11 ms·

The metabolic face of migraine

juskrey 5y ago
I had no headaches for a straight year on strict low carb diet
- wayoutthere 5y ago
  I honestly had the opposite; I tried Keto and had headaches for a month. They went away about 15 minutes after I ate a chocolate bar.
  - lambdaba 5y ago
    That was probably because of electrolytes. Magnesium supplementation would have been a good idea, and still is.
mmastrac 5y ago
It will be interesting to see the next phase of migraine treatments - psilocybin, CRGP inhibitors, etc. It really feels like we're getting close to understanding what a migraine truly is. I believe "cortical spreading depression" is a fairly recent discovery and has opened up a lot of avenues of research vs the past belief that migraine was purely vascular. This video was a pretty good update on state-of-the-art treatments, including those in trial: https://www.youtube.com/watch?v=LB9nYDvpfbA https://www.youtube.com/watch?v=LB9nYDvpfbA
- podgaj 5y ago
  everyone always makes it complicated. How about riboflavin? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447943/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447943/ I have seen the effect of this first hand.
  - mmastrac 5y ago
    Riboflavin and the other nutraceuticals are in this paper. Co Q10, magnesium, etc all have promising prophylactic effects. We still need research and treatments for those who get migraines despite the prophylactics.
nickclaw 5y ago
This is fascinating, I've suffered occasional migraines for 15 years, and while I've found over time that it's highly connected to my diet combined with other stressors (like intense exercise, lack of sleep, high stress, etc...), I've never seen the mechanism described so clearly as "a mismatch between the brain’s energy reserve and workload." I wonder if the "migraine hangover" is also part of the brains process to "restore brain energy homeostasis" or is just an unfortunate side effect.
plutonorm 5y ago
Translation: People with highly sensitive nervous systems get migraines because they are overstimulated. It can also be caused by mutations in mitochondria which reduce energy output. Both of these cause mismatches in the amount of energy being consumed and the amount of energy being expended. I can confirm that my migraine frequency has doubled since having children.
- treeman79 5y ago
  Tests for that mutation? I have a condition that could be caused by mitochondrial energy problems. I also have horrific migraines. Also an extremely hypersensitive nervous system. Some pills I take at 1/10th the lowest dose and still can barely handle the side effects. My current pet theory is a low level infection of the mitochondrial. I have enormous rebounds on antibiotics. Would love to explore other avenues.
- lambdaba 5y ago
  Which is why ketogenic diets are so effective against such "diseases of overstimulation", ketone bodies have a stabilizing effect and gaba/glutamate balance normalizes. My personal conviction is the ketotic state is the default state for humans, in part given this stark contrast
mdip 5y ago
I started getting Migraine headaches in the late spring at age 17 and continued to get them in the spring/fall weekly for about two decades[0]. I remember the age and the season because, up to that point, I had headaches. What happened that day resulted in a trip to the emergency room, on my insistence; I thought my brain was bleeding[1]. After 4 hours, I was sent home with a note to take two extra strength Tylenol. And for the 20 years that followed, that was about the quality of treatment I received. Everything, for me, is solved with a medication that is very rarely prescribed for Migraine. My issue is that I cannot take the usual medications (imitrex, etc). They are effective, but I lack a gene that is required to flush them from my system correctly. So 30 minutes after taking the pill I'd be the happiest I've ever been in my entire life, and about 1.5 hours later, I'd be miserable. It was comical-if-they-weren't-happening-to-you mood swings, which almost killed me[2]. I've seen several doctors for this. After a mess of semi-unrelated circumstances around that event which almost killed me, I ended up on a prescription for Depokote. It's a very old medication, originally prescribed for seizures and I now commonly used off-label for bipolar. It was prescribed to me with the endorsement of "a few of my patients responded well to this, none of them had side effects, and this is where we're at on the list of choices" ... basically, the guy had no confidence it would work, so I didn't either. It was prescribed mid-summer, and I noticed after about a week that I felt like I was carrying around zero anxiety[3], and a number of other fantastic side-effects[4]. By the end of the following spring, I was convinced it worked -- completely. It was the first year I had gone any season without a single Migraine headache. Interestingly, I'd get the "aura", on occasion, but it would never melt into horrifying pain. The whole time, regardless of specialist, there wasn't anyone who could give me a really good idea of just what the hell was really going on in my skull. I'll admit, after reading this, I'm wondering if I really have Migraine or if I don't have some other thing (cluster was ruled out). My triggers are seasonal; and I have bad days when there has been a large shift from high->low or low-> high. Interestingly, though, if I get a migraine, I am pretty much insulated from getting another one for about a week, which implies some sort of biological process that is serving some function, since multiple repeats of that trigger, or even much stronger ones, will not cause a second migraine for several days after one already landed. [0] Varying lengths but until I learned to cope with the symptoms, it at least destroyed the entire rest of the remaining day once it hit. Often remained a day after, as well. [1] I really, really, hated hospitals as a kid. My parents took me on my insistence because they knew I would only demand to go if I seriously thought I was dying ... even though it was a headache. [2] A combination of medications related to Migraine which I took during an attack (as prescribed) resulted in my serotonin levels sending me to the hospital. It. Was. Bad. [3] I never thought of myself as anxious, and it's never been an issue in my life -- that I know of -- that has held me back. But, holy cow, the difference was stark. [4] For medications with "brain affecting" side-effects, I do not read the label. My wife takes that responsibility. My thinking is: (1) placebo/nocebo effect is really strong when the thing it effects is emotional/personality. (2) I can't trust my brain to evaluate what is happening to itself -- it's compromised by the medication.
gadders 5y ago
This was a good podcast on the subject of migraines that I listened to last week: "Throbbing head, nausea, dizziness, disturbed vision – just some of the disabling symptoms that can strike during a migraine attack. This neurological condition is far more common than you might think, affecting more people than diabetes, epilepsy and asthma combined. While medications, to help relieve the symptoms of migraine, have been around for some time, they haven’t worked for everyone. And what happens in the brain during a migraine attack was, until recently, poorly understood. Peter Goadsby is Professor of Neurology at King's College London’s Institute of Psychiatry, Psychology & Neuroscience and is a true pioneer in the field of migraine. Over the course of his career, he has unravelled what happens in the brain during a migraine attack and his insights are already benefiting patients - in the form of new medications that can not only treat a migraine, but also prevent it from occurring. Peter shares this year’s Brain Prize, the world's largest prize for brain research, with three other internationally renowned scientists in the field." https://www.bbc.co.uk/programmes/m000vp2z https://www.bbc.co.uk/programmes/m000vp2z
- alexreds 5y ago
  There are a bunch of recently approved new migraine medicines that block CGRP instead of serotonin. I have suffered migraines since my teens and while Sumatriptan provides some relief, it is not great and has to be taken as soon as I get an auora to be at all effective. Stress and high fructose corn syrup, which is in EVERYTHING, are my triggers. I have not yet tried the new meds, but I am hopeful. https://cureheadaches.org/2020/07/15/new-migraine-medications-approved-reyvow-ubrelvy-and-nurtec/ https://cureheadaches.org/2020/07/15/new-migraine-medication...
  - podgaj 5y ago
    Serotonin is metabolized by MAOA, witch needs riboflavin (FAD) work effectively. https://ars.els-cdn.com/content/image/1-s2.0-B9780444641250000141-f14-01-9780444641250.jpg https://ars.els-cdn.com/content/image/1-s2.0-B97804446412500...
JoeAltmaier 5y ago
They talk of how migraine might be adaptive. But isn't it possible that migraine is a side-effect of another adaptive gene for a different effect? Nature doesn't care if we're miserable. Just that we survive (as an individual or community) and reproduce. Imagine if miserly consumption of some chemical was calorie-adaptive or saved for emergencies, but the same gene meant migraines at other times. The gene would still proliferate, with no need to explain the negative effects as adaptive?
- dillondoyle 5y ago
  If have a bad enough migraine can't go hunt or gather food. Though sex or orgasm can help with headaches in my experience so maybe that's a driver :)
  - fallingfrog 5y ago
    In my experience an orgasm only makes a migraine go away for 3 or 4 seconds. It’s like a brief moment of relief then you feel the pain come rushing back.
    - dillondoyle 5y ago
      Ouch. I don't think i've experienced a migraine so debilitating as to some who suffer it sounds awful.
svcrunch 5y ago
Fascinating work, thank you for sharing. Here's a link to the full paper: https://orbi.uliege.be/bitstream/2268/247255/1/Gross%20et%20al%20Metabolic%20face%20of%20migraine-Nat%20Rev%20Neurol%202019.pdf https://orbi.uliege.be/bitstream/2268/247255/1/Gross%20et%20...
- DanielleMolloy 5y ago
  Thanks for the link! I must have been logged in via my institution and didn’t realize the article wasn’t public.
lazypenguin 5y ago
One of my relatives suffers from migraines and they are seriously debilitating with sensitivity to light and intense nausea. There are strong meds that can help prevent them but they always intrinsically knew that certain foods were a trigger for them. It seems over the years that the connection between migraines and nutrition has been strengthening. I could not access the journal but I would have loved to know what their conclusions and recommendations were. Especially the part related to diet modification.
- svcrunch 5y ago
  Full text: https://orbi.uliege.be/bitstream/2268/247255/1/Gross%20et%20al%20Metabolic%20face%20of%20migraine-Nat%20Rev%20Neurol%202019.pdf https://orbi.uliege.be/bitstream/2268/247255/1/Gross%20et%20... Lots of excellent recommendations starting from page 6 onward ("Theraputic studies") An incomplete list of long term strategies presented in the paper: - aerobic exercise - b-vitamin supplementation (several different ones are mentioned), and magnesium supplementation - ketogenic diet (train the brain to use non-glucose sources of energy) - sleep management (are you getting enough?) Given the root-cause analysis of migraines presented in the paper, there's one additional treatment which I'll experiment with: milk thistle supplementation. Milk thistle boosts levels of glutathione in the liver, which appears to have a bearing on migraines.
- wayoutthere 5y ago
  I do too; they have at times been debilitating. I’ve found no prescription drug works better than marijuana. There is also a significant hormonal component to migraines. Women have 2-4x as many migraines as men — an effect that is also seen in trans women who are taking estrogen, which indicates that it’s probably hormones rather than genetic. Not ruling out a dietary component, but it’s obviously a complex set of symptoms with likely dozens of contributing factors.
  - nickclaw 5y ago
    After trying some prescription drugs I've also found Marijuana works the best for me. It's the difference between lying on the bathroom floor waiting to throw up and being semi-functional (I am pretty stoned, so not totally functional) around the house. I don't think it's a cure so much as a great way to manage the pain while the migraine is at its peak, unfortunately the migraine hangover still lasts for days.
podgaj 5y ago
Riboflavin! https://onlinelibrary.wiley.com/doi/full/10.1111/jcpt.12548 https://onlinelibrary.wiley.com/doi/full/10.1111/jcpt.12548 The link to the mitochondria is through FAD, a metabolic derivative of Riboflavin, which is used in the electron transport chain. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447943/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447943/
- boffinism 5y ago
  Didn't work for me. I think it's easy to come up with a pet theory ("migraines are caused by X, and therefore prevented by Y"), especially when there is some science to support you. But when you dig into it, you learn that while some treatments are wildly effective for a few people, no treatment is widely effective. If it were, migraines wouldn't be such a thing in the developed world. So by all means, let people know that Riboflavin might help them, but be wary of prescribing it to all and sundry when in truth, it will only help a minority.
  - podgaj 5y ago
    How much, how long, and what type? You’re not being scientific about it at all.
    - deleted 5y ago
      [deleted]
- DanielleMolloy 5y ago
  This shouldn’t be downvoted, B2 / riboflavin is mentioned in the article too, next to Magnesium and Q10. Note that the recommended amount (100mg+) is far above the daily recommendation (~2mg).
pugworthy 5y ago
I rarely get the headache side of migraines, but I do get the visual aura fairly often. If over-stimulation is a factor, then certainly they are a bit self regulating since I have to just stop using the computer, stop reading, stop looking at my phone, etc. until it's gone. If you've not had the visual migraine effect before, the impact is a bit like if you looked a bright light, then tried to read something.
- greatgib 5y ago
  Very very interesting topic. I was also used to suffer from the visual migraine as you describe it. For another exemple, it is like looking at the phone in complete darkness with the phone brightness set to the maximum; but that effect in daylight with the screen set to low/normal brightness level. Maybe I'm wrong, but the deductions I did from my issues was that it might be related to work conditions. For example, I used to have the computer screen at 90° of a window. And there was probably constantly a little bit of light reflexion on my screen. So it is not so much to be noticable or annoying, but for a full day it will exhaust my eyes and brain. And I would regularly have the issue at the end of the day. Then, I changed of work and of light conditions, and I almost never got the issue anymore. (Still once in a while, but very very rarely compared to before) Also, I discovered that there are a lot of good advice regarding the work environment that you should try to respect: - no excessive room temperature (>21) - no sun or light directly in front. No light reflexion from the back or side. - room ambiant light the closest possible to the brightness of the screen But, a point that could support the theory of this publication is that, when the issue arrived, it was often that I was feeling hungry for sweets and desperately looking for a snack.
- BrandoElFollito 5y ago
  I do not usually get the headache part either but the visual part is epic. The first time I got it, a few years ago, I thought I was having a stroke. The visual area gets ripped in two by the diagonal, the two pieces move away and are replaced with a silver band. The picture stays more or less complete, but broken in two. The image kind of pulsates, or rather waves. I was terrified the first time, then visited the ophthalmologist, did a tomography of my head and ended up at a neurologist. He was a specialist of migraines and told me that about 30% of migraines are without headaches. My father has migraines, my younger brother too and both have headaches. I had some other extasy-like migranes and I am usually exhausted afterwrds and sleep 10 to 12 hours straight. I am lucky to have only a few cases a year.
alfiedotwtf 5y ago
Migraine sufferer here. Know your triggers! I used to suffer migraines at least once a months, and head aches at least once or twice a week. But then I found my triggers... So the Philae Lander landing on a comet on a Wednesday night, at sometime like 3am, and the next morning I had a really bad migraine. It was right then and there that I realised I only ever got migraines on Saturday and Sunday. Why did I all of a sudden get on then? Lack of sleep! I started experimenting, and eventually found that if I had under 4 hours of sleep for 3 days in a row, surely enough on the fourth day I would most likely have a migraine! It was an awesome epiphany. I’ve also managed to dramatically reduce headaches too - by having at last 6 hours sleep, I will have most likely staved away my usual tension head aches. I’m also under the suspicion that my headaches are effected by a lack to serotonin, but haven’t had my bloods checked for that yet.
yolobouquet 5y ago
I suffered from migraines for many years, always after a night's sleep. I had sleep studies and they determined I was not getting enough oxygen. I had surgery for a deviated septum and tissue in my nasal passages and throat was scoured back. I continued to get migraines and was given a CPAP. The headaches continued. I was in my 40s when my dentist asked me if I got headaches in the morning. She said I was grinding my teeth and I needed to start wearing a mouth guard at night or I was going to crack a molar. I still get migraines but they are much less frequent than they used to be.
- TheSpiceIsLife 5y ago
  This leads me to ponder if the cause of the tooth grinding could be resolved, would the frequency of migraines reduce further still? Have you tried taking a magnesium di-glycinate based magnesium supplement. Magnesium can help relax the small fast twitch muscles in the jaw.
- 11235813213455 5y ago
  what's your resting jaw position? at rest, teeth shouldn't touch, there should be a small gap, and your tongue is usually touching the upper palate, just behind front teeth. Your resting breath-rate and heart-rate shouldn't be too high, relaxation and exercise will help (at any age!), try breathing deeply a few times, then exhale all the air, empty lungs and hold this for 20s and more
mancerayder 5y ago
I get a devastating headache every few weeks lasting a few days from the base of my skull inside, and it feels like the type of headache that you get from drinking something cold too fast, a bit milder, and lasting a few days. It seems to be triggered from sitting in front of the PC (I try to always stand), doing something dumb at the gym (benching and pushing my neck into the bench so I no longer bench), sitting awkwardly for too long (like a train seat), or looking at a slight angle down while working. It feels like nerve impingement and it travels sometimes to just one side of my face, and even hurts above my eye. Sometimes I feel nauseous too. I've had this for many years. It's more likely to happen if I've slept poorly or get stressed. What's the difference between that and migraine? I hear people all the time saying they suffer from migraines, and I'm told it's connected to a 'quadrant' type of pain. Are people being diagnosed with migraines maybe suffering from a similar nerve issue that I have? And by the way, that I have a nerve impingement is purely my own hypothesis, and difficult to prove/disprove I think.
- sweetsocks21 5y ago
  This sounds similar to something I had for years. I would get a left side migraine every couple months for 3-4 days. Other times I would have a regular headache in various areas, like behind the left eye. The occasional nausea was a symptom too. I would also get pin prick pain somewhere on my face, usually cheek or nose. It ended up being one of the cervical vertebrae were out of place, and once it was put back I never had an issue again. So I wouldn't be surprised if it's a pinched nerve or similar neck issue in your case.
  - mancerayder 5y ago
    What type of doc found that ? And was it found with an MRI or X-Ray, or just by feel? I had an MRI that showed nothing unusual. I've never seen a chiropractor. If someone found something out of place and put it back, and solved my issue, I would be the happiest person on Earth for a while.
    - NickNameNick 5y ago
fallingfrog 5y ago
I once got a migraine with aphasia. I was noticing that the visual alligator crack rainbow lightning stuff was finally going away and I decided to check Facebook. I found that while the letters snd words looked normal, it was all gibberish. I tried saying something out loud and I found that all that came out was a mess of random phonemes. It lasted about half an hour. It looks like this if you want to see: https://youtu.be/IG7NuH5QTdE https://youtu.be/IG7NuH5QTdE In retrospect I probably should have gone to a doctor once I realized I was unable to speak..
kyle_morris_ 5y ago
I was a migraine-per-year person as a kid and migraine-per-quarter person for much of my adult life. I kept a food log and identified that a caffeine and chocolate combo to be a consistent trigger. In addition if too bright of a light shined in my eyes(let’s say a car door shut and the sun reflected off of the door’s window as I looked at it) it would also trigger a migraine. After working to limit those triggers I’ve found that I don’t get migraines much anymore. Adding in sumatriptan when they do come on has been helpful. If you find yourself with migraine symptoms I definitely recommend trying to identify the triggers, food, stress or otherwise.
- treeman79 5y ago
  This is good advise. The list of possible triggers is endless. A complete elimination diet is a good starting point. FL-41 migraine glasses are amazing sight. Eliminate all “scents” candles, perfumes, fancy soap, etc. Can be shocking as you introduce things back in what you find is a trigger.
AtlasBarfed 5y ago
Exercise would increase the "potential" of the brain and lessen migraines then? Not necessarily DURING a migraine, but as a preventative measure? Or are measures of "expenditure" vs "reserve" measured in other ways than oxygen consumption / energy production?

I had no headaches for a straight year on strict low carb diet

wayoutthere 5y ago
I honestly had the opposite; I tried Keto and had headaches for a month. They went away about 15 minutes after I ate a chocolate bar.
- lambdaba 5y ago
  That was probably because of electrolytes. Magnesium supplementation would have been a good idea, and still is.

It will be interesting to see the next phase of migraine treatments - psilocybin, CRGP inhibitors, etc. It really feels like we're getting close to understanding what a migraine truly is. I believe "cortical spreading depression" is a fairly recent discovery and has opened up a lot of avenues of research vs the past belief that migraine was purely vascular. This video was a pretty good update on state-of-the-art treatments, including those in trial: https://www.youtube.com/watch?v=LB9nYDvpfbA https://www.youtube.com/watch?v=LB9nYDvpfbA

podgaj 5y ago
everyone always makes it complicated. How about riboflavin? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447943/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447943/ I have seen the effect of this first hand.
- mmastrac 5y ago
  Riboflavin and the other nutraceuticals are in this paper. Co Q10, magnesium, etc all have promising prophylactic effects. We still need research and treatments for those who get migraines despite the prophylactics.

nickclaw 5y ago

This is fascinating, I've suffered occasional migraines for 15 years, and while I've found over time that it's highly connected to my diet combined with other stressors (like intense exercise, lack of sleep, high stress, etc...), I've never seen the mechanism described so clearly as "a mismatch between the brain’s energy reserve and workload." I wonder if the "migraine hangover" is also part of the brains process to "restore brain energy homeostasis" or is just an unfortunate side effect.

plutonorm 5y ago

Translation: People with highly sensitive nervous systems get migraines because they are overstimulated. It can also be caused by mutations in mitochondria which reduce energy output. Both of these cause mismatches in the amount of energy being consumed and the amount of energy being expended. I can confirm that my migraine frequency has doubled since having children.

treeman79 5y ago
Tests for that mutation? I have a condition that could be caused by mitochondrial energy problems. I also have horrific migraines. Also an extremely hypersensitive nervous system. Some pills I take at 1/10th the lowest dose and still can barely handle the side effects. My current pet theory is a low level infection of the mitochondrial. I have enormous rebounds on antibiotics. Would love to explore other avenues.
lambdaba 5y ago
Which is why ketogenic diets are so effective against such "diseases of overstimulation", ketone bodies have a stabilizing effect and gaba/glutamate balance normalizes. My personal conviction is the ketotic state is the default state for humans, in part given this stark contrast

mdip 5y ago

I started getting Migraine headaches in the late spring at age 17 and continued to get them in the spring/fall weekly for about two decades[0]. I remember the age and the season because, up to that point, I had headaches. What happened that day resulted in a trip to the emergency room, on my insistence; I thought my brain was bleeding[1]. After 4 hours, I was sent home with a note to take two extra strength Tylenol. And for the 20 years that followed, that was about the quality of treatment I received. Everything, for me, is solved with a medication that is very rarely prescribed for Migraine. My issue is that I cannot take the usual medications (imitrex, etc). They are effective, but I lack a gene that is required to flush them from my system correctly. So 30 minutes after taking the pill I'd be the happiest I've ever been in my entire life, and about 1.5 hours later, I'd be miserable. It was comical-if-they-weren't-happening-to-you mood swings, which almost killed me[2]. I've seen several doctors for this. After a mess of semi-unrelated circumstances around that event which almost killed me, I ended up on a prescription for Depokote. It's a very old medication, originally prescribed for seizures and I now commonly used off-label for bipolar. It was prescribed to me with the endorsement of "a few of my patients responded well to this, none of them had side effects, and this is where we're at on the list of choices" ... basically, the guy had no confidence it would work, so I didn't either. It was prescribed mid-summer, and I noticed after about a week that I felt like I was carrying around zero anxiety[3], and a number of other fantastic side-effects[4]. By the end of the following spring, I was convinced it worked -- completely. It was the first year I had gone any season without a single Migraine headache. Interestingly, I'd get the "aura", on occasion, but it would never melt into horrifying pain. The whole time, regardless of specialist, there wasn't anyone who could give me a really good idea of just what the hell was really going on in my skull. I'll admit, after reading this, I'm wondering if I really have Migraine or if I don't have some other thing (cluster was ruled out). My triggers are seasonal; and I have bad days when there has been a large shift from high->low or low-> high. Interestingly, though, if I get a migraine, I am pretty much insulated from getting another one for about a week, which implies some sort of biological process that is serving some function, since multiple repeats of that trigger, or even much stronger ones, will not cause a second migraine for several days after one already landed. [0] Varying lengths but until I learned to cope with the symptoms, it at least destroyed the entire rest of the remaining day once it hit. Often remained a day after, as well. [1] I really, really, hated hospitals as a kid. My parents took me on my insistence because they knew I would only demand to go if I seriously thought I was dying ... even though it was a headache. [2] A combination of medications related to Migraine which I took during an attack (as prescribed) resulted in my serotonin levels sending me to the hospital. It. Was. Bad. [3] I never thought of myself as anxious, and it's never been an issue in my life -- that I know of -- that has held me back. But, holy cow, the difference was stark. [4] For medications with "brain affecting" side-effects, I do not read the label. My wife takes that responsibility. My thinking is: (1) placebo/nocebo effect is really strong when the thing it effects is emotional/personality. (2) I can't trust my brain to evaluate what is happening to itself -- it's compromised by the medication.

gadders 5y ago

This was a good podcast on the subject of migraines that I listened to last week: "Throbbing head, nausea, dizziness, disturbed vision – just some of the disabling symptoms that can strike during a migraine attack. This neurological condition is far more common than you might think, affecting more people than diabetes, epilepsy and asthma combined. While medications, to help relieve the symptoms of migraine, have been around for some time, they haven’t worked for everyone. And what happens in the brain during a migraine attack was, until recently, poorly understood. Peter Goadsby is Professor of Neurology at King's College London’s Institute of Psychiatry, Psychology & Neuroscience and is a true pioneer in the field of migraine. Over the course of his career, he has unravelled what happens in the brain during a migraine attack and his insights are already benefiting patients - in the form of new medications that can not only treat a migraine, but also prevent it from occurring. Peter shares this year’s Brain Prize, the world's largest prize for brain research, with three other internationally renowned scientists in the field." https://www.bbc.co.uk/programmes/m000vp2z https://www.bbc.co.uk/programmes/m000vp2z

alexreds 5y ago
There are a bunch of recently approved new migraine medicines that block CGRP instead of serotonin. I have suffered migraines since my teens and while Sumatriptan provides some relief, it is not great and has to be taken as soon as I get an auora to be at all effective. Stress and high fructose corn syrup, which is in EVERYTHING, are my triggers. I have not yet tried the new meds, but I am hopeful. https://cureheadaches.org/2020/07/15/new-migraine-medications-approved-reyvow-ubrelvy-and-nurtec/ https://cureheadaches.org/2020/07/15/new-migraine-medication...
- podgaj 5y ago
  Serotonin is metabolized by MAOA, witch needs riboflavin (FAD) work effectively. https://ars.els-cdn.com/content/image/1-s2.0-B9780444641250000141-f14-01-9780444641250.jpg https://ars.els-cdn.com/content/image/1-s2.0-B97804446412500...

JoeAltmaier 5y ago

They talk of how migraine might be adaptive. But isn't it possible that migraine is a side-effect of another adaptive gene for a different effect? Nature doesn't care if we're miserable. Just that we survive (as an individual or community) and reproduce. Imagine if miserly consumption of some chemical was calorie-adaptive or saved for emergencies, but the same gene meant migraines at other times. The gene would still proliferate, with no need to explain the negative effects as adaptive?

dillondoyle 5y ago
If have a bad enough migraine can't go hunt or gather food. Though sex or orgasm can help with headaches in my experience so maybe that's a driver :)
- fallingfrog 5y ago
  In my experience an orgasm only makes a migraine go away for 3 or 4 seconds. It’s like a brief moment of relief then you feel the pain come rushing back.
  - dillondoyle 5y ago
    Ouch. I don't think i've experienced a migraine so debilitating as to some who suffer it sounds awful.

svcrunch 5y ago

Fascinating work, thank you for sharing. Here's a link to the full paper: https://orbi.uliege.be/bitstream/2268/247255/1/Gross%20et%20al%20Metabolic%20face%20of%20migraine-Nat%20Rev%20Neurol%202019.pdf https://orbi.uliege.be/bitstream/2268/247255/1/Gross%20et%20...

DanielleMolloy 5y ago
Thanks for the link! I must have been logged in via my institution and didn’t realize the article wasn’t public.

lazypenguin 5y ago

One of my relatives suffers from migraines and they are seriously debilitating with sensitivity to light and intense nausea. There are strong meds that can help prevent them but they always intrinsically knew that certain foods were a trigger for them. It seems over the years that the connection between migraines and nutrition has been strengthening. I could not access the journal but I would have loved to know what their conclusions and recommendations were. Especially the part related to diet modification.

svcrunch 5y ago
Full text: https://orbi.uliege.be/bitstream/2268/247255/1/Gross%20et%20al%20Metabolic%20face%20of%20migraine-Nat%20Rev%20Neurol%202019.pdf https://orbi.uliege.be/bitstream/2268/247255/1/Gross%20et%20... Lots of excellent recommendations starting from page 6 onward ("Theraputic studies") An incomplete list of long term strategies presented in the paper: - aerobic exercise - b-vitamin supplementation (several different ones are mentioned), and magnesium supplementation - ketogenic diet (train the brain to use non-glucose sources of energy) - sleep management (are you getting enough?) Given the root-cause analysis of migraines presented in the paper, there's one additional treatment which I'll experiment with: milk thistle supplementation. Milk thistle boosts levels of glutathione in the liver, which appears to have a bearing on migraines.
wayoutthere 5y ago
I do too; they have at times been debilitating. I’ve found no prescription drug works better than marijuana. There is also a significant hormonal component to migraines. Women have 2-4x as many migraines as men — an effect that is also seen in trans women who are taking estrogen, which indicates that it’s probably hormones rather than genetic. Not ruling out a dietary component, but it’s obviously a complex set of symptoms with likely dozens of contributing factors.
- nickclaw 5y ago
  After trying some prescription drugs I've also found Marijuana works the best for me. It's the difference between lying on the bathroom floor waiting to throw up and being semi-functional (I am pretty stoned, so not totally functional) around the house. I don't think it's a cure so much as a great way to manage the pain while the migraine is at its peak, unfortunately the migraine hangover still lasts for days.

podgaj 5y ago

Riboflavin! https://onlinelibrary.wiley.com/doi/full/10.1111/jcpt.12548 https://onlinelibrary.wiley.com/doi/full/10.1111/jcpt.12548 The link to the mitochondria is through FAD, a metabolic derivative of Riboflavin, which is used in the electron transport chain. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447943/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447943/

boffinism 5y ago
Didn't work for me. I think it's easy to come up with a pet theory ("migraines are caused by X, and therefore prevented by Y"), especially when there is some science to support you. But when you dig into it, you learn that while some treatments are wildly effective for a few people, no treatment is widely effective. If it were, migraines wouldn't be such a thing in the developed world. So by all means, let people know that Riboflavin might help them, but be wary of prescribing it to all and sundry when in truth, it will only help a minority.
- podgaj 5y ago
  How much, how long, and what type? You’re not being scientific about it at all.
  - deleted 5y ago
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DanielleMolloy 5y ago
This shouldn’t be downvoted, B2 / riboflavin is mentioned in the article too, next to Magnesium and Q10. Note that the recommended amount (100mg+) is far above the daily recommendation (~2mg).

pugworthy 5y ago

I rarely get the headache side of migraines, but I do get the visual aura fairly often. If over-stimulation is a factor, then certainly they are a bit self regulating since I have to just stop using the computer, stop reading, stop looking at my phone, etc. until it's gone. If you've not had the visual migraine effect before, the impact is a bit like if you looked a bright light, then tried to read something.

greatgib 5y ago
Very very interesting topic. I was also used to suffer from the visual migraine as you describe it. For another exemple, it is like looking at the phone in complete darkness with the phone brightness set to the maximum; but that effect in daylight with the screen set to low/normal brightness level. Maybe I'm wrong, but the deductions I did from my issues was that it might be related to work conditions. For example, I used to have the computer screen at 90° of a window. And there was probably constantly a little bit of light reflexion on my screen. So it is not so much to be noticable or annoying, but for a full day it will exhaust my eyes and brain. And I would regularly have the issue at the end of the day. Then, I changed of work and of light conditions, and I almost never got the issue anymore. (Still once in a while, but very very rarely compared to before) Also, I discovered that there are a lot of good advice regarding the work environment that you should try to respect: - no excessive room temperature (>21) - no sun or light directly in front. No light reflexion from the back or side. - room ambiant light the closest possible to the brightness of the screen But, a point that could support the theory of this publication is that, when the issue arrived, it was often that I was feeling hungry for sweets and desperately looking for a snack.
BrandoElFollito 5y ago
I do not usually get the headache part either but the visual part is epic. The first time I got it, a few years ago, I thought I was having a stroke. The visual area gets ripped in two by the diagonal, the two pieces move away and are replaced with a silver band. The picture stays more or less complete, but broken in two. The image kind of pulsates, or rather waves. I was terrified the first time, then visited the ophthalmologist, did a tomography of my head and ended up at a neurologist. He was a specialist of migraines and told me that about 30% of migraines are without headaches. My father has migraines, my younger brother too and both have headaches. I had some other extasy-like migranes and I am usually exhausted afterwrds and sleep 10 to 12 hours straight. I am lucky to have only a few cases a year.

alfiedotwtf 5y ago

Migraine sufferer here. Know your triggers! I used to suffer migraines at least once a months, and head aches at least once or twice a week. But then I found my triggers... So the Philae Lander landing on a comet on a Wednesday night, at sometime like 3am, and the next morning I had a really bad migraine. It was right then and there that I realised I only ever got migraines on Saturday and Sunday. Why did I all of a sudden get on then? Lack of sleep! I started experimenting, and eventually found that if I had under 4 hours of sleep for 3 days in a row, surely enough on the fourth day I would most likely have a migraine! It was an awesome epiphany. I’ve also managed to dramatically reduce headaches too - by having at last 6 hours sleep, I will have most likely staved away my usual tension head aches. I’m also under the suspicion that my headaches are effected by a lack to serotonin, but haven’t had my bloods checked for that yet.

yolobouquet 5y ago

I suffered from migraines for many years, always after a night's sleep. I had sleep studies and they determined I was not getting enough oxygen. I had surgery for a deviated septum and tissue in my nasal passages and throat was scoured back. I continued to get migraines and was given a CPAP. The headaches continued. I was in my 40s when my dentist asked me if I got headaches in the morning. She said I was grinding my teeth and I needed to start wearing a mouth guard at night or I was going to crack a molar. I still get migraines but they are much less frequent than they used to be.

TheSpiceIsLife 5y ago
This leads me to ponder if the cause of the tooth grinding could be resolved, would the frequency of migraines reduce further still? Have you tried taking a magnesium di-glycinate based magnesium supplement. Magnesium can help relax the small fast twitch muscles in the jaw.
11235813213455 5y ago
what's your resting jaw position? at rest, teeth shouldn't touch, there should be a small gap, and your tongue is usually touching the upper palate, just behind front teeth. Your resting breath-rate and heart-rate shouldn't be too high, relaxation and exercise will help (at any age!), try breathing deeply a few times, then exhale all the air, empty lungs and hold this for 20s and more

mancerayder 5y ago

I get a devastating headache every few weeks lasting a few days from the base of my skull inside, and it feels like the type of headache that you get from drinking something cold too fast, a bit milder, and lasting a few days. It seems to be triggered from sitting in front of the PC (I try to always stand), doing something dumb at the gym (benching and pushing my neck into the bench so I no longer bench), sitting awkwardly for too long (like a train seat), or looking at a slight angle down while working. It feels like nerve impingement and it travels sometimes to just one side of my face, and even hurts above my eye. Sometimes I feel nauseous too. I've had this for many years. It's more likely to happen if I've slept poorly or get stressed. What's the difference between that and migraine? I hear people all the time saying they suffer from migraines, and I'm told it's connected to a 'quadrant' type of pain. Are people being diagnosed with migraines maybe suffering from a similar nerve issue that I have? And by the way, that I have a nerve impingement is purely my own hypothesis, and difficult to prove/disprove I think.

sweetsocks21 5y ago
This sounds similar to something I had for years. I would get a left side migraine every couple months for 3-4 days. Other times I would have a regular headache in various areas, like behind the left eye. The occasional nausea was a symptom too. I would also get pin prick pain somewhere on my face, usually cheek or nose. It ended up being one of the cervical vertebrae were out of place, and once it was put back I never had an issue again. So I wouldn't be surprised if it's a pinched nerve or similar neck issue in your case.
- mancerayder 5y ago
  What type of doc found that ? And was it found with an MRI or X-Ray, or just by feel? I had an MRI that showed nothing unusual. I've never seen a chiropractor. If someone found something out of place and put it back, and solved my issue, I would be the happiest person on Earth for a while.
  - NickNameNick 5y ago

fallingfrog 5y ago

I once got a migraine with aphasia. I was noticing that the visual alligator crack rainbow lightning stuff was finally going away and I decided to check Facebook. I found that while the letters snd words looked normal, it was all gibberish. I tried saying something out loud and I found that all that came out was a mess of random phonemes. It lasted about half an hour. It looks like this if you want to see: https://youtu.be/IG7NuH5QTdE https://youtu.be/IG7NuH5QTdE In retrospect I probably should have gone to a doctor once I realized I was unable to speak..

kyle_morris_ 5y ago

I was a migraine-per-year person as a kid and migraine-per-quarter person for much of my adult life. I kept a food log and identified that a caffeine and chocolate combo to be a consistent trigger. In addition if too bright of a light shined in my eyes(let’s say a car door shut and the sun reflected off of the door’s window as I looked at it) it would also trigger a migraine. After working to limit those triggers I’ve found that I don’t get migraines much anymore. Adding in sumatriptan when they do come on has been helpful. If you find yourself with migraine symptoms I definitely recommend trying to identify the triggers, food, stress or otherwise.

treeman79 5y ago
This is good advise. The list of possible triggers is endless. A complete elimination diet is a good starting point. FL-41 migraine glasses are amazing sight. Eliminate all “scents” candles, perfumes, fancy soap, etc. Can be shocking as you introduce things back in what you find is a trigger.

AtlasBarfed 5y ago

Exercise would increase the "potential" of the brain and lessen migraines then? Not necessarily DURING a migraine, but as a preventative measure? Or are measures of "expenditure" vs "reserve" measured in other ways than oxygen consumption / energy production?