Advances in medical research, the consumer empowerment, and rising cost of health care have demonstrated the need to treatment models that are holistic and client driven. Complementary and alternative medicine (CAM) offers consumers choices. It includes traditional healing practices, medical systems that are thousands of years old and new or innovative treatments that may be consider unconventional. Well known examples of CAM include herbal remedies, mindfulness, meditation, manipulative/movement therapies, and Chinese Medicine. Knowledge of CAM offers social workers in all settings the opportunity to provide education and advocacy in seeking client centered and culturally competent treatment options.

Friday, May 6, 2011

Migraines and CAM: The Use of Nutraceuticals

The use of herbal remedies, nutraceuticals, predates modern pharmacology.  According to Winslow and Kroll (1998) consumers use nutraceutical because of cultural reasons, religious reasons, and belief that they are healthier than pharmacological interventions.  There are fewer reports of negative effects with neutraceuticals.  It is therefore not surprising that migraine sufferers turn to neutraceuticals as a popular CAM intervention.  Nutraceuticals, considered a food supplement by the Food and Drug Administration are readily available in health food stores, pharmacies, and supermarkets.  They are inexpensive and do not require a referral from the specialist or general medical provider.  Taylor (2009) conducted a systematic review of neutraceuticals that included Petadolex, magnesium, feverfew and riboflavin.  This study is important because it compares the effectiveness of various nutraceuticals.  Petadolex, also known as P. hybridus or the butterbur root extract, has been used for migraine relief because of its combined anti-spasmodic, anti-inflammatory and calcium channel blocking effects.  Some pharmaceuticals prescribed by medical providers also have these properties.  Taylor reviewed the efficacy of magnesium.  In a clinical report (as cited by Teitelbaum, 2007) there is circumstantial evidence that some the migraine sufferers have low levels of magnesium.  Another nutraceutical that is popular for migraine relief is Feverfew, also called bachelor's button.  Feverfew is an anti-inflammatory, which may inhibit chemicals that cause the blood vessels in the brain to spasm (Agosti, Duke, J.E Chrubasik, & S. Chrubasik, 2006).  Riboflavin (Vitamin B2) has also been evaluated for its efficacy in migraine relief.  The theoretical basis for using riboflavin is its ameliorating effect on the mitochondrial dysfunction that might be involved in the pathophysiology of migraines.
Despite the evidence, the use of nutraceuticals is largely trial and error.  Consumers need to be aware of the potential hazards that neutraceutical pose, given the lack of quality control, information and research trials (Winslow & Kroll).  The dangers of nutraceutical increase when they are used in conjunction with other prescription and non-prescription medications.  In addition to nutraceuticals, consumers also turn to other CAM interventions in order to seek relief.
Agosti, R., Duke, R.K. Chrubasik, J.E. & Chrubasik, S. (2006).  Effectiveness of Petasites hybridus preparations in the prophylaxis of migraine: A systematic review.  Phytomedicine, 13(9-10), 743-746.
Taylor, F.R. (2009).  Lifestyle changes, dietary restrictions, and neutraceuticals in migraine prevention.  Techniques in Regional Anesthesia and Pain Management, 13, 28-37.  doi:10.1053/j.trap.2009.03.008
Teitelbaum, J. (2007). Natural Rx for migraines.  Townsend Letter:  The Examiner of Alternative Medicine, 292(4), 121.
Winslow, L. C., & Kroll, D.J. (1998).  Herbs as medicine.  Archives of Internal Medicine, 158, 2192-2199.


  1. Growing up in a Chinese family, herbal remedies and nutraceticals are part of my culture. I was taught by the elderly that Western medicine can only heal our body temporarily. In order to get well completely, we need to use herbal remedies on a daily basis to treat your body. Though, the downside of herbal remedies is that it requires a long time before we can see a result, whereas Western medicine you can see a difference within a day or two. Because of my culture and upbringing, I do believe in herbal remedies and nutraceticals. However, as a practitioners, I would not suggest my clients to use herbal remedies and nutraceticals over western medicine, because I believe clients should have the choice to choose the treatment that they are comfortable with. However, if my clients express concerns with the medicine that they are taking (i.e. side effect), I would advice them to look at other treatment options and help them explore.

  2. I would tell my clients who are interested in using herbs, supplements and etc to consult with their primary care physician before using them. I would inform them to be aware that some dietary supplements may interact with their medications or other supplements. Also supplements may have their own side effects too. It is important to know that supplements do not go through the same rigorous testing like prescription medications before they hit the market. Also, many supplements have not been studied in pregnant women, nursing mothers or children. I am not against the use of alternative medicines and I am not saying that they are ineffective. What I am saying is limited research has been done to examine the evidence of such use. I would recommend my clients to talk with their doctor about any complementary and alternative medicine practices to ensure safety when using in addition to regular prescribed medication.

    Annie Yip, MSW Student