DEAR DR. ROACH: I am eight weeks pregnant, and I had migraines before I was pregnant. (I was on prescriptions until I started family planning last year.) I always took medicine at the onset of these occurrences, and halfway through the day, my migraine would subside. Usually I’d take between four and six Excedrin Migraine pills, or Aleve. Now I am getting very bad headaches during the pregnancy, and I am worried about taking OTC medicines. Is there a safe supplement or dietary adjustment I can make to help my bad headaches while I am pregnant? — F.J.

ANSWER: Migraine headaches often get worse during pregnancy because of hormonal fluctuations. Many of the prescription medications are not considered safe during pregnancy, and I understand why many pregnant women are reluctant to take any medications.

Unfortunately, not all supplements are safe during pregnancy. For example, vitamin A in very high doses (greater than 10,000 IU daily) is clearly unsafe in pregnancy. However, there are two supplements, magnesium and riboflavin, that are helpful in preventing migraine.

Magnesium has been shown in several studies to be helpful for migraine prevention, and is frequently used for other reasons in pregnancy and is considered safe. One study used magnesium citrate doses of up to 600 mg per day.

Riboflavin (vitamin B-2) also has been shown to reduce migraines at a dose of 400 mg daily.

Tylenol generally is considered safe in pregnancy at reasonable doses, and is probably your best bet for treating a migraine already in place. As far as dietary restrictions go, find your personal dietary triggers, if any, and avoid them. Common triggers include alcohol, especially red wine, chocolate, aged cheese, MSG, caffeine and nitrites/nitrates.

DEAR DR. ROACH: Please let me know your opinion of the no-wheat diet. It is the first diet that has taken away my cravings for sweets, which has been my lifelong battle and the end of any healthy-eating plan I’ve ever been on. I have felt wonderful on this plan, am eating healthy, and am hoping to finally end my “addiction” to sweets by eliminating wheat.

I would like to know if you have any reservations, and if so, what they might be. Do you have any particular comments about what to or what not to be sure to eat or include in this plan for whole health? — Anon.

ANSWER: Excess processed, refined grains are a big problem for many people. These are rapidly converted to sugar, raising insulin levels, which promotes fat growth. Having whole-grain products, or these foods in combination with healthy fat and protein, slows absorption and reduces the adverse effects of these kinds of carbohydrates.

I don’t say that elimination of grain is right or necessary for everybody. Whole grains form an important part of many healthy diets, in combination with the other components, especially plants and nuts. However, it sounds like this diet is working well for you. Grains are certainly not necessary for a healthy diet.

DR. ROACH WRITES: In March I wrote a column on personal lubricants and made some product suggestions. Some of these may be difficult to find, and a reader wrote in to inform me about the products by the UK company Yes, available at yesyesyes.org. I reviewed the product information and think these are excellent choices, with no ingredients that are likely to cause local or systemic reactions.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

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