In my earlier posts on migraines, I found this herb, butterbur (Petasites hybridus), listed in traditional treatments for migraines. Working with the assumption that most migraines are results of bacterial shifts, then this would likely be an antibacterial.

For Migraines

• “Petasites hybridus, has emerged as a promising treatment. “[2014]
• “11 prophylactic drugs received a strong recommendation for use (topiramate, propranolol, nadolol, metoprolol, amitriptyline, gabapentin, candesartan, butterbur, riboflavin, coenzyme Q10, and magnesium citrate)[2012]
  • Bold items are common for CFS

Impact on Bacteria

• “exhibited significant antibacterial activity against B. subtilis. [but not against Escherichia coli, Staphylococcus aureus]” [2005]

That is it! Very little research on the mechanism of action.

Depression in CFS is different than conventional depression.

• “Abnormal cerebral perfusion patterns in CFS subjects who are not depressed are similar but not identical to those in patients withdepressive illness…Depressed patients differed from those with CFS in having relatively less perfusion of the left prefrontal cortex.” [2000]
• “Asymmetry (R > L) of tracer uptake at parietotemporal level is demonstrated in CFS as compared with Major Depression.” [1996]

In 1999, while reading up on antibiotic protocols for Chronic Fatigue Syndrome, I came across the reports of Dr. Philip Bottero, MD, who was doing a protocol of multiple rotating antibiotics very similar to Dr. Cecile Jadin, MD. The unusual thing was he was treating patients with psychopathies and obtaining a high rate of remission (Clinique de la Résidence du Parc, 1986) and “Chronic psychopathologies associated with persistent rickettsia and/or similar germs (chlamydiae)” Acta Mediterranea di Patologia Infettiva e Tropicale, 1987) – “For 60 cases of diseases that are called “Psychic” associated with persistent rickettsiae; we have: 55 good and excellent result, 5 failure,”

This caused me to suspect many psychological disturbances were the results of bacteria — more recently, gut bacteria. But what does PubMed says?

• “several medications (pioglitazone, metformin, exenatide, atorvastatin, gram-negative antibiotics), which have traditionally been used to treat metabolic disorders showed a certain potential to treat depression in first randomized controlled clinical trials.” [2015]
• “L. rhamnosus (JB-1) …these findings highlight the important role of bacteria in the bidirectional communication of the gut-brain axis and suggest that certain organisms may prove to be useful therapeutic adjuncts in stress-related disorders such as anxiety and depression” [2011]
• “The concept that intestinal microbial composition not only affects the health of the gut, but also influences centrally-mediated systems involved in mood, is supported by a growing body of literature…. Bifidobacterium infantis…Probiotic treatment resulted in normalization of the immune response, , and restoration of basal NA concentrations in the brainstem.[2010]
• “B. infantis ….provides encouraging evidence in support of the proposition that this probiotic may possess antidepressant properties” [2008]
• “39 CFS patients were randomized to receive either 24 billion colony forming units of Lactobacillus casei strain Shirota (LcS) [Yakult] or a placebo daily for two months…. also a significant decrease in anxiety symptoms among those taking the probiotic [2009]
• “a multispecies probiotic containing Bifidobacterium bifidum W23, Bifidobacterium lactis W52, Lactobacillus acidophilus W37, Lactobacillus brevis W63, Lactobacillus casei W56, Lactobacillus salivarius W24, and Lactococcus lactis (W19 and W58)  …. provide the first evidence that the intake of probiotics may help reduce negative thoughts associated with sad mood.[2015] Note: This is a Ecologic probiotic and should be available in Europe (soon)!
• “we compared the effects of two different Bifidobacteria on anxiety and depression-like behavior; an antidepressant was also used as a comparator…  whereas B. longum 1714 induced antidepressant-like behavior in the tail suspension test.” [2014] [PDF-2015]
  • “these data suggest that B. longum 1714 had a positive impact on cognition and also that the effects of individual Bifidobacteria strains do not generalise across the species. ” [2015] i.e. not any B.Longum will have this effect.

In my last post I had discovered the migraine –> CFS pathway: Increased risk of chronic fatigue syndrome in patients with migraine: A retrospective cohort study [Oct 2015]. This suggests that migraines may be an indicator of the start of a dysfunction leading to CFS in some patients, see “evidence linking the migraine brain to various GI disorders” [What the Gut Can Teach Us About Migraine Jul 2015] and an even older study Migraine of gastrointestinal origin[1995].

In this post, I am going to attempt to drill into this because many CFSers suffers from migraines (just like they suffer from POTS and IBS very often).

• “Several studies demonstrated significant associations between migraine and celiac disease, inflammatory bowel disease, and IBS.” [2014]
• “probiotics [Ecologic(®)Barrier, 2.5×10(9) cfu/g] may decrease migraine supporting a possible role for the intestine in migraine management. Feasibility and lack of adverse reactions justify further placebo-controlled studies” [Oct 2015]

  • Bifidobacterium bifidum W23, Bifidobacterium lactis W52, Lactobacillus acidophilus W37, Lactobacillus brevis W63, L. casei W56, Lactobacillus salivarius W24, and Lactococcus lactis (W19 and W58).

• “a trend of more frequent H. pylori infections in patients with migraine” [2014]
• “it has been documented that at 6 and 12 months, bacterial eradication [of H. Pylori] is associated to disappearance of symptoms in 23% and 28% of cases, and to a significant decrease of intensity, frequency and duration of acute attacks in the remaining patients.”[2013] – note that the antibiotics used impacts many families of gut bacteria
  • The effect of Helicobacter pylori eradication on migraine: a randomized, double blind, controlled trial[2012].
  • Beneficial effects of Helicobacter pylori eradication on migraine[1998].
• “There is a growing body of literature on the potential use of .. diet interventions for primary headache disorders. This review identified literature on the use of a variety of diet and nutraceutical interventions for headache. Most of the studies assessed the efficacy of these interventions for migraine, though some explored their role in tension-type headache and cluster headache. The quality of the evidence in this area is generally poor.” [Jun 2015]
• “led to the identification of two potential compounds present in live green real veggies which could be considered for anti-migraine activity with better binding affinities than the reference drugs used and with liver-protective properties.” [2015]
  • “The product contains, among other constituents, glucosinolate (cabbage and broccoli), glutathione (cabbage, broccoli, parsley), sulforaphane (cabbage and broccoli), indole-3-carbinol (from cabbage), carnitine (carrots) and betaine (beetroot). The team points out that indole-3-carbinol and sulforaphane can cross the blood-brain barrier whereas other components cannot and many are not even absorbed by the body when taken by mouth.” [ScienceSpot] – Comment: these veggies are inline with the class of vegetables that I advocate are good for CFS.
• “A significant inverse relation was observed between dietary folate equivalent consumption and migraine frequency.” [Feb 2015] — reduces frequency but does not eliminate.

• “Migraineurs with aura were more likely to have low intake of chocolate, ice cream, hot dogs, and processed meats. Those who experience migraine at least once per week were more likely to have low intake of skim/low-fat milk and white and red wine.” [Aug 2015] –

• “effects of a low-fat plant-based diet intervention on migraine severity and frequency…A low-fat diet has been shown to reduce headache frequency, intensity, and duration, with subsequently lowered medication use..The most commonly reported triggers in these and other analyses include: chocolate, cheese, citrus, alcohol, and coffee’[2014]

• “our results support the idea that sterile inflammation plays a role in migraine pathogenesis. ” [2011]

• “We also recommend the use of the following supplements in the preventative treatment of migraines, in decreasing order of preference: magnesium, Petasites hybridus, feverfew, coenzyme Q10, riboflavin, and alpha lipoic acid.” [2009]

  • Note the overlap with recommended CFS supplements with Petasites hybridus ,butterbur , feverfew being new herbs to review in a future post.

Bottom Line

Hopefully someone will fund a study testing each of the probiotics in this post on Migraines. There is a single study so far using a mixture that included L.Casei. At the moment, there is no data on which probiotics would be effective. Similarly, there have been no studies on the use of H. Pylori antibiotics on migraines when there was not H. Pylori present — I expect similar remission and relief rates would occur (i.e. H Pylori is not the cause, but the antibiotics are the cure for some!  aka Wrong Model, Right Treatment!)

The probiotic that I reviewed in my last post, BIFIDO|MAXIMUS, while untested in clinical studies for migraines has the appropriate characteristics according to the model that I am using. Ecologic(®)Barrier is a dutch probiotic that may be challenging to get for many