Migraine is more than a headache – a rethink offers hope

I used to get frequent migraine attacks - there were times when I would be down 3 days in a week, just unable to be productive. A lot of it was induced by stress.

I then tried something novel - I took some LSD. I had an intense psychedelic trip, dug deep into my psyche, realized I was a giant ball of anxiety. The anxiety's root cause was ultimately a fear of mortality (around the same time, my dad was going through a terminal illness, we spent many years in and out of ICUs, so a lot of that had soaked into me). I had to come to terms with my own mortality, which happened when I just "melted" away and lost sense of self momentarily, and once I did, I felt so much lighter as I came out of the trip.

My migraines stopped right then and there; I kid you not. I didn't get a single headache for the next 4-5 years, and in general, I was also a lot more balanced and at peace, even though I went through some highly stressful times. It was miraculous.

Of course, life has a way of creeping up on me, and I do get migraines occasionally, but when I do, I know how to stop them - I just need to slow down, meditate (not feel-good meditations all these meditation apps promote, but actually meditate and feel your muscles relaxing). That single LSD trip taught me how to relax myself physiologically.

Not saying this is going to work for everyone, just sharing my personal experience. Please keep in mind that playing with psychedelics is like playing with fire. Exercise caution.

I've suffered from migraines all my life. It worsened as I've gotten older. One day long attacks turned into three day long attacks. Then turned into five day long attacks. I've taken various preventatives and abortives over the years to varying success. It runs in my family so I never thought to see a neurologist for them. A couple years ago I had a bad string of them and my medicine wasn't really touching it, so I finally decided to see a headache specialist. The doctor very quickly got me started one of these anti-CGRP medications.

Almost immediately, I dropped to 0-1 attacks a month, and when they do happen they are both less painful and my other medicine knocks them out fast.

Literally life changing.

I got my first migraine in my early teens. I was over at a friend's house and we were playing in the basement on a summer day, then went outside where the sun reflected off a window into my eyes.

It would start with a shimmering pattern obstructing my vision where the bright light was, which would grow into a c shape and get bigger until it surrounded my vision and then faded away. About 15 min after the shimmering pattern faded the blistering pain would start and last for about 5 hours, with lingering light sensitivity until the next day.

I later realized that something about a rapid change in brightness (from dark to bright) would trigger them for me.

Another time was triggered by a high school shop teacher lighting a welding torch.

The best way to relieve the pain I found was to turn out all the lights and dunk my head in cold water, which I discovered eventually in desperation for relief.

I would only get them every few months, but when I did I would be pretty useless for most of the day. I stopped getting them in my early 20s. No idea why, but I am grateful. They sucked!

I was around 13 when I had my first migraine. A solid block of pain on the right side of my head. That occasional migraine became more frequent over the years. I had a headache 24/7 in one specific place in my head.

In my early 30's, after blood tests, food elimination, x-rays and finally an MRI I was told that I had Chronic Daily Migraines.

Most days were 6-7/10 pain. Those days that were 10/10 I perfected the art of lying down and breathing in such a way that I barely moved. Noise / light were never an issue, the pain got worse when I moved.

Then I got a daith piercing.

I had read that a daith could help.

I got the daith ~14 years ago and I have not had any sort of headache since. Both my daughters who had migraines got a daith and they too have no headaches.

I get the sample size is not useful, but if you have migraines, go into your local proper piercing studio and ask for a daith - they will almost certainly reply "On which side of your head is the pain?"

I started having migraines at 8 years of age, several a week. This persisted all through my life till 42 years later, I had a blood pressure emergency where I ended up in ER with 190/100 blood pressure. Thankfully, it never repeated and was never diagnosed but as a consequence I was put on Olmesartan, a blood pressure medication that relaxes the blood vessels. Eventually, the dose was reduced to the lowest, 5mg, once a day, to which I added 240mg magnesium glycinate, which they sell in Costco. I have been mostly migraine free since for several years and ones I do get are mild compared to before.

My cardiologist, who prescribed the blood pressure medication, is mystified saying that while beta blockers are a migraine prevention medication, olmesartan isn't a beta blocker and maybe it was just my (mild) hypertension which needed to be treated. I doubt that I had hypertension when I was 8 but I'm just thankful that decades of pain have come to an end.

I was diagnosed with migraine as a kid when I was 10. The doctor made me undergo a battery of tests including a contrast CT scan that consumed aj entire day, only to confirm at the end of the day that it was migraine. The migraines weren't even that debilitating but my mom was just being extra careful.

After that, I still got headaches at a good frequency and tried all sorts of specialists from orthos to opthalmologists, all of who checked their areas of the body and said I was perfectly normal. The one doc I didn't see was a gastro and this was a mistake.

Eventually I grew older and realised first that my headaches were always preceded by some sinus congestion and milk was a trigger of said congestion. So I switched to lactose free milk and that helped.

Eventually I realised that I was a chronic acid reflux patient, that a lot of small symptoms I had had over the years (a feeling of something stuck in the throat, congestion etc) were basically just the gut throwing up acid, or more accurately LPR/silent reflux. The reflux was the actual trigger of my headache. So my usual medication of Paracetamol, or worse, ibuprofen was actually making it worse in the medium/long term.

I switched my strategies to fixing the gut/acid reflux instead of treating the headache. The max I do nowadays is 325mg of paracetamol if I need to sleep and the pain doesn't let me. Ibuprofen is a nuclear option that I haven't resorted to in years.

The gut issue is still not resolved, I suppose years of damage to the oesophagus takes time to heal, so I'm still prone to reflux but I make do with a bland diet, avoiding triggers like milk and resorting to PPIs for short bursts during an attack. Oh and I also do the bending while swallowing trick that was on HN sometime back, which has helped immensely.

My headaches are mostly a thing of the past. Haven't had a debilitating one in years.

I spent most of my life thinking "migraine" was just a really bad headache. Until I started getting migraines. The best way to describe it is a band of white hot pain, almost a stabbing sensation. It started behind the eyes and would spread everywhere. Not confined to my head, a full-on nervous system meltdown: extreme light sensitivity, blurred vision, trouble with balance and coordination, nausea, numbness, and residual effects that lasted over a day. With a migraine, there is no "take an advil and power through" - you sit in a dark room and pray.

Any other migraineurs share what I call "Silver Bullet Fatigue" at trying new treatments? I've been at this for six decades with no magic solution for my own migraine problems, and I've lost count of all the neurological investigations, meds, scans, treatments, and helpful or sometimes utterly silly suggestions that have come up short over the years. Some have come close but had undesireable side effects, others made me very ill in their own right. At this point I just don't have much desire to go through the treatment wringer again. Am I alone in this sort of fatigue?

First, I know different people have different triggers from me. I used to have migraines every few days to every few months from age 13 to 23. These would incapacitate me. I would get the aura and be almost blind for an hour, then throw up a couple times, and have a bad headache for 2-4 hours, then I could function again but still felt crummy for the next 24 hours. I noticed that pickles were a trigger, and I thought "pickles have a lot of sodium". So, out of desperation as something to try, I read the labels of everything I was eating and cut out everything that had more than a little sodium: frozen pizza, frozen dinners, deli meats, etc. At the time I was having migraines every few days, and then I didn't have another migraine for years. I was so glad they stopped. I now doubt it was the sodium. In cutting out sodium, I happen to cut out processed foods, which includes lots of suspicious ingredients. I suspect Tyramine was the main culprit. There's a diet called The Headache Diet that is focused on minimizing Tyramine. Guess what else pickles have a lot of? For last last 30 years, here are all the things that have caused my migraines: Lithium Carbonate (Orotate is OK), Pickled Herring (Tyramine), Soy Sauce (Tyramine), Hyaluronic Acid (synthetic, Mobilee is OK), Tianeptine, Sulbutiamine, and a strobe light. Every migraine I have had in the last 30 years can be explained by those - only 8-12 migraines total. I still precisely control my sodium and eat no processed foods.

I have been a migraineur for decades. Mine are classic aura, with the whole "looking through broken glass" thing for a half hour or so when they happen. This year one of my partner's doctors mentioned positive results from supplementing with Vitamin B-2 and Coenzyme Q10, and it has dramatcially lowered their frequency. Mine are especially bad when the air pressure is seesawing which it does a lot here in the spring and fall, but I would guess I'm down to something like 20% of the previous years numbers.

Definitely worth trying.

I have been diagnosed with vestibular migraines. No pain, just dizziness and brain fog and vision issues (feels like my eyes don’t point in the same direction). I also have a doctor that says I have symptoms of mold exposure (lots of correlative testing and also house testing and remediation). I have also been diagnosed with temporal lobe epilepsy by my neurologist, but my mold doctor says that is consistent with mold exposure. I also have a vestibular degradation, one side of my balance center is damaged. I think all of it is related and linked by inflammation. I do think that mold is part of the story, but definitely not all of it. Anti seizure medication helps a lot. Ubrelvy (a gepants) also helps a lot. Getting the right kind of sleep and exercise and staying hydrated also all help. I am nearly 50 and this a new thing that has happened in the last 2-3 years. Was not fun to go through this on the tail end of running a startup. The brain fog was debilitating. I am now 80% better with meds (and a shit ton of supplements) but still on the journey to figure out how to get back to normal and off all the meds. I do think it is inflammation related but it could be one of a zillion things, or a combination of many.

I read a book a while ago. Unfortunately, I don't remember the name (maybe AI can find it), but the premise was based on a metaphor: there are multiple hot air balloons that, together, affect the chance/severity of a migraine. Something like food, sleep, stress, hydration, and one more. One of these "balloons" filling up may be enough to trigger a migraine, while all of them partially filling up can also trigger a migraine.

Sorry for the rough recall, but the point is that there may not be a silver bullet solution simply because it's not one thing contributing all of the time. I can trigger on all four of the ones I listed. I've had migraines for a week straight now because I recently developed tinnitus and am struggling to sleep. However, I had a migraine the week before because I inadvertently consumed red dye, which triggered massive inflammation in my body.

So, for me, it's all about managing multiple things enough to not get above the threshold.

I used to have very many (multiple a week) and was under specialist care for it in my 20s. Turned out to be stress though (doctors didn't buy this but couldn't find any other reason either, but once I stopped going to the office, I have had 0; I stopped going 25 years ago and had 0 for 25 years). I found what killed them almost immediately; 1 shot of vodka. When I saw the lines and the auras starting to come (usually tunnelvision and some vague jagged lines would announce an oncoming attack), I would immediately knock down 1 shot of vodka and it would go away while just causing a slight headache, but none of the rest of the very bad things I would otherwise have like double vision, splitting cluster headaches, auditory features, dizziness and tingling in my face, some of that lasting for days. I would all skip that with 1 shot. Just not having them is nicer though; whatever helped, I am very happy I discovered it relatively early on.

Hello, fellow migraine sufferers. I sincerely want you to read the fantastic essay "In Bed" by Joan Didion. It is a fantastic reflection on what it is like to have migraines and it makes me cry every time I read it because it makes me feel seen and understood.

"For I had no brain tumor, no eyestrain, no high blood pressure, nothing wrong with me at all: I simply had migraine headaches, and migraine headaches were, as everyone who did not have them knew, imaginary."

Read it; it's a google search away. You'll thank me.

My eyes were opened a few years ago when I was reading my mom’s brain mri report. She had cancer and was undergoing radiation treatment. The MRI noted lesions and said they could be due to cancer/radiation OR MIGRAINES!

Holy moly! Migraines can cause brain damage!

If you've suffered, seek a current expert (e.g., a neurologist migraine specialist who has recently completed training).

The newer CGRP inhibitors have been highly effective, but that also has made some specialists grow stale in their assessment skills.

Pain is emotionally debilitating, but sorting out complex chronic migraines takes persistence, patience, and an excellent diagnostician. It can take a few long-term trials of treatment and environmental/behavior changes. Be a good patient: bring accurate contemporaneous journals and openness to new suggestions, and stick with an agreed regime pending re-evaluation. Above all, don't just try to power through or mask the pain.

> When May started researching migraine in the 1990s, the leading hypotheses were that migraine was either a psychological issue or a vascular headache disorder, with throbbing pain caused by dilation of blood vessels. The psychological associations came with stigma, May says. [...] A lot changed in the 1990s, when May and others began conducting brain scans of people with migraine.

Sure, who the hell is this guy, and his discovery of the cortical spreading depression phenomenon:

https://en.wikipedia.org/wiki/Aristides_Le%C3%A3o

I've thought for a long time now that everyone has a migraine all the time, but migraine sufferers temporarily lack the brain's ability to ignore the ever-present pain.

In other words, the migraine isn't the addition of pain, but the absense of a pain relief mechanism. I have no sources to back this up, other than personal observation.

> Migraine can even drive full-blown visual hallucinations similar to the ‘reflections of the living light’ painted by Hildegard von Bingen, a twelfth-century abbess who was thought to have experienced a condition that is now called migraine with aura.

I don't think the aura effects are usually considered hallucinations?

I get mild migraines sometimes, with hardly noticeable headache, but with aura. In a way, it's pretty cool. You can directly perceive the abnormal brain activity and how it develops in real time. (I get the classic zigzag lines wandering across the field of vision.)

After checking on my migraine with aura by doing a MRI they found a large AVM in my brain which could kill me any time.

So if you get the chance, take an brain MRI. You never know what they might find.

Migraines are the absolute worst. On average I would get 6-8 a year. My triggers are primarily not eating frequently enough, bright lights and constant loud sounds. Knowing that, I mostly am able to avoid them and I can usually tell early enough when one is coming on to course correct. I never really explored any medication with my doctor because it was infrequent enough that I didn't really think of it. Then I had the worst migraine of my life. Typically I would vomit some as it starts to get really bad. Usually at that time I'm already laying on the bathroom floor because there are no lights of any kind in my bathroom that aren't tied to the switch. Also I rapidly alternate between being freezing cold and burning up so the cold floor is ideal (I also bring a blanket.) If it has hit this point I'm often in there for 4-6 hours before I can at least move to the bedroom.

The worst one, however, I spent 8 hours in the bathroom and for that entire 8 hours I never stopped vomiting. Well, I did, but only because there was nothing left inside of me. Dry heaving for that amount of time is not fun and it is even worse when combined with the terrible pain of the migraine. I never want to have that happen again. I genuinely don't know how people who get Migraines once a week or even more often can do it. If I got migraines like that every few days I would have blown my brains out a long time ago.

I try to avoid my triggers as best as possible but I was also prescribed sumatriptan as a last resort to take if I know it is going to hit. It has its own side effects that suck but it sucks a lot less than the migraine it prevents.

I tried to find this advice in the thread but couldn’t, and I’m surprised since it’s surprisingly common!

Some sweeteners such as aspartame can trigger migraines (also some gut issues) depending on the quantity and person. While most of the people can take them just fine in principle, others suffer migraines a while after taking them. In my case, this was a relative who suffered a lot until finding out by pure chance that certain sweeteners where the reason, but you can find countless cases.

I tend to get migraines occasionally. For me the trigger is stress. So if I can try to avoid stress, I wouldn't get migraines as quickly. Sadly, in modern life it's sometimes hard to avoid stress.

Maybe 5 years ago, to treat my migraines, my girlfriend advices me to visit a massage therapist in Pattaya, as he's helped many people, Thai and foreigner, to get rid of migraines. I had a message session at his shop (including a lot of neck and head massages) and he gave me some herbal medicine to eat for 1 or 2 months. Afterwards, didn't have migraines for a couple of years. But the migraines came back, I think about 2 years ago. I might visit the message therapist again in the future if we plan to visit Pattaya (we live in Chiang Mai province, so it's like 800 km away).

I know of a girl in our village who also had a lot of migraines. She visited some kind of Chinese medicine doctor in Chiang Mai. He made some small holes in the head, blood would go outside. Not sure how many sessions the girl got, but from my understanding her migraines are gone now.

My migraines are usually as follows:

- usually lasts for around a day

- sometimes one side of the brain (temple area) is very painful (like a drill inside), sometimes both sides

- arteries around the area in brain where is pain are visibly thick

- pain in head & neck area, not so much in rest of body

- sensitive to light

Showering in hot water helps relieve the pain a bit, my guess is because it might improve blood flow. I tend to take hot showers a couple of times a day during migraine attacks.

Other things that seem to relieve a bit are ginger tea (fresh ginger), tiger balm on pain area in head & head and neck messages.

> “I used to think that disability travels with pain, and it’s only when the pain gets severe that people are impaired. That’s not only false, but we have treatments to do something about it,” says Richard Lipton, a neurologist at the Albert Einstein College of Medicine in New York City.

Am I the only one unable to grok this statement?

I started having migraines in my late teens after drinking too much alcohol at parties, I used to think they were hangovers. It was only much later, after getting migraines in daily life, I found out after visiting a neurologist that those hangovers were migraines. Been having frequent migraines ever since, most of the time triggered by stress. Often I'd have attacks 3-4 times a week, fortunately the intensity is not crippling, more like a 6-7 out of 10. And now the good part, I have been supplementing Omega 3 and Magnesium during the last couple of months and haven't had a severe attack since. It's worth trying out if you suffer frequent attacks like I did.

edit: my experience with sumatriptan, is that it helps stave off an attack, but frequent use increased the frequency of my attacks, leading to almost daily attacks, so I stopped taking it.

Magnesium L-Threonate changed my life. I no longer experience headaches daily.

I always feel a bit weird when reading migraine threads on the internet, because mine seem so much milder, but it's still debilitating. I remember first noticing the migraines in grade when I was 16, but it took me years before realizing they were migraines. I thought that most people had pain like I did, and just powered through with some Advil/Tylenol.

My migraines follow a very regular schedule. I wake up and just know that I will have a migraine. It's like a nagging thought. Worse after days of poor/little sleep, or days where the temperature changes dramatically, or if there is a big storm. At around 14:00 the pain grows in intensity, I feel nauseous and uncoordinated, very sensitive to light. Lying in a dark room and listening to a podcast/YouTube video is the best way to get through this period, I can get to the edge of sleep and it makes it easier. At around 20:00 the pain has usually mostly subsided, and by 22:00 I'm pain free but exhausted.

I tried a few prescription medications after talking with a doctor, but they didn't have much of an effect, so I just accepted that once every 1/2 weeks I would have to deal with it. Whenever I would read about migraines online, I would feel relieved, because mine seemed so much more mild. No aura, the pain is usually gone within a day, and if I needed to be out and about I could manage, even though it was painful.

About 5 years ago an ex-partner offered me a Bufferin (Aspirin mix), and right away it helped with the symptoms. Read into it and saw a study that suggested some people respond well to high-doses of aspirin and caffeine for migraine relief. It worked exceptionally well for me. 9/10 migraines knocked out immediately, with the rest being substantially reduced in length and intensity. I get maybe 1 migraine a year now that is truly bad.

Recently talked to a new doctor who prescribed me propanolol (he was afraid about the high dose of aspirin on my stomach), and it's been just as good.

I just feel fortunate to have easy access to migraine relief, and I hope that others are able to find something that works for them as well.

Reading this as I'm just coming down from a migraine. I've been getting them since I was a young teen. I get migraines with aura. They used to last for hours. Sometimes I get them multiple times per week, then they disappear for months/years and suddenly will get them again. No significant life or dietary changes in between. I've never been able to pin down what causes them.

These days they've become much more manageable. The aura and headache part takes 30-60 minutes as opposed to 5+ hours when I was a teen. I do experience brainfog, fatigue, dizzyness and nausea for 24+ hours afterwards, but at least I'm not stuck under the covers for hours.

Anti-CGRP medicines are life changing.

The only medicine I’ve used that has all but completely eliminated my migraines during usage (Aimovig).

Unfortunately, to get these — you have to provide an arm and a leg to insurance, even when a neurologist is vouching for you.

Nothing makes me consider violence more than meeting with a highly educated, vetted, practitioner of medicine — having a conclusive conversation about a treatment plan, and then having my fucking insurance say “ope, sorry — you have to prove you need this medicine by trying anti-depressants (which might incidentally help, but not designed for migraines), or this other thing which also may incidentally help (but not designed for migraines)”

Get this — I got a prescription for Aimovig, all positive results (for a year and a half) and my insurance is still getting in the way of fulfilling the script (each month). If I miss the dose, I get a massive rebound migraine — and I’ve missed several doses because my insurance wants to send another letter to my neuro “hey are you claiming this is still worth it?”

What does one do here? Lawyer up?

To hell with the drugs that they throw at you for headaches. It's your diet, lifestyle and poor sleep that's drives this bus.

I'll save you 10 years of my suffering and the awful side effects induced from the cocktail of drugs in this article and say I've reversed cluster headaches and can now tell when anything is not good for my body goes into it.

I did an elimination diet, I skip breakfast usually, and did 1 successful session of hyperbaric oxyegen treatment and it's completely changed my life.

Ive been able to continue ketosis periodically and am adding foods back now 1 by 1 to see what induces pain and believe it or not your body will tell you.

My latest revelation was legumes which tricks you, high in carb item that apparently is a different type of carb that doesn't digest in the bottom of your gut like other carbs. (1)

This list of positive side effects can only seen as a miracle to me from being on the edge of survival (my clusters were headed towards a manic state)

-I don't get down and cynical at all like I used to -my daily energy is a magnitude of about 5x stronger -confidence and positivity are the first reactions i have now so it's greatly uplifted everyone around me - there is a level of even keel rationality that I have now that I've never ever had - just alot more calmer overall and easier to get the busy mind not to overworry

I've tried many drugs and techniques but everything felt like a bandaid on the problem and not actually addressing it

Big and large psychedelic doses, triptans, cgrp, mood stabilizers, steroids. If they had it i tried it.

It took about 1 month of major diet changes to start feeling better. A year in now and the two things that feel the worst for setting off mild nero inflamation are 1-not getting good sleep and 2-eating highly processed foods

Your mileage may vary, everyone reacts to food differently.

1 - https://www.frontiersin.org/journals/nutrition/articles/10.3...

I think everyone who suffers migraines has their own “relationship” with them.

Myself, I can tell when I am “pre-migraine” and know I have to sit down for a bit lest one develops. They most often come from eating junk food after exercise (I’m looking at you, Fritos). And warming my hands often helps speed the recovery, though I always end up with “tender brain” for 24-48h after.

I’m intrigued by another poster having success with Magnesium L-Threonate and will be placing an order today. Even if I don’t have a migraine, I have a headache 8 days out of 10.

I recall about 10 or 15 years ago at work in the lunchroom it was me and maybe six younger people. Me age 40 them about age 20 six all said they have migraines I didn't, didn't know anyone who did. It seemed odd so many claimed to have migraines. I assumed they meant a bad headache not actual migraines but were using the term migraine to mean a bad headache.

Migraines being more than a headache has been the norm for at least 15-20 years. I remember hearing about how cluster headaches could be treated with psilocybin. I'm not able to access the rest of this article, but what's the new thing here? We already knew for years its not "just a headache"

I have experienced migraines since my teens, usually starting with annoying visual artifacts, facial numbness, difficulty speaking, and progressing to intense pain. The worst of them would also cause auditory discomfort. In my 20s, I could reliably trigger a migraine by doing something intensely physical (like playing basketball with friends) and drinking lots of cold water or taking a cool shower. Since then, it's been harder to determine a cause other than stress. About 15 years ago, work was really stressful and I had numerous migraines in a four-month period. Once I even got a demerol IM shot, which seemed like much ado about nothing -- I was hoping for great relief, but it didn't seem to do much. Now in my 50s, I only get about one a year, and it's pretty mild.

I get one about once a decade. My mother got them frequently.

Real migraines absolutely suck. A lot of folks describe regular headaches as “migraines,” but they are a pale imitation of the real thing.

In my case, they usually start in the morning, but don’t get really excruciating until early evening. I usually figure out it’s a migraine, about lunchtime. Around 9-10PM or so, I puke, then the headache starts leveling off, until I fall asleep. The next day, it’s as if nothing happened.

I did “short-circuit” one, the last time one started, using advice that I remembered from my mother. I sat in a recliner, in a dark room, with a towel wrapped around the top of my head and eyes (probably looked ridiculous). It’s important not to engage my eyes at all. After a couple of hours, the headache stopped.

I can get migraines, but they’re “silent migraines” which means there’s little or no pain aspect. Thankfully it was pretty straightforward to root out the trigger - caffeine. I still love coffee, but I’m decaf only now. I drink Equator Coffee’s natural process decafs.

Just an anecdote, but very close person of mine was diagnosed with migraine when she was 12 yo old so.

Last year, being 40+ years old, suffering from weekly/daily pain events, she found out that diagnose was wrong (one doctor just asked that have you ever thought that this probably isn't migraine) and correct diagnose was Horton / cluster headache.

Eating migraine meds (lots of different ones) for several years were helping, but probably only due placebo effect.

Now, the medicine for headache attacks is simple: breathing pure oxygen for 15 minutes.

After last attack (1.5 year ago, stopped almost immediately breathing oxygen) there has not been any headaches.

Usually, it would not been nice to get diagnose for cluster headache, but on this case it was kind of life saver.

Still, just an anecdote.

I had a migraine for more than 15 years. After quitting caffeine completely as a self-experiment, it never came back. When the migraine came, I had it for at least 3 days without improving. So I had to take something with Triptan, like Dolortriptan.

Some anecdata on prevention experiences:

* metaprolol (pulse-slowing beta-blocker): fewer attacks per month, "dampened" attacks, bad side effects (fatigue, energy loss, dark moods)

* magnesium supplements: no noticable effect (they say it might have an effect if you happen to get too little through your food)

* vitamin B: no noticable effect

* simvastatin (cholesterol lowering medicine): some fewer attacks per month, but attacks when they come seem full strength

* candesartan (also a blood pressure medicine): much fewer attacks per month, "dampened" attacks, very few side effects, current "winner"

(CGRP's are expensive, haven't tried.)

For stopping attacks, triptanes work well.

I get a migraine with aura about once every 6 months. It can last between a few minutes to several hours. When this happens, part of my field of vision disappears randomly and it becomes difficult to focus on anything or read. Then after the aura, I get a bad headache.

Sometimes, if I start to feel sensitive to light (a sign that I'm about to have a migraine aura), I take a paracetamol and it prevents it completely. The trick for me is to catch it early and notice the signs. My migraines seem to correlate with my stress levels, too much thinking and/or insufficient sleep.

long-time listener, first-time caller on HN. I've had migraines since I was a teen. Full blackout vision, then debilitating headache for 48 hours. About 18months ago I cut out food containing thickening agents (Xantham gum aka 415, et al). Have only had a migraine since then when I've had food containing these (which seems to be an increasing number of foods). I don't suggest it's a cure all, but worth trying for others out there. I've sat in job interviews, my wedding, kids' events dreading having one occur.

Just throwing it in here in case it helps someone: if you have migraines, get an eye exam to check if you need glasses (you might not realize it!) and that your prescription is still sufficient.

Anecdotal, but: I know someone with relevant migraine problems did a log of everything she was eating or doing, searching for possible triggers. After a few weeks there were a couple of suspects: glutamate, chocolate, and also some legumes. Removing these worked and reduced greatly the amount and extent of the problem. Currently legumes is ok sometimes, but consuming one of the first two is almost a guaranteed episode.

I am suffering from migraine since 20 years and it's really painful. In 20 years, the only causes that I can infer are sleep deprivation and weekend.

I found some relief with acupuncture: a bench of sessions of acupuncture reduce the intensity and increase the distance between two attacks. In the last years I was prescribed triptanes and they are very effective to me, but I feel "strange" when I get them.

i have been getting bad migraines for as long as i can remember. bad enough to vomit when i was a kid. nothing ever helped except when i took a healthy dose of lsd in highschool and they stopped completely for five years or so. i had been getting them around once every two months before that. then they came back in college and slowly got worse until i was having basically one long migraine for up to a week at a time. then i started taking nurtech. it helped a lot but only worked half the time — and when it did work i could still feel my body reeling from it but without pain. here is something curious: i noticed that nurtech would put me into an extremely good mood… almost to the point of being a different person. without any euphoria or intoxication. specifically, i noticed that i was much more open emotionally, much more personable and friendly. more open to letting people in. and thats when i really started to have a new perspective on just how much this disease had robbed from me. i cant even imagine how awesome it would have been to not be interrupted by these migraines, to not have to feel the throbbing pain, and maybe the whole trajectory of my life would have been different if i had been a little kinder and likable which, if im being honest, i was kind of known for not being. i dont really take nurtech anymore because i have found that hard physical work, sunlight, reducing total calories and cardiovascular exercise basically put them into remission. and im afraid of what nurtech might do to me long-term after seeing how profoundly it alters my personality. based on everything i know, i think its safe to say that migraines are a metabolic disorder. neurons become overexcited due to metabolic dysfunction which then causes a depolarization cascade that sweeps across other regions of the brain. thats why keto helps so much. i wonder if ozempic has a beneficial impact on migraine?

Haven't had a migraine with visual auras since giving up alcohol fwiw. My friend's dad specializes in headache treatment he said majority is dehydration which would add up for my case but interesting to see a comment below where someone gets them from too much water so I guess having the correct water balance is key.

I get migraines when I drink too much water! Not even kidding. Full blown visual aura followed by intense pain for a day.

Commenting to save this for post for later. I suffer from migraines regularly. I will try some of the suggestions here.

I used to think everyone got migraines everyday, then I got diagnosed with sleep apnea. Hardly a thing for me anymore now that I use cpap, but I dealt with them constantly until my senior year in college.

But it reminds me how we only really know our own reality, and it's easy to assume our experience as "normal".

I had migraines which ceased when I switched from a steroid nasal spray to an allergy nasal spray. I guess the steroid spray was not good for my brain.

Edit: I even reintroduced the spray 2 years later (out of allergy spray) and had another migraine. It was surprising, as I only used it for a few days.

Lucky enough to get really quick relief from over the counter migraine meds (triptanes) at even tiny doses. Life changing when I realized I didn't have to do just obscene amounts of ibuprofen and coffee for pretty poor results, and even a half of these tiny pills worked.

I used to wonder if the headaches I have had were migraines. Then I had the kind where you go blind for a few minutes, followed by a migrain. Was the worst headache I've ever had, but I was so glad to have my vision back.

my wife would get a migraine every single day around 1pm. she scheduled her college around them. she did a bunch of genetic tests, and (this is not science to me, i dont know the process at all) she ended up trying a methylated vitamin b complex, 8333% usda dose, and they dried right up forever. i feel for anyone dealing with them. i got my first one 7 years ago and learned i am sensitive to soybeans. i can pop some raw soybeans into my mouth and have a visual aura and migraine within 30 minutes, it's fascinating.

I get migraines with aura prior to storms

I’ll be damned if they’re not the result of some sort of swelling or inflammation of capillaries or the optic never or something. I can feel it in such clear detail.

As someone with a traumatic brain injury, I get a lot of migraines. My favorite piece of advice from a doctor? 'Allow yourself to relax'.......sure.....that's the issue.....

I seem to get migraines from plant fats and stimulants like caffeine.also caffeine withdrawal.Been drinking chaga coffee a few days and feel so much better in the evening

I had migraines with aura as a child from 12 to 16 years old. But then I got bruxism and the migraines went away. Traded one problem for another, I guess.

I don't love Huberman, but his episode on headaches/migraines was very informative. There was a lot of helpful tips for those suffering.

My migraines have been with me for ten years now and they have slowly evolved their symptoms and triggers. Started off more as typical migraines that happened every other day, though i had head issues everyday. it later evolved to neck pain, jaw pain, temple numbness, throbbing headaches, inability to think or process things. lots of cooccurring head symptoms include feeling of blood pulsing.

visited countless medical people, most offered no real solutions or relief. only consistent insight, temperature baths for my head reduced at least tthe superficial symptoms but not the cognitive symptoms, the superficial symptoms seemed to be aggravated by sleep. the cognitive symptoms correlated to hard processing and thinking, straining the brain. but the detriment to my life made it hard balancing work and responsibilities. worse is the symptoms are debilitating at times and invisible, good luck getting sympathy or understanding from other people with that being the case. im homeless cause its better to not have repsonsibilities and control how much i strain my brain than deal with the headaches daily and worse.

this whole ordeal makes you realize how limited the medical profession is.

Our understanding of migraines seems to be increasing exponentially

Stop all forms of coffee for 3 months you will be amazed at how few you get after that. Tea is fine, just no coffee. Life changer for me.

I get migraines about 6 - 8 times a year, complete with visual aura and very occasionally speech aphasia. I tracked them in a spreadsheet for years so have a rough idea of triggers but it's proven fairly bad at predicting.

I've tried many drugs to combat them, but there is one thing that helps me short-circuit it 99% of the time is a high amount of caffeine. It's not perfect -- I liken it to side-stepping a train; you get missed by the train itself but still get thrown off by the wind and noise, still fall hard on the ground, still get bruised but not hurt as badly -- but it works well enough, so as soon as I get the visual aura, I slam back a strong coffee and know that it'll work. Why? No idea, perhaps the pressure in the brain's blood vessels are affected?

What I don't see as often discussed is the subtle changes in consciousness that accompany migraines.

For me, in the pre phase (12 hours or less before the true onset), the first sign that I'm heading towards one is a sudden immediate bias towards pessimism with a kind of resignedness too (which is quite unlike my normal states of mind). That's often my first clue. It's like the storm clouds are gathering on the horizon and all light and colour is drained from my life.

Then, the visual aura hits. Now I know what's happening with certainty and I hit my caffeine prophylactic. The caffeine stimulation combined with the first inklings of pain and knowledge that you're about to go "into the shit" gives you quite a fight/flight feeling. You're at a bit of a loss as to what to do, since you're amped up but there's nothing to do but wait it out.

Then once the aura fades, you feel quite strange. I'll typically go lie down at this stage. If the caffeine worked (which is like 99% likely for me), I feel in a kind of haze but I'm not in deep pain - just uncomfortable and mentally quite scattered, though I'm no longer pessimistic about the future. In fact, it's like time collapses, and I'm forced to be in the moment. It makes me feel sick to try to think about the past or future - it all feels like a huge burden to try to internalize those states of time. I just try to focus on my body and how I'm feeling. It's almost like a meditative state. I can't sleep due to the caffeine but I try to rest and keep my mind clear.

At some point I'll realize that I'm mostly through it, and can get up and move around and generally kind of resume my day. But it feels like a hangover of sorts. Everything is hazy. Thinking is difficult. Very sensitive to light and noise.

Then, surprisingly, the next day I'll feel mentally GREAT like my mind was cleaned.

Which brings me to the most interesting part of all this for me - the migraine has a lot of similarities to a psychedelic trip. There's a come-up that's distressing, a plateau where one is forced to be in-the-moment, a depletion afterwards, and the next day onwards a feeling that things are cleaner and better ordered than before, like your mind and spirit has been defragged.

Perhaps both the migraine and the psychedelics are stressors or some kind of release valve on your brain.

One wonders if there's increased brain plasticity post-migraine like with psychedelics.