Tobias Kurth

20 September 2013

Should I Lose Weight to Fight Migraine?

It’s in the news yet again, thanks to a study from Johns Hopkins University School of Medicine. This time, it’s a link between obesity and episodic migraine (as opposed to chronic migraine).

The study concluded that the obese population was 81% more likely to have episodic migraine (EM) than the general population. Or, about this many in a group of obese subjects would have episodic migraine:

So – naturally – what’s the solution that’s being proposed? Exercise and a healthy diet, of course!

And no one wants to discourage anyone from a healthy diet and exercise, do they?

Well, of course not. And neither do I. In fact, I would suggest that those two things might just out-do any pill that has been invented. Maybe.

But I’m afraid there’s a real danger in over-simplifying the connection.

The study, in fact, shows that there’s an increasing risk of EM as you become more obese. So – the more weight I lose, the fewer migraine attacks I’ll have – right?

Here are a few reasons why we shouldn’t be hasty to draw this conclusion.

Which is a result of which? Does the obesity increase the chance of migraine, or is it the other way around? Just because there’s a correlation does not mean that one causes the other.
Obesity is clearly not the one risk factor or cause of migraine. If it’s one factor in 100, there could be 99 other things that are more important to deal with first. We don’t know. But we can see from the chart above that obesity â‰ migraine.
What about migraine medications? Many meds are known to promote weight gain in some people. Could that alone explain the results of this study?
Dr. Tobias Kurth, interviewed by Reuters, pointed out that historically obesity is on the rise but migraine is not. If there was a strong correlation, why aren’t both rising together?
What about conditions that are comorbid with migraine? Could they be causing the obesity, and not migraine itself?
There are a number of other factors we don’t know about. Would these statistics hold true with younger migraineurs? What about different types of body fat?

So let’s not raise an eyebrow at the overweight person with migraine – assuming that it’s all their fault that they have migraine – if only they’d just get it together….

No no no. There could be many factors leading a person to be obese – in fact, following a doctor’s treatment plan for migraine could have even contributed to the weight gain. So let’s be real careful here before we act like we know what the problem is.

Now, before you run for another bag of candies or a Peppermint White Chocolate Mocha with Whipped Cream, let’s remember a few things. There does seem to be a connection, and it could actually be that weight gain does contribute to your risk. And there’s no doubt at all that a healthy diet and exercise are two of the best migraine fighters out there.

No, we shouldn’t pin all our hopes on weight loss, and aim to lose the pounds at the exclusion of all other goals and at all costs. However, improving our health, including aiming for a healthy weight, simply has to be a part of our overall treatment plan.

15 February 2013

Migraine with Aura: Higher heart attack risk than smoking and diabetes?

James Discoveries & Stats, News 10

According to recent research, women who have migraine with aura are at an increased risk for “cardiovascular events”.

This study was actually an investigation into the Women’s Health Study, a large study, which we’ve talked about before, which collected all kinds of information about thousands of women over 15 years.

What were the biggest risk factors for cardiovascular events (CV), such as heart attack and stroke?

High Blood Pressure
Migraine with Aura
Diabetes
Family History of Heart Attack
Current Smoking
Obesity

That’s right, migraine with aura came in as the #2 risk factor for women.

There’s no doubt that this study will increase interest in the study of migraine and heart problems. The connection between the two is not yet understood, although theories are beginning to emerge.

But the link is not new. We’ve known for some time that there’s an increased risk of cardiovascular problems in migraineurs, and not just women who have migraine with aura (for example the same researcher, Dr. Tobias Kurth, reported that men with migraine seem to have an increased risk of heart attack).

Some good news has also come from the Women’s Health Study – for example, women with migraine with aura are less likely to be disabled after stroke.

Even with migraine, your risk is probably low unless it’s combined with other factors above. Still, this is a reminder that migraine can be dangerous, and it does need to be treated. It should also raise awareness for migraineurs and their doctors that they should be cautious of other risk factors, including medications that may increase their risk.

For more, read Migraine and Heart Disease: 7 Critical Things to Know Now.

For more on the study: Migraine with aura confers high CV risk in women

11 January 2013

Migraine: Why Genetic Studies haven’t Solved all our Problems.

James News 0

So if we’ve identified the genes that are causing migraine, doesn’t that mean we’re close to a cure?

Don’t let the news headlines confuse you. Although we’ve come a long way, it’s not like we’ve discovered a “switch” in the brain that we can now “flip” to “turn off” migraine – or chronic daily headache – or cluster…

Photo courtesy of dullhunk

At the European Headache and Migraine Trust International Congress, Dr. Tobias Kurth (a Director of Research at the French National Institute of Health and Medical Research) took the time to clarify with some wise words:

Whenever there is a new genetic study, you can easily become almost convinced that now we have the gene and we can treat migraine better. No! Currently there is no indication to test migraine patients for specific genes. It wouldn’t help you at all in terms of treatment or prognosis.

Make no mistake: We have achieved a lot over the last years, and many groups continue to do extraordinary work. However, we all have to realize that we still don’t know the precise mechanisms involved in genetic markers of migraine. We haven’t really shown that having these genes is a predictive tool that can tell patients that they will get migraine, or if they have it what their disease course will be.

This is an important reminder – and it’s not all bad news. Here are a few things to note regarding migraine and genetic research:

We still don’t know the whole genetic story when it comes to migraine.
Even if and when we know the whole genetic story, that will still only be a part of the migraine story. In other words, it’s quite possible we’ll never find a simple “genetic migraine switch” – the story will be more complex.
We ARE learning a lot about how migraine works from this new genetic research.
As we understand more about the migraine chain reaction, we are able, here and now, to start developing new treatments based on the new information.
We are also already able to understand more about migraine and how it impacts patients and interacts with other conditions (such as cardiovascular disease).

Yes, get excited about migraine genetic research. But don’t let your cousin think that the latest news report means you’ll be cured next week if you only go to the right doctor.

via: New genetic findings in migraine: So what?

20 December 2010

Migraine, Stroke, and Good News

James Discoveries & Stats 2

A recent study suggests that women with a certain type of migraine have less to worry about when it comes to stroke.

We’ve talked a lot about migraine and stroke cardiovascular diseases. The general consensus at the moment is that migraine can increase your risk, but your risk is still very low (unless you have other risk factors as well).

So the link is something to be aware of as you try to decrease your overall risk, but it’s no reason to panic. However, it is giving us clues into what migraine is and how it impacts overall health.

But we’re still a long way from understanding the connection, a fact that was highlighted once again in a large study supported by the National Heart, Lung, and Blood Institute and the National Cancer Institute in the USA.

The Women’s Health Study involved 27,852 women, and it once again found a link between migraine and stroke. But this connection was a little different than the ones we’ve heard before.

This particular connection had to do with women who experience migraine attacks with aura – typically seeing flashing lights or zig zags before the pain stage of the attack. We know that these women in particular seem to have a higher risk of ischemic stroke. But it also seems that their strokes are less severe.

According to this study, women with migraine with aura were twice as likely to have no significant disability after a stoke.

The study’s principal author, Dr. Tobias Kurth, is speculating that there’s a mechanism in the blood vessels that may explain the connection. But as we’re studying the underlying biology of migraine and stroke, he points out:

The message from this study should be reassuring for migraineurs. It is important for women who have migraine with aura to know that their risk of stroke is considerably low and there is high likelihood of a migraine-associated stroke being mild.

This finding won’t likely change the life of many migraineurs. And there are likely to be more findings from this study as researchers analyze the results. However, each unique finding tells us a little more about what migraine is actually doing to the body.

23 November 2006

Men with migraine have heart attack risk

James Discoveries & Stats 0

It’s another study on the link between migraine and heart disease. But this one is especially interesting because it’s a study of men. Since men are statistically less likely to have migraine than women, there are less studies out there.

This particular study was presented at the 2006 meeting of the American Heart Association in Chicago. The study indicates that men with migraine have a 24% higher risk of major cardiovascular problems – in fact, a 42% higher risk of heart attack. The author of the study was Dr. Tobias Kurth, an assistant professor of medicine at Brigham and Women’s Hospital and Harvard Medical School (Boston, USA).

We still are learning about why this link exists. Some researchers believe it may have to do with the changes in blood vessels during an attack. But these studies continue to demonstrate that there is a link in both men and women, and that migraine is much more than a temporary discomfort. Those with migraine need to pay attention to their heart health even more than the average person. It would be worth mentioning to your doctor at your next checkup.