My Head Hurts! Unlock the Mystery of Migraines: How They Impact Your Vision and What You Can Do About It with Dr. Banik

December 21, 2024 01:01:00
My Head Hurts! Unlock the Mystery of Migraines: How They Impact Your Vision and What You Can Do About It with Dr. Banik
Open Your Eyes with Dr. Kerry Gelb
My Head Hurts! Unlock the Mystery of Migraines: How They Impact Your Vision and What You Can Do About It with Dr. Banik

Dec 21 2024 | 01:01:00

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Show Notes

Migraines are more than just headaches—they can be debilitating conditions with severe physical and visual symptoms. Affecting 12% of the U.S. population, migraines often bring nausea, light sensitivity, and for 20-25% of sufferers, frightening visual disturbances that resemble serious conditions like retinal detachment or stroke. These visual symptoms can occur even without the telltale headache, making them especially perplexing and worrisome. This week, Dr. Kerry Gelb is joined by Dr. Rani Banik, a renowned neuro-ophthalmologist and functional medicine expert based in New York City. Dr. Banik specializes in treating migraines and other vision-related conditions through a holistic approach. As the…
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Get up to a five thousand dollar system installed for half price as low as two thousand five hundred dollars. There's only one of these available from Merle's Water Conditioning. Go to mndeals.com and claim the offer today. That's mndeals.com a service of AM 1280. [00:05:37] Speaker D: The Patriot Good morning, I'm Dr. Kerry Gill and welcome to Wellness 1280 on Open your Eyes Radio. Please listen as we discuss the newest information in the world of health, nutrition and sports. Every Saturday morning, 6am Central Time on AM 1280 the Patriot. Also, please share your thoughts by emailing me at drkerrygobgmail.com that's D R K E R-Y-G-E-L-BMail.com and visit my new website, wellness1280.com where we have all guest links, Wellness 1280 info and previous shows. Wellness is taking over the Patriot Airways for the next hour. Sit back and enjoy my interview with Dr. Rani Banik. A migraine is a type of headache that can cause severe throbbing pain or a pulsating sensation. It is accompanied by nausea, vomiting and extreme sensitivity to light and sound. Migraines are more common in females and affect about 12% of the US population. Interestingly, approximately 20 to 25% of people with migraines experience frightening visual symptoms such as flashing lights, zigzag patterns, blurred vision or distorted vision that can mimic conditions like retinal detachment, optic neuritis or even stroke. Notably, many individuals with these symptoms may not experience accompanying headaches. Today's guest Dr. Ronnie Banik, a neuro ophthalmologist based in New York City. Dr. Banik is a functional medicine expert, author and ophthalmic surgeon with a special interest in treating headaches and migraines. Her books include Beyond Carrots and beyond leafing greens. Dr. Banik, thank you for joining me today on Open youn Eyes Radio and podcast with Dr. Kerry Gel. [00:07:30] Speaker E: Thank you so much Dr. Gelb. It's a pleasure to be here. [00:07:33] Speaker D: So people may not know what a neuro ophthalmologist is. Before you explain it, I just want to tell you from an eye doctor's point of view. You know, whether we're optometrists or ophthalmologists, when optometrist or ophthalmologists don't know what's wrong with the patient. We dump them on the neuro ophthalmologist. You're kind of like the dumping ground for the people that we don't know how to diagnose. So tell us about being a neuro ophthalmologist and having to deal with all these crazy cases. [00:07:59] Speaker E: Yeah, we are. I wouldn't call it a dumping ground. You know, we welcome our patients with open arms because they're having some issue and, you know, we haven't yet been able to find out what that issue is. So as a neurophthalmologist, you know, our goal is to try to find out, find connections between symptoms and the eye or the brain. And oftentimes it will be something in the brain that's causing these unusual symptoms. There's some connection between the eye and the brain, which is the optic nerve. So that's what we do where we act like detectives. We gather lots of evidence, we put it together and we try to come up with the culprit. What's causing this problem. We oftentimes see unusual cases. For example, sudden vision loss. That's not explained by common things or patchy vision or grainy vision. These are some complaints. The other big category of complaints that we see is double vision. We actually see quite a bit of double vision. And it's our role to figure out, okay, what's the underlying cause of the double vis, a misalignment between the eyes? Is there something else like a cataract or dry eye? What's really the underlying cause of this problem? [00:09:06] Speaker D: So many people have headaches, and headache itself isn't a specific diagnosis like a stomach ache. You know, we need to find out what's causing the headache. And there's probably over 150 causes of different headaches. How do you go about when a headache patient comes in, into your office to be able to diagnose them and put them in the right category so we can help that patient? [00:09:28] Speaker E: Well, a detailed history is key. So there are very specific questions I ask, ask the patient basic things like where is the headache? Is it in the front of the head? Is it on the side of the head? Is it one sided, Is it both sided? And then also frequency is important. How often are you getting a headache? So like if you get a headache, let's say once in a blue moon, it's probably not something more serious like migraine. But if someone's getting headaches, you know, two, three, four, five times a week, that's a little bit More concerning. And that raises a few red flags. And then the other thing that we always ask about is, you mentioned it earlier, Dr. Gel, which is, you know, what are the associated symptoms, is their associated light sensitivity or sound sensitivity or nausea or vomiting, or perhaps even some patients have tingling, which is a pretty scary symptom where they'll have tingling on one side of their face or down one arm, down their leg. So if there are symptoms like that, then that may mean that it's not just a regular headache, which many of us get, like a tension headache. It could be migraine, it could be something more serious. So that's when we really try to again, gather all the pieces of information, put them together and come up with a diagnosis. But there are specific criteria for all of these different headache syndromes, even for tension headache. There are very specific diagnostic criteria for each type of headache syndrome. And so I guess the key, what I'm saying here is not all headaches are the same. So we don't just lump them into one category. [00:10:48] Speaker D: Well, that's interesting because the international classification of headaches, they have primary headaches, secondary headaches, and cranial neuropathies. Today we're going to focus on primary headaches, headache. But if you could just tell. Tell us about the difference between primary, secondary and trigeminal neuralgia. Cranial neuropathies. [00:11:08] Speaker E: Yeah. So primary headache is when there's no definitive trigger. It just kind of comes on. A secondary headache would be, let's say someone had a brain tumor, so a different reason for the headache to happen. So there's an independent diagnosis. Or let's say somebody had brain trauma and they had concussion, they're having headaches. That falls into a different category. The primary headache syndromes tend to be tension or migraine. There's some other ones as well. Then the third category you mentioned, which are these other cranial neuropathies, the trigeminal nerve is a very important nerve. We have 12 cranial nerves altogether. The trigeminal nerve is cranial nerve number five. The reason why it's so important is because it gives us sensation to our scalp, to the covering of our brain, which is called the dura. It gives us sensation to our face, the eye socket, the cheeks, the sinuses, the jaw. So it has many different branches. And this is the nerve that gets triggered in migraine. So when actually all headache syndromes, this nerve gets triggered, it gets turned on, it gets sensitized, it gets inflamed. And that's typically what is responsible for the Pain in various different parts of the head or parts of the face. But it's that trigeminal nerve that's key. But sometimes patients don't fall into any of those traditional categories of headache. And they have pain. Let's say somebody has pain just in the eye socket, in their forehead area. It could be trigeminal neuralgia, meaning just one branch of that nerve is involved. So there's various different syndromes that can happen with the trigeminal nerve. Sometimes people have tearing or redness of the eyes or even nasal stuffiness with headaches. So they fall into very specific headache syndromes. [00:12:53] Speaker D: And migraines, being one of the primary headaches, affects about 15% of the population. And more people have migraines than diabetes, epilepsy, and asthma combined. So it's a very common problem. And I believe it's the number two cause of disability, number one in females under the age of 50. So a lot of people have it, but a lot of people are confused about the different symptoms and is it just on one side? So if you Google the different signs and symptoms, can you go over some of the signs and symptoms? Because we want to distinguish between attention headache and a migraine. [00:13:31] Speaker E: Absolutely. And that's a great question. And interestingly, I just did a video on this yesterday for social media on the diagnostic criteria for migraine. So it's a little complicated, but I'm going to try to summarize it in five different. With five different criteria. So criteria number one, there have to be at least five attacks. We need at least five episodes of this type of headache. Number two, the headache usually is about four hours to 72 hours in duration. So there's a time frame there. So if you have a headache, let's say half an hour, you drink some water, you know, take a little rest, it goes away. That's not a migraine. So it has to be that duration. Number three is that this is a little bit more complicated. Now, the nature of the headache. Migraine is typically unilateral. It has a throbbing or pounding sensation. It's usually pretty severe, moderate to severe in intensity. So it's not a mild headache. And also it's so bad that it prevents you from doing things you want to do. Let's say you're normally driving or you're working or you're reading. You don't want to do any of those activities or exercising. You don't want to do them because of the headache. And then criteria number four is that there is usually that associated other symptoms which you mentioned nausea or vomiting, light sensitivity or sound sensitivity. And then the fifth criteria is there can be no other cause for the headache. So as I mentioned earlier, if someone has a brain tumor then and they get headaches, that's not migraine. That's because of the brain tumor. If someone has meningitis, that's not a migraine. So those are the five criteria that distinguish it from tension headache, which is a lot more common as well. [00:15:03] Speaker D: You know, it's interesting because the migraine begins deep in the brainstem and the brainstem controls breathing, blood pressure, heart rate, consciousness, sleep, digestion, balance and coordination. And when we get back after the break, I want you to explain how migraines could affect all these things because it's affecting the brain brainstem. You're listening to OPEN your eyes Radio with Dr. Kerry Gelb. I'm speaking with Dr. Rani Bannack, author of Beyond Carrots, Beyond Leafy Greens. And Visit our website Dr. Dr. Rani Banik R A N I B a n I k.com we'll be right back. [00:15:38] Speaker G: I went to the eye doctor the other day with my daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming nearsighted. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones or maybe because kids now spend less time outside. My genetics probably aren't helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called MySight. This specific one day contact lens is already worn by thousands of children in the US it is proven to slow down the progression of nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting to see her have even more success in the classroom and when she plays sports. I Recommend you visit openyoureyesradio.com to find an eye doctor that specializes in this treatment program. Learn [email protected] Life takes a toll on our bodies. [00:16:40] Speaker F: No way around it. Whether it's sitting hours on end at your computer or working a physical job, over time your body pays the price. There is however an effective way to turn back the clock on pain relief factor developed by doctors Relief factor helps support your body's response to inflammation. The difference instead of masking pain relief factor helps eliminate it for good. And it's 100% drug free. If the pains that come with living a full life are affecting you, do as so many others have. Turn back the clock on pain with relief factor. Their three week quick start is just 1995. Less than a dollar a day. When you feel good, it's amazing how much more you get out of life. So visit relieffactor.com or call 1-800-4helpf that's 1-800-the number 4 relief. Try it for only 1995. While we can't stop aging, not yet, we can stop pain. Turn back the clock with relief actor. [00:17:37] Speaker G: I went to the eye doctor the other day with my daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming nearsighted. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones or maybe because kids now spend less time outside. My genetics probably aren't helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called MySite. This specific one day contact lens is already worn by thousands of children in the US it is proven to slow down the progression of nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting to see her have even more success in the classroom and when she plays sports. I Recommend you visit openyoureyesradio.com to find an eye doctor that specializes in this treatment program. Learn more at open your eyes radio.com. [00:18:37] Speaker D: We'Re back with Dr. Ronnie Bannock, author of Beyond Carrots, Beyond Leafy Greens. Go get a books, they're excellent. You're going to learn about how to prevent macular degeneration and the nutrients you need for your eyes. If you go to her website, Dr. Rani Banik R A N I B a n I k.com she also has some free ebooks to help people which talk about headaches and the best way of choosing sunglasses. So when we left the break we were talking about migraines and different, you know, telling the difference between migraines and tension headaches. But and we were talking about how it begins in the brain stem and you can get these really weird aura symptoms from the brainstem because the brainstem controls breathing. We talked about a little before blood pressure, heart rate so people could have these crazy headaches. A friend of mine who's a physician, his daughter was had, was fainting she was getting these fainting, and they had to go down to Miami to, you know, to see headache specialists and a neurologist down there. And it turned out it was a complex migraine that was. They're fainting. But if you understand what the brainstem does, then you could kind of understand why you would get these type of aura symptoms. So if you could go into that a little bit. [00:19:55] Speaker E: Sure, sure. And I want to just underscore that, yes, there are many, many symptoms that can happen with migraine. And actually, the last I counted, there were over 40 different symptoms. And what I also want to really highlight is that migraine is not just a headache. It's a neurologic condition. There are changes in the brain. There are electrical changes in the brain. There are blood vessel changes in the brain. So sometimes the blood vessels constrict. That can cause symptoms, sometimes they dilate, they can cause other symptoms. And also, obviously there are neurologic changes in the brain. So it's a neuro, vascular, electrical issue in the brain. And so with these. Some of these other symptoms, we think. And, you know, this is all. You know, it's. It's crazy to think that migraines have been around for thousands and thousands of years. It goes back in history, like very famous people in history had migraine. We still don't exactly know what's happening in the brain. We can hypothesize that when the nervous system gets activated, also our autonomic nervous system can get activated. So our sympathetic or parasympathetic balance can get thrown off. And we think that maybe because of that, patients may have certain symptoms like nausea or vomiting or loose stools, diarrhea, increased urination, sweating. And sometimes with the eye, we can see some sympathetic changes. Sometimes patients can have a change in their pupil size. Their pupil may get larger during a migraine, or sometimes the lid may become a little bit droopy. It's called ptosis. So this can all happen during migraine. And as you mentioned earlier, paralysis, which is very, very scary. You know, people can't move, they can't feel their arm or leg. Yes, that definitely needs to get worked up. But in many cases, when the workup is negative, we call that complex migraine or sometimes even hemiplegic migraine. So there are different types of migraine, but again, it's not just a simple headache. I think that's a big misconception out there, is that. And then. Oh, the other thing I wanted to mention is that some people who have migraine don't even get a headache. They may just get the visual symptoms, which I'm sure. Dr. Gel, if you've seen this, where patients come in flashing lights, we call it scintillating scotoma, where they can't see for about 15 to 30 minutes. There's all the zigzags, geometric patterns in their vision. Then it goes away, but then they never get the headache. So that can happen as well. And that's called acephalgic migraine. All these different variations of migraine. [00:22:23] Speaker D: So sometimes we have patients and they have these auras and it affects both eyes, but I've seen it only affect one eye. So when it affects just the one eye and it's a retinal migraine, does that mean the blood supply is changing going to the retina as opposed to the blood supply going to the brain? If you could explain that to our audience. [00:22:43] Speaker E: Absolutely. So I'll just back up a little bit and explain the. The bilateral phenomenon when both eyes are affected. That's called visual aura. And that's because there's a change in the back of the brain where the vision center is the occipital cortex. Usually we think that there is a blood vessel that constricts, causing lack of oxygen to that part of the brain. People start to see these flashing lights, then there are electrical changes, the blood flow is restored, and then they get the headache. But it's both sides of your vision in both. Sorry, both eyes, but the same side of your vision in both eyes. That's aura with the flashing lights. Now what you mentioned, Dr. Gelb, is when only one eye is affected. So you're absolutely sure it's one eye you cover? Okay, this eye is not normal. This eye is normal. The eye that's not normal. What we think is happening is that there's also some kind of spasm in a blood vessel in the retina. And so transiently, the retinal blood vessel goes into spasm. And so people may have. Now this is interesting too. There can be different types of symptoms. There can be a washout of vision, so everything can go totally white in some patients, or it could go totally dark or gray or pixelated. But it's one eyed. And whenever that happens, we do do a more extensive workup because we want to just make sure there's not a different reason for this happening. Yes, yes, it could be a retinal migraine, which is relatively benign, but we also want to make sure that there's not a clot that's going to the retina or to the brain. So we do a full stroke workup. It's much more involved. And as long as all the stroke workup is negative, then we can call it a retinal migraine. And interestingly, there's actually some published reports where patients were having this retinal migraine. And photographs were taken of the back of the eye. So fundus photographs were taken. Fluorescein angiography was performed. So these are tests that we typically do in the office to check the retina. And it was documented that during the episode, the retinal blood vessels are very constricted, so you can see the spasm. And as soon as the episode resolves, the blood vessels open up and they go back, back to normal size. So that's been documented in the literature, but we think it's spasm. And actually, because of that, the treatment actually works very, very well for retinal migraine because we don't have to treat for a migraine. We treat for the spasm. And some of the blood pressure medications that we normally use for blood pressure, we also use that for retinal migraine. So it's a very, very specific type of symptom, very specific type of treatment for that symptom. [00:25:08] Speaker D: You know, determining whether it's a stroke or it's a migraine. Typically with a stroke, it, you know, it is more sudden. Where a migraine is more. Is more gradual symptoms, of course, you can't always go by that, but that's, you know, where. That's kind of what I've noticed in practice. Is that a correct statement? [00:25:29] Speaker E: Yeah. So with migraine, interestingly, there are four phases of migraine. So there's. There is the prodrome, where someone may not be feeling well. Sometimes people know, okay, the weather's changing. Oftentimes barometric pressure changes are a common trigger for migraine. They may feel, okay, I'm not feeling so well, or I'm feeling a little sleepy, or I'm feeling a little nauseated. And then there's the aura phase, when people can see flashing lights, or they can get the tingling numbness, or they may even smell something. That's the ORA phase. Then there's the actual migraine phase, which is again, typically the headache, then the postdrum. So there can be a buildup. So again, the prodromal phase, the oral phase, before the headache starts. And those prodrome phases can actually last up to a few hours. It's not just instantaneous, it's building up to it. This is also really important because we have that build up to the migraine. That means that there's a window to treat it, to try to prevent it from happening. I always talk to my patients about this. As soon as you feel something happening, your body is not right, it's about to happen. You're on the edge of a migraine. You need to do your preventative strategy, whether that's supplements, whether that's taking a prescription medication, whether it's going to sleep or staying hydrated. You need to find what works for you to prevent it from becoming that full blown migraine where a stroke would. [00:26:51] Speaker D: Be more subtle, sudden. [00:26:53] Speaker E: It would be sudden and it involves some loss, loss of function. So again, not like shimmering light, but where it's black, you know, where people are not seeing or if they're having trouble with their speech or their face is droo. Very acute onset symptoms. And if it's less than an hour, it's called a TIA or transient ischemic attack. But when it's longer than an hour in duration, then it's a stroke. But if you, either way, whether you're not sure, is it migraine, is it something else? Could it be a stroke? Get it checked out, don't wait, don't sit at home. If we're even the slightest bit worried that something is happening and it doesn't feel right for your body, go immediately to the emergency department. That's my most important recommendation is don't just wait. Because you know if it is something serious, it can be treated. And time is of the essence. We have these amazing treatment treatments now for stroke, even eye stroke, we have treatments for, but you have to get to the emergency department in time for them to give you those treatments. [00:27:54] Speaker D: Explain that about tpa, because if you're not there within three hours, you're not going to be able to use tpa. Three or four hours. Explain that why it's so important. If you think you're having a stroke, you got to go to a place where they have tpa. [00:28:06] Speaker E: Yeah. So TPA is tissue plasminogen activator. It's basically a clot busting drug. And if you're having an acute stroke, again, if you get to the ER in time, they do the workup, they do a CAT scan to confirm that there's a stroke there. They call in their teams, there are people on call who can do this. They take you into the procedure room, they inject tpa. Usually it's intravenous and to try to break up a clot that could be causing the stroke. The window Now, I'm not completely up to date on, you know, there are different criteria for, for the window. For some it could be three hours. For others it could be six hours. For eye stroke, depending on where you go. In some cases, we may give it up to even 12 hours after the symptoms have started. So either way, just try to get to the doctor as, or the emergency department as fast as you can. Not your eye doctor's office. You need to go to the emergency department. [00:28:59] Speaker D: Is there any benefit to chewing an aspirin? [00:29:02] Speaker E: I wish, I wish we knew. We don't. That's a great. I mean, I, there's, I don't think, actually, I take that back. Because if it's a hemorrhagic stroke, so there's two types of strokes. There's. There are ischemic strokes and then there are hemorrhagic strokes. And if you take, take an aspirin, it may increase your risk of hemorrhage. So maybe hold off on that. But definitely, you know, if you've missed your blood pressure medications, take those, take your normal meds, try to get to the ER as soon as possible. [00:29:29] Speaker D: Thank you for that. So I want to go back to the headache and pain. There aren't pain receptors in the brain, but on the blood vessels. So where are the, where's the pain coming from? When somebody gets the headache in a migraine, when, after the constriction we get the dial, the blood vessel dilates and that's when some people get the headache. Not everybody gets a headache, but when some people get there, where are the pain receptors coming from? Is it just the blood vessels or are there other places? [00:29:57] Speaker E: So the trigeminal nerve is what's involved here. And the trigeminal nerve goes to the covering of the brain, which is called the dura. So whenever the blood vessels dilate, if there's inflammation of the blood vessels, the dura then pick up those chemicals that are released, these inflammatory chemicals that are released, these pain modulators that are released. The dura gets inflamed, the trigeminal nerve gets inflamed. And that's why we feel pain. [00:30:21] Speaker D: We're up against the brain. [00:30:22] Speaker E: If we had a trigeminal nerve, we wouldn't feel pain. [00:30:25] Speaker D: We're up against the break. I'm talking with Dr. Rani Banik, her books Beyond Carrots, her website, Beyond Leafy greens, our website, Dr. Ranny Bannock dot com. We'll be back after the break. [00:30:37] Speaker G: I went to the eye doctor the other day with My daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming nearsighted. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones. Or maybe because kids now spend less time outside. My genetics probably aren't helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called My Sight. This specific one day contact lens is already worn by thousands of children in the US. It is proven to slow down the progression of of nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting to see her have even more success in the classroom and when she plays sports. I Recommend you visit openyourizeradio.com to find an eye doctor that specializes in this treatment program. Learn [email protected]. [00:31:42] Speaker E: How does the baby move in your tummy? How does the baby eat? Can the baby hear me? [00:31:47] Speaker D: How did the baby get in there? [00:31:49] Speaker I: Wow. [00:31:50] Speaker E: A pregnancy can sure generate a lot of questions. But what's important is that a baby is a baby inside and out of the womb. Not just after birth but nine months before at conception. [00:32:02] Speaker I: That's right. Every baby is a miracle. Hello, my name is Marianne Koharsky. I'm the director of Pro Life Across America. If you know someone who is pregnant or in need of alternatives or assistance or would like to support the work of Pro Life Across America, please visit our [email protected] or better yet simply dial 250 on your cell phone and say the key word Pro Life. Pro Life Across America is non political and totally educational. [00:32:28] Speaker E: A baby's heart is beating 18 days from concept. [00:32:37] Speaker G: I went to the eye doctor the other day with my daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming nearsighted. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones. Or maybe because kids now spend less time outside. My genetics probably aren't healthy helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called MySight. This specific one day contact lens is already worn by thousands of children in the us. It is proven to slow down the progression of Nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting to see her have even more success in the classroom and when she plays sports. I Recommend you visit openyoureyesradio.com to find an eye doctor that specializes in this treatment program. Learn [email protected] we're back with Dr. Rani Banik. [00:33:40] Speaker D: Her books Beyond Carrots, Beyond Leafy Greens. Her website, drama. R A N I B A N I K. She also has an Instagram. Dr. Rani Banik, R A N I B A B A N I K. Go to her website and she has some free books to help people with headaches and choosing sunglasses. So before the break, we were talking about pain. Some people get the pain after the constriction. Some people don't. Some people get the aura, some people don't. Why do some people get the aura? Why do some people don't? Why do some people get the pain? Why do some people don't? Well, we have no idea. [00:34:17] Speaker E: We have no idea. I wish I could tell you otherwise, but, you know, migraine is very personal. Every single person has their own set of symptoms. And even though it may run in families, it's actually very commonly run, you know, runs in families. No two people are alike. So your migraine could be very different from your sister's migraine or your mother's migraine or your cousin's migraine. And maybe it's because, you know, there are different triggers for different people. There are many genes also that are associated with migraine. There are over 50 different genes that have been associated with migraine. And each of these genes has its own role. We don't quite understand what the role is for most of them, but some of them have to do with pain modulation. Some of them have to do with electrolyte channels in our cell membranes. I wish we knew, but we don't. But I would say do a little detective work. If you have a tendency towards migraine, try to keep a diary and figure out, okay, what is it that may have triggered your symptoms and what may cause you to have a more severe migraine one day and a less severe migraine another day? Is it something you ate? Is it, for example, fermented foods? Is it msg, which is a common additive in foods? Is it dehydration? Is it stress? Is it lack of sleep? Is it too much caffeine? Is it too little caffeine? Figure out what your personal triggers are. That way you can Control your migraine much better. You have a little bit more control over it. [00:35:45] Speaker D: Yeah, I want to go deep into the triggers, but before I do that, something very important. If someone is taking birth control pills and they have auras, they have a six times greater risk of having a stroke. So what kind of advice do you give people who have auras and have migraines and also are taking a birth control pill because of the stroke risk? [00:36:08] Speaker E: Yeah, so that stroke risk is much more significant if someone smokes as well. So definitely if someone's on birth control pills, I would advise smoking cessation. That's number one. The other thing is there are certain medications, certain classes of medications used for migraine which are not safe in people who are at risk for stroke. So talk to your doctor. If you do need to have a prescription medication and you're on birth control pills, talk to them about which medication class is best for you. So that's my major advice with that. [00:36:44] Speaker D: So people that have light sensitivity and have migraines are these special glasses called fluorescein 41 or FL41 that block the blue light between little green 480 to 520 nanometers. Tell me if you've had success with those type of filtering glasses. [00:37:03] Speaker E: I have. And actually those glasses are, to my knowledge, the only scientifically proven glasses to help with migraine. There are some variations on the tints. You know, there are different ranges that have been tried, but I have found that first of all, they're this. They have a very unique tint. So if you look at them, they're kind of like this rose color tint. So you're looking through the world with rose color glasses, but they definitely cut the light sensitivity, whether it's sunlight or indoor fluorescence or even like blue light coming from your screen, they can help with that. And there are different companies that make them, but just make sure that you're getting that tint. FL41. Now, there are also some companies do sell medical grade contact lenses with this tint in them. So if you're really very, very, very light sensitive, I have had success with these specially tinted contact lenses for my migraine patients. But that's something again, that you really have to have a long discussion with your doctor about, because let's say you wear, you know, this FL41 tint, your eye color will look different. It will look like you have kind of like a reddish, purplish kind of an eye. So, and of course, you need to be, be, you know, careful with contact lens hygiene and all of that. So it's an option. It's not my favorite option, but it's an option. And what I found to be most helpful for light sensitivity is actually nutrition. We know that in our macula, in the back of the eye and the retina, we have these nutrients called the macular carotenoids lutein and zeaxanthin. And these two nutrients can help fight against macular degeneration. They're powerful antioxidants. There is also some research to show that they help with light sensitivity and blue light, if you are light sensitive, whether you have migraine or not, if you're light sensitive, then maybe consider increasing your intake of these nutrients and even taking a supplement for at least three months to see if things get better. Better. So that's why I always recommend to patients diet and supplementation first. See how that goes. [00:39:08] Speaker D: Excellent advice. Thank you for that. So let's go back to what the cause of migraines triggers. I always find that tyramine. Foods with tyramine tend to be one of the biggest triggers, especially if they're eating cheap American cheese. You know, those yellow American cheese. They come in with a migraine and I start asking, what'd you eat today? Typically it's from not today, but it's from the day before. And talk about again about the triggers. Would you find you're a headache expert. People come to you from all over the world about migraines. What do you find as the biggest triggers? I find foods with tyramine. But how about you? [00:39:44] Speaker E: I would kind of take a step back and say hydration status is probably across the board. What I found to be the biggest trigger for migraine, when people are dehydrated, they're just simply not drinking enough or if they've done like a really intense workout. I have some patients who love to go to the gym. They do their training, they do hiit training, cardio workouts, and they think they're doing great for, you know, great things for their body. But they're not drinking enough, they're not getting enough electrolytes and boom, they'll get their visual aura of migraine and then they'll get a full blown migraine attack. So hydration with electrolytes is really, really important in terms of food triggers. Yes. Tyramine, which is a compound found in many foods. [00:40:26] Speaker D: But what foods are tyramines in? If you could mention a couple. [00:40:31] Speaker E: So you mentioned cheese, other fermented foods. I'm just thinking like beer, wine, avocados have it. Yeah. [00:40:42] Speaker D: Canned figs have it. So that have tyramine. But I noticed usually it's, it can. [00:40:47] Speaker E: Be used as a preservative as well. So that's why it's added to some foods. But those foods, msg, which I mentioned earlier, which is monosodium glutamate, which is a big preservative found in a lot of like Asian foods. And then different people have different sensitivities. Like for example, some people are very sensitive to histamines in foods. So if they have like strawberries or bananas, then they'll develop a migraine. Some people, it's not necessarily the food, but it's their blood sugar that's the issue. So if their blood sugar tends to be more on the low side, then they may have a migraine. So you, again, you have to do a little detective work to figure out, okay, what is it? [00:41:26] Speaker I: It. [00:41:26] Speaker E: And you're exactly right, Dr. Gel, like think about, not just right before your headache started, think about going back the day before. What was it that you had or had along the course of the past 24 hours or 36 hours that may have triggered your migraine? Red wine is another one, unfortunately. You know, we always kind of associate red wine with good health. But some of the tannins in red wine or the nitrates can, or sulfites also can trigger migraine in many people. So try to stay away from darker wines. If you're prone to migraine, maybe switch to whiter types of wines. [00:42:00] Speaker D: How about gluten? [00:42:01] Speaker E: That's a great question. This is really controversial amongst the headache community of providers who treat headache. A lot of them just don't believe it that gluten is a big culprit. I think that gluten, we know, it's been well documented that it can lead to gut issues, it can lead to leaky gut, increased intestinal permeability, which may potentially let in more triggers into your body and then it triggers inflammation. We don't know. But what I would say is if someone has really chronic migraine, and chronic migraine is defined as migraine more than 15 days a month. If someone has chronic migraine, you really should do a trial of gluten free and also dairy free, because these are two very pro inflammatory foods that are associated with other kinds of inflammatory conditions, specifically autoimmune conditions. So try a couple of months being gluten free and dairy free and see if that helps you. [00:42:56] Speaker D: Because I've seen people that that from gluten or breads and pastas, they stop that and their Migraines have gotten better. Same like you mentioned, nitrates like deli meat, bacon, hot dogs, pepper, those kind of meats that have nitrates. And I've seen problems. How about chocolate? How about chocolate? People love chocolate. Chocolate goes, I guess, with caffeine, with coffee. Talk to us about that. [00:43:21] Speaker E: So caffeine is really a double edged sword when it comes to migraine. It depends on what your baseline caffeine intake is. Let's say you have very little caffeine, almost no caffeine in your diet, then you can use it therapeutically to get rid of a migraine. Because what caffeine does is it works on adenosine receptors on those blood vessels in the brain and it helps to normalize the blood vessel rather than for it to constrict and dilate. It helps it to stabilize. So yes, you can use caffeine as therapy. And a lot of people, they actually love Coca Cola as a treatment for their migraine because they start to get a migraine, they have one Coke and boom, it knocks it out. So that can be effective. But on the other end of the spectrum, if you have a lot of caffeine in your diet, let's say you're drinking like four, five, six cups a day of coffee and then other caffeinated beverages, that is probably going to dull your body's response to those adenosine receptors and the caffeine's response on those receptors. So you just need more and more and more caffeine to get the same effect. So if that's the case, your increased caffeine intake could be propagating your migraine. And so you should really think about cutting it down. You don't want to suddenly cut it out. Your body's not going to like that. You're going to go through caffeine withdrawal. So just what I typically recommend is if you normally have a lot of caffeine, cut it down by half a cup a week. So let's say you're at six cups a day, go down to five and a half for a week, and then five and so forth and get down to, you don't have to cut it out completely, but get down to one to two cups maximum per day rather than your six cups a day. Now chocolate has a little bit of caffeine in and so we think that actually a lot of people, so before the migraine starts, some people get cravings and a lot of people crave chocolate for whatever reason. Maybe it adds the smell, maybe it has the caffeine. I don't know cocoa, the antioxidants. I'm not sure why people crave chocolate, but so there's been this myth that's associated chocolate with migraine because the Breaker. [00:45:23] Speaker D: Chocolate I Love Chocolate booklet. We're talking with Rani Banik. Her books Beyond Carrots Beyond Leafy Greens. Go get her books. Her website is drrannybanek.com we'll be back after the break. This is Dr. Kerry Gel for OPEN YOUR EYES Radio. [00:45:37] Speaker G: I went to the eye doctor the other day with my daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming nearsighted. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones or maybe because kids now spend less time outside. My genetics probably aren't helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called My Sight. This specific one day contact lens is already worn by thousands of children in the US it is proven to slow down the the progression of nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting to see her have even more success in the classroom and when she plays sports. I Recommend you visit openyourizedradio.com to find an eye doctor that specializes in this treatment program. Learn [email protected] you want to feel important. [00:46:39] Speaker H: You want to be part of something bigger, something that matters and that you can help change things. You want to feel like you belong. We felt that way too. I'm Sergeant First Class Daphne Pierre from Robbinsdale, Minnesota and that's why we did something about it. We aren't just Minnesota Army National Guard soldiers. We are people just like you and together we can make a difference. Take on your legacy. Visit nationalguard.commn to find out more. Sponsored by the Minnesota Army National Guard Aired by the Minnesota Broadcasters Association Location in this station. [00:47:07] Speaker I: You've heard of Heritage Christian Academy, but why do parents rave about this school using words like amazing, excellent, biblically immersive education, experienced, Blessed. Discover for yourself on Tuesday, January 14 at 7 for a future family info night. Tour the Pre K through 12 campus from classrooms to the sports fields. Visit with staff and leadership to answer questions and experience your students day. Come follow find out why Heritage Christian Academy for more information search Heritage Christian. [00:47:36] Speaker G: Academy Maple Grove I went to the eye doctor the other day with my daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming nearsighted. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones or maybe because kids now spend less time time outside. My genetics probably aren't helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called My Sight. This specific one day contact lens is already worn by thousands of children in the US it is proven to slow down the progression of nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting. Exciting to see her have even more success in the classroom and when she plays sports. I Recommend you visit openyoureyesradio.com to find an eye doctor that specializes in this treatment program. Learn [email protected] we're back. [00:48:38] Speaker D: This is Dr. Kerry Gel. We're back with Dr. Rani Banik. We're talking about chocolate. Tell me about chocolate. Let's finish. [00:48:44] Speaker E: So chocolate has a lot of great things in it. It has cocoa, it has antioxidants, it's got a little bit of caffeine. So many people crave chocolate before their migraine starts. And so because of that craving chocolate has been thought to be a trigger for migraine. But actually there's no hard evidence to show that it's really a trigger. So go ahead and have your chocolate but just in moderation. You know, don't eat like a huge chocolate bar. You can have like one or two squares, preferably dark chocolate. Don't go crazy on the chocolate, but you don't necessarily need to cut it. I know a lot of people are so relieved when they hear that. Like ah, thank goodness I don't have to cut out my chocolate. [00:49:19] Speaker D: So we're going to talk about the treatment now. A functional medicine kind of treatment. But let me just, let me just add that stress could cause migraines, poor sleep, musc, muscular skeletal issues, menstrual cycle, menopause. There's certain toxins such as personal hygiene products. We talked about caffeine. So let's talk about treatment. First things, essential oils. Can that help us with migraines? And what kind do you like? If it does? [00:49:49] Speaker E: Yes, that's it. That's a great point, Dr. Gel. Like I always love to start with natural things first. Natural strategies first and Essential oils are wonderful. Some of them have very calming properties, anti inflammatory properties. So my favorites are a combination of peppermint, lavender and frankincense. And what I do is actually make my own oil at home. I combine them together very, very dilute, like 5%. And then you add a carrier oil. And then you can put in a little rollerball bottle. You can put it in your forehead. Don't get it in your eye because it will really sting if you accidentally get in your eye. So put it here, put at the base of your neck. Some people like to put it on their soles of their feet when they're sleeping. It's very calming. Now, some people, they don't like essential oils if they have migraine because they're very, very sensitive to smells, like strong smells particularly. So that may not be a for them other than topical application. You can also have it in a diffuser in your home or for really bad migraine attacks. If people can tolerate the smell. What I do is I have them put in a diffuser, I have them put their head like a towel over their head and then breathe it in directly for about two or three minutes. And that gets directly through the olfactory nerves into the brain and again calms things down. And there's actually research to show that essential oils are helpful for migraine. [00:51:07] Speaker D: We talked a little bit about the FL41 glasses. I heard you talk about getting a migraine and rubbing on the trigeminal nerve. And that actually helps. Can you talk a little bit about that? [00:51:19] Speaker E: Yes. So there are different branches of the trigeminal nerve that are in the eye socket right above your brow. There's a supratrochlear branch and then the supraorbital branch and then the infratrochlear branch, which is right here. And oftentimes in migraine, people will feel like a very focal pain right in those areas. So what I recommend is it's called acupressure. You can do yourself. You don't need to go to an acupuncturist for this. You take your fingers and you put a lot of pressure, as much as you can take basically without doing any harm, obviously. But you want to put a lot of pressure there for about 10 seconds at one location, then you move on to the next location, which is right here, 10 seconds, and then you let go and then you do the third location. Oftentimes that pressure kind of breaks the circuit of pain. And it can sometimes, in some cases just, just knock out the migraine like, relieve the migraine, but sometimes you have to do a few cycles of this. But definitely, like, try it if you're. Again, if you're in the midst of an attack, it's really, really severe. You don't have your medications with you. You don't have, you know, anything else that can help you try the acupressure because it can really, really make a big difference. [00:52:27] Speaker D: Tell me about supplements. Let's start off with magnesium. [00:52:30] Speaker E: So, yeah, so magnesium for migraine has a lot of research behind it. It's probably the most researched for migraine of all the various various nutrients and magnesium, it has many different roles in the body, but what we think it does in migraine is that it helps to relax both the nerves and the muscles in the body, so it releases tension. And the magnesium that was used in most studies was magnesium oxide. Now, there are many different types of magnesium out there on the market, but magnesium oxide at a dose of 400 milligrams a day. Now, what I found, yes, it did work. It helped to reduce the frequency and severity of migraine. So most headaches, special specialists, you start with magnesium. What I found is that, you know, with my own experience and doing my own research into all of this, is that magnesium oxide can have a lot of side effects because it's a magnesium salt, meaning that the magnesium molecule is down to the oxide is oxygen. It's a salt form. It causes GI issues like cramping in the stomach and even diarrhea. So I found that chelated forms of magnesium are better for migraine. Chelated means that the magnesium is bound to an amino acid acid or some other type of acid. So, for example, magnesium glycinate is a chelated form of magnesium or magnesium threonate or magnesium malate. And these chelated forms can actually get into the brain better than the salt form. So there's another reason to do that. So whenever someone is migraine, I try to steer them away from oxide, which is, again, what most literature says, to use the oxide form towards a chelated form. And that's actually what I have in my own supplement brand in my supplement for migraine Calm, I have magnesium malate for that reason. So that's the first thing. But then also, there are many other nutrients that have been studied for migraine. Riboflavin is one of them. Riboflavin is vitamin B2. It's very important for energy production by our mitochondria. And there are studies to show that people with migraine have vitamin 2 deficiency. I actually did my own testing. I tested all my own micronutrients when I was. I have migraine by the way, and I was trying to figure out what's the root cause of my migraine. And I had a magnesium deficiency as well as a riboflavin deficiency. And supplementation helps. Of course, you can do it with diet as well. Same for magnesium. You can eat foods rich in magnesium. But if you're having really bad migraine, maybe it's time to take a supplement. So magnesium riboflavin are my two go tos and that's also included in my supplement. [00:54:58] Speaker D: Calm. [00:55:01] Speaker E: Curcumin. Yes. Which is anti inflammatory. It has many health benefits. Benefits. And then also feverfew, which is a. It's a natural compound, it's a botanical and it's related to aspirin. So it's not exactly aspirin, but it's related to aspirin. So it calms down inflammation and helps with pain. [00:55:21] Speaker D: Rosemary? [00:55:22] Speaker E: Yes. And rosemary is great for brain health. And there are some studies to show that rosemary, I believe it's rosemarinic acid is the active ingredient in rosemary. So it helps to. It helps with cognition. There's actually a lot of research behind that with rosemary and cognition. But it's also been shown to help with migraine. So that's why I have that combination of those ingredients in CALM and omega 3s. [00:55:48] Speaker D: And how about COL210? [00:55:51] Speaker E: So there is actually research with omega 3s. A lot of people who have migraine have an imbalance in their omegas. They have too many omega 6s, not enough omega 3s. And so supplementation diet first and then supplementation with omega 3s can be helpful. Helpful in terms of CoQ10. It has been researched. But going to the biochemistry of CoQ10, this is again based off of my own diving into the, into the biochemistry of all this Coq 10. It's naturally made by our bodies and it's important for mitochondrial energy production. Very important. And it is low in migraine in people who are predisposed to migraine. The problem with CoQ10 is if you take it as a supplement over the counter donor, it's a very long molecule, it has over 20 carbons in its chain and it doesn't get absorbed very well. So you can take a ton of CoQ10, yet it may not be getting to where it needs to get go into the brain. And so that's my kind of hesitation. [00:56:47] Speaker D: With CoQ10, ubiquinol, the reduced form is the same. [00:56:51] Speaker E: So I know A lot of people use the reduced form. That's a shorter version of it. So absolutely, you can do that. That. I have another version I also like. It's called Mito Q. It comes, it's made by a company in New Zealand and that's a much 8 to 10 carbon long derivative of CoQ10. [00:57:10] Speaker D: We have about two minutes left. I want to talk about the elimination diet. Now we eliminate things and see if we feel better not getting the migraines. Are there any tests that we could do? Like does Genova have a test, a neutral value to tell us so we don't have to do elimination? Is there a way elimination diet? Is there another way? [00:57:32] Speaker E: So sometimes what I do is I do food sensitivity testing in my patients with migraine. I do a lot of testing, micronutrient testing. Sometimes I'll do stool samples looking for gut dysbiosis, but oftentimes I'll do a food sensitivity test looking for IGG as well as iga. And so with igg it basically means that your body's creating an immuno response to a particular food in the food and that will really give you a lot of insights into which foods your body may be reacting to. So if you're going to do an elimination diet, you want to specifically eliminate those types of foods. Now there's a general elimination diet also. You can do that without testing, which is basically you're eliminating gluten and dairy, sometimes even nightshades from your diet. Definitely processed foods, you can do that as well without testing. You can do it. Some people say three weeks, but I say three months. Months, because the antibodies last for three weeks. But the blood cells that make them, the white blood cells that make the antibiotic, the antibodies, they live for three months. So you want all those antibody producing cells to kind of die out and to reset your immune system. So do it for three months if you can, and then slowly try to reintroduce foods. [00:58:46] Speaker D: Well, we have to end it there. I want to thank Dr. Rani Ban, Neuro ophthalmologist, for joining me today. People want to find out more about you. How can they do it? [00:58:55] Speaker E: My website's the best way. So as you mentioned earlier, Dr. Ronnie bannock.com I also do a lot of social media, so I have an Instagram account, Dr. Rodney Bannock, I have a YouTube channel and I just started a podcast as well. It's called the IQ Podcast. And Dr. Gel, I'd love to have you come on as a guest one day. [00:59:13] Speaker D: I'd love to come on Yes, I. [00:59:15] Speaker E: Share all kinds of insights into eye health and brain health. [00:59:18] Speaker D: I want to thank Dr. Bannock for being my guest. Until next week, this is Dr. Kerry Gel for Open youn Eyes radio and podcast. We'll be back with you next week. [00:59:27] Speaker E: Crystal Women's Clinic has been empowering women and protecting life in the twin cities since 1992. Today, powerful pro abortion voices are proclaiming their views more boldly than ever before. We need your support to help expecting moms and their babies. Please go to supportlife.org and give today. [00:59:42] Speaker B: What would you buy today if it was half price? Go to mmdeals.com click on the red Tell us what you want button and we'll try to find it for you. You at half price mndeals.com works with local businesses to offer great deals for Patriot listeners like you. We've sold pellet grills, water systems, furnaces, hot tubs, balloon rides, and more. What would you buy today if it was half price? Go to mndeals.com and let us know. While you're there, read the reviews and check out the current deals. MnDeals.com is a service of AM 1280 the Patriot. With the vast majority of media today leaning hard left, it can be tricky to find news that actually shares, let alone defends, a conservative viewpoint. HotAir.com provides analysis and commentary from conservative writers like Ed Morrissey. HotAir.com AM 1280 the Patriot with so. [01:00:30] Speaker F: Many options, why choose Arizona State University? [01:00:32] Speaker I: For me, the only online option was. [01:00:34] Speaker E: ASU because of the quality. Their faculty was really involved with their students and care about your personal journey. [01:00:41] Speaker I: The dedication to my personal development from. [01:00:44] Speaker E: My professors, that's been extremely valuable to me. [01:00:47] Speaker F: Earn your degree from the nation's most innovative university online. That's a degree better. Explore more than 300 undergraduate, graduate and certificate programs at ASUonline. ASU edu.

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