Headaches: How a sleep hormone may help relieve severe headaches

Stabbing headache - that name tells you everything you need to know about the specific pain associated with this unique type of headache.

Theyre also known as ice-pick headaches, cluster headaches and even suicide headaches. As these names painfully suggest, this variety of headache causes sharp pains that are isolated in specific points on the head. Although the headache is usually brief, it sometimes recurs throughout the day and in the worst cases may cause short-term disability.

An article in the US journal Neurology shows that supplements of the hormone melatonin may provide relief for stabbing headaches while also helping users get a good nights sleep without feeling dazed and confused the next day. But while this supplement offers a variety of benefits, it comes with an important warning.

When the medication wont do 
The typical preventive treatment for stabbing headaches is a nonsteroidal anti-inflammatory drug (NSAID) called indomethacin. As with all NSAIDs, indomethacin may cause digestive problems, accompanied by dizziness and even headaches. In the three case studies examined in Neurology, two of the subjects were unable to use indomethacin.

In case number one, a woman who couldnt tolerate indomethacin experienced as many as 10 stabbing headaches each day. After she began taking 12 mg of melatonin each day just before bedtime, her headaches subsided and she was pain-free when followed up at two months.

Indomathacin was also not an option for the second case: A woman who suffered two stabbing headaches every day began taking a daily melatonin dose of 9 mg and reported complete relief within 24 hours. Followed up after four months, she reported that no headaches had returned.

In the third case, a woman who was relieved from stabbing headaches with indomethacin use found that 3 mg of melatonin taken before bed each evening prevented the headaches as well as the drug did. She was pain-free at a two-month follow up.

These three case studies indicate that controlled trials should be conducted to confirm the effectiveness of melatonin supplements as an alternative to indomethacin.

Fooling Mother Nature 
Melatonin helps regulate the sleep/wake circadian rhythm that (ideally) remains consistent from night to night. Which is one of the reasons its effective as a sleep-aid. In addition, studies have shown that melatonin may even play a role in the bodys natural defences against cancer.

But because melatonin is a hormone (produced in the brain by the pineal gland), I asked HSI Panellist Dr Allan Spreen if its wise to boost levels with a supplement. Dr. Spreen agreed that some caution should be taken.

Dr. Spreen: Many people use melatonin for sleep, and keep increasing the dose until it works (and it does). I would use tryptophan that way, continuing to increase the dose each night until the patient fell asleep (and he/she will).

However, Im more cautious with melatonin. I dont recommend it for anyone under 40, except when addressing jet lag, for which it works well. The idea there is that you take a pretty decent dose at the destination bedtime to more quickly condition your body to the new diurnal rhythm.

As we age, melatonin production decreases, so Im not as nervous for someone over age 40 using it as a youth-type agent, and I think theres something to it. The substance is well researched to be both an antioxidant, and a nutrient of considerable worth in other areas. The cautious types talk about 1.5 mg at bedtime (never anytime but bedtime), for ages 40 to 50, then 3 milligrams for people over age 50. I subscribe to that. Those who take a lot more I think are swimming in uncharted waters - nobody has any real data that its bad (or that its not).

Eat & sleep
If youre not sleeping well, or if youre experiencing stabbing headaches, you might try increasing your intake of foods that contain melatonin before resorting to a supplement which is available on prescription only in the UK.

Melatonin-rich foods include: bananas, cherries, ginger, tomatoes, corn, cucumber, beets and rice. And always turn off the lights - and TV - when you turn in for the night. Your bodys natural production of melatonin may be inhibited by sleeping with the lights on.