Tuesday, July 08, 2008

Q&A: Dr. McLeary's Anti-Migraine Cocktail

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Dr. Larry McLeary's book The Brain Trust Program includes an Anti-Migraine Cocktail, which Dr. McLeary recommends taking for migraine prevention.

Before starting this or any other program, you should consult with your own doctors to assess any potential risks based on your unique situation.

The Brain Trust Program: A Scientifically Based Three-Part Plan to Improve Memory, Elevate Mood, Enhance Attention, Alleviate Migraine and Menopausal Symptoms, and Boost Mental Energy

I recently picked up a copy of the book after hearing good things about other people's experiences with the cocktail. I had a few additional questions about the program, so I sent Dr. McLeary an e-mail. He graciously responded immediately and gave me permission to share his answers here with all of you.

1. How and why did you develop the anti-migraine cocktail?

My background is in pediatric neurosurgery (performing brain surgery in children). I have taken care of many children with very sick brains due to a variety of causes including head trauma, electrocution, near drowning, congenital malformations, hemorrhages, radiation, increased pressure on the brain from fluid buildup and from brain swelling and other reasons, illicit drugs and so forth. In addition to the surgical procedures they required, I wanted to help these kids recover more rapidly and more completely. Many years ago I started investigating various nutritional strategies that I thought might help. Deciding how they worked allowed me to decide which to select. What the medical literature suggested was that in spite of the literally infinite insults that may afflict the brain, there are relatively few metabolic pathways that mediate the effects of these insults. Several of the most significant involve the ability of nerve cells to generate the energy they require on a continuous basis, abnormalities of cellular calcium metabolism that release excitotoxic neurotransmitters and pathways that "calm down" such processes.

As I was doing research for the book, I wondered whether such an approach might be relevant in the etiology and treatment of migraine syndromes. While migraine headaches are related to alterations that incite painful responses in the coating membranes of the brain and the walls of the blood vessels that flow over the surface of the brain, the "triggering" mechanism I believe is actually within the brain tissue. As I discuss in The Brain Trust Program, I believe a relative energy deficit within nerve cells is a key contributor to migraine pathology. When energy generation fails, the neurons can't pump the calcium out of their interior and this calcium buildup causes inappropriate firing. It also consumes more energy, which drives a vicious cycle consisting of energy failure and subsequent increased activity which worsens the energy failure, and so on.

There is support for this in the medical literature. By combining various nutritional supplements based on their ability to facilitate enhanced energy generation and reduce excess neuronal firing, I believed that migraine symptoms could be improved. Based on the response of many, many migraine sufferers, I believe this has been the case.

2. There is a good deal of research about magnesium and CoQ10 for migraine prevention. But where does support for the use of the other substances in the migraine cocktail (taurine, huperzine A, vinpocetine) come from? Why do you recommend this specific combination of vitamins & supplements?

There is a relative paucity of research on a number of the nutritional supplements I recommend regarding their efficacy in migraine syndromes. I believe this is so because they are used for other reasons and that is where popular focus resides.

However, by teasing out the mechanisms that are responsible for generation of migraines and selecting compounds that have proven efficacy (as documented in the medical literature) in reversing these pathways, I felt that such an approach might be helpful. Since most recommendations are basically a rehash of old information, no new compounds are ever suggested. However, by using a mechanistic approach based on what causes migraines and how various nutritional supplements work, I was able to provide migraine sufferers with new treatment options.

A convenient way to think about this approach is as follows:

Agents that increase neuronal energy production -- Included here are B vitamins, coenzyme Q10 and ketone bodies.

Ketone bodies are partially burned fats that are generated naturally in the liver and serve as an even more efficient brain fuel than glucose. As estrogen levels fluctuate, as they do during menstrual cycles (a frequent contributor to migraine production), glucose transport to the brain is diminished. This produces an energy deficit and contributes to the cellular abnormality that contributes to the production of migraines.

During these times, ketone bodies are able to take over for a fall in brain glucose. MCT oil (medium chain triglyceride oil) is a potent source of the fats that produce ketone bodies. These agents enhance brain energy production.

Agents that decrease over-activity and excessive firing of neurons -- These include magnesium, taurine, Huperzine A and vinpocetine.

When these groups of nutrients are consumed together, they act to interrupt the negative spiral of actions that ultimately generate migraines.

3. How should I evaluate the different brands of supplements to choose the best option?

This is a broad question and the best answer is to buy them from suppliers you have had experience with and feel good about previously. The one additional thought I have is regarding MCT oil. Only use products that are 100% MCT oil. I usually recommend MCT Gold. You can buy it online and 33 ounces cost about $18-20.


In addition to reading The Brain Trust Program, you can learn more about Dr. McLeary and his work by visit his website, DrMcLeary.com.

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