The report highlighted the need for better communication and support for younger migraine patients. A visit to a good doctor is key, but children and teens also need support at home, school, work, and in the community in general. Many people don’t even realize that many children do experience migraine attacks, and that those attacks may or may not be different than an adult attack.
The new site is divided up by age group. Children and their parents can click around to learn how to communicate their symptoms to other people, how to find help at school, and how to help themselves deal with migraine attacks.
Each section is age-specific, not only in language but also in topics and specific health concerns. Older patients will be thinking about college and preparing for adulthood. Younger patients commonly experience abdominal migraine, so you’ll see information about “tummy aches“.
Is vitamin B12 – otherwise known as cobalamin – a migraine-fighter? Researchers from the USA think it may be. With the obligatory “more studies are needed” disclaimer.
We’ve actually talked a lot about vitamin B12, because it’s already well known for its important roles, related to migraine. You may remember that testing homocysteine levels may be one way to detect migraine, because this test may show deficiencies in B6, B12 and folate. High levels may not only be a sign of migraine, but also depression, and blood clots. Read more at A Blood Test For Migraine?.
We also talked about how heartburn drugs may relate to a B12 deficiency, which is why migraine patients may want to avoid these medications. NSAIDs (e.g. ibuprofen) may also cause problems with B12 levels, if used too often.
But actually, there have been many studies on B12, as these researchers point out in their 2020 paper, published in the journal Best Practice & Research Clinical Anaesthesiology, titled Utilization of B12 for the treatment of chronic migraine. In fact, for 70 years we’ve been talking about B12 and migraine, thanks to a study in the Netherlands in 1951.
The researchers discuss some of the relationships between B12 and migraine. But one of the biggest is the relationship with nitric oxide (NO), which we’ve also discussed often. B12, in its active form (hydroxocobalamin), helps control levels of NO. Here is just part of the explanation of the paper:
While the pathogenesis of migraine is not fully understood, NO is an important contributing element, and its effects can be mitigated through the scavenger action of vitamin B12. Patients experiencing migraine have neurogenic inflammation and vascular dysfunction, enabled by increased release of NO and homocysteine. N0 is an endothelial-derived vasodilator, and oxygen radical that plays a role in cell signaling [46]. Multiple factors. including CGRP. stimulate N0 production. NO turns on a pathway resulting in vasodilation of smooth muscle. Clinically, NO serves as a factor in pain pathways, including chronic pain, inflammation, central pain sensitization, and hyperalgesia via cyclic guanosine monophosphate {cGMP) contingent activity.
Utilization of B12 for the treatment of chronic migraine
It’s technical stuff, but if you’re at all familiar with migraine, you’ll recognize some of the connections here.
There are also many studies that directly show a decrease in migraine with B12 supplementation. However, these researchers warn that the studies were generally small, and that we need to see larger clinical trials, especially trials that only involve B12. This is always tricky, because sometimes a supplement only works, or may work better when taken with other supplements. But we need to know somehow how much B12 by itself affects migraine.
As mentioned above, B12 can also help the body avoid blood clots, leading to conditions such as stroke, which has also been known to be related to migraine for many years.
So in the end, these researchers basically say that there are many positive studies, and it makes sense from what we know about migraine that B12 plays an important role. But we need more studies. If only to find out who this may help. Is it only people with a deficiency? Is it only those with a certain type of migraine? We’re not sure.
Meanwhile, make sure you have good levels of B12 in your diet. Dairy products and eggs (eggs are pretty amazing, actually), salmon and tuna, beef and especially organ meats, are all high in vitamins and especially B12. If you’re vegan, you may be especially prone to B12 deficiency, so talk to your doctor. Some foods are fortified with B12, but you may need to look at other options.
Supplements may also help vegans and non-vegans in their fight against migraine. Garden of Life mykind Organics Vitamin B Complex is recommended by ConsumerLabs and also highly rated by customers. Consider talking to your doctor about your B vitamin levels.
B12 does seem to directly lower migraine attacks in some people, but even if it plays a smaller role in conjunction with other things, a proper level is critically important to your overall health.
Sensitivity to odours is osmophobia. Yes, this can refer to a fear of smells, but the hypersensitivity to smells related to migraine applies as well.
I was going to include a picture of perfumes here, but just the picture made me feel like I was getting a headache. Try it for yourself! If you dare…
A study published in the Journal of Headache and Pain last month provides some interesting insights into common sensitivities and also a possible progression of the symptom.
The researchers, in this case, recognized that many “migraine symptoms” are not only present during an attack, but also before, after, or between attacks – or all the time. This is important to understand for people who still think that migraine only affects you when you have a “migraine headache”.
The biggest offenders probably won’t surprise you. The easy winner was “sweet perfumes”. But next to that, the odours of various foods, cigarette smoke, and exhaust fumes were common offenders. All of these sometimes covered all categories above in the sense of when they were a problem, some being bothersome all the time, and all for some people were considered triggers.
Also not surprising was that if a smell bothered you before an attack, it was likely to bother you during an attack. If it bothered you during an attack, chances were better that it would bother you all the time.
Perhaps most interesting in this study were the age differences. Patients who tended to be sensitive to certain smells between attacks tended to be about 10 years older, and/or they had had migraine for 8 years longer. This may indicate that migraine sensitivity does progress. Would the osmophobia be less if migraine had been treated properly in the early years? This study didn’t address the question, but it seems possible.
Some good news is that people with a high sensitivity to odours did not necessarily seem to be more disabled in general. In other words, although obviously this is a part of the migraine disability, it doesn’t seem like it is necessarily a sign that your migraine is getting more severe. A possible exception were those who became especially sensitive just before a migraine attack.
It may also be encouraging to know that the researchers found that patients were not nearly as likely to have an attack triggered by a certain odour as was believed from an earlier study. It could be that certain smells become more intense and annoying at certain times, such as right before an attack. But that does not necessarily mean that the perfume or whatever is actually triggering an attack.
It’s about time to have an update on QULIPTA, otherwise known as atogepant, a newer migraine preventative.
You may remember that we were talking about atogepant back in 2020. At a time when many medications were coming out as injections, atogepant was a bit of a breath of fresh air. A preventative, taken orally, and only taken once a day (10, 30 or 60mg), with or without food. Much more convenient even than many other oral preventatives.
Atogepant was approved by the FDA in 2021, but studies continue. QULIPTA came up at the June 2022 American Headache Society 64th Annual Scientific Meeting a number of times, and we’re learning more about it as it begins to be used more in the general population.
For example, it was found that some patients seem to lose weight when taking atogepant. It’s a minority, but still a significant number. Not only were patients less likely to gain weight, some actually lost weight taking the medication. Something to watch.
It was confirmed once again that you can take atogepant with or without food. The difference seems to be negligible.
It seems that although many patients find their symptoms diminishing in the first month of treatment, others do need to wait 2 or even 3 months before atogepant works for them. And so far, patients taking the preventative for a year seem to still benefit (we’ll keep watching this – remember, the medication is very new!).
A patient who took the COVID-19 mRNA vaccine experienced continuous migraine visual aura, and was successfully treated using atogepant. This may be a useful treatment for migraine symptoms after vaccination, another one to watch.
More studies have been done on the overall safety of QULIPTA. So far, the news is good – it seems to be generally safe. However, as with any medication, it is very important to tell your doctor about any supplements, medications, vitamins, and so on, that you may be taking. This may affect your dosage.
Since I haven’t been able to post as much as I would like, I’m not doing highlights as often either. So this time we’ll look back over the past 5 months to see which posts have been most popular with guests to this site. Here’s what you might have missed, in case you want to catch up. 🙂 The most popular posts are first in the list…
Bonus… An article that was popular from the past 5 months, but written further back. This time, it’s MS and Migraines: New Research – I would love to hear your comments if you’ve had experience with both.
