Managing Dizziness and Migraines: Insights on Medication and Supplements - Neurology

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Shunao, vertigo, migraine?


Hello Dr.
Jiang,
On January 9th, I woke up and immediately felt like the room was spinning, making it difficult to stand.
I had a video consultation with a family medicine clinic, and they diagnosed me with suspected vestibular imbalance causing dizziness.
They prescribed anti-inflammatory and anti-dizziness medications, but I continued to feel a persistent lightheadedness.

On January 11th, I visited the ENT department at Chang Gung Memorial Hospital.
They examined my ears and found no issues.
They also tested my response to quickly turning my head and lying down, which did not trigger the same spinning sensation.
The doctor asked if I experienced headaches, and I mentioned that I occasionally have sudden migraines that are severe enough to require pain medication to help me sleep.
After the examination, the doctor prescribed a medication called Shunao for two weeks to take before bed.
Since starting it on January 11th, I have noticed a gradual improvement in my dizziness.
I saw your response to another consultation mentioning that Shunao is a calcium channel blocker.
I would like to ask if it is safe for me to take calcium, magnesium, and zinc supplements during this time.
If it is safe, should I wait two weeks after finishing the Shunao medication? Thank you for taking the time to read my lengthy message, and I appreciate your response.

Jiang Xiaojie, 30~39 year old female. Ask Date: 2023/01/17

Dr. Jiang Junyi reply Neurology


Hello Ms.
Jiang,
You mentioned, "Can I usually supplement with calcium, magnesium, and zinc as health products?" Generally speaking, when nutritional status is adequate, our bodies do not lack magnesium, calcium, or zinc.
The absorption of magnesium from the diet can be affected by other dietary components; excessive intake of phosphorus, zinc, fatty acids, oxalic acid, phytic acid, and dietary fiber can reduce magnesium absorption.
However, with aging or chronic kidney disease, the absorption rate of magnesium in the intestines decreases.
Supplementing with calcium, magnesium, and zinc can help alleviate migraines and exacerbated neuritis caused by nutrient deficiencies.
"As for whether I need to wait two weeks after finishing Shunao," you can actually supplement them simultaneously without any adverse effects.
Currently, the oral medications for migraine prevention include four main categories: antiepileptic drugs, beta-blockers, calcium channel blockers, and antidepressants, each with its own advantages and disadvantages.
There are many causes of dizziness, such as anemia, autonomic dysfunction, and inner ear imbalance, which may contribute to your symptoms.
I recommend consulting a neurologist for further evaluation and treatment.
Thank you for your inquiry, and feel free to discuss further.
Wishing you good health and peace.
Dr.
Jiang, Tao Medical Center, cares about you.

Reply Date: 2023/01/17

More Info


Managing dizziness and migraines can be quite challenging, especially when symptoms overlap and affect daily life. Based on your description, it seems that you have been experiencing dizziness potentially linked to inner ear issues, as well as occasional migraines that require medication for relief. Let's break down your situation and address your questions regarding medication and supplements.

Firstly, dizziness can arise from various causes, including inner ear disorders, vestibular dysfunction, or even migraines themselves. The fact that your ear examination was normal is a positive sign, indicating that the dizziness may not be due to a structural issue in the ear. The medications prescribed by your physician, including anti-inflammatory and anti-dizziness medications, are appropriate initial treatments for managing your symptoms.

Regarding your migraines, it’s common for individuals with vestibular disorders to experience headaches or migraines, as both conditions can share similar triggers, such as stress, lack of sleep, or dietary factors. The medication you were prescribed, which is a calcium channel blocker, can help in managing migraine symptoms by stabilizing neuronal excitability and reducing the frequency of migraine attacks.

Now, concerning your question about supplementing with calcium, magnesium, and zinc while on the medication, it is generally safe to take these supplements. However, there are a few considerations to keep in mind:
1. Timing of Supplements: While there is no strict requirement to wait for two weeks after finishing your medication to start taking supplements, it is advisable to consult with your healthcare provider. They can provide personalized advice based on your overall health status and any other medications you may be taking.

2. Potential Interactions: Calcium and magnesium can interact with certain medications, potentially affecting their absorption. For example, if you are taking any medications that require a specific pH level for absorption, taking calcium or magnesium at the same time may alter their effectiveness. Therefore, spacing out the timing of your supplements and medications is often recommended.

3. Dosage: When considering supplements, it’s essential to adhere to recommended dosages. Excessive intake of minerals can lead to adverse effects. For instance, too much magnesium can cause gastrointestinal issues, while excessive calcium can lead to kidney stones or cardiovascular problems.

4. Dietary Sources: Before turning to supplements, consider whether you can meet your nutritional needs through a balanced diet. Foods rich in calcium include dairy products, leafy greens, and fortified foods. Magnesium can be found in nuts, seeds, whole grains, and green leafy vegetables. Zinc is abundant in meat, shellfish, legumes, and seeds. A well-rounded diet can often provide the necessary nutrients without the need for supplementation.

5. Monitoring Symptoms: As you begin to incorporate supplements, keep track of any changes in your symptoms. If you notice improvements or worsening of your dizziness or migraines, report these changes to your healthcare provider. This information can help them adjust your treatment plan accordingly.

In summary, while it is generally safe to take calcium, magnesium, and zinc supplements while on your current medication, it is crucial to consult with your healthcare provider for personalized advice. They can guide you on the appropriate timing, dosages, and potential interactions with your medications. Additionally, maintaining a balanced diet and monitoring your symptoms will be key in managing your dizziness and migraines effectively. Always prioritize open communication with your healthcare team to ensure the best outcomes for your health.

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