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Ask HN: Migraine prophylaxis?

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Re: Ask HN: Migraine prophylaxis?

#13
2 likely triggers:

- excessive polyunsaturated fats in your diet

- poorly digested fibers in your intestines

Use butter/coconut oil instead of soybean/canola/sunflower oil if that's your case. Avoid PUFA at all cost.

Also, cut grain-enriched ('whole') bread and avoid grains in general, i.e., favor mashed potatoes over rice, avoid peanuts etc.

Find more here: https://www.google.com.br/search?q=migraine+ray+peat+forum

Re: Ask HN: Migraine prophylaxis?

#14
Stress seems to be a trigger for me, so I actively try and keep my work related stress as low as possible - eg. not taking on work with tight deadlines. I also find that drastic changes in my caffeine consumption can also trigger a migraine.

I'm "lucky" in the sense that I start losing a significant part of my vision before a migraine attack, at which point I might smoke a small amount of low quality cannabis (I get extremely anxious when I realise I'm about to get a migraine and I've found this relaxes me and helps for the nausea) as well as taking an oral dose of Rizatriptan Benzoate. I've not had success with other triptans I've used, so I always make sure to have Rizatriptan Benzoate close by.

TLDR, by managing my stress levels along with keeping an eye on my caffeine intake, I've not had a migraine in months.

Re: Ask HN: Migraine prophylaxis?

#15
My trigger was MSG (monosodium glutamate) but don't take my word for it. strong naturally occurring umamy taste can trigger for me too.

you should keep a journal of everything you eat, especially if you can take note of the ingredients.

For me 1 or 2 days after consumption triggers it, but staying away MSG helps in my case.

MSG sensitivity isn't taken seriously because it only really affect a tiny subset of the population and the food industry has interest in it not alarming the 99%.

I'm taking B2 which strengthens the blood brain barrier too.

Re: Ask HN: Migraine prophylaxis?

#16
post #2

Triggers for me are dehydration, tiredness, stress and oo much bad food. I found that eating meat and dairy also had a massive effect on me and led to me giving them up. I have been more or less Vegan since figuring that out 20 odd years ago.

MSG is added to nearly every shop bought meat dish.

Re: Ask HN: Migraine prophylaxis?

#17

My trigger was MSG (monosodium glutamate) but don't take my word for it. strong naturally occurring umamy taste can trigger for me too. you should keep a journal of everything you eat, especially if you can take note of the ingredients. For me 1 or 2 days after consumption triggers it, but staying away MSG helps in my case. MSG sensitivity isn't taken seriously because it only really affect a tiny subset of the popul…

I've had one experience in Indonesia where I had a massive amount of noodles with a massive amount of MSG in it. Soon after consumption of said noodles, I had a migraine attack. I also had a ton of work stress at that point, so I'm not 100% that MSG was the actual trigger for me.

Re: Ask HN: Migraine prophylaxis?

#18
As a background. I am nearly 40, 70 kg, 176m, pretty active person but not doing very regular sport. I had migraine starting at the age of 10 or 12.

The best ways, for me, not to trigger a migraine are:

- very good sleep. It means taking a 25 minutes nap during the day if I feel tired.

- very good hydration. I drink about 1.5L in the morning and just a single cup of coffee.

- low stress. The lower the better because stress reduces the quality of my sleep.

- if it starts, I try to stop the migraine as early as possible with directly 1g Aspirine. This is my way but here you need to ask your M.D. because of course I cannot tell you what you should take as medication!

I was only able to achieve this as I started working from home (for the nap if tired).

Sorry for the throwaway account. I am traveling, but if you have questions, just ask and I will answer here.

Edit: from the other comments we all follow more or less the same method.

Re: Ask HN: Migraine prophylaxis?

#19
Of course I have no idea what your problem is. And while I'm not sure I ever quite raised to the level of "migraine", as I only on a couple of occasions got something like a full-blown aura or blurred vision, living with 3-4 major, debilitating headaches a week was a regular occurrence for me in my teens and 20s. (In hindsight I'm not even sure how I got through college. They mostly struck in the afternoon, so I guess I was mostly getting my life lived in the morning, which wasn't much fun since I was an evening person, due to, well, a good chunk of the things I'm about to list....)

In rough order: Discovering I had celiac disease. This was the big breakthrough without which I could make no progress, but it's not the only trigger I have.

Caffeine withdrawal; I have somewhat reluctantly dropped it from my diet because I withdraw at the drop of a hat (did you have 2.5 diet colas instead of 3 by 3pm? Headache time!) and I got tired of having to plan my days around making sure I got the right amount. (Possibly related to celiac; it can affect the speed with which things like that enter the blood stream.)

Discovering I'm not "allergic" to cashews or pistachios in the anaphylaxis sense but that they give me headaches.

Red dye 40. (Mostly in things I shouldn't be eating anyhow, but this was an extra twist of the knife.)

Poor sleeping posture; a new mattress for me was helpful, I'd recommend back exercises for everybody (specifically bridges), or at least everybody 6 foot plus. Excessive snoring/sleep apnea.

Excessive sugar, or even just excessive simple starches; blood sugar spikes.

Dehydration. (For whatever reason, there are a number of situations in which my thirst signal is simply inadequate and I must consciously consume water. I don't die (obviously), but I get massive headaches here that do not respond worth a crap to any OTC painkiller very well. I'm still sorta trying to figure this one out to see if it's a symptom of some other underlying issue, or if it's just the way I am.)

Real root beer, for whatever reason; appears to be more than just the sugar. (This took a while since I don't drink it very often, but it ruined a couple of ice cream social-type things before I figured it out.)

I'm not sure if this was a headache trigger, but discovering that I had some major heart issues that was a total asshole and only appearing while I sleep (vagal paroxysmal atrial fibrillation), so I had almost no clue that I had the issue, almost certainly a further effect of celiac. Treated with magnesium, potassium, taurine and l-arginine, vitamin C, vitamin K, and vitamin D. (Yes, it takes almost all of those for me. Celiac is "fun" when it comes to nutrition; you "get" to learn a lot about nutrients.) The heart issue itself may have been causing headaches directly, it certainly indirectly contributed to the several reasons my sleep has been poor for most of my life.

I recommend trying something like an elimination diet: https://greatist.com/grow/easy-elimination-diet-for-food-int... That particular link describes more of a "medium effort" sort of thing; you can also go whole hog and eat nothing but simple meats, fruits, and veggies for a while, and slowly fold things back in over weeks. It's extreme, but if you are someone who is sensitive/allergic to, say, soy, wheat, and dairy, it's really the only sane way to find that out. It blows to find out you've got one or more of the "major allergies" but it's a hell of lot better than not knowing!

Plus there's a chance you do the full elimination diet and it doesn't affect your migraines at all; well, you pretty much eliminated food issues in one fell swoop. Still a win.

Also grab a sleep recording app for your phone and record the audio of your sleep. I'm not sure science is 100% here yet but it seems to me we're going to end up in a place where basically all snoring beyond the most minor indicates bad sleep. If you've got a lot of snoring or any other sign your sleep is compromised, see about getting into a sleep study. In fact I pretty much just uniformly recommend everyone who has not done this do it, because the cost is virtually nil (the apps are free and it takes 5-10 minutes top to set this up for a night) and the potential benefits large; it's worth doing for anyone who isn't 100% sure they're awesomely healthy. If nothing else, the costs are so low it's just worth it to satisfy your own intellectual curiosity about how well you're sleeping; if you discover it's great, well, now you know, which is nice.

As you may have guessed from the previous paragraphs, it took me about 5-8 years to work it all out. But I have gone from being rocked by headaches almost continuously to pretty much never having a headache without knowing exactly what I did wrong, what I should have done instead, and how to prevent it in the future. Losing an evening to headaches is now almost always because I did something stupid, rather than inexplicable life.

Re: Ask HN: Migraine prophylaxis?

#20
My triggers would be bright light, prolonged loud noise, insufficient food, dehydration, and (I think) pistachios.

In terms of prophylaxis, my neurologist had me supplement with 130 mg of magnesium, which helped. What really knocked down the frequency, though, was when my psychiatrist started me on Lexapro, an SSRI, for anxiety.

When I get an attack anyway, 50mg sumatriptan. Doesn’t always totally eliminate it, but usually at least helps.

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