The People's Perspective on Medicine

Show 1133: How Can You Overcome Migraine Headaches?

The FDA recently approved a new medication, erenumab (Aimovig), to prevent migraine headaches in people who experience them frequently. Treatments and lifestyle changes can also make a difference.
Jennifer S. Kriegler, Director of Headache Medicine Fellowship at Cleveland Clinic
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How Can You Overcome Migraine Headaches?

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Nearly 40 million Americans know the nausea and throbbing pain of migraine headaches. This debilitating condition that can create one-sided head pain may make it difficult or impossible to carry on with work or everyday tasks.

How Can You Prevent Migraine Headaches?

There are drugs that can be used to treat migraine headaches, but the FDA recently approved the first drug specifically to prevent them. What should you know about Aimovig, the brand name for erenumab? How does it work? We’ll also discuss price and whether insurance companies are likely to pay for it.

What Should You Know About Migraine Headaches?

Our guest expert describes the range of symptoms that can accompany migraine headaches. Find out about triggers such as chocolate or a change in the weather.

Medications for Migraines:

What are the medications used to treat migraines? We discuss their effectiveness and the limits on how often they can be used. What else can you do to prevent the onset of a migraine?

Treating Cluster Headaches:

In addition, we discuss another variety of excruciating headache called a cluster headache. How do these differ from migraine headaches and what is the best way to treat them?

This Week’s Guest:

Jennifer S. Kriegler, MD, is director of the Headache Medicine Fellowship at the Cleveland Clinic. She is part of the Center for Neurological Restoration and the Headache Section of the Neurological Institute in the Department of Neurology of the Cleveland Clinic.

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After 35 years, I was finally freed from increasingly debilitating migraines the day I had my metal dental fillings removed. Along with the migraines, my 35 years of hypoglycemia, frigid hands and feet along with slate blue fingernail moons in any air conditioned room, brain fog (attributed to perimenopause), chronic insomnia and more also ended that day. After becoming increasingly ill for 10 years, they tested me for heavy metal exposure and I had extremely high levels of mercury and very high levels of lead with smaller amounts of a variety of others. With having metal fillings, it was determined that was the first step before chelation. I felt the difference as I drove home from having the first half of the fillings removed, despite still being quite numb. A subsequent test after only 2 of the prescribed chelation treatments showed my mercury and lead levels had dropped dramatically. It was the fillings. I had long worked to eat and live “clean”, which probably helped the turnaround to be so fast and dramatic.

Migraine sufferers should try eliminating cow’s milk dairy and goat milk products, which have protein very similar to cow. My migraines stopped after eliminating dairy. Also recommend getting a food sensitivity test…..

According to a neurologist I have been getting migraines since I was a child when I would throw up for no reason. The migraines have gotten worse over the years and now at 69 they are triggered by my osteoarthritis which is widespread in my neck, shoulders, spine and other areas. Also, bad weather is a trigger.

I had miserable migraines for all of my late 30’s and all of my 40’s.

After I went through menopause at 51 I never had another migraine headache!!! So grateful. Sadly, now a couple of my grandchildren get these headaches and some are on Imitrex.

So happy to be through with them as they seriously limited my life.

I had terrible migraines growing up, I learned from someone to drink a cup of hot coffee, take two aspirin, and put a cold something on the back of my neck. Also, swearing at the migraine seemed to help run it out. I got to where I could stop one before the pain started. The coffee shrinks the blood vessels in the head, as does the cold towel or whatever. I have used a bag of peas or a cold beer in a pinch.

As a dentist, I see many patients who experience headaches and migraines. Many times, these symptoms are related to jaw position and malocclusion. If the jaw is not in the correct position, and the teeth are in the way, the muscles of the face, head and neck are affected and go into spasm. A dentist who specializes in GNM or neuromuscular dentistry with consideration to gnathology (the study of how the teeth interdigitate), can make an orthotic to reposition the mandible in a way to shut off the muscular tension and help to relieve headaches. This approach does not involve medication and is reversible.

Suffered with headaches and migraines since I was little. It’s amazing to me how far the world has come with technology yet nobody can fix the headaches. Thank God for Imitrex, even though it’s not good for me to take, since I have cardiovascular disease. One can hurt so badly that if someone told me to chew on tree bark, I would do it. My sympathy to all those headache/migraine sufferers out there.

My preventative regimen includes at least 30 minutes to one hour daily of aerobic exercise (moderately exerting brisk walking), turmeric 6000 mg daily, riboflavin 400 mg daily, magnesium glycinate 6 capsules daily, avoidance of added sugar, regular sleep routine, a diet rich in unprocessed foods, tizanadine 4 mg nighly and Lyrica 600 mg daily. It seems like a lot, and I still get several headaches per month. That’s an improvement over several headaches weekly.

There have been scientific tests that show many who get migranes are defecient in magnesium. There are books about the importance on this mineral and some good information on line too. Look up migrane headaches and magnesium. Magnesium oil is a good way to get magnesium as using topically this way helps you to sleep deeper, it help with pain when rubbed on the area and many other things.

Hands on cranial work can often be of great help to migraine sufferers. I practice such therapies as a nationally certified massage therapist with specialized training in “cranio sacral therapy.” The real experts in this hands on work are the osteopaths who practice cranial osteopathy. They are a rare breed but as licensed physicians their work is covered by medical insurance, medicare etc. The work is exceedingly gentle and has been explored and refined by these physicians for about a hundred years. It is sad indeed that the larger medical community fails to even explore this non toxic and often effective approach. Groups such as The American Migraine Foundation reject these therapies citing a lack of verifiable research data but data of this sort is generated so that highly profitable drugs can then be marketed. D.O.s can prescribe these same drugs and at the same time make gentle structural corrections to address the physical causes of this harrowing malady.

I started getting aural migraines quite frequently about 25 years ago. I also had a hyperthyroid at the time. The thyroid problem was taken care of but not the migraines. I still got them on and off but not so frequently over the years. In 2011 my new doctor recommended I take Metoprolol 50mg in the morning. Since then I have had them infrequently over the years.

For years I have suffered from headaches that would last from 3 days to weeks but have discovered that 400 mg of magnesium a day has greatly reduced the frequency, severity and duration. Inexpensive, safe, and I recommend trying it to see if it helps you.

I had horrible headaches on one side of my head for years before I learned I had breast cancer. Pain is telling you something is wrong. Took chemo, breast removed 27 yrs. ago…and no more headaches. Have your hormones checked.

I would get migraines 2 to 4 times a year even while on a daily 81 mg aspirin. If I took an Excedrin as soon as I noticed visual changes it would greatly reduce the symptoms. I’ve been on 2.5 mg Eliquis for a year and haven’t had a migraine yet.

I was hospitalized with them. I also had an emergency room doctor tell me that they wouldn’t nauseate you. He obviously never had one. You also feel like shooting yourself in the head is the only cure. I finally found out the birth control pills I was taking to regulate my menstrual cycle was causing them. The doctor didn’t tell me that while I was in the hospital. I read it in a medical journal
while waiting for my appointment with the doctor. So, I just stopped the pills. I have never had another migraine since. When I changed doctors and got an OB/Gyn, I was going over my history and I was advised to never take hormones again. That advice was fruitful and i have heeded it ever since.

I had the same issue: I was put on birth control pills during perimenopause to help with THOSE symptoms but the pills caused migraines. Once I stopped the pills the migraines stopped. Now, however, I have a problem with vestibular migraine – no headache but I get vertigo or dizziness without warning. Just trying to control the triggers for that but you can’t control the weather!

I was vegan for years but at some point started eating eggs from my pet chickens. I started getting aural migraines, I had several over a few months. I read that researchers don’t know what causes them but people who suffer these types of migraines are more likely to have a stroke. My mother died of a stroke and had these types of migraines. I made the connection… high cholesterol. I stopped eating all animal products 9 years ago now and never had another one again.

While on birth control pills I experienced migraines with aura and tunnel vision. Stopping birth control pills improved the condition to fewer headaches precipitated by food like my period, cheese and red wine.

After menopause while on hormone replacement therapy the headaches went away but occasional auras still happened.

A small stroke settled in my left eye, My Opthamologiist referred me to a Cardiologist who found an atrial septal defect in my heart. After it was repaired the aura episodes disappeared.

No further headaches or auras were experienced for years. Then I had a cardiomyopathy and the old familiar aura appeared. My heart has totally recovered but I am left with ocular migraines. They are auras in my vision.

I try to eat whole organic foods when possible and avoid highly processed foods. it helps.

My 18 year old daughter suffers from almost continuous he aches that never go below a pain lever 5. We are taking her to college and are terrified. We’ve gotten her a single room to help her manage her exposure to triggers and to have a refuge when she needs to shut down. We’ve been though three classes of drugs and continues on verapamil er with little real relief, and Botox was not effective. We tried 3 sphenocath treatments that also had no impact. She uses migrarelief and we’ve tried the cephaly use. The onset of the migraines followed a consussion, although she says her daily headaches predate the concussion. She eats as gluten free as possible which seems to lessen the intensity. Since we’ve graduated from the children’s neurologist what type of professional should we seek out in a next Step? She’s going to school near Houston so we plan to transition to an adult doctor there. Pain clinic? Neurologist? New med trial?

Consider using the new FDA approved injectable called Aimovig. I just had my 5th dose yesterday and my migraines have improved greatly. The only real side effect is constipation, which can be managed with Miralax. I have also been using the Botox every 3 months along with trigger point injections and nerve blocks for the past couple of years. I take Almotriptan for the migraines I do get, but they don’t get as bad as they used to be by a long shot since taking the Aimovig. Good luck to your daughter. My heart breaks for anyone who suffers with debilitating migraines – they are the worst thing I’ve had to deal with, and I’ve had a lot of medical problems over the years!

Cindy, has she been tested for celiac disease? It isn’t the first suspicion, but sometimes that is how celiac disease presents.

Cindy, I do feel your pain- my son started to have migraines when he was 13 years old. It has been a life struggle to figure out how to help him. I feel the anger of why our medical system has only come up with drugs to “try to treat the symptoms” instead of finding the cause. It is obvious to me it all has to do with hormones. But what can a doctor do about it?? All my son can do is to try to avoid his triggers- dehydration, not eating before bedtime and STRESS. He is 31 years years old now and has had less migraines as he has become older.
I would suggest having her go to a OB/GYN who specializes in hormones.

For the posters in the Houston Tx area, I recommend Dr. Loftus at Bellaire Neurology. He is a headache specialist who helped me a lot with effective treatments.
Migraine sufferers should also know that a new drug (Aimovig) has been released that is probably the biggest improvement in migraine treatment in decades because of its ;limited side effects.

I would recommend getting her to a functional medicine/integrative medicine practitioner and have her tested for food allergies and sensitivities. They can also test for things like heavy metals and thyroid antibody levels. There is probably an underlying auto immune problem causing the migraines. You will likely find you will have to pay out of pocket for such services since the heatlh insurance world doesn’t see value in people getting cured as opposed to “managed”. To find someone near you try
Best wishes

I get an average of 10 -15 headaches a month where I have to take sumatriptan or naratriptan to relieve it. This to me seems like a lot but next month I start Medicare and they won’t pay for anything else. Any suggestions as to what else I can do?
I really enjoy your show every week.
Thank you

If going gluten free ‘as much as possible’ is of some help, then I’d suggest going 100% gluten free. If does not help after 2 months, then this is not the problem. But you have to really commit to it and know this: if a food contains “modified food starch”, that food contains a LOT of gluten. Watch out for it. I have been gluten free for about 18 years now, so I know a little bit about it.

But anyway, I was having 2 to 4 migraines a week for years, until January 1st of this year, which is when I went on a low a carb diet. I have had only 5 headaches since January 1st. That is HUGE for me. I am not sure what is making the difference in my headaches. Was it some other food that I am allergic to? Or is it simply that I was eatling too much sugar for my body? I may never know. But I can tell you it made an enormous difference. If your daughter is having that much continuus pain, it is time to make some dietary changes to see if they will help.

I never found a medication that had any effect on a migraine, and I had them a few times a month for about 30 years. Then I learned the total relaxation technique, coupled with telling myself it was getting better, or going away, or not going to start in the first place. And with that I stopped getting them at all. This is about 40 years ago. I learned to do it sitting up (you can always find privacy in a bathroom); just let your head, face, chin, neck, shoulders, arms, etc., go totally limp, and then say in your mind, “This headache is going away.”

Voila! Better than any medicine.

For a number of years I also took sumatriptan in injection form. It was the only things that would touch the pain. I read about the mineral magnesium and how most of us are deficient in it, about the part it plays in so many body functions, and that a lack could cause headaches. I added 3 200 mg magnesium citrate to my daily vitamins, and the headache frequency went to almost zero. I very rarely get any headaches now much less a migraine–thank goodness.

Quite by accident, the aura that preceeds a migraine was stopped when I also had a stomach problem and took Alka Seltzer. I have used this a couple of times. The condition of the stomach may have a connection with migraines.

I recently read that an apple a day will keep migraines at bay. One has to eat an apple a day for a week or so to see results. This should be done in the morning. What is your take on this?

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Since I’m past menopause I don’t get migraines. I only had them when I was having a period.

Migraines come in many forms to different people. Some of the frightening auras, nausea, temporary blindness, nausea vomiting and dizziness that accompany that one-sided severe head pain make the episodes totally debilitating. Having to avoid light and sound because both become unbearable can last for hours or days. From a day to even weeks, some experience a brain fog and fatigue that keeps them home bound. Severe headaches are often mistakenly thought to be migraines when, actually, they belong in other categories and require different management.

I took Sanomigran for years as a prevention as I had migraines from the age of 11. When Imigran came out I took them when I had a break through migraine. They were an absolute Godsend for me, as I used to be sick and have to lie down 2/3 three times every month all my life.. Now 73 I very rarely get one and just take Imigran if I do .

I have been put in a six week study and to prevent migraines you eat 4 pickles a day. I also am a chronic pain back and leg sufferer and my orthopedist gave up on me so one of the remedies they are trying is a peanut butter sandwhich with your big meal and my hands have stopped hurting waiting to see about my back and leg pain.

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