We’ve all had headaches. Some more than others, I suspect. I woke up the other morning with a pounding headache, as a matter of fact. Having a headache is definitely not the way to start your day. Perhaps not surprisingly, people who have diabetes can certainly get headaches, and apart from the “usual” culprits, these headaches can stem from fluctuations in blood sugar. There are ways to treat and manage them, however. Read on to learn more.
What is a headache anyway?
Simply put, a headache is a pain that occurs in any part of the head — on the side, in the front, or in the back. The type of headache pain can vary widely, from sharp, to dull, to throbbing. And the frequency of pain may be different — the pain may come on all of a sudden, or more gradually, and it can last an hour or last days.
Types of headaches
A headache is a headache, right? Not exactly. There are two main forms of headaches: primary and secondary. A primary headache is due to a problem with or overactivity of pain structures in the head, such as blood vessels, nerves, or muscles. Examples of primary headaches include:
• Cluster headaches
• Tension headaches
Secondary headaches occur as a symptom of a disease or condition, such as:
• Blood clot
• Brain aneurysm
• Brain freeze (also known as “ice cream headache”)
• Brain tumor
• Carbon monoxide poisoning
• Ear infection
• Sinus infection
• Monosodium glutamate (MSG)
• Panic attacks
• Changes in hormones
Why might diabetes cause headaches?
Having diabetes doesn’t necessarily mean that you’ll automatically have headaches. However, diabetes headaches tend to occur due to changes in blood sugar levels. The more “up and down” your blood sugars are, the more likely you may get a headache.
High blood sugar (hyperglycemia): High blood sugar is generally defined as a blood sugar of 180 mg/dl or higher. You may not know that your blood sugar is high, and symptoms of highs can develop over time. However, a headache is often an early sign of high blood sugar. This headache may develop gradually and become more severe as blood sugars rise.
Low blood sugar (hypoglycemia): Low blood sugar is a blood sugar below 70 mg/dl. Symptoms of lows tend to be much more apparent, or noticeable, than symptoms of highs. Along with feeling shaky, dizzy, hungry, anxious, or confused, a headache can suddenly appear, seemingly out of nowhere.
It’s likely that fluctuations in blood sugar trigger headaches due to the response of blood vessels in the brain as a result of other hormones, such as epinephrine and norepinephrine. In other words, those blood sugar ups and downs trigger headaches stemming from hormone changes. If you’ve noticed that headaches come hand-in-hand with high and/or low blood sugars, make sure you check your blood sugars often enough that you can quickly treat the situation and prevent the headache. In the case of lows, promptly treat the low blood sugar, starting with 15 grams of fast-acting carbohydrate (for example, 4 ounces of juice, 4 glucose tablets, or 8 ounces of skim milk).
There are a number of ways to treat headaches, and treatment depends, in part, on the type of headache that you have.
Medication: Some headaches respond well to over-the-counter remedies, including aspirin, acetaminophen, and ibuprofen. More potent, prescription medications include triptans (a type of medication that blocks pain pathways in the brain), ergot alkaloids, narcotics, beta blockers, and antidepressants. Some of these medications are also used to prevent headaches, such as migraines, from occurring.
Natural remedies: Rubbing natural oils, such as thyme, rosemary, or peppermint oil on your temples and forehead may be helpful. Taking 400 milligrams of magnesium daily has been shown to help prevent headache (watch out for side effects, though, which include diarrhea). Butterbur extract can provide migraine relief, too, although there are safety concerns about this product. And try sipping on a cup of ginger or chamomile tea for relief. Note: Always check with your health-care provider before taking or using supplements or natural remedies.
Stress reduction: Meditation, relaxation training, yoga, acupuncture, biofeedback, massage, and heat therapy can all be helpful with headache relief. Even cognitive behavioral therapy can be beneficial.
Dietary changes: Certain foods and beverages can be headache triggers. Common culprits include:
• Red wine
• Aged cheeses
• Citrus fruits
It may be apparent which foods or drinks set off that headache, but in other instances, you may not know. The best way to pinpoint the trigger food(s) is to keep a food diary, noting what and when you ate, as well as the onset and severity of your headache.
Of course, if blood sugar changes trigger headaches for you, work on getting and keeping your blood sugars in your target range. That will likely mean working with your health-care team to manage your eating plan, physical activity, and/or diabetes medications. If you do experience headaches on a frequent basis, don’t suffer: Talk with your doctor to find out the type of headache that you have, as well as the best type of treatment for you.
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Amy Campbell: Amy Campbell is the author of Staying Healthy with Diabetes: Nutrition and Meal Planning and a frequent contributor to Diabetes Self-Management and Diabetes & You. She has co-authored several books, including the The Joslin Guide to Diabetes and the American Diabetes Association’s 16 Myths of a “Diabetic Diet,” for which she received a Will Solimene Award of Excellence in Medical Communication and a National Health Information Award in 2000. Amy also developed menus for Fit Not Fat at Forty Plus and co-authored Eat Carbs, Lose Weight with fitness expert Denise Austin. Amy earned a bachelor’s degree in nutrition from Simmons College and a master’s degree in nutrition education from Boston University. In addition to being a Registered Dietitian, she is a Certified Diabetes Educator and a member of the American Dietetic Association, the American Diabetes Association, and the American Association of Diabetes Educators. Amy was formerly a Diabetes and Nutrition Educator at Joslin Diabetes Center, where she was responsible for the development, implementation, and evaluation of disease management programs, including clinical guideline and educational material development, and the development, testing, and implementation of disease management applications. She is currently the Director of Clinical Education Content Development and Training at Good Measures. Amy has developed and conducted training sessions for various disease and case management programs and is a frequent presenter at disease management events.
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