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THE TREATMENT OF MIGRAINE HEADACHE

Posted Nov 23 2008 11:02am 3 Comments

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THE TREATMENT OF MIGRAINE HEADACHES USING HUMAN CHORIONIC GONADOTROPIN

by

Edward Leyton MD CCFP

Introduction: Hormonal migraine headaches are defined as a typical migraine headache that occurs in a periodic fashion around the time of the menstrual cycle. The preventive treatment outlined here was first described by Nevil Leyton MB LRCP in London England in the 1940's. Dr. Leyton noticed that migraines could be induced in some individuals who were given estrogen by injection. Subsequently he developed the idea that an 'anti-estrogenic' hormone such as that found in the chorion of the placenta might prevent attacks. This was supported by the fact that for many migraine patients the headaches disappear or markedly improve during pregnancy, when Human Chorionic Gonadotropin (HCG) is secreted by the placenta in high levels. He subsequently went on to treat migraines using both this approach and that of histamine or prostigmine desensitization at his Harley St. Clinic and the London Clinic. Over thirty years Dr. Leyton treated over 10,000 patients from all over the world. This approach was never accepted by the mainstream medical profession, even though he published three books on the subject (now all out of print). The treatment was first described in the Lancet in 1942(1), and subsequently in the Medical Press and Circular in 1944 and 1952(2,3). Dr. Leyton also authored three books on the subject: two medical texts entitled "Migraine and Periodic Headache - A Modern Approach to Successful Treatment"(4); "Headaches - The Reason and Relief"(5); and a lay text "Migraine"(6). The treatment was so successful that another book written by E. Harvey-Sutherland entitled "Migraine Clinic - An Eight Year Survey of Preventive Treatment" described the advent and growth of the Putney Migraine Clinic and was published first in 1957 with a second addition in 1958.(7)

I have used his HCG treatment for the past 20 years in my practice with good success, but have not used the histamine or prostigmine part of the protocol. I prefer to use food avoidance and stress reduction as adjuncts. This is a preventive treatment - it is not to be used in acute attacks.

History:The following clinical history points are helpful in deciding whether you will respond to HCG treatment:


- migraines began at or shortly after menarche
-
migraines are made worse by oral contraceptive, or other estrogenic hormones

-migraines are absent or markedly reduced during pregnancy

- migraines are limited to the peri-menstrual period. This is not an absolute condition for a trial of HCG

- migraines are reduced or absent after menopause, but resume with hormone replacement therapy

- the migraines are 'classical' vs. cluster type headaches

Side Effects: One side effect is a risk of ovarian cysts - I have not observed this in 20 years - it is only a theoretical risk. The menses may be affected - they may be delayed at higher doses of HCG, but this delay can be avoided by giving the injection at least 1 week before the expected date of the onset of menses.

The Protocol:In Canada HCG is available on prescription sold as Profasi HP® in 10,000 IU vials as a dry powder with a diluent of 10 ml. The treatment is administered according to the following schedule, after obtaining your informed consent:


Week 1: 0.1 ml. (100 IU) intramuscularly into the deltoid twice. (eg Mon. & Thurs.)

Week 2:0.2 ml (200 IU) intramuscularly into the deltoid twice.

Week 3:0.3 ml. (300 IU) intramuscularly into the deltoid twice.

Week 4:0.4 ml. (400 IU) intramuscularly into the deltoid twice.

Week 5:0.5 ml. (500 IU) intramuscularly into the deltoid twice.

Week 6-11:0.5 ml. (500 IU) intramuscularly into the deltoid weekly for six weeks

Week 12-23:1.0 ml. (1000 IU) intramuscularly into the deltoid every two week

Month 6-12:1.5 ml. (1500 IU) monthly until the patient has had a year of injections

As you reach the 500 IU level try to avoid having the injections less than one week pre-menstrually, although this is not critical. You will usually notice an effect by the time 12 weeks are up. This effect is usually a decrease in frequency, severity or duration, or all of these. You may be completely free by then. Any improvement should be a sign to continue, hoping for further improvement. At the end of one year you can be given the option of stopping the treatment, but I usually do not advise this, as the migraines often return in a few months. The treatment can safely be given indefinitely. You might want to stop at menopause. If you stop and the headaches return, you should begin at the low dose again. In Dr. Nevil Leyton's experience, the second attempt at treatment after discontinuation may not be as successful, possibly due to anti-HCG formation.

The use of this treatment for male patients is entirely empirical. Obviously they do not have a menstrual cycle so the choice of whther to give this treatment to a male migraineur cannot be based on the above. If a male patient has not responded to diet and stress changes then HCG could be tried. There is no harm to be done at the dosages used, and males have similar pituitary hormones to females.

The Results: The success rate is usually about 70-80% if patients are chosen by the above criteria. Since migraine is a multi-factorial disease, it is important to address other triggers such as tyramine containing foods, dairy allergy, stress, and difficulty expressing anger in conjunction with the above treatment. Migraines do not usually return if the treatments continued.

 

References

1. Leyton, Nevil. Lancet (1942); 1:488

2. Leyton, Nevil. A New Approach to the Treatment of Migraine. Med. Press and Circ. (1944); 11:302

3. Leyton, Nevil. Med. Press and Circ. (1951) 226:46

4. " Migraine and Periodic Headache - A Modern Approach to Successful Treatment" by Nevil Leyton MA, MRCS, LRCP. William Heinemann Medical Books Ltd.(1954 - 2nd edition)

5. " Headaches - The Reason and Relief" by Nevil Leyton (Heineman 1958)

6." Migraine" by Nevil Leyton MA, MRCS, LRCP. W & G Foyle Ltd. (1962)

7." Migraine Clinic - An Eight Year Survey of Preventive Treatment" by E. Harvey-Sutherland Saint Catherine Press Ltd. London (1958 - 2nd edition).

 

Acknowledgements

I would like to acknowledge with pride my father's untiring and creative energy in the prevention of suffering by migraine patients. Please forward any treatment results to holodoc@sympatico.ca, as I hope to publish something on this sometime. Thank you.

©Copyright 1995 Edward Leyton BSc MD CCFP

Disclaimer

The information provided is for educational purposes only and is not intended to prescribe treatment. Please see your health care provider for details of any treatment. This treatment must be administered by a physician.

Comments (3)
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Migraine headache occur than relaxation techniques such as deep breathing, gentle yoga or meditation are helpful to reduce the pain. Other techniques like bed rest in a darkened room, apply an ice pack or cool cloth, light walking, prenatal massage therapist and Acupuncture therapy which will give you relief from the headache. Every pregnant woman should always consult with her physician prior to taking any medication during pregnancy stages.

This is very interesting, but I noticed that you don't really emphasis enough on how to actually treat those migraines.

I made some research and found some great migraine home remedies.

Hormonal Headache / Migraine is one of the effects of female hormonal imbalance. Estrogen and progesterone are the two most important female hormones. A hormonal imbalance occurs when the ratio of these two hormones deviate from normal levels. In most cases estrogen concentrations stay stable while progesterone decreases; this is known as 'estrogen dominance'.

There are many routes to the treatment of imbalance in female hormones. A woman can effectively control hormonal imbalance symptoms with the use of oral pills or natural progesterone, testosterone, and estrogen creams. The safest and most effective means is the use of natural bioidentical creams. http://www.premenstrualsyndromesupport.com/Female-Hormones.php

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