It’s coming back for another year! The Migraine World Summit, the internet-conference that brings together the world’s experts on migraine and headache, is coming this March!

Many of us would love to watch all the interviews that will be free online during the conference, but it’s not always possible. Life goes on and … for many … migraine visits at the most inconvenient times. Frustrating – that migraine can keep you away from some of the most important new information about fighting migraine. But that’s typical enemy strategy.

But I’m still asking you to take two minutes to get your complimentary tickets today – even though it’s still a few weeks away – and even though you may not be able to watch online. Why?

First, getting your tickets today will mean you will be the first to hear announcements about the summit. The dates were just announced a few days ago (it’s March 20-28 2019), but the speakers and schedule are yet to be announced. You’ll get insider information if you get your ticket early.

°!° Quick tip: Direct a few friends to this post and have them get tickets too – especially if they don’t have migraine themselves, but they’re willing to support you. Once you get the early schedule announcement, ask if they could watch the interviews that will be the most important to you (depending on the topic) and take notes for you.

Second, getting your tickets today will send a message to researchers, health professionals, and important policy makers, that we are serious about fighting migraine. Why?

Because the Migraine World Summit is a growing, professionally done and worldwide summit like no other. It’s getting attention around the world. The better the “stats” – that is, the more people who get tickets, watch, and participate, the more we will get the attention of those who can get the research done, provide the funding, and vote for change.

°!° Quick tip: Could you think of four people – two with migraine, and two people who are supportive, to share this post with? Then work together to see if you can catch the interviews that will make the most difference in your fight against migraine, taking notes for the others. Maybe you can get together (online or otherwise) to discuss what you’ve learn, and create a new strategy to fight migraine!

Of course it will help you if you can watch the free interviews and events (perhaps be a complete game-changer for you, as it has been for others). But if you can do nothing else, get a ticket. And share this post with others so that they will see how important this is.

So don’t wait until March – it will cost you nothing, just a couple of minutes to sign up. If you can participate more later – great! I hope you’ll find more answers and better health. But either way, become part of the movement today.

1 February 2019

CGRP Antagonists: Not for Everyone? Experts Weigh in…

James Medications 1

When it comes to the new migraine drugs, such as Aimovig, Ajovy and Emgality, we can say, “So far so good”. Positive clinical trials, minimal side effects – there is legitimate hope that this new class of drugs will help many migraine patients.

That being said, specialists and researchers are not without their concerns about CGRP antagonists. So let’s take a quick look at what some of those concerns are.

Why would anti-CGRP drugs be a problem, if they fight migraine? CGRP seems to play an important role in sending pain signals. Lessening migraine symptoms by inhibiting CGRP seems to be working well for many people.

But here’s the catch – CGRP is in your body for a reason. If we lower CGRP levels, what will that affect? Our knowledge is limited, but it seems that CGRP has a wide range of important functions in the body. And the trials done so far are fairly short-term. What will the long term results be?

As Dr. Lawrence Robbins points out, “We will have a better feel for the true risk in 10 years.” Yes, but meanwhile?

Here’s the big challenge. Which patients will most benefit from these new meds? No one wants to spend more than is necessary – what if a cheaper treatment works better? And what if some patients have a higher risk of problems from anti-CGRP treatment?

Headache specialist Dr. Andrew Hershey wrote:

With the ongoing development of 4 different antibodies targeting the CGRP pathway, it will be difficult to determine whether unique patient populations will have a response to a specific drug or whether one agent is superior to others. Furthermore, many patients will probably still have a response to standard multidisciplinary treatment that is less costly in patient and provider time and dollars.”
Promise and Pitfalls of Preventing Migraine With CGRP Inhibitors

As we’ve already discussed, the clinical trials up to this point haven’t brought any major issues to light. But there is good reason to continue trials, and watch for problems.

Based on the science we have to date, what are the experts concerned about? What types of risk, or what types of concerns are they expressing? Here are a few of the top ones to watch for over the next few years:

Cardiovascular concerns: CGRP plays an important role in the cardiovascular system. For example it is involved in the dilation of blood vessels. Could long term use contribute to cardiovascular problems? The trials generally haven’t included groups at high risk. This is probably the biggest one specialists are watching for, and some may be reluctant to prescribe CGRP antagonists to those already at high risk for hypertension.
“Antidrug Antibodies and Immunoallergic Hypersensitivity”: Without getting into the details, this means that a drug can have a long term effect of causing unwanted immune responses, and/or the drug may become less effective as time goes by.
Hormones: Could these drugs interrupt proper hormone function? Specialists are especially watching those with thyroid problems, and also growth in children and adolescents (these drugs are only approved for adults for now).
Gastrointestinal disturbances: Could anti-CGRP drugs have a bad effect on your gut? Doctors will be especially watching those who have recently had ulcers or who have irritable bowel syndrome.
Pregnancy: Or, trying to get pregnant. Could CGRP interfere with pregnancy?

Again, we don’t have all the answers yet. These are concerns based on what we know about CGRP in the body, but there simply isn’t enough evidence to know the effect that these new medications will have, particularly long term. Hopefully, these issues will be minimal – or, in many cases, non-existent.

Some doctors may consider prescribing anti-CGRP medication for a time, and then having patients take a “drug holiday” for a while. Some may be hesitant to prescribe the drugs to those with cardiovascular or gastrointestinal problems.

Consider the risks – but remember, at this point, the risks seem to be small for most of us, especially if we’re not taking these drugs long term, and if we’re not already in one of the high risk groups above.

The question is not whether or not you should get the best possible treatment. The question is – what is the best possible treatment for you? Some patients will still find other treatments and combination treatments to be far superior and far cheaper than the new anti-CGRP drugs. Others will be helped by medications like Emgality, who have not been helped by other meds in the past.

As Dr. Amy R. Tso and Dr. Peter J. Goadsby wrote in 2017

An important task will be to attempt to identify patients more likely to benefit so personalized therapy can begin to offset the cost of the treatments by minimizing the number of patients treated who have no useful response.
Anti-CGRP Monoclonal Antibodies: the Next Era of Migraine Prevention?

For a summary of some of the challenges and concerns when it comes to this new class of drugs, check out Promise and Pitfalls of Preventing Migraine With CGRP Inhibitors. For a longer and more technical article for specialists, with many questions that may need to be answered, go to At Stake: The Possible Long-Term Side Effects of CGRP Antagonists.

28 January 2019

Hard to Talk During a Migraine Attack? You’re not alone!

James Discoveries & Stats, Information 0

If you have trouble talking during a migraine attack – or even before it fully hits you – you’re not alone. Speech problems are a well known, but complex, part of migraine.

Journalist Lindsay Patton-Carson recently wrote about her migrainous struggle with words – and it’s not just speaking them, it’s writing them. She began to connect the dots, she writes, “I did notice that as my migraine frequency increased, my word recollection decreased.”

A recent study set out to look at various specific types of speech disturbances in migraine patients. These were people with “episodic” migraine (not chronic). Using a mobile app, everyone provided three speech samples per day, while tracking their migraine attacks.

This research was not so much studying whether or not people could remember words, but things like pitch of voice, how fast you speak, and how clearly you enunciate (clear pronunciation).

There were, as expected, speech differences in patients with migraine. Not just when they were in the middle of an attack, but all the time (as compared to the control group).

However, the main focus was on changes during the pre-attack phase (prodrome) and the main (normally headache) phase. About half of the patients had significant speech changes during an attack, and about a quarter experienced changes during the pre-attack.

The most significant changes were in how fast and clearly the patient spoke, and “phonatory duration”, an ability to hold a vowel sound (which tends to decrease with age).

Language difficulties (such as slurred speech) are common in migraine – and a common way to diagnose migraine with aura. In an online poll, 90% of our visitors had experienced some kind of language problem related to migraine. It’s well known that there are brain changes during an attack (see Is Your Brain “Slower” During A Migraine Attack?). Interestingly, none of the patients who experienced pre-attack speech issues knew it was happening – it was only found through research of the recordings they made.

This study, though very preliminary, may start to help us understand what types of speech changes are most common and why.

One of the study authors explains

Changes in speech patterns during migraine attacks might be expected given the relatively widespread alterations in brain function and functional connectivity that occur during migraine attacks. The ability to share our thoughts and ideas through spoken communication is a complex and fragile process . . .
Dr. Todd J. Schwedt [source]

Remember, changes in speech and language are not just one thing, and they are complicated. But they’re also common. Yet another reason to fight back against migraine.

Read more here: Migraines can cause altered speech

25 January 2019

Continued Confusion about Food Allergies

James Discoveries & Stats 0

A study published this month in the USA warns that many are still confused about food allergies and sensitivities. But it also shows that your health issues may be changing.

Angry food — Is your food angry? 🙂
(Photo credit: Tim McCune)

The study, published at the JAMA Network, was titled Prevalence and Severity of Food Allergies Among US Adults. The researchers found that 19% of adults in the USA claimed to have a food allergy. But delving a little deeper, they found that only 10.8% of them actually did have a food allergy.

10.8% is a concerning number, of course – that means that over 26 million people in the USA alone have a food allergy. But why do twice that many think that they do?

As science writer Ed Cara points out, it’s mostly a matter of terminology (see Millions of Americans Are Wrong About Having a Food Allergy, Study Suggests). “Allergy” is a very technical term for a serious condition. But many people simply use it to mean that they feel uncomfortable after they eat something, which could mean “food sensitivity” or “food intolerance”, not a food allergy.

Of course, “intolerance” in itself is a vague and controversial term. Either an allergy or sensitivity could lead to a headache, but the way you respond and treat each could be vastly different. As Cara writes:

Some people also seem to have delayed immune reactions to food without IgE in the picture, though we’re less sure about how commonly this happens and how to accurately diagnose it. Many doctors, for instance, criticize tests that promise to find these so-called food sensitivities with ease.
Millions of Americans Are Wrong About Having a Food Allergy, Study Suggests

Even if you get a headache after eating certain foods, you may be able to eat them without a problem if you switch to a healthier diet in general. The issue of sensitivities, allergies and triggers is complex and hard to nail down in clinical trials.

However, we are reminded that we should pay attention to symptoms, and discuss them with our doctor. A food allergy can be potentially life-threatening, but if any food is causing problems, there may be ways to find treatment or make lifestyle changes that will decrease your headache symptoms.