14-SadKingRichMelissa, 22, suffered from chronic headaches and gastrointestinal pain, with pain so severe at times she considered suicide. Several different gastroenterologists and internists had evaluated her but could not give her a diagnosis or an explanation for her complaints. The last specialist Melissa saw accused her of making up her symptoms as a cry for attention. Sadly, this type of response is common in physicians who have big egos and are too incompetent to understand their patient’s case. I have heard it many times from my chronic patients and in emails from readers. It is always upsetting that a physician would accuse a patient of such a thing.

When I was able to see Melissa I was able to properly diagnose her with abdominal migraine. These migraines are associated with imbalances in the serotonin system and its impact on blood flow regulation. In her case the migraines were impacting the vascular system in her gut-brain axis. Her case required a lot of work, but because she was suffering so badly I immediately referred her to a family physician to prescribe her migraine medication. The medication really helped if she took it immediately when symptoms started.

Although she now had a tool to reduce her suffering, the real work had just begun—I had to figure out why she was having the migraines, especially since the medications eventually stop working well for many patients, and Melissa was having episodes daily. After a complete evaluation it was obvious many factors contributed to a faulty serotonin system. She had blood sugar issues, magnesium deficiencies, hormonal imbalances, and poor dietary habits. As we addressed each of these issues over the course of a year, the abdominal migraines became less frequent, to the point Melissa had an attack only once or twice a year instead of almost every day.

I share Melissa’s case with you for several reasons. First, although serotonin is associated with depression, imbalances in serotonin can cause many problems, including migraines, chronic constipation, poor cognitive function, flushing episodes, and more. Also, looking at serotonin imbalances from a natural approach requires more than just taking St. John’s Wort or 5-HTP. Proper serotonin physiology is linked to multiple mechanisms. If your brain is not working well and you have symptoms of serotonin imbalances, this chapter is very important for you to understand.

Datis Kharrazian, DC, DHSc, MS, MNeuroSci