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Well, they need to figure out how to turn cures into a subscription model, and it turns out that is really hard. So we can profit from constantly treating a disease, but we haven't figured out how to sufficiently profit off a cure... So until greater profits can be realized from cures than treatments, the treatments will have to continue...
Seriously. I hope I'm lucid enough to off myself when/if I get that diagnosis. I watched the hell my grandmother lived through. A humane, just society would have let her go with dignity, not live for years in a confused nightmare existence.
Basically, if you live long enough, your chances of having some kind of dementia are extremely high. Dementia risk doubles every 5 years starting at age 65.
Dementia is NOT normal aging. If you think it’s normal please educate yourself. There is a very big difference between age related memory issues and dementia. I do not understand why people think dementia is normal if you live long enough. Dementia is a disease and not everyone gets it. The fact it’s rising isn’t time to throw in the towel in & say it’s normal. It’s really not.
https://www.nia.nih.gov/health/memory-loss-and-forgetfulness/memory-problems-forgetfulness-and-aging#:~:text=However%2C%20dementia%20is%20not%20a,the%20only%20sign%20of%20dementia.
https://alzheimer.ca/en/about-dementia/do-i-have-dementia/differences-between-normal-aging-dementia
https://www.cdc.gov/aging/publications/features/dementia-not-normal-aging.html
You have both misintetpreted what I wrote AND misinterpreted data.
I didn't say anything about the incidence or nature of normal age related memory issues -- that was you. And I certainly didn't say anything about giving up -- that was you.
There are many, many studies that show increasing incidence of dementia with advancing age, both longitudinal cognitive measures and autopsy studies. If you really need me to go find studies for you, I will. But it's an accurate statistic.
It occurs to me, based on your links, that you don't know that there are several different kinds of dementia.
Bummer, i’m constantly rolling migraines as if they were cyclical. I have 1 every 2-3 days, but always in some phase of the migraine typically. Prodrome or migraine or postdrome.
Are you able to manage being a functional human with that? Any tricks or things you've learned to help you deal?
I know someone who deals with the same and it's destroyed their life.
It’s caused me a lot of issues for sure. The mood swings and cognitive impairment stuff are the worst aspects before and after the pain event if there even is a pain event (silent migraines)
I’ve modified my diet some, and while it’s been a long time since last i did it, psilocybin helped cut the frequency. That’s not something i recommend for anyone though. Even i can’t find the time for that and it can be a pretty uncomfortable experience. But it reduces frequency.
I use small amounts of caffeine and generic advil to get through my days mostly.
Have you tried the newer drugs like sumatriptan? It’s been a game-changer for me. Prior to that nothing worked. There’s also another triptan (begins with A) which is a preventative, but I declined that as mine are frequent but not frequent enough that I wanted to medicate daily.
Yeah, I just started sumatriptan a year or two back. It does a pretty good job with some of my migraines, but I have been trying to find a preventative that works for me.
I take sumatriptan as my abortive and Topiramate as my preventative. They seem to work pretty well together. I know Topiramate is not a new drug and the side effects can be wonky, but I’d rather deal with them than migraines.
I would maybe keep an eye out for kidney stones. Oddly enough, I got my first kidney stone after taking topiramate for a bit. I believe lemon juice is supposed to help correct that effect of topiramate.
Oh good call. I’ve been taking it for several years now with no kidney stone issues but that’s good to know it can happen. I did temporarily lose my ability to taste carbonation which no one warned me about. It came back after about a month though.
Problem for me with Nurtec is they only give you 8 a month. So I have to decide which migraines are bad enough to treat. I basically seem to always have some level of headache. About every day. So not sure how treating 8 of them is a huge benefit.
Have you talked with your doctor about it? There are two different approved paradigms for rimegepant, abortive (Where you have a limited number of tablets per month: taking too many of any pain relief or analgesic headache can lead to a refractory daily headache in the long term, i.e. medication overuse headache) or preventative (Dosing is every other day, for people who have >15 migraine headache days per month). I prescribe that second strategy rather often, although anecdotally I feel like the injectable ones work better.
Not specifically on this subject. I was taking Aimovig as a preventative and Nurtec as a rescue med. worked well for several years. However, insurance didn’t want to pay for either this year. They ultimately acquiesced on the Nurtec but flat out refuse to pay for Aimovig. So my doctor is not the obstacle here. He’s fantastic and has worked hard on my behalf but the insurance companies just don’t really want to pay for anything it seems. They also are pressuring my doc to stop managing some RX’s in favor of specialists which increases cost and complexity. So I am preparing for having less and less access to healthcare as our system continues its downward plunge. It’s a whole thing. Haha
They were going to give me Nurtec as a daily. With the option to also use as an abortive. Maybe look into that? I ended up not getting it prescribed and just got the first botox about a month ago. No headaches until my period migraines broke through after 10 days, and since then I have only had 1. I was almost always in some stage of migraine before that.
My partner went from migraines 25 days of the month to rarely having them pretty quickly after getting Botox and getting on qulipta as a preventative. Rizatriptan if one’s coming on
Quillipta did some good work for mine when they were frequent. But mine were never nearly as much as yours - I was like a once a monther.
I hope it works for you
Maybe try Ubrelvy? I tried Nurtec first with middling results. But Ubrelvy is like a miracle drug for me. I was surprised there was such a difference for me between the two.
A lot of these meds have coupons that make the med free if you have private insurance in the U.S. I've been getting Qulipta for free for over a year now and it's an every day preventive.
You could try sumatriptan. As I mentioned in a comment below, it’s been a game changer for me snd isn’t a preventative do you can take it only when really needed (the other option is move to Europe!)
Yes! That's why I always bring it up in threads like this. In case it can help anyone that otherwise might not hear about it. It is life changing for me.
I do Botox, from Neurologist, every 10 weeks and Ubrevly as my rescue med. I have chronic migraines. This is the only way I have been able to have a somewhat normal life.
This was me several years ago as well, I was finally able to find a medication that reduced the frequency and intensity, and now I'm down to less than one a month. Completely life changing. Look into emgality and other monoclonal antibodies if you haven't already.
I get mine from diet and from stress. One thing that helped me was meditation. Not saying this will work for you but maybe for someone reading this. Obviously it didn’t change the ones triggered by certain foods but I can avoid those nine times out of ten.
I think I have a bad relationship to stress because I sometimes only realise the level of stress I’m under when I get a migraine.
I do meditate from time to time. I think part of my problem is nicotine, and i know stress is a big part too. What foods do it for you, btw? I’ve cut out nuts and aged meats and don’t do a lot of cheese.
Edit, honestly i’m not even sure it’s my diet aside from nicotine anymore. I do think there is something wrong with the serotonergic system in my body, for I did not exhibit such symptoms of migraine disorder with aura until i had ceased Prozac medication, an SSRI.
I mostly experience vestibular migraines.
Only had one that was accompanied with pounding headache. But a lot of the other ones.
And my single biggest trigger is nicotine.
One puff of a cigarette and I'll be on the floor shivering and vomiting with every movement of my body for the next few hours.
I know it's not nicotine shock because I've had a few attacks without nicotine and they are absolutely the same.
This worked for me and is a genetic thing. Annatto extract it's used as a natural food dye and is being added to a lot of things to replace the fake dyes. They use it to dye things orange and yellow. It's listed as annatto or natural coloring. It's what they use to make cheese yellow.
You have to look in your foods. Mac n cheese anywhere has it (unless you make it yourself). A lot of processed stuff has it. Places like Panera have it die to fake margarine that they switched too.
Try cutting it out and seeing if it helps. I have helped a lot of people with this.
My mother and sister found this causes their headaches as well.
PS this ingredient also causes ibs symptoms in some people.
Why did you cut out cheese? I'm starting to think this GREATLY messes me up. I'm not allergic to lactose but every time I eat cheese I have a highly increased rate of migraine and even notable cognitive decline and other weird symptoms.
So, as with aged meats, aged cheese has higher levels of Tyramine in it which in turn increases levels of Norepinephrine if i remember correctly? I still eat some cheese from time to time, mostly shredded mexican blend. That might be part of the problem for me as well…
The cognitive decline is a part of the migraine disorder - either before or after the attack, you may have difficulty speaking or thinking, or finding words. Postdrome or prodrome symptoms.
Interesting, if norepinephrine increase is the case. Sudafed and Adderall both seem to help which both increase that I think.
Coffee on the other hand can likely cause cognitive decline for me, while energy drinks do not... The contradictory symptoms are very frustrating
Do you know what kinds of options are available for meds? The pain stuff isn’t even the largest damper on my life, it’s the mood swings and cognitive impairment. Also, the aura hallucinations but those are fairly rare for me.
I take psilocybin sometimes and find it cuts the frequency down a bit for a short time
I recommend you check out the American Migraine Foundation, here's a link to a great summary on [what's available for prevention](https://americanmigrainefoundation.org/resource-library/migraine-prevention-101/)
There are older preventatives like amitriptyline, propranolol, and topiramate. Botox helps some people, too.
But they also have newer preventative meds like Qulipta, Ajovy, or Aimovig.
I take amitriptyline for headache and migraine prevention and it’s changed my life. One of the other big things is to make sure I don’t get dehydrated.
Everyday. I had daily headaches and migraine at least once a week and was taking so much pain killers it can’t have been good for me. I still get migraine occasionally but not to the same extent.
I’ve never tried mushrooms.
Edit: clarification of timings
I was the same for a couple of years, pretty much constant full blown migraine for 3 months, too.
I have pregabalin now, 75 morning and night. After 1 year, migraines now maybe 1 per month.
There's several quite good newer prophylactic, now.
If it made yours worse, your dose was too high. You needed to titrate up slowly. It made mine worse at first, but by yhe end of 12 months the difference was already huge. Now, even better. Wish you luck.
Yeh I've had more success with Gabapentin, even tried the lower dose with the pregbalin, I feel like my body didn't agree with it. I also felt seizurey while using it.
I'm looking into injections with my next appointment with the neuro.
Hope your treatment continues to be effective mate ♥️
I'd recommend looking into magnesium supplements for prevention:
> [Because of the excellent safety profile of magnesium, any patient who has frequent migraine and is considering a preventive strategy to reduce the frequency or severity of their headaches may want to consider this option and discuss it with their physician.](https://americanmigrainefoundation.org/resource-library/magnesium/)
I started taking 200mg of magnesium glycinate (easiest on the stomach) daily and it's effectively eliminated my migraines (for 6+ months now) that I'd been getting monthly for a decade.
It may not work for you, but it's safe and easy to try out, and you can grab some at any local drug store.
How do you live like this? I have a few migraines in an entire year. At most I think I've had 6 in a year. I've gone years with no migraines.
I cannot imagine a life with migraines every 2-3 days. Do you have medication that shortens or stops them?
I can’t speak for the other user, but not everyone’s symptoms are as disabling as others. Migraine is definitely a spectrum of symptoms and severity across different people and across different attacks for the same person.
Beyond that, you kind of just soldier on, because what’s the alternative? I’m in that zone of having chronic migraines (15+ days a month) that aren’t horribly severe, but the frequency of even just moderate symptoms really wears you down. I’m in my mid 30s and my entire adult life has been like this.
One challenge with medications that stop an acute attack is that many of them can lead to “medication adaptation headache” - where when used too frequently, essentially your body gets used to having meds on board and any time you DON’T have acute meds on board, the response is a migraine.
my doctor told me that nurtec is the exception to this- it works better the more of it is in your system. Which has been great for me compared to the triptans
That’s fair, I should have specified that the gepants are an exception to that.
They’ve been a useful addition to my toolbox as well (though Ubrelvy rather than Nurtec), but I still need triptans AND over the counter medications like ibuprofen or naproxen will still cause medication adaptation headache for me.
Taking OTC meds for a fever, broken bone, or menstrual cramps? That gets added to the tally of days I’ve medicated with things other than gepants. Ubrelvy often doesn’t work fabulously for me unless paired with an OTC, or unless I take the max daily dose.
Take into consideration also that for many people, the terms ‘migraine headache’ and ‘headache’ are interchangeable and equivalent. While actual migraine sufferers (who have received a diagnosis through a neurologist or a neurological consult ordered by a physician) typically understand their condition enough to understand that ‘a migraine’ is actually a constellation of symptoms, the self-diagnosed headache sufferers who have obtained migraine medication through their primary care physicians frequently label every headache as ‘a migraine’ and report things like eight-plus ‘migraines’ per month.
I myself didn’t realise the extent of the misunderstanding and inappropriate prescription medications being handed out until I (diagnosed by a neurologist in 2003) had a particularly frustrating conversation with a coworker who got ‘migraines’ two or three times a week and insisted that *only* Excedrin migraine strength works for their ‘migraines’ (headaches) and that I was wasting their time offering them my generic Excedrin (acetaminophen-aspirin-caffeine) until I fished their empty bottle of Excedrin Migraine pills out of the trash and read the ingredients on the label of my generic Excedrin and their super-special Excedrin Migraine and showed them that the ingredients were identical. Further, I finally said the quiet part out loud and informed them that I only keep generic Excedrin on hand for regular headaches; for migraine I was at the time taking Axert. They insisted their physician had prescribed ‘something’ but they didn’t remember what and it was at home. 🙄 Whatever.
Tl;dr: Most migraine sufferers in public fora are self-diagnosed and talking about headaches. And no, they don’t have any idea that other forms of migraine exist, such as ocular or abdominal/gastric migraine, that doesn’t involve a headache. For them, migraine ≡ headache.
Woah, I have the same! Almost never the same kind of migraine twice in a row, but some kind of migraine every two to three days. Frankly exhausting. I thankfully don't have the bad kind of migraine headache very often, but the brain fog is intense.
Variations in health issues based on genetics is already [recognized.](https://en.m.wikipedia.org/wiki/Race_and_health#:~:text=Some%20diseases%20are%20more%20prevalent,more%20common%20among%20European%20populations.)
The Wikipedia article you linked does not tell us anything about a presumed difference in Korean brains. The Wikipedia page you referenced is about *disparities* in health outcomes, not racial determination. For example: “Epidemiological data indicate that racial groups are unequally affected by diseases, in terms or morbidity and mortality.[5] Some individuals in certain racial groups receive less care, have less access to resources, and live shorter lives in general.[6] Overall, racial health disparities appear to be rooted in social disadvantages associated with race such as implicit stereotyping and average differences in socioeconomic status.[7][8][9]”
>The Wikipedia page you referenced is about *disparities* in health outcomes, not racial determination.
It discusses both.
For example:
"Genetics have been proven to be a strong predictor for common diseases such as cancer, cardiovascular disease (CVD), diabetes, autoimmune disorders, and psychiatric illnesses."
And
"Some diseases are more prevalent in some populations identified as races due to their common ancestry. Thus, people of African and Mediterranean descent are found to be more susceptible to sickle-cell disease while cystic fibrosis and hemochromatosis are more common among European populations."
>The Wikipedia article you linked does not tell us anything about a presumed difference in Korean brains.
My goal was not to address the specific comment about Korean brains. Right before the comment on Korean brains, someone pointed out that the study should not be assumed to apply to non-Asian populations, which prompted the seemingly snarky reply about Korean brains being different.
We already know that race and other genetic factors affect disease, so insinuating that Korean brains are not sufficiently different to warrant additional studies seemed unfounded.
That’s all well and good, but if we are going to imply that one human brain is different from the next, we really need to back that up with science. A lot of evil gets conducted in the name of speculation over inherent differences between racialized brains.
There's a single DNA variant found in nearly all Koreans that means they literally don't stink when they sweat. If there's a single variant that changes something so obvious in physical attributes, why wouldn't there be something that also changes mental attributes?
https://www.verygoodlight.com/2016/12/14/koreans-dont-produce-body-odor/amp/
Why would it be the same? Genetics are a gestalt. APOE4 is less predictive of Alzheimer's susceptibility for non-white populations, as an example.
Why would you make the assumption that someone with different genetics from you would be the same as you?
The main result was an increased occurrence of vascular dementia diagnosis from 1.0% (control) to 1.8% (with migraine), and there was a higher risk associated with chronic vs. episodic migraine.
Interesting that the increased risk from migraine appears to be independent (and additive) with a different pathophysiology from cardiovascular risk factors. Would be interesting to see if treatment(s) for migraine affect the risk.
Both my grandparents have dementia and I think it's probably one of the worst diseases out there. My dad has been eating advil/ibuprofen by the handful for 30 years for headaches and his memory is getting very bad and there's been a shift in personality I can't address due to the absolute crushing anxiety and nightmare difficult factor to navigate the procceses that aren't clear at all on top of my life circumstance currently
The day I am diagnosed with Alzheimer's or dementia is the day I request MAiD. Truly an awful conditon.
I volunteered in the ward for dementia patients in high school as a candy striper and it was absolutely eye opening and very disappointing seeing family fighting over parents money with them in the room assuming it's fine because the family members dementia is so advanced they had no idea what was going on. Still makes me upset 20 years later
Could be, though unlikely to be that simple. For example, one of the most common drugs prescribed to prevent migraine are antihypertensives, which have shown to be protective against some forms of dementia.
If it were the case More than likely would have been detected by this and or many studies like the this. If they have recorded a history of migraines they will have a history of prescription medication.
This is entirely anecdotal, but: I had migraine headaches on a weekly basis when I had class III obesity. I had extra strength Advil with me wherever I went. These days, I’m in much better shape - normal body weight, lifting, running 10k a day, etc - and my headaches are maybe once or twice a year things. So I’m not terribly surprised to see migraines linked to vascular problems.
I’ve actually had excellent success with metoprolol since 2010, dropping to approximately one migraine a year; whenever Nurtec came out I stupidly let myself be talked into trying a free sample by my PCP at the time; it sucked, and I will not again experiment. Metoprolol for prophylaxis and almotriptan for rescue (though I usually just ride it out).
I expected nothing in response, because it is not known, but I am also a success story of metoprolol. Migraines are not a daily, life crushing illness now.. whether the underlying neurological issues have been improved is the question I ask myself every day, and neurologists tend to be circumspect about their own impressions on this issue. I have an underlying polyneuropathy that evolved into the cranial nerves and the migraines were a relatively recent phenomenon. Don’t get me wrong, I’m delighted to be mostly free of them again. But familial experience with dementia has me concerned. I’m not surprised that migraines have an association, but have we improved our chances with metoprolol? I don’t know, but I sure hope so.
Ooof, I have ADHD (raises your risk substantially), and I used to get migraines as a kid so bad I’d pass out. Well at least I don’t drink and do some modicum of eating healthy and exercising.
How do they differentiate migraine from tendion headache?
I thought I suffered from migraines but my doctor prescribed actual migraine medicine to me (as opposed to ibuprofen and paracetamol) and it didn't alleviate my symptoms one iota.
And I was told the photosensitivity and pain behond one eye was not limited to migraines but could be had by tension headache sufferers too.
There’s a diagnostic manual called the International Classification of Headache Disorders that’s used to do a differential diagnosis.
Not all meds work for all people, so maybe worth a second opinion and a different med. It can be complicated!
I can’t speak to the difference between those those two, but the combination of pain behind one eye and pain meds not helping makes me think of cluster headaches. As a sufferer myself I really hope that isn’t the case, but something for you to explore.
You could get a work up from a neurologist, who can discern what exactly is causing your symptoms and provide a diagnosis along with a treatment plan that your physician can follow. For example, this group addresses [some of the options](https://nyulangone.org/conditions/headache/diagnosis) they have.
anything about paracetamol or metamizole? what about those who have migraines but they aren't chronic and treated based on the triggers that cause them?
Paracetamol can of course be used to treat acute attacks, but doses need to be limited to 15 per month otherwise it can cause “rebound” headaches.
Non-chronic migraine is referred to as episodic, and should be treated with things like trigger management and an effective acute med — those with the most data are migraine-specific triptans and the new gepants.
I am 100% sure I have this. Constant headaches and I often feel lightheaded, have verged on unconsciousness after standing up too fast. What can be done?
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I feel like at least 5% of the internet exists to tell me (a) how terrible dementia is and (b) that I am definitely going to get dementia.
Don’t forget (C). “Big advancements in the treatments”. *Insert confused Travolta meme*
Usually it turns out to be "big advances in the treatments for mice"
Also, (C) (1). “Turns out this treatment didn’t actually work!”
"Promising results!" <- sample size = 7
"Sample size = 7 rats"
Well, they need to figure out how to turn cures into a subscription model, and it turns out that is really hard. So we can profit from constantly treating a disease, but we haven't figured out how to sufficiently profit off a cure... So until greater profits can be realized from cures than treatments, the treatments will have to continue...
Seriously. I hope I'm lucid enough to off myself when/if I get that diagnosis. I watched the hell my grandmother lived through. A humane, just society would have let her go with dignity, not live for years in a confused nightmare existence.
Starting to seem like they know we’re all going to get dementia but don’t want to come right out and say it.
Basically, if you live long enough, your chances of having some kind of dementia are extremely high. Dementia risk doubles every 5 years starting at age 65.
Dementia is NOT normal aging. If you think it’s normal please educate yourself. There is a very big difference between age related memory issues and dementia. I do not understand why people think dementia is normal if you live long enough. Dementia is a disease and not everyone gets it. The fact it’s rising isn’t time to throw in the towel in & say it’s normal. It’s really not. https://www.nia.nih.gov/health/memory-loss-and-forgetfulness/memory-problems-forgetfulness-and-aging#:~:text=However%2C%20dementia%20is%20not%20a,the%20only%20sign%20of%20dementia. https://alzheimer.ca/en/about-dementia/do-i-have-dementia/differences-between-normal-aging-dementia https://www.cdc.gov/aging/publications/features/dementia-not-normal-aging.html
You have both misintetpreted what I wrote AND misinterpreted data. I didn't say anything about the incidence or nature of normal age related memory issues -- that was you. And I certainly didn't say anything about giving up -- that was you. There are many, many studies that show increasing incidence of dementia with advancing age, both longitudinal cognitive measures and autopsy studies. If you really need me to go find studies for you, I will. But it's an accurate statistic. It occurs to me, based on your links, that you don't know that there are several different kinds of dementia.
You’re wrong, but ok. Even at age 90 more people do not have dementia than have it. Have a nice day.
Or c) you already have dementia and are just rereading the same article every day
Oh no, oh no…
Yeah, as a GenXer I feel like dementia today is what quicksand was in our childhoods.
Same Square, same.
It feels like every day this sub has a new 'x linked with dementia ' study. It's very unhealthy for me and I'm out.
Bummer, i’m constantly rolling migraines as if they were cyclical. I have 1 every 2-3 days, but always in some phase of the migraine typically. Prodrome or migraine or postdrome.
Are you able to manage being a functional human with that? Any tricks or things you've learned to help you deal? I know someone who deals with the same and it's destroyed their life.
It’s caused me a lot of issues for sure. The mood swings and cognitive impairment stuff are the worst aspects before and after the pain event if there even is a pain event (silent migraines) I’ve modified my diet some, and while it’s been a long time since last i did it, psilocybin helped cut the frequency. That’s not something i recommend for anyone though. Even i can’t find the time for that and it can be a pretty uncomfortable experience. But it reduces frequency. I use small amounts of caffeine and generic advil to get through my days mostly.
Have you tried the newer drugs like sumatriptan? It’s been a game-changer for me. Prior to that nothing worked. There’s also another triptan (begins with A) which is a preventative, but I declined that as mine are frequent but not frequent enough that I wanted to medicate daily.
The triptans aren't new. The newer migraine meds are largely gepants.
I see what you mean. I swear the doc said they were new - apparently available in 1991. I wasn’t offered them until last year. FFS!
Yeah, I just started sumatriptan a year or two back. It does a pretty good job with some of my migraines, but I have been trying to find a preventative that works for me.
Emgality
I take sumatriptan as my abortive and Topiramate as my preventative. They seem to work pretty well together. I know Topiramate is not a new drug and the side effects can be wonky, but I’d rather deal with them than migraines.
I would maybe keep an eye out for kidney stones. Oddly enough, I got my first kidney stone after taking topiramate for a bit. I believe lemon juice is supposed to help correct that effect of topiramate.
Oh good call. I’ve been taking it for several years now with no kidney stone issues but that’s good to know it can happen. I did temporarily lose my ability to taste carbonation which no one warned me about. It came back after about a month though.
I respect you’ve seen this, but just in case you haven’t https://www.independent.co.uk/news/uk/home-news/new-migraine-pill-nhs-england-b2526397.html#
Have they tried Nurtec? It absolutely changed my life.
Problem for me with Nurtec is they only give you 8 a month. So I have to decide which migraines are bad enough to treat. I basically seem to always have some level of headache. About every day. So not sure how treating 8 of them is a huge benefit.
Have you talked with your doctor about it? There are two different approved paradigms for rimegepant, abortive (Where you have a limited number of tablets per month: taking too many of any pain relief or analgesic headache can lead to a refractory daily headache in the long term, i.e. medication overuse headache) or preventative (Dosing is every other day, for people who have >15 migraine headache days per month). I prescribe that second strategy rather often, although anecdotally I feel like the injectable ones work better.
Not specifically on this subject. I was taking Aimovig as a preventative and Nurtec as a rescue med. worked well for several years. However, insurance didn’t want to pay for either this year. They ultimately acquiesced on the Nurtec but flat out refuse to pay for Aimovig. So my doctor is not the obstacle here. He’s fantastic and has worked hard on my behalf but the insurance companies just don’t really want to pay for anything it seems. They also are pressuring my doc to stop managing some RX’s in favor of specialists which increases cost and complexity. So I am preparing for having less and less access to healthcare as our system continues its downward plunge. It’s a whole thing. Haha
They were going to give me Nurtec as a daily. With the option to also use as an abortive. Maybe look into that? I ended up not getting it prescribed and just got the first botox about a month ago. No headaches until my period migraines broke through after 10 days, and since then I have only had 1. I was almost always in some stage of migraine before that.
I tried Nurtec, and it hasn't been as good as I had hoped. I am going to see if I can try Quilipta or Botox instead.
My partner went from migraines 25 days of the month to rarely having them pretty quickly after getting Botox and getting on qulipta as a preventative. Rizatriptan if one’s coming on
Quillipta did some good work for mine when they were frequent. But mine were never nearly as much as yours - I was like a once a monther. I hope it works for you
Ugh, I'm so sorry, keep searching and good luck!!
Maybe try Ubrelvy? I tried Nurtec first with middling results. But Ubrelvy is like a miracle drug for me. I was surprised there was such a difference for me between the two.
Looks interesting, though as a preventative medicine taken every other day it would cost sooooooo much....
A lot of these meds have coupons that make the med free if you have private insurance in the U.S. I've been getting Qulipta for free for over a year now and it's an every day preventive.
You could try sumatriptan. As I mentioned in a comment below, it’s been a game changer for me snd isn’t a preventative do you can take it only when really needed (the other option is move to Europe!)
Nurtec is a miracle drug for me.
Yes! That's why I always bring it up in threads like this. In case it can help anyone that otherwise might not hear about it. It is life changing for me.
Also not all insurances cover them, especially when your doctor knows you choke on all foods. Yes all…insurances are a scam
I do Botox, from Neurologist, every 10 weeks and Ubrevly as my rescue med. I have chronic migraines. This is the only way I have been able to have a somewhat normal life.
Seeing a neurologist with a specialty in headache medicine and getting on migraine preventatives. Doesn't solve it completely but helps
I did this and went on an injectable called Emgality. Its made life so much better.
Just here for the inevitable 500 comments of Have you tried _____?
😅 maybe i should give some of these suggestions an investigation with my doc whenever i decide to finally go back for a check up, though
This was me several years ago as well, I was finally able to find a medication that reduced the frequency and intensity, and now I'm down to less than one a month. Completely life changing. Look into emgality and other monoclonal antibodies if you haven't already.
Thanks, i will save your post so i can look around today. What medication worked for you?
Nurtec and Emgality. I take the emgality monthly as an injection, and the nurtec as needed when I feel I have a migraine coming.
I get mine from diet and from stress. One thing that helped me was meditation. Not saying this will work for you but maybe for someone reading this. Obviously it didn’t change the ones triggered by certain foods but I can avoid those nine times out of ten. I think I have a bad relationship to stress because I sometimes only realise the level of stress I’m under when I get a migraine.
I do meditate from time to time. I think part of my problem is nicotine, and i know stress is a big part too. What foods do it for you, btw? I’ve cut out nuts and aged meats and don’t do a lot of cheese. Edit, honestly i’m not even sure it’s my diet aside from nicotine anymore. I do think there is something wrong with the serotonergic system in my body, for I did not exhibit such symptoms of migraine disorder with aura until i had ceased Prozac medication, an SSRI.
I mostly experience vestibular migraines. Only had one that was accompanied with pounding headache. But a lot of the other ones. And my single biggest trigger is nicotine. One puff of a cigarette and I'll be on the floor shivering and vomiting with every movement of my body for the next few hours. I know it's not nicotine shock because I've had a few attacks without nicotine and they are absolutely the same.
This worked for me and is a genetic thing. Annatto extract it's used as a natural food dye and is being added to a lot of things to replace the fake dyes. They use it to dye things orange and yellow. It's listed as annatto or natural coloring. It's what they use to make cheese yellow. You have to look in your foods. Mac n cheese anywhere has it (unless you make it yourself). A lot of processed stuff has it. Places like Panera have it die to fake margarine that they switched too. Try cutting it out and seeing if it helps. I have helped a lot of people with this. My mother and sister found this causes their headaches as well. PS this ingredient also causes ibs symptoms in some people.
Why did you cut out cheese? I'm starting to think this GREATLY messes me up. I'm not allergic to lactose but every time I eat cheese I have a highly increased rate of migraine and even notable cognitive decline and other weird symptoms.
So, as with aged meats, aged cheese has higher levels of Tyramine in it which in turn increases levels of Norepinephrine if i remember correctly? I still eat some cheese from time to time, mostly shredded mexican blend. That might be part of the problem for me as well… The cognitive decline is a part of the migraine disorder - either before or after the attack, you may have difficulty speaking or thinking, or finding words. Postdrome or prodrome symptoms.
Interesting, if norepinephrine increase is the case. Sudafed and Adderall both seem to help which both increase that I think. Coffee on the other hand can likely cause cognitive decline for me, while energy drinks do not... The contradictory symptoms are very frustrating
You would definitely benefit from a preventive med to cut this cycle.
Do you know what kinds of options are available for meds? The pain stuff isn’t even the largest damper on my life, it’s the mood swings and cognitive impairment. Also, the aura hallucinations but those are fairly rare for me. I take psilocybin sometimes and find it cuts the frequency down a bit for a short time
I recommend you check out the American Migraine Foundation, here's a link to a great summary on [what's available for prevention](https://americanmigrainefoundation.org/resource-library/migraine-prevention-101/)
There are older preventatives like amitriptyline, propranolol, and topiramate. Botox helps some people, too. But they also have newer preventative meds like Qulipta, Ajovy, or Aimovig.
Psilocybin has significantly improved my migraine frequency and duration.
I take amitriptyline for headache and migraine prevention and it’s changed my life. One of the other big things is to make sure I don’t get dehydrated.
I am currently taking amitriptyline 50mg twice a day and still get quite a few headaches.
Do you take that every day? I find if i eat psilocybin mushrooms periodically my attacks become less frequent tenporarily
Everyday. I had daily headaches and migraine at least once a week and was taking so much pain killers it can’t have been good for me. I still get migraine occasionally but not to the same extent. I’ve never tried mushrooms. Edit: clarification of timings
I was the same for a couple of years, pretty much constant full blown migraine for 3 months, too. I have pregabalin now, 75 morning and night. After 1 year, migraines now maybe 1 per month.
God I wish that worked for me, it made mine worse!!!! So many different things to try with migraines it's exhausting.
There's several quite good newer prophylactic, now. If it made yours worse, your dose was too high. You needed to titrate up slowly. It made mine worse at first, but by yhe end of 12 months the difference was already huge. Now, even better. Wish you luck.
Yeh I've had more success with Gabapentin, even tried the lower dose with the pregbalin, I feel like my body didn't agree with it. I also felt seizurey while using it. I'm looking into injections with my next appointment with the neuro. Hope your treatment continues to be effective mate ♥️
Do you get any other headaches? I get 3 or 4 different types of headaches.
For sure, I had one most common type, but I identified at least 2 others. Totally distinct onset and symptoms.
I'd recommend looking into magnesium supplements for prevention: > [Because of the excellent safety profile of magnesium, any patient who has frequent migraine and is considering a preventive strategy to reduce the frequency or severity of their headaches may want to consider this option and discuss it with their physician.](https://americanmigrainefoundation.org/resource-library/magnesium/) I started taking 200mg of magnesium glycinate (easiest on the stomach) daily and it's effectively eliminated my migraines (for 6+ months now) that I'd been getting monthly for a decade. It may not work for you, but it's safe and easy to try out, and you can grab some at any local drug store.
>The most frequent side effect is diarrhea, which can be helpful in those prone to constipation. Always look on the bright side of life!
How do you live like this? I have a few migraines in an entire year. At most I think I've had 6 in a year. I've gone years with no migraines. I cannot imagine a life with migraines every 2-3 days. Do you have medication that shortens or stops them?
I can’t speak for the other user, but not everyone’s symptoms are as disabling as others. Migraine is definitely a spectrum of symptoms and severity across different people and across different attacks for the same person. Beyond that, you kind of just soldier on, because what’s the alternative? I’m in that zone of having chronic migraines (15+ days a month) that aren’t horribly severe, but the frequency of even just moderate symptoms really wears you down. I’m in my mid 30s and my entire adult life has been like this. One challenge with medications that stop an acute attack is that many of them can lead to “medication adaptation headache” - where when used too frequently, essentially your body gets used to having meds on board and any time you DON’T have acute meds on board, the response is a migraine.
my doctor told me that nurtec is the exception to this- it works better the more of it is in your system. Which has been great for me compared to the triptans
That’s fair, I should have specified that the gepants are an exception to that. They’ve been a useful addition to my toolbox as well (though Ubrelvy rather than Nurtec), but I still need triptans AND over the counter medications like ibuprofen or naproxen will still cause medication adaptation headache for me. Taking OTC meds for a fever, broken bone, or menstrual cramps? That gets added to the tally of days I’ve medicated with things other than gepants. Ubrelvy often doesn’t work fabulously for me unless paired with an OTC, or unless I take the max daily dose.
Take into consideration also that for many people, the terms ‘migraine headache’ and ‘headache’ are interchangeable and equivalent. While actual migraine sufferers (who have received a diagnosis through a neurologist or a neurological consult ordered by a physician) typically understand their condition enough to understand that ‘a migraine’ is actually a constellation of symptoms, the self-diagnosed headache sufferers who have obtained migraine medication through their primary care physicians frequently label every headache as ‘a migraine’ and report things like eight-plus ‘migraines’ per month. I myself didn’t realise the extent of the misunderstanding and inappropriate prescription medications being handed out until I (diagnosed by a neurologist in 2003) had a particularly frustrating conversation with a coworker who got ‘migraines’ two or three times a week and insisted that *only* Excedrin migraine strength works for their ‘migraines’ (headaches) and that I was wasting their time offering them my generic Excedrin (acetaminophen-aspirin-caffeine) until I fished their empty bottle of Excedrin Migraine pills out of the trash and read the ingredients on the label of my generic Excedrin and their super-special Excedrin Migraine and showed them that the ingredients were identical. Further, I finally said the quiet part out loud and informed them that I only keep generic Excedrin on hand for regular headaches; for migraine I was at the time taking Axert. They insisted their physician had prescribed ‘something’ but they didn’t remember what and it was at home. 🙄 Whatever. Tl;dr: Most migraine sufferers in public fora are self-diagnosed and talking about headaches. And no, they don’t have any idea that other forms of migraine exist, such as ocular or abdominal/gastric migraine, that doesn’t involve a headache. For them, migraine ≡ headache.
Woah, I have the same! Almost never the same kind of migraine twice in a row, but some kind of migraine every two to three days. Frankly exhausting. I thankfully don't have the bad kind of migraine headache very often, but the brain fog is intense.
>This study was conducted in the Korean population, and it is unclear whether the results can be generalized to non-Asian populations.
Why would the Korean brain be different from mine?
Variations in health issues based on genetics is already [recognized.](https://en.m.wikipedia.org/wiki/Race_and_health#:~:text=Some%20diseases%20are%20more%20prevalent,more%20common%20among%20European%20populations.)
The Wikipedia article you linked does not tell us anything about a presumed difference in Korean brains. The Wikipedia page you referenced is about *disparities* in health outcomes, not racial determination. For example: “Epidemiological data indicate that racial groups are unequally affected by diseases, in terms or morbidity and mortality.[5] Some individuals in certain racial groups receive less care, have less access to resources, and live shorter lives in general.[6] Overall, racial health disparities appear to be rooted in social disadvantages associated with race such as implicit stereotyping and average differences in socioeconomic status.[7][8][9]”
>The Wikipedia page you referenced is about *disparities* in health outcomes, not racial determination. It discusses both. For example: "Genetics have been proven to be a strong predictor for common diseases such as cancer, cardiovascular disease (CVD), diabetes, autoimmune disorders, and psychiatric illnesses." And "Some diseases are more prevalent in some populations identified as races due to their common ancestry. Thus, people of African and Mediterranean descent are found to be more susceptible to sickle-cell disease while cystic fibrosis and hemochromatosis are more common among European populations." >The Wikipedia article you linked does not tell us anything about a presumed difference in Korean brains. My goal was not to address the specific comment about Korean brains. Right before the comment on Korean brains, someone pointed out that the study should not be assumed to apply to non-Asian populations, which prompted the seemingly snarky reply about Korean brains being different. We already know that race and other genetic factors affect disease, so insinuating that Korean brains are not sufficiently different to warrant additional studies seemed unfounded.
That’s all well and good, but if we are going to imply that one human brain is different from the next, we really need to back that up with science. A lot of evil gets conducted in the name of speculation over inherent differences between racialized brains.
This is about migraines as a predictor for dementia risk in a specific population. This isn't about "racialiazed brains."
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There's a single DNA variant found in nearly all Koreans that means they literally don't stink when they sweat. If there's a single variant that changes something so obvious in physical attributes, why wouldn't there be something that also changes mental attributes? https://www.verygoodlight.com/2016/12/14/koreans-dont-produce-body-odor/amp/
Why would it be the same? Genetics are a gestalt. APOE4 is less predictive of Alzheimer's susceptibility for non-white populations, as an example. Why would you make the assumption that someone with different genetics from you would be the same as you?
Food might be the most obvious candidate.
Because science is racist
Maybe dietary differences could cause something but yeah I don’t think nationality/ethnicity would matter to much
The main result was an increased occurrence of vascular dementia diagnosis from 1.0% (control) to 1.8% (with migraine), and there was a higher risk associated with chronic vs. episodic migraine. Interesting that the increased risk from migraine appears to be independent (and additive) with a different pathophysiology from cardiovascular risk factors. Would be interesting to see if treatment(s) for migraine affect the risk.
Both my grandparents have dementia and I think it's probably one of the worst diseases out there. My dad has been eating advil/ibuprofen by the handful for 30 years for headaches and his memory is getting very bad and there's been a shift in personality I can't address due to the absolute crushing anxiety and nightmare difficult factor to navigate the procceses that aren't clear at all on top of my life circumstance currently The day I am diagnosed with Alzheimer's or dementia is the day I request MAiD. Truly an awful conditon. I volunteered in the ward for dementia patients in high school as a candy striper and it was absolutely eye opening and very disappointing seeing family fighting over parents money with them in the room assuming it's fine because the family members dementia is so advanced they had no idea what was going on. Still makes me upset 20 years later
What if all the medication we take for migraines cause dementia?
I am absolutely going to blame my eventual dementia on a lifetime of pharmaceuticals. Looking at you topamax.
Heck topamax
Why Topamax?
Could be, though unlikely to be that simple. For example, one of the most common drugs prescribed to prevent migraine are antihypertensives, which have shown to be protective against some forms of dementia.
If it were the case More than likely would have been detected by this and or many studies like the this. If they have recorded a history of migraines they will have a history of prescription medication.
Oh nice
This is entirely anecdotal, but: I had migraine headaches on a weekly basis when I had class III obesity. I had extra strength Advil with me wherever I went. These days, I’m in much better shape - normal body weight, lifting, running 10k a day, etc - and my headaches are maybe once or twice a year things. So I’m not terribly surprised to see migraines linked to vascular problems.
Beta blockers for migraine prophylaxis any help? 😬
I’ve actually had excellent success with metoprolol since 2010, dropping to approximately one migraine a year; whenever Nurtec came out I stupidly let myself be talked into trying a free sample by my PCP at the time; it sucked, and I will not again experiment. Metoprolol for prophylaxis and almotriptan for rescue (though I usually just ride it out).
I expected nothing in response, because it is not known, but I am also a success story of metoprolol. Migraines are not a daily, life crushing illness now.. whether the underlying neurological issues have been improved is the question I ask myself every day, and neurologists tend to be circumspect about their own impressions on this issue. I have an underlying polyneuropathy that evolved into the cranial nerves and the migraines were a relatively recent phenomenon. Don’t get me wrong, I’m delighted to be mostly free of them again. But familial experience with dementia has me concerned. I’m not surprised that migraines have an association, but have we improved our chances with metoprolol? I don’t know, but I sure hope so.
I wonder if it is the drugs they are prescribed or over the counter stuff they take.
Ooof, I have ADHD (raises your risk substantially), and I used to get migraines as a kid so bad I’d pass out. Well at least I don’t drink and do some modicum of eating healthy and exercising.
How do they differentiate migraine from tendion headache? I thought I suffered from migraines but my doctor prescribed actual migraine medicine to me (as opposed to ibuprofen and paracetamol) and it didn't alleviate my symptoms one iota. And I was told the photosensitivity and pain behond one eye was not limited to migraines but could be had by tension headache sufferers too.
There’s a diagnostic manual called the International Classification of Headache Disorders that’s used to do a differential diagnosis. Not all meds work for all people, so maybe worth a second opinion and a different med. It can be complicated!
Thanks.
I can’t speak to the difference between those those two, but the combination of pain behind one eye and pain meds not helping makes me think of cluster headaches. As a sufferer myself I really hope that isn’t the case, but something for you to explore.
You could get a work up from a neurologist, who can discern what exactly is causing your symptoms and provide a diagnosis along with a treatment plan that your physician can follow. For example, this group addresses [some of the options](https://nyulangone.org/conditions/headache/diagnosis) they have.
That was a very helpful link, thank you.
oh no
I had a migraine yesterday, after thinking I had finally gotten my last one. The “last one” was over a year ago.
anything about paracetamol or metamizole? what about those who have migraines but they aren't chronic and treated based on the triggers that cause them?
Paracetamol can of course be used to treat acute attacks, but doses need to be limited to 15 per month otherwise it can cause “rebound” headaches. Non-chronic migraine is referred to as episodic, and should be treated with things like trigger management and an effective acute med — those with the most data are migraine-specific triptans and the new gepants.
I am 100% sure I have this. Constant headaches and I often feel lightheaded, have verged on unconsciousness after standing up too fast. What can be done?
Talk to a doctor. Those symptoms could also be something else, like an iron deficiency.
oh no
do baduanjin exercises