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Treating chronic headaches is a complex problem. Everyone’s headache symptoms and causes are different, and determining the root of your particular headache can be a lengthy process. While treating this cause will likely eliminate or drastically reduce your symptoms, you also need immediate pain relief when a headache strikes. In this interview with Dr. Evan Hirsch, we discuss his approach to treating headaches, the use of magnesium for immediate relief, and some of the common root causes he sees in his practice.

migraine relief

Where do you Begin When Treating Headaches?

Dr. Evan Hirsch is an integrative medicine practitioner who focuses on determining and treating the root cause of a patient’s condition rather than focusing solely on the symptoms. He treats patients with a wide range of conditions, both in his office and virtually. When treating patients with chronic headaches, he focuses on answering two questions:

  1. How do we get rid of the pain immediately?
  2. What is the root cause of the problem?

Where many traditional approaches can fail is that the treatment options that offer immediate pain relief likely do not root out the underlying cause. This can fail to offer permanent relief, lead to a long-term dependency on medications, and cause secondary issues like rebound headaches.

Magnesium for Immediate Pain Relief

Magnesium is a critical element in the body, and studies suggest that might play an important role in the prevention and treatment of headaches and migraines. It is believed that many types of headaches are caused by a constriction of the blood vessels or spasms in the vascular system. Because magnesium is a vasodilator – or a substance that widens the arteries by relaxing the smooth muscle cells in the arterial wall – it can be a highly effective treatment for headaches. Magnesium can help relax these muscles and therefore alleviate the pain.

If you suffer from chronic headaches, Dr. Evan recommends treatment with magnesium. However, it is important to first determine your ideal dosage to minimize side effects. Diarrhea is one of the most common side effects, and Dr. Evan developed the following protocol to determine what level of magnesium your bowels can tolerate.

  1. Start with a small dose of magnesium.
  2. Increase the dosage every three days. Magnesium can take this long to have a full effect on your bowels.
  3. Continue increasing until you feel discomfort or get diarrhea. This dose indicates your bowel tolerance, and the previous dose is the maximum amount you should take.

If this dosage does not effectively treat your headache pain, other options to increase your magnesium intake include:

  • Intravenous magnesium
  • Magnesium spray or gels
  • Magnesium baths

Dr. Evan recommends chelated magnesium over other forms such as magnesium oxide or magnesium oxalate. You can read more about Dr. Evan’s “Magnesium Ramp-Up” protocol in his book, “Fix Your Fatigue”, as well as learn about his other recommendations for helping people overcome chronic headaches.

Determining the Root Cause of Your Pain

The second pillar is determining the root cause of a person’s headaches. One of the most common underlying factors is inflammation. Inflammation is the body’s immune response to some type of stimulus. Determining what is causing that response is key to uncovering the root cause of your headaches.

Three of the most common causes of inflammation that Dr. Evan sees in his practice are food allergies, infections, and mold.


Food Allergies or Intolerances

Many foods are believed to trigger migraines to include gluten, soy, dairy, corn, chocolate, and caffeine. However, what food triggers your allergic response can be difficult to determine.

Likewise, your response may be due to an intolerance rather than an allergy. While an allergy generally causes a response every time, an intolerance may only cause a response when a substance reaches a certain level in your body. This explains why a certain food may trigger your headache one time but not another.

A functional or integrative medicine practitioner, nutritionist, or headache specialist can help you develop a protocol to determine what foods may be triggering your migraines. If you are interested in learning more about this process, book a Case Review to understand what functional lab testing could be beneficial given your history and unique symptoms. 


Underlying infections can also cause headaches. One of the most common that Dr. Evan sees in his practice is Bartonella. Bartonella is a bacterium transmitted by fleas, body lice, and ticks that is often seen as a co-infection with Lyme Disease. It can cause severe neck pain as well as headaches. Other infections that may cause headaches include meningitis, encephalitis, and a wide range of bacterial and viral infections. A doctor can help determine whether infection is playing a role in your symptoms.


Mold toxicity is another often overlooked cause of chronic headaches. Mold may be present in your house, office, or other place you frequent regularly, and you may not even be aware of it! Mild symptoms of mold exposure might include common allergy symptoms like sneezing, coughing, and itchy or watery eyes. In more severe cases it can cause nausea, dizziness, fatigue, and headaches.

See your doctor if you believe mold exposure might be a factor in your headache symptoms.

Learn More

As I discussed with Dr. Evan, attending summits – live or virtually – can be a simple and effective way to increase your knowledge about the causes of and treatments for headaches. Summits provide a one-stop shop of experts and research that can help you delve into a variety of topics.

If you want to learn more about finding effective pain relief for your headaches as well as identifying and rectifying the root cause, you can purchase a recording of our Headache and Migraine Summit. The seven-day summit covers a wide variety of topics to help you gain control over your headaches.

If you are interested in a more personalized approach, book your initial Case Review with a Migraine Freedom™ coach where we can discuss your unique symptoms and potential treatment options.

Tried everything and still getting migraines?

A trained Migraine Freedom™ Coach can help!