Migraine help- where do I start?

[Peaceseeker]

I have been experiencing more and more migraines over the last year. Some of them do appear to be hormonal, as I almost always get one at the end of every period. I also get one anytime I cry more than a little bit and sometimes when I haven't eaten much that day.  Not sure about any other triggers I should look for, like food allergies? My mom started experiencing them in her 40's as well.

Caffeine and Tylenol works to knock them down.  Without that it is pain and intense nausea that is nearly unbearable.  The problem is I am EXTREMELY sensitive to caffeine.  It makes me feel horrible and the last time I medicated with one small 8 oz cup of coffee at night I was up for over 30 hours straight.  I sometimes get heart palpitations and a huge increase in anxiety from small doses of caffeine.  So I have basically eliminated caffeine from my life except when I get a migraine.

Anything else I can try?  I tend to be the person who gets all the rare side effects in medication, so I am nervous about taking prescription medication. However the migraines are starting to interfere with my quality of life and my work. (Actually it is usually the caffeine and its resulting sleep deprivation affecting my work!) I am open to seeing a doctor but I have no insurance and no primary care physician.  So I am going to have to pay out of pocket for any testing or medications and would rather have an idea of what to ask for or where to start.  I am open to natural remedies as well.

[bluemongoose]

Coffee makes me ill too...I usually do a caffeine pill with Advil. That usually works for me, but that doesn't help you if caffeine is a no go!

I'm not an essential oil person at all, but peppermint oil diluted with coconut oil and then rubbed on the back of my neck and temples and sometimes forehead helps with the tension that causes some of my migraines.

The sinus induced ones (crying) I start with a warm shower and then a neti pot.

I also get them at the end of my period...those ones are killed best by the Advil and caffeine pill method.

[Catwoman]

Have you tried Midol? It has the acetaminophen and the caffeine, but for some reason, it doesn’t keep me awake, so maybe you would have better luck with that than with coffee. (You can also get store brand Midol, usually called something charming like “Menstrual Relief” — it’s exactly the same as Midol and is a lot cheaper.) 

I take prescription Imitrex and also have Fioricet, but the Fioricet makes me loopy and draggy the next day, so I rarely take it. I told my new doctor that I was looking for natural treatments for migraines and she gave me prescription strength magnesium supplements and riboflavin supplements and she said they should help decrease the frequency of my migraines as well as help with the intensity, and they seem to be working. I took several brands of magnesium in the past and got no results at all, but the doctor said the prescription kind is much better, and although I admit I was a little skeptical, it seems like she was right.

[HS Mom in NC]

See a neurologist that specializes in headaches.  That's what worked for my daughter.  There are different classes of meds that treat different kinds of migraines.

[MaeFlowers]

I'll second the magnesium for menstral migraines. I take OTC magnesium but it does help prevent them from happening in the first place. I discovered it accidentally when I started taking magnesium to help with anxiety.  

I can't have caffeine, either. When I get migraines from tension, I take a tylenol and lie down at even the first inkling of one coming on. I need quiet and darkness until that tylenol kicks in.

[Katy]

Excedrine at the first sign of a headache.  If you can stand the sugar and caffeine, take with a bottle of Mexican Coke (the ones in the glass bottles). Rub peppermint essential oil on your temple on the side of the pain. That combination can take mine from disabling to merely obnoxious.

Since they're hormonal I'd look at lower histamine diet and possibly adding things like broccoli and more fiber to your diet.  Both even out estrogen levels that tend to go wonky at that age.

Some people find drinking more water helps a lot too.

Otherwise I agree with a neurologist. Sometimes Imitrex is all you need.

[Selkie]

I've had migraines for about 30 years. What really helps me are those heating pads that you heat up in the microwave. I wrap one around the back of my neck and one around my forehead.

Also, having food in my stomach always makes the migraine feel a bit better. 

[Vintage81]

I would recommend reading the book Heal Your Headache by Dr. David Buchholz. Not only does it explain migraines better than any doctor I've ever been to, it also gives great information on food triggers and medications.  

As far a supplements go, my neurologist recommends taking Vitamin B2 (riboflavin), Magnesium (citrate or chelated), and CoQ10. I also read in another migraine thread here on the WTM boards something about Selenium, so I tried it. I've had less headaches since taking it, but I'm not sure if it's because of that. 

I also agree with seeing a neurologist. There are medications specific to relieving migraine pain that may be more helpful to you, especially since you have the caffeine sensitivity. 

I hope you get to feeling better soon!

[bluemongoose]

Oh I forgot about magnesium! Yes to that! It has made the frequency less here as well. My hormones are wonky too, as I'm also 40.

[Greta]

 

I haven't read the other replies yet, so forgive me if I'm repeating anything!  But I wanted to share my experiences.

First of all, (((hugs))) because migraines stink.  I've had them since puberty, but mine became chronic when I hit 40.  Chronic, by the way, is defined as 15 or more migraine days per month.  If you are having chronic migraines now, that's when a doctor will prescribe you preventive medications in addition to treatment ones.  I've tried all the standard ones (I think) at this point.  The calcium-channel blocker was the worst.  I took only two doses of it.  It made me feel like I was having a heart attack or something, chest pains, rapid breathing, and just this weird feeling that my heart was really struggling.  It was awful, but I assume my reaction is not common!  Topomax made me feel really tired, loopy, disoriented, like I was in a brain fog (it also reduced my appetite and made me lose a little weight.  I didn't mind that, but if you're underweight it might not be wise.).  And it didn't help anyway.  Amitriptyline worked for a few months but then stopped, and when we tried increasing the dose, it gave me heart palpitations.  It had also made me very sleepy even at the lower dose, and I was sleeping about 9 hours every night and still having a very hard time waking up.  Beta blockers did nothing to help.  Made me feel a little bit weak, but not too bad (my blood pressure was already on the low side of normal.  I've heard that people with high blood pressure have a lot of success with beta blockers, so your experience might be different).  I'm currently trying Botox injections, and I can't say there have been any miraculous benefits (I think it's reducing the severity some, but not the frequency, I'm still having them basically every day, just as before.  But my neuro says you need at least three treatments to know how well it will work, and I've only had two so far).  But I will say that it's had ZERO side effects, so that's nice at least.  

As far as non-prescription things I've tried:  feverfew, butterbur, vitamins B2 and D, and magnesium all did absolutely nothing for me.  My migraines became chronic when I was on a low-carb ketogenic diet.  Going off of that diet and getting on a high-carb, vegan diet reduced the severity tremendously.  That helped more than any other single thing that I've tried, including the prescriptions, but if you're not eating low-carb, this might or might not be relevant for you, I can't say.  Regular aerobic exercise reduces the severity a bit.  Ginger and turmeric help some.  Avoiding alcohol and high-tyramine foods is an absolute necessity for me.  This, unfortunately, is a whole lot of foods:  anything aged (cheeses), cured (deli meats), pickled (pickles, olives), or fermented (sourdough, miso, soy sauce).  And some foods are just naturally high in tyramine such as citrus fruits (which I LOVE and dearly miss), nuts, chocolate, bananas, eggplant, avocado, and many others.  (So just a personal whine/vent:  being vegan without nuts, avocados, citrus, and miso/soy sauce is not fun.  But I am committed to it now for ethical and spiritual reasons in addition to the health reasons that initially set me on that particular path.)

About caffeine:  withdrawal can trigger a migraine.  So if you're having frequent migraines, it's actually recommended that you avoid caffeine.  And given the negative effects that it has on you, you might be better off with a preventive prescription rather than relying on caffeine.  Yet another thing that I dearly miss:  coffee.  

You also mentioned that not eating enough will trigger a migraine, and it does the same thing to me.  I think that the reason the low-carb diet was so bad for me in this regard was that insufficient carbs means insufficient serotonin, and migraines are intimately tied to neurotransmitter levels (though I don't claim to understand the details of how that works, both my GP and my neurologist have told me that's the case).  So I recommend eating plenty of complex carbs:  potatoes, whole grains, beans and legumes.  (And incidentally, I lost weight going from low-carb to high-carb, so I no longer believe the "carbs make you fat" claim.  But I do eat moderate/low protein and low fat.  I think where many people get into trouble is eating both high-fat and high-carb.)

You might want to watch this video about the use of ginger to treat migraines:  https://nutritionfacts.org/video/ginger-for-migraines/   I've found that it does help, but the effect doesn't last as long as an NSAID or triptan, so I have to keep taking it pretty frequently.

ETA:  I forgot to mention that crying triggers a bad migraine or severely worsens an existing migraine for me too.  I think it's those neurotransmitters again, but I don't know.  In any event, I try very hard to avoid crying!  No more sad movies for me.  Also, dehydration is a major trigger.  But I found that making an effort to drink extra water did nothing.  So I just drink to thirst and that works just fine.

[JanetC]

Having done this journey with my daughter’s headaches, it takes time and patience. There were tests and medication trials and lifestyle change trials and biofeedback, etc.

Everything you are probably doing to relieve your headaches probably has a rebound effect. If you overuse caffeine as a headache relief strategy, then stopping caffeine causes a rebound headache. Same is true for ibuprofen and Tylenol based pain relievers. If you take too frequently, you get a rebound headache if you stop. 

Step one is get insurance. See if you are eligible for any sort of Medicaid or Obamacare or whatever. Since this will likely be a long-term treatment journey, you don’t want to be paying out of pocket. Since this may mean waiting for an open enrollment period, here are some other steps to try:

Start keeping a medical journal of symptoms, medications/supplements used, and anything else that might be correlated with your headaches (such as period, sleep quality, etc). This will help you see small bits of progress (going from 20 headaches per month with an average severity of 8 to 18 per month with an average severity of 6.5 doesn’t necessarily feel like progress unless you can see it in writing.) Note that neurologists often got mad at us for not being able to identify your triggers. It’s actually not your fault if you can’t: With chronic headache, not everyone can find a trigger. But we did see things like poor sleep increasing the severity of headaches. 

Try alternative medicine - it’s often much cheaper while you look for insurance. If you are migraine prone, you will always be migraine prone. You may be able to wean yourself off of strong medications, but you will always need to lead a lifestyle that accommodates your tendency to get headaches, for example watching out for junk food and ensuring you get good sleep. Naturopaths can guide you through those lifestyle changes and they are often good listeners. Also, it would fit with your preference to avoid prescription meds. It’s not likely to be complete cure, but it may hep until you can afford the conventional medical system, and you will know that you tried everything you could before using prescription drugs. 

[Greta]

Oh, another thing I forgot to mention.  Initially, I thought that I didn't have food triggers, because I couldn't correlate my migraines to any particular foods other than alcohol.  But then I read that food typically triggers a migraine 12-24 hours after you eat it, not immediately.  So then I figured out that high-tyramine foods were triggering me.  

But it seems that everything I do to help reduces the severity of my migraines, which don't get me wrong is great.  If they were still as severe as they were initially, I honestly don't know how I'd be able to function.  Unfortunately nothing I do seems to reduce the frequency.  But they aren't as bad and they don't last as long, so I am profoundly grateful for that!

[Peaceseeker]

15 hours ago, Kinsa said:

Have you tried OTC Excedrine Migraine? Works wonders for me.

I have and it does work. It is basically caffeine and Tylenol though, and I experience all the horrible  side effects of caffeine when I take it. ?

[Peaceseeker]

Thank you every one!  You have given so much information to think about here.  I am going to start with journaling to figure out patterns and triggers along with staying hydrated and doing some easy walking.  I may try the B 2 and magnesium supplements and start with that to see if I have any improvements.  I do love aged cheeses and I do have a dairy sensitivity so that might be something to ponder.  I did feel much better when I was eating vegan for a few weeks but I wasn't tracking anything so I am not sure if the frequency or intensity really changed.

It's not chronic yet- I am guessing I get somewhere between 4-8 per month but I need to track to know for sure.  Sometimes it feels like the same migraine over a couple of days- like it doesn't quite leave and then comes back for round 2!

[Peaceseeker]

5 minutes ago, happysmileylady said:

I ALWAYS had 3 day migraines when I got them.  If I didn’t take a relpax, it was guaranteed to last 3 days.  

 

I hate to 'like this' but I try to acknowledge responses.  Three day migraines sound horrible!

[J-rap]

We're a very migraine-centered family, unfortunately.  That is, the migraine gene runs very, very deep, and I've learned a lot over the years through trying to help my family members.   I'd be happy to give a few tips on what has helped.  

My dh began having chronic daily migraines when he was in his early 30's, and they continued (daily) for about 15 years.  What finally helped was getting the book Heal Your Headache and learning about all the triggers and the threshold theory.  I know someone else recommended this book too.  My dh had tried a multitude of things before reading this book, including various prescriptions and botox.  Dr. Buccholtz (author of the book) really laid out a great step-by-step guideline to lower the accumulation of triggers (to avoid reaching that threshold which then results in a migraine).  My dh cut out lots of foods:  most cheese, bread, peanut butter, bananas, all citrus, caffeine, red wine, and lots of other items.  He also added a calcium channel blocker, which really made a difference.  His daily migraine decreased to a pain level of about a "1" (out of 10) after that, and he was good with that.

My dd's have been more stubborn.  Hers became chronic daily migraines at about the age of 16.  They got worse and worse, and after about 3 years were at about a pain level of 5-9 (out of 10) daily for about a year.  It was a really awful year for her.  Her body seems to be hyper-sensitive to her environment, and she has really had to learn how to make major changes in her life.  Over the years, she has changed to a strict vegetarian/GF diet, exercises consistently but very gently every day, drinks lots of water, wears sunglasses whenever she goes outdoors, avoids sitting in the sun ever, doesn't make sudden movements, meditates and prayes -- basically reduces any outside stress as much as possible.  Meds don't help her at all (she has tried almost everything by now), but living a relaxed, stress-free lifestyle has made a big difference.  Her migraines are still daily but now down to about a 3-5 pain level after 8 years, and this appears to be continuing in that direction (of getting better).  It's been a long haul and obviously hers is a very extreme case...  But wanted to let you know that even in these extreme cases, it can and will get better!