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Doctors’ tips on what to avoid with migraines


What if you could ask the top migraine doctors in the country for advice on how to control your headaches? We have!

First, stop the self-blame

“Patients come to me and say, ‘Oh, I should not have had a glass of wine when I went out,’ or ‘I should not have been so late.’ Many of my migraine patients are type A personalities who are very successful and overachievers. I tell them it’s okay to slip in now and then. You can not prevent your migraines 100%. Robbing yourself only increases your stress levels, and we know that stress is the leading cause of migraines. ”

Mary Ann Mays, MD

Drop the extra pounds

‘We have known for some time that obese people are more likely to get migraines. They are also more likely to have chronic migraines, which means they get at least eight a month. One theory is that your extra fat cells produce inflammatory proteins that cause this headache. The good news is that if you lose weight, research shows that your migraines will improve. ”

Alan Rapoport, Managing Director

Leave the ‘headache diet’

‘About 30% of migraine patients have at least one food trigger. But the list of foods that can potentially cause problems is overwhelming. Most information about food generators is anecdotal, not based on studies. Therefore, I do not recommend that my patients follow a specific ‘headache’ diet or avoid certain foods. Why force them to avoid things they enjoy, if it is not even a trigger in the first place? On the days that they get headaches, I make them think back to what they have been eating for the past 24 hours. If one of the foods is on the trigger list, they can avoid it for a few weeks to see if it makes a difference.

Merle Diamond, MD

Get treatment

‘It sounds obvious, but it really is not. More than half of all people who get migraines are never diagnosed. They are at home and treating their headaches with over-the-counter medicine. But it’s bad. First, they live with crippling pain when they do not need it. Second, they take free painkillers such as ibuprofen or acetaminophen several times a week, which can lead to headaches being used too much. This in itself becomes a major headache to deal with. Your GP is a good start, but consult a headache specialist if you are unable to get relief.

Mary Ann Mays, MD

Consider complimentary medicine

‘There are some supplements I recommend to my patients. None is a miracle cure, but it can sometimes help with traditional prescription medicine. These include:

  • Butter. The usual dose is 50-75 milligrams twice a day. I personally did not find it to be too effective in my practice, although one of my most defiant patients swears that she was cured by it
  • Magnesium, 400 milligrams per day
  • Melatonin, taken about an hour before bedtime to make sleep regular
  • Coenzyme Q10. Usually 300 milligrams per day
  • Vitamin B2. 400 milligrams per day

Usually I start with one for my patients, and if they do not respond, I add a second. And if they still do not respond but have no side effects, I add a third. ”

Alan Rapoport, Managing Director

Keep a headache plan

‘The better, the less likely you are to end up in the ER. Many of my patients need a three-point strategy. The first point is an acute medication, such as a prescription triptan or ergot, which you should take as soon as you feel your headache appear. Then there is a rescue medication, such as a prescribed NSAID, that you will take if the first medication does not work. Finally, if you get more than eight headaches a month, you should probably use a preventative medication, such as a beta-blocker or CGRP antagonist. If after all this you still end up in the ER, or if your job is missing due to your headache, you should consult your headache specialist again to get a better plan. “

Merle Diamond, MD



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