newcomb: Or they’re just trying to be cool, I’ll wear my sunglasses at night.
Dr. Maupin: If they look like they’re going to throw up, they’re not trying to be cool
and they’re ready to go home. Those are the symptoms. Usually it is here. People say
“this is my migraine. It’s right here every time”. It’s usually in one place,
one space. Or it’s one sided. Dr. Newcomb: So it’s not just sinus cavities.
Dr. Maupin: No. The sinus cavities are both sides in general. If I want to know if someone
has a sinus headache I go like this. If that hurts, that’s a sinus headache. If they
have, (these are the non-migraine headaches), if they have a tension headache they say ‘oh
it’s right here and it goes all the way down and I have a neck pain and then my headache
starts up here and it’s both sides and it feels tight’. That’s the muscles of their
head, the outside of their skull tensing up and causing them to have pain from muscle
tension. Dr. Newcomb: Those are the headaches, the
few that I’ve had. They all start right back here at the top of the neck and the shoulders
where all those muscles tighten up. I talk to patients about it because when, if you
have a stressful situation at work and you have a long drive home you can actually feel
your arms get longer as you drive, as that stress calms, and you relax.
Dr. Maupin: As you’re calming down. But if you’ve noticed that your shoulders have
reached your ears before the end of the day and you have a headache that’s generally
a muscle spasm headache, a tension headache. Dr. Newcomb: All that’s knotted up. And
then it comes over the top and they feel it here.
Dr. Maupin: Right. And so they think sometimes that’s a migraine. They sometimes have nausea
with that. However, I suggest massages, acupuncture, any kind of muscle relaxation. Sometimes just
exercises and biofeedback help. But in general, patients are so bad by the time they come
to me about that that I have to send them to a pain specialist to have them injected
and then their headache is gone and they realize what it is.
Dr. Newcomb: Once it’s gotten that severe. I talk about a technique in my practice called
“thought stopping”. If stress is magnified in your life and you’re obsessing about
certain things and worrying about certain things, you have to learn how to do thought
stopping. Tell yourself no; tell yourself stop.
Dr. Maupin: Stop obsessing over something. Dr. Newcomb: Yes stop even thinking about
it. Make yourself think about something else. And if you can do guided imagery, you can
imagine a walk along a brook in the woods or sitting in a hay barn watching a storm
go across the valley. Whatever might be relaxing for you.
Dr. Maupin: That’s really difficult for a lot of people. And it takes a lot of training.
Dr. Newcomb: It is for a lot of people but you can train them to do it. But then they
have to choose to do it. It’s like we were talking about earlier.
Dr. Maupin: Or yoga. Yoga is a great way to relieve tension headaches. There is another
kind of tension headaches. Patients go “oh, it hurts right here”. And they’re gritting
their teeth. Dr. Newcomb: Ice cream, brain freeze.
Dr. Maupin: No that’s brain freeze. That’s from your sinuses and this is from your TMJ
joint. And that kind of headache is usually from grinding your teeth all night, which
is bad for your teeth but it is also bad for your headaches. Those patients I send to their
dentists for a mouth guard to wear at night and that usually helps. Sometimes chiropractors
or other pain specialists can inject it or manipulate it so that they don’t have that,
but that’s another type of headache. But I have to rule out all of these different
headaches before I say “Yep you’ve got a migraine and hormones will help”. Then
I look at their labs. If their testosterone is low, that’s the key to migraines, and
there’s no other kind of testosterone that works on migraines that crosses the blood
brain barrier and stops a migraine or prevents it other than pellets or IM shots, shots in
the muscle. Something that’s not oral that doesn’t go under the skin or vagina or under
the tongue. None of those fix migraines, sadly. We have to put the testosterone directly under
the skin. Dr. Newcomb: Why? I mean I know we’ve had
this conversation multiple times for other issues and you talk about the metabolic interference
of the digestive process or the absorption process that are different with sublinguals
or skin creams or oral pills. Is it the same kind of thing? Is it a metabolic adaptive?
Dr. Maupin: It’s a change. They’re transformed as they go through the skin or the vagina
or under the tongue. That hormone gets changed just to be absorbed. And then, it’s usually
changed into an estrogen which makes headaches worse. You have to get pure testosterone,
just like you had when you were younger, to the brain. To cross the blood brain barrier
it has to be pure testosterone not one of the lesser androgens, which are other kind
of testosterone like hormones. It has to be pure to get to your brain. And obviously the
problem is in your brain. The testosterone relaxes all those vessels and allows them
to shrink and let the blood out of the skull. Dr. Newcomb: When you say pure testosterone
you are talking about bioidentical products not plant derivative products.
Dr. Maupin: Well plant derivative. I mean bioidenticals are plant derivative. However,
they’re just made from a plant, chemically the same, exactly as our hormones. So they
have to be that, but they also have to be non-oral, non-transdermal, no other delivery
system. They have to be under the skin. Dr. Newcomb: That’s the testosterone issue
with migraine headaches. And when we were talking before you said something about a
menstrual cycle issue as well. Dr. Maupin: Right. This is very common. If
you have migraines that happen mid-cycle, or if you have migraines that happen right
before your period and during your period if you’re a female. (I’m not accusing
you of having migraines. This is just for the girls.) If you have that type of headache
generally, that’s from a drop of your estrogen right before your period or a sharp rise of
your estrogen at ovulation. Those are a change in your estrogen level. We usually put people
on the pill if they’re not menopausal or we put them on constant estrodial. A natural
estrodial works best. And usually, same hormone everyday is how we do it. Pellets work great
for that because they don’t go up and down every day. And we don’t use oral because
that just doesn’t tend to work very well except in a birth control pill.
Dr. Newcomb: So if you’re suffering from migraines and you have gone to your doctor
and you have described your symptomology and they don’t identify that it’s something
like a muscle tension, or sinus or TMJ issue, then you have to consider is it possibly a
hormonal issue. And as you said they discovered this by working with men because when the
blood tests came back on the men they noticed the testosterone was low. They gave them testosterone
and the migraines stopped. And so now they extrapolate that to women as well. And what
they’ve discovered is that helps. We’ll talk in other podcasts about andropause which
is a word that’s generally applied to and understood to be an issue for men and concerning
men, because of the testosterone issue. But women also have to have testosterone and women
also have andropause issues and one of those is related to migraines with the testosterone.
Dr. Maupin: They’re always very surprised when they come in for another reason for andropause,
fatigue, or loss of sex drive or loss of muscle mass, or gaining weight, fatigue, irritability,
depression. Dr. Newcomb: All those cluster symptoms, irritability.
Dr. Maupin: They come in for all of those symptoms that haven’t been helped by other
methods. And all of a sudden their migraines are gone too. To them it’s like “oh I
didn’t even come in for this, and it’s gone.”
Dr. Newcomb: It’s kind of like you notice it by its absence.
Dr. Maupin: Right. You notice that you haven’t had a headache in 4 months or 5 months. And
“oh that’s amazing I don’t know how that happened”.
Dr. Newcomb: I haven’t had a headache since my mother came to visit. Well that might not
be a migraine. Dr. Maupin: That’s right. That may be tension.
Dr. Newcomb: If you have questions about headaches. If you have questions about hormones or any
of the things we’ve talked about in our 33 podcasts. You can ask us those questions
directly at [email protected] You can also, if you have time and you’re
interested, read my blog at brettnewcomb.com. Dr. Maupin: And if you’d like to know more
about biobalance health or bioidentical hormones visit our website at biobalancehealth.com.
Or call 314-993-0963.