DEAR DR. DONOHUE: Will you say something about migraine headaches? What causes them? I have them so bad that the back of my head hurts, and the top of it hurts sometimes. It hurts so bad that I cannot lie down. – J.B.

Not every severe headache is a migraine headache, and treatment with migraine medicines doesn’t relieve other kinds of headaches. I’ll describe a migraine for you, and you can be the judge.

Some migraine headaches are preceded by flashing lights, numbness in the lips or some other neurological symptoms. Those preheadache events are auras. They happen only to a minority of migraine patients. More commonly, a migraine begins with a headache, which starts out as dull, deep, steady pain but transforms into painful pulsations. The headache is often on one side of the head, but 30 percent of those affected experience pain on both sides. Nausea is common with a migraine, and as is sometimes vomiting. Loud noise and light make matters worse, and people with this kind of a headache take themselves to a dark, quiet room where they can lie down. Movement of any sort makes a migraine worse.

Triggers for a migraine include foods, drink (especially red wine), menstrual periods, stress, too little sleep, too much sleep, physical exertion, hunger, fatigue and birth-control pills.

Treatment for a migraine begins with simple medicines like Tylenol. If Tylenol doesn’t relieve it, than an anti-inflammatory drug like Indocin might. If that doesn’t work, a combination of Tylenol with the anti-inflammatory can often bring relief. If the combination is a no-go, then the triptan drugs are specifically designed for migraine. They go by the names of Zomig (zolmitriptan), Imitrex (sumatriptan), Maxalt (rizatriptan), Relpax (eletriptan) and Axert (almotriptan). All require a prescription.

You need to talk to a doctor about your headache. Your symptoms are not typical of migraine.

The headache booklet discusses all the common kinds of headaches and their treatment. Readers can order a copy by writing: Dr. Donohue – No. 901, Box 537475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: It’s my understanding that trans fats come from partially hydrogenated oils. Why, then, do I see items labeled as containing no trans fats when the label states they contain partially hydrogenated oil? – T.R.

Oils and fats are long chains of carbon atoms. A saturated fat is a fat whose carbon atoms link with as many hydrogen atoms as they can. The “saturation” has to do with hydrogen saturation – the material is completely filled with hydrogen. Saturated fats stimulate liver production of cholesterol.

Partially hydrogenated oils – also called partially saturated oils – have carbon atoms that do not have their full complement of hydrogen. That’s what makes them only partially hydrogenated. These substances don’t prod the liver into maximum cholesterol output.

Partially saturated oils and fats can be fully hydrogenated – filled with hydrogen so that all their carbon atoms have all the hydrogen they can possibly hold. Full hydrogenation turns the partially saturated oils and fats into trans fats. Trans fats give products a longer shelf life, but they push the liver to maximum cholesterol production. That’s what makes them bad guys.

A label can state there is no trans fat if there is only a miniscule amount.

DEAR DR. DONOHUE: When my mother went to the dentist, after not having had a regular checkup for three years, she had several cavities. The only difference during those years was her drinking bottled water instead of tap water. Did that cause the cavities? – B.W.

Water, bottled or tap, doesn’t cause cavities. Cavities come from bacteria that cling to teeth. Those bacteria feed on carbohydrates, particularly sugar, and produce acid that dissolves tooth enamel and lays the groundwork for a cavity.

People should visit their dentists twice a year to nip cavities in the bud and to prevent them through fluoride treatment. Your mother’s cavities could have come from drinking non-fluoridated bottled water instead of fluoridated tap water.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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