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CGRP Drugs and Weight Gain

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Do CGRP injections cause weight gain? If so, what can I do about it?

This is a (somewhat belated) response to a question from Char in the United States. If you have a question, use the button on the right to fill in the form.

weight gain

Char was specifically asking if there is a CGRP injection that doesn’t cause weight gain.

One of the concerns that doctors have had regarding the new CGRP medications is that they are – well, new! Of course, every medication has to be new at some point. But what that means is that long term testing is really only starting. (For some of the concerns expressed early on, check out At Stake: The Possible Long-Term Side Effects of CGRP Antagonists. Weight change is one of the questions that is highlighted.)

So at this moment in history, we are waiting for long term trials, and also watching carefully clinical experience – that means your experienced with the drugs.

Many people are being helped by the new medications, but there are reports of weight change – not just weight gain, but weight loss. The Robbins Headache Clinic reported on some of the early experiences they had with the CGRP medications. Here’s what they’ve written about weight changes:

Bloating & Weight Changes: weight gain can be a problem, and if significant enough we stop the medication. This does not appear to be as much a problem as with other medications such as Lyrica, Depakote, gabapentin and the tricyclic anti-depressants, but we are seeing it. This could be because our feeding and hunger is centered in the hypothalamus which is not protected by the blood-brain barrier. A few people have lost weight, and if it is significant then we stop the medication.

CGRP QUESTIONS/ANSWERS

So in short, they saw both weight gain and weight loss. However – and this is important – CGRP related medications don’t seem to be the worst offenders when it comes to weight gain.

The Pain News Network also reported on a survey of those using the new medications. According to the survey, 12% of patients reported some weight gain (see New Migraine Prevention Drugs Making Inroads).

We have to remember that these are not controlled studies. And so we come to a very important question – are these drugs directly causing weight gain?

Here’s a simple example. If you are constantly nauseous, and a CGRP injection significantly improves your health, what just might happen? You might eat more.

This is the argument that Drugs.com makes for Aimovig. “Does Aimovig cause weight gain or loss?” – no, but changing migraine symptoms may. You may think that their answer is a little overconfident, but the fact remains that there may very well be a complex set of reasons why you gain or lose weight on a CGRP drug.

So back to Char’s concern – what to do?

First, be sure you are communicating your concerns with your doctor. This is a case when customized medical help is very important. Your doctor can help you find the best solutions for you.

Second, and this will help your doctor, be sure to keep a detailed diary of your symptoms and any changes that you notice.

Third, try another CGRP medication. Unfortunately, we simply do not know enough at this point to give you a list of CGRP related medications that are least likely to cause weight gain for you. Like many classes of drugs, it can make a significant difference if you try another drug of the same class.

And, of course, as your symptoms (hopefully!) lessen, take the time to learn and re-learn some basic healthy habits.

We would love to hear your experiences and suggestions – leave a comment! 🙂

VR for Headache: Time for an Update

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Back in 2006, we were already talking about using virtual reality to fight pain. One of the pioneers was a VR program known as “SnowWorld”, an immersive “cooling” experience.

snowy scene

So where has VR treatment come since then? Unfortunately, clinical trials probably haven’t kept up with the technology. A study published in 2019 brought together some of the information that is available today. Here’s a summary of what we know:

  • VR is very promising when it comes to “acute” pain. For example, if you had a bad burn and you had to have your wound cleaned, virtual reality is probably going to help lower your pain levels. This would seem to be promising for shorter term headache as well, or for use during the peak of a headache condition.
  • VR may help with chronic pain conditions, but we really don’t have enough information yet. It seems to help most when you’re actually in the VR world, but will it provide benefit between “treatments”? Maybe. But we have a long way to go before we really know enough about the dosage (how long the treatment should be) and the frequency of treatment.
  • Migraine patients in particular are a challenge because of the common symptom of photophobia. In other words, someone having a migraine attack will likely be sensitive to light, and will be seeking a dark room, not an immersive screen experience. However, this doesn’t rule out VR – there may be ways to have a low light immersive experience that includes sound. (A simple example – I recommend an app called Environments for iOS or Android. It’s just a picture, and sound – but go to “Alpine Blizzard”, take a glance at the picture, then close your eyes and listen with headphones. Seriously.)

So the update is that VR still has a lot of promise when it comes to treating pain, but clinical research is lagging behind.

Have you found that VR helps you with any symptoms? Reducing tension, decreasing pain? Let us know.

Meanwhile, here’s more detailed information from the recent study: Virtual reality as an analgesic for acute and chronic pain in adults: a systematic review and meta-analysis. You might also want to check out this recent article from the New York Times: Virtual Reality as Therapy for Pain

A Great Way to Say “Thank You”

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There are many, many people around the world who are fighting back against migraine. Why not take a moment to say “Thank You”?

National Migraine Foundation Headache Heroes 2020

The National Headache Foundation is making thank yous a focus of their 50th anniversary. You are invited to nominate “Headache Heroes” in these categories (quoted from the official page):

  • Healthcare Provider: Any healthcare provider who has made a difference.
  • Patient: Someone living with migraine disease or headache disorders.
  • Caregiver: The unsung hero caring for someone living with migraine disease or headache disorders.
  • Advocate: An individual or organization that is making a difference in the headache and migraine community.

What I like about this is that it reminds us that there are many headache heroes out there. I wish they had added to the list “researcher” – we are very thankful for the many who are researching migraine and making a real difference. (A great way to thank a researcher is to make a small or large donation to the Migraine Research Foundation.)

The nominees will be invited to the NHF’s 50th anniversary Gala (a very fancy fundraising event), and will be able to purchase a ticket at a discounted rate (still $300!). The winners will get one free ticket ($400). Hey, it is a fundraiser, after all!

Nominating someone through the National Headache Foundation is a simple action you can take to say “thank you”. But why not take this list and write a personal thank you to these people? In this day and age, I suggest sending a written letter if possible, which has much more value than it did in years past. But an email, or a face to face thank you – or hey, bring over some small gift to that person.

Yes, nominate someone today (time is limited, so don’t wait! Nominations are open to the 17th of April 2020, but you know what will happen if you don’t do it now). 🙂

But nominations aside, let’s not forget to say thank you – I admire you – keep up the fight!

Eyestrain? Seriously, Try Iris Now.

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Lately we’ve been hearing a lot about the dangers from the light from our screens. In fact, it’s not just eyestrain. It’s problems with sleep (a major migraine trigger), and general health issues that researchers are only beginning to understand.

Iris settings

Recently I’ve gotten to know a great computer app that helps cut down on some of the typical problems with monitors. Now you’ve probably heard of some of these. For example, f.lux is excellent, and free. It can match sunrise and sunset in your area to give your screen a more natural look. It’s been around forever.

There’s also Redshift, another free one, which is open source.

Iris has both paid and free options. The main program is paid (lifetime or subscription, but not expensive!), but you can try it for free for seven days. And I encourage you to give it a try right now.

Here’s how Iris is different. First, it has a gazillion options in the pro version. Really, this thing can do a lot of tricks.

But here’s the biggest thing – it can significantly cut down on flicker as it dims your screen. This is a huge plus for migraine and headache sufferers.

Give it a try and see if it makes a difference. Try the main version first, with the free trial (you don’t need to enter credit card information – yay!). You can use a very basic version absolutely free (Iris Mini). But the main version isn’t expensive.

I’ve been doing some study on health and light and would like to write more later. But seriously, for anyone who does significant work on the computer, this is a big one. I started using f.lux years ago, and that already made a significant difference. And I’m using Iris right now.

There are a lot of things you can do to improve your health when it comes to natural and artificial light. Even with the paid version of Iris, it’s one of the cheapest options out there to try. Check out the official Iris website, and you can read more about the science and technology behind the software.

Do You Have a Food Intolerance?

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After suffering from migraine attacks for decades, Christy Nielson finally discovered that most of her attacks were being caused by what she was eating. A simple solution, but how easy was it to discover?

Eggs and flour - are you sensitive to one or both?

In her case, it wasn’t too difficult, but it took so long because food intolerance isn’t generally the first thing your doctor looks for. They may suggest some of the common migraine food triggers early on, but that’s not quite the same thing.

Christy ended up trying something that most of us have heard of, but many of us have never tried – an elimination diet. This isn’t just avoiding triggers. It’s avoiding the most common foods that cause problems, and then gradually re-introducing them.

Elimination diets track foods that are considered to be responsible for 90% of food allergies. Now, you may not have an allergy, but these foods may still cause problems, such as…

  • Migraine
  • Fatigue
  • IBS
  • Insomnia
  • Joint Pain
  • Acne
  • Heartburn

So the plan is to cut out the following foods – 100% – for three weeks. That means carefully reading labels, and never cheating. It’s not long – you can do it!

Then you introduce one of the foods back into your diet for 2 weeks. Keep a diary – are any symptoms bothering you? If you’re good after a couple of weeks (there may be an adjustment period at the beginning), go on to the next food.

What follows is a typical list of 12 items. However, it’s not a complete list. Talk to your doctor for ideas. You might want to try these things first, and then move on to other possibilities as your doctor directs. You don’t want to get overwhelmed with an endless list right at the beginning.

  • Alcohol
  • Caffeine
  • Citrus Fruits
  • Corn
  • Dairy
  • Eggs
  • Gluten
  • Nightshades
  • Peanuts
  • Refined Sugars and sweeteners
  • Shellfish
  • Soy

Christy went on an elimination diet and also had lab tests – showing that eggs and wheat were the problem. Eliminating those led to a drastic improvement – read more here: How Trying a Migraine Diet Changed One Woman’s Life Forever

For more on elimination diets, check out these articles:

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The articles on Headache and Migraine News are © 2004-2024 J. Cottrill.
Every effort is made to ensure the accuracy of each article, and to point you to further sources of information. However, this site is for informational purposes only and should never replace a visit to your doctor.