Towards Ending Migraines

[alywest]

Thanks for the reply! I'm confident we can figure this out. I find it helpful to read through your experiences to get ideas.



Good to know. I've been taking Zolmitriptan ("Zomig"). It definitely works but it gives me a mini flare up (I have Celiac), wide spread flesh pain like bruises all over, so I don't like to take it too often. I read there's a nasal spray so for that one too so I'll try that next and hopefully avoid the side effects. Are you taking anything or doing anything to prevent the migraines entirely or just taking the ondansetron and rizatriptan when the migraines starts? I think I read on another post you take acetazolamide; do you still take it? I get a lot of brain stem area stiffness/soreness with the migraine which makes me wonder if that's part of the cause. It's a similar feeling to the onset of influenza or other virus (like herpes zoster) so I'm also taking lysine and BCAA's that contain lysine and no arginine. Also doing some neck stretches throughout the day. And, like you, never ever let blood sugar drop. Also I have B12 and folic acid and other B vit deficiences, so much so that my eye lid keeps twitching so guess I got to bit the bullet and take B supp's. I do take inositol and some other things to support methylation but I guess it's not enough. One more question for you... do you find it necessary to take T3 throughout the day or do you take it twice a day (it's typically prescribed 2x per day I think). Currently I take 5MCG of Cytomel morning and another 5MCG at night. In the morning I also take Levothyronine 50MCG, so this is near to the ratio Doc RP suggests but I'm wondering if I should split the Cytomel up even further. I'm not liking the idea of taking serotonin antagonists due to the constipation effects but I think there's something to the BCAA supplementation...
A new method for rapidly and simultaneously decreasing serotonin and catecholamine synthesis in humans
I have some of the Impower Pro Amino BCAA's which do not contain tryptophan or tyrosine but it does have phenylalanine. I think the last time I took these, I took about 20 capsules per day, amounting to about a gram each of the important AA's in the supp., and did not experience migraines at the time. I had to quit because I had esophagus related problems (due to Celiac probably) and could not swallow the capsules. I might try emptying out the capsules in OJ or something and start that up again..

I did take acetazolamide and it really helped. Weirdly it ended up giving me really bad joint pain after a few weeks of taking it (at least I think that was what caused it) so I stopped taking it but the migraines still have gotten better over the long run since I took it. I didn't have any while I was taking it. I don't find it absolutely necessary to take the T3 all day long because I have really lowered the amount I take. I think if you're taking T4 as well you should be ok with once or twice a day. I try to take a little more at night but I don't always remember to. Right now my migraines really only happen right around my period or ovulation. I am currently taking 400mg progesterone during the second half of my cycle and it seems to be reducing the inflammation I tend to experience during PMS that results in a migraine. My migraines are really rooted in my gut, I really feel how much my gut gets affected by them when I have them. Ondansetron helps, so does famotidine. And I know this will bother some people but I take an antidepressant called Trintellix and it has various 5HT receptor agonist and antagonist properties, as well as being an SSRI. I find it is helping to even me out. I think that serotonin processing is possibly the real issue for a lot of folks with migraines. Don't get me wrong, I understand that it's bad, but we all have serotonin and until I started the Trintellix I was having dizzy spells which actually got worse when I would take cyproheptadine or lisuride. If you look at studies discussing endotoxin and ssri's, they actually help to minimize the damage done by endotoxin when it is injected into rats and such. There's a plethora of research about it. In fact, there's a really interesting paper about how depression and sickness behavior are one and the same and it cites various studies showing the connection between endotoxin and depression:

In the tail suspension test (TST), LPS increased the immobility time without affecting spontaneous locomotor activity, suggesting that LPS induced depressive-like behavior in mice. Treatment with fluoxetine (30 mg/kg) or paroxetine (10 mg/kg) significantly shortened LPS-induced increases of immobility time. These results suggested that antidepressants exert anti-inflammatory effects in vivo, and that the serotonergic system may partially mediate these effects. In addition, the anti-inflammatory effects of antidepressants may help alleviate the symptoms of LPS-induced depression in mice.

These same inflammatory markers are seen in cases of flu and other illnesses that result in "sickness behavior" which is a model that is very similar to depression. Don't get me wrong, I think Ray Peat is a genius, but even he knows that SSRI's are doing something to help people, but it's clearly not the increase in extracellular serotonin that's doing it. If that were the case then taking 5HTP would be the perfect remedy for depression, migraines, etc. So that's just my 2c.

 

[Zpol]

I did take acetazolamide and it really helped. Weirdly it ended up giving me really bad joint pain after a few weeks of taking it (at least I think that was what caused it) so I stopped taking it but the migraines still have gotten better over the long run since I took it. I didn't have any while I was taking it. I don't find it absolutely necessary to take the T3 all day long because I have really lowered the amount I take. I think if you're taking T4 as well you should be ok with once or twice a day. I try to take a little more at night but I don't always remember to. Right now my migraines really only happen right around my period or ovulation. I am currently taking 400mg progesterone during the second half of my cycle and it seems to be reducing the inflammation I tend to experience during PMS that results in a migraine. My migraines are really rooted in my gut, I really feel how much my gut gets affected by them when I have them. Ondansetron helps, so does famotidine. And I know this will bother some people but I take an antidepressant called Trintellix and it has various 5HT receptor agonist and antagonist properties, as well as being an SSRI. I find it is helping to even me out. I think that serotonin processing is possibly the real issue for a lot of folks with migraines. Don't get me wrong, I understand that it's bad, but we all have serotonin and until I started the Trintellix I was having dizzy spells which actually got worse when I would take cyproheptadine or lisuride. If you look at studies discussing endotoxin and ssri's, they actually help to minimize the damage done by endotoxin when it is injected into rats and such. There's a plethora of research about it. In fact, there's a really interesting paper about how depression and sickness behavior are one and the same and it cites various studies showing the connection between endotoxin and depression:

In the tail suspension test (TST), LPS increased the immobility time without affecting spontaneous locomotor activity, suggesting that LPS induced depressive-like behavior in mice. Treatment with fluoxetine (30 mg/kg) or paroxetine (10 mg/kg) significantly shortened LPS-induced increases of immobility time. These results suggested that antidepressants exert anti-inflammatory effects in vivo, and that the serotonergic system may partially mediate these effects. In addition, the anti-inflammatory effects of antidepressants may help alleviate the symptoms of LPS-induced depression in mice.

These same inflammatory markers are seen in cases of flu and other illnesses that result in "sickness behavior" which is a model that is very similar to depression. Don't get me wrong, I think Ray Peat is a genius, but even he knows that SSRI's are doing something to help people, but it's clearly not the increase in extracellular serotonin that's doing it. If that were the case then taking 5HTP would be the perfect remedy for depression, migraines, etc. So that's just my 2c.

Thank you so much for sharing your knowledge (which you have a lot of!) and experience on this. Every little bit helps, including anecdotal. I understand what you are saying about the serotonin processing. In brain chemistry it's never about a single neurotransmitter being too high or too low. We have to be careful not to fall into that reductionist way of thinking. Physiology is much too complex for that. Serotonin, dopamine, adrenaline, etc are always fluctuating in the brain's modules, and in the gut ('the second brain') for various reasons; the goal is to keep them in balance, not any single one excessively high or low. Admittedly I do not understand the processing of serotonin well enough yet to draw any conclusions for myself. I was Rx'd Tegaserod, a 5-HT4 agonist years ago for IBS, and then several other SSRI's, none that actually helped my IBS but I do remember having headaches when I tried to get off them so I don't think I'll go down that path again but for whatever reason, the triptans do get rid of my migraines so go figure. Definitely have to find someway to lower LPS for good. It's interesting you bring up 'sickness behavior'. I've been thinking this is a real thing for me. I've had severe disease for most of my life and as much as I tried to avoid sick person mentality, I have had to live as one so I'm sure I have some embedded behaviors that will need to be addressed before I can live like a normal person.

 

[alywest]

Thank you so much for sharing your knowledge (which you have a lot of!) and experience on this. Every little bit helps, including anecdotal. I understand what you are saying about the serotonin processing. In brain chemistry it's never about a single neurotransmitter being too high or too low. We have to be careful not to fall into that reductionist way of thinking. Physiology is much too complex for that. Serotonin, dopamine, adrenaline, etc are always fluctuating in the brain's modules, and in the gut ('the second brain') for various reasons; the goal is to keep them in balance, not any single one excessively high or low. Admittedly I do not understand the processing of serotonin well enough yet to draw any conclusions for myself. I was Rx'd Tegaserod, a 5-HT4 agonist years ago for IBS, and then several other SSRI's, none that actually helped my IBS but I do remember having headaches when I tried to get off them so I don't think I'll go down that path again but for whatever reason, the triptans do get rid of my migraines so go figure. Definitely have to find someway to lower LPS for good. It's interesting you bring up 'sickness behavior'. I've been thinking this is a real thing for me. I've had severe disease for most of my life and as much as I tried to avoid sick person mentality, I have had to live as one so I'm sure I have some embedded behaviors that will need to be addressed before I can live like a normal person.

Interestingly I just listened to an interview with Dr. Mark Manhart DDS, who runs the Calcium Therapy Institute, and he argues that the issues in the gut start with the gums. Interestingly I just went to the dentist and had some periodontitis. Dr. Manhart uses calcium treatment on the gums in his office, and then he sells some calcium treatments online, but they don't really compare to the real thing. Anyway, his whole premise is the calcium and zinc go in through the gums and heal the bone and gums, but also can heal the intestines. It seems like a really Peat-friendly approach to dental care, but at the same time it approaches the issue from the opposite end, so to speak! Ray is obviously very focused on ridding endotoxin from the gut and that will cure everything else. I have a really hard time with the Peat diet, and one thing that has always bothered me about the whole philosophy is that Peat has none of his natural teeth remaining. I don't know why but I have always equated health with teeth and gums, so I guess I'm biased, but it scares me to even think about losing teeth. Based on where my mouth was going before I came across both Peat and Manhart, I was probably going to lose at least one tooth at my last check-in, but I believe because of my improved thyroid health and the calcium treatments my teeth and gums were healthy enough to not require major surgery. But I clearly have a lot of work to do. I was recently in touch with Manhart by email and he told me that they're soon to release calcium strips which in his words, will be better than either the carpules or chips (what he currently has available.) I think one of the reasons I trust him is because he sells these things for pennies and doesn't even charge for the shipping.

 

[alywest]

BTW sorry @tara for hijacking this thread! I'll start a new one if anyone is interested.

 

[Zpol]

BTW sorry @tara for hijacking this thread! I'll start a new one if anyone is interested.

Right! Please do let us know if it'd be best to start a new thread. Maybe it's no biggie though since it's all info pertaining to migraines.

Interestingly I just listened to an interview with Dr. Mark Manhart DDS, who runs the Calcium Therapy Institute, and he argues that the issues in the gut start with the gums. Interestingly I just went to the dentist and had some periodontitis. Dr. Manhart uses calcium treatment on the gums in his office, and then he sells some calcium treatments online, but they don't really compare to the real thing. Anyway, his whole premise is the calcium and zinc go in through the gums and heal the bone and gums, but also can heal the intestines. It seems like a really Peat-friendly approach to dental care, but at the same time it approaches the issue from the opposite end, so to speak! Ray is obviously very focused on ridding endotoxin from the gut and that will cure everything else. I have a really hard time with the Peat diet, and one thing that has always bothered me about the whole philosophy is that Peat has none of his natural teeth remaining. I don't know why but I have always equated health with teeth and gums, so I guess I'm biased, but it scares me to even think about losing teeth. Based on where my mouth was going before I came across both Peat and Manhart, I was probably going to lose at least one tooth at my last check-in, but I believe because of my improved thyroid health and the calcium treatments my teeth and gums were healthy enough to not require major surgery. But I clearly have a lot of work to do. I was recently in touch with Manhart by email and he told me that they're soon to release calcium strips which in his words, will be better than either the carpules or chips (what he currently has available.) I think one of the reasons I trust him is because he sells these things for pennies and doesn't even charge for the shipping.

That's interesting. The onset of the migraines started around the time I was taking a Vit D supplement, I also started getting cavities at about the same time. I've since stopped the Vit D so hopefully my calcium regulation will get balanced out over time. I can't have dairy (gives me flare ups) so I'm at a loss as to what to do about calcium (I do eat greens so that helps too). I drink mineral water that has high calcium content (Gerolstiener) and add magnesium to it. My blood calcium slightly high but parathyriod hormone is good. I did use to have receding gums, even before I started RP dietary suggestions. I managed to stop that from happening with using baking soda, salt, hydrogen peroxide, water pik, and flossing every night. I'd be interested in the calcium strips, I'll have to keep an eye out for those. Also I'm low in zinc so that could be part of it. Thank you for this info!

 

[tara]

BTW sorry @tara for hijacking this thread! I'll start a new one if anyone is interested.

I'm happy, seems to all be related.

 

[tara]

Has anyone tried progesterone for aborting their acute migraines? Ray Peat suggested it helps with the migraines.

I think I had some occasional early successes with heading off migraines in early prodrome with small - moderate dose progesterone before I has used it very much. I never succeeded in stopping one once it was really underway, even with quite large dose. S I used the progesterone for longer, it was less clear that it was having a useful effect.

 

[Logan-]

I think I had some occasional early successes with heading off migraines in early prodrome with small - moderate dose progesterone before I has used it very much. I never succeeded in stopping one once it was really underway, even with quite large dose. S I used the progesterone for longer, it was less clear that it was having a useful effect.

I see, thanks.

 

[tara]

Update:
Migraines are frequent, often several/week, but current medications resolve them more quickly. Medications themselves are probably causing trouble.
Not spending so much time in pain and extreme lack of function - this is an improvement!. But because they are so frequent, it is still a serious problem.

Current foods:
Potatoes, sweet potatoes, onions, greens, and other veges as available, mushrooms, ...
Meat - beef, lamb, fish, occasional shellfish, liver, heart, kidneys, chicken, eggs ... try to get high collagen cuts sometimes
Grated carrot salad occasionally (aim to do more frequently).
Fruit - several pieces fresh most days, depending on availability/season - oranges, kiwi, apples, pears, bananas, pineapple, ... sometimes whole, sometimes in smoothies
- dried fruit
- a little fruit juice
Various other foods from time to time - rice, oats, buckwheat, a little nuts and seeds ...
Coconut oil, coconut, a little olive oil and olives
Probably other things ...
Preparation: Bake, roast, saute, boil, combine, blend, ... soups, roasts, smoothies, porridge, ...

Avoid milk and other dairy products as much as I can. Milk bothers me noticably.
Limit PUFA, wheat, refined sugar, coffee, chocolate, but not complete avoidance.

Supplements: daily Ca, Mg, vit-C. Less frequent - B-vits, zinc, vit-K, others. Intend to get back into routine with B-vits.
Have experimented with various things - currently nettle extract, lysine, glycine, taurine.

Largely manage to organise food so I'm seldom getting into hunger stress. Big improvement! But very time-consuming.

I've now been eating a lower PUFA diet for more than 5 years. It's not extremely low compared with what some people do, but it's a lot less than I was doing before. Maybe it's helping.

Life stresses have changed - some better, some difficult, hard to resolve.
No longer living in a cold, drafty, moldy house. Nice to be warm in winter.

 

[tara]

Today so far I ate:
Breakfast: Oat porridge with fruit smoothie, mushrooms and egg cooked in coconut oil.
Lunch: Lambs heart, onion, capsicum, broccoli, cauliflower, rice
Dinner: rice, peas, corn, chicken
Snacks: dried fruit, kiwis, snack balls made with oranges, dates, figs, coconut, nuts, coconut oil, cocoa ...
Still to come: may bake potato chips, tomato sauce.

Yesterday:
Oat porridge with raisins and green fruit smoothie
Lambs heart, potato, sweet potato, onion, kale
Roast lamb, cauliflower, grated carrot salad with homemade mayonaise (coconut oil, olive oil, apple cider vinegar, egg), baked potato chips
Snacks: kiwis, orange, banana, snack balls
Orange juice

I seem to sustain energy more easily if I eat well-cooked starchy foods regularly. I eat sweet snacks, but if I displace too much starch with sugar I start to feel a bit sick.

 

[Adrienlcrx]

Hom Just like me @tara , you eat fruit rather like a snackbet instead of a meal I seem to be doing a lot better with this. On average you have to approach 2500 calories by hit in all the important nutrients, isn't it?

 

[Goat-e]

I haven’t read through this whole thread so apologies if this has already been discussed... @tara have you tried cannabis for migraines? I once came across some research that showed that some cannabinoids can stop the excessive release of serotonin from platlets (iirc) which is often what happens during a migraine attack. I was skeptical, but desperate too, so I tried it. My experience is that used (vaped not smoked) at the first warning signs (for me pain in the right temple and feeling sick to my stomach) it can completely stop it from developing. Interestingly doing that won’t even get me ‘high’, it almost feels like I’ve simply added in something I was missing and my system can go back to running normally.

It’s slightly less successful if I allow the migraine to develop fully, at that point it will require a much higher dose and is only effective about 75% of the time (which is still pretty good).

But since I’ve been treating migraines as some sort of ‘endocannabinoid defficiency’ the frequency of migraines has actually dropped considerably and the only time they start is through lack of adequate sleep, whereas before many, many things triggered them.

I know many people are anti-cannabis on this forum, partly because Peat tried cannabis leaf tea for migraines and found it did nothing (most cannabinoids are fat soluble, not water soluble so that’s hardly surprising) and he said it should ‘never be smoked’, which is sensible because inhaling smoke of any sort is probably not that great. But my own experience with it is very positive, and I’m extremely grateful for the difference it has made for me.

 

[LucyL]

Have you looked at Angela Stanton's Migraine protocol? She has a book 'Fighting Migraine Epidemic, Complete Guide How to Treat and Prevent Migraines without Medications' . She focuses primarily on salt, and has some interesting protocols/tests surrounding salt. She has a theory of a hyperactive brain, that needs more electrolytes (salt) and water than most people.

 

[tara]

Hom Just like me @tara , you eat fruit rather like a snackbet instead of a meal I seem to be doing a lot better with this. On average you have to approach 2500 calories by hit in all the important nutrients, isn't it?

I do aim to eat at least three meals per day that include cooked starch and protein and at least two of them including veges, as well as the snacks.
I haven't calculated calories and micros recently - I probably should check again. I do aim to avoid stressful hunger, to eat a variety of foods, and eat enough to maintain myself. I haven't found a way to do that on just 3 meals a day. I do use some supplements too.

@tara have you tried cannabis for migraines?

Not so far. Thanks for the idea and report. I'll keeping it in mind as something to potentially try somewhere down the line. I have concerns about some of the potential side-effects, but that applies to the pharma drugs too.

Have you looked at Angela Stanton's Migraine protocol? She has a book 'Fighting Migraine Epidemic, Complete Guide How to Treat and Prevent Migraines without Medications' . She focuses primarily on salt, and has some interesting protocols/tests surrounding salt. She has a theory of a hyperactive brain, that needs more electrolytes (salt) and water than most people.

Thanks. This looks really interesting - I'll read further. I have felt for a long time that electrolyte balance could be key, but not found a way to work effectively with it yet. I'm not sure I'll be keen to follow her into low-carbing, but I'll look at her ideas.

 

[Goat-e]

@tara have you seen this? Renin angiotensin system: A novel target for migraine prophylaxis Peat's talked favourably of Losartan recently and it appears to be useful in preventing migraines.