Chemotherapy causes a wide variety of side effects, the specificity of which varies from medication to medication. One side effect that accompanies some types of chemotherapy treatments is headaches that can range in severity from a regular headache to a migraine. For some, this is merely a side effect, while for others it is an indicator of a nutrient deficiency caused by the chemotherapy.

The chemotherapy drugs cisplatin, cyclosporine, and interlekin-2 have been shown to decrease magnesium levels to a point that it becomes a deficiency. With these particular medications, the deficiency presents itself within the first three weeks after beginning their chemotherapy treatments and can continue for many months. A simple blood test will confirm a magnesium deficiency. With some drugs, the oncologist may do routine magnesium treatments with chemotherapy to prevent a deficiency. Others will wait to treat a deficiency once it appears. Supplementing with 200-600mg of magnesium per day will treat a magnesium deficiency and its associated headaches and migraines. If you are having chemotherapy related migraines not caused by a magnesium deficiency, a lower dose of magnesium may still be effective in reducing the frequency and/or severity of your headaches.

Other options for treating headaches and migraines during chemotherapy include: 5-hydroxytryptophan (5-HTP) at 400-600mg per day. 5-HTP is converted to serotonin in the body, which is an important brain chemical. Many of the most effective migraine drugs work by affecting the way serotonin is processed. There have been several studies that indicate 5-HTP is as effective as some prescription medications when it comes to reducing the frequency and intensity of migraine attacks. 5-HTP should not be taken with St. John’s wort or SAMe unless you are being monitored by your doctor for interactions. Another possible solution is supplementing with 400mg per day of vitamin B2 (riboflavin). One study showed a 50% reduction in the number of attacks, but more research is needed to know for sure if this is a reliable method of treatment.

There is another form of treatment still in the preliminary stages of research, both for the treatment of migraines and for the treatment of some types of cancer – coenzyme Q10, or CoQ10. When taken 100-1200mg 3 times a day over a period of time, CoQ10 works with the chemicals in the brain to reduce the severity and frequency of attacks. It has also been shown in some studies to cause some types of cancer cells to self-destruct in a process called apoptosis. Before starting a CoQ10 regimen, talk to your doctor. It can interfere with some forms of chemotherapy treatment. It also interacts with some other medications such as blood thinners and high blood pressure medications. 

In addition to these solutions, you also have good, old-fashioned acetaminophen (Tylenol) to treat your headaches. Only use the recommended dose, as taking too much can cause liver toxicity. 4,000 mg, or 4 grams, per day is the maximum safe dose in a 24-hour time frame. Also, don’t combine Tylenol with narcotic prescriptions like Lortab, Vicodin, Percocet, Darvocet, or others. Many contain acetaminophen, and combining them with Tylenol and inadvertently cause an overdose. If you are taking these, include their acetaminophen dosage in your total daily count. Avoid aspirin and other non-steroidal anti-inflammatory (NSAID) medications if you have anemia or other bleeding disorder, or if you are on blood thinners, as it can cause your platelet count to drop, which will further thin out your blood.

If you want to try solutions that don’t involve taking medications or supplements, try laying down in a dark room that is quiet or with soft, relaxing music or nature sounds. Place a cold compress on your head. If you don’t have a cold pack in the house, wet a washcloth with cold water and freeze it for 15 minutes, then use it. ChemoCare also recommends massage, reflexology, and acupressure. If needles don’t bother you, acupuncture is also an option, but be sure to use a licensed acupuncturist. Acupuncture has the added benefit of increasing white blood cells, red blood cells, and platelet counts that have been reduced because of your chemotherapy treatments.

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