A couple of specific migraine questions

August 11, 2015 3:51 PM

Migraine sufferers and anyone who has tried the Buchholz 1-2-3 plan, I have a few questions:

I am looking for experiences from migraineurs, with the knowledge that none of you is my doctor! Thank you so much!

I have been suffering from migraines for a few years now. They are not the debilitating kind where I have to lay in a dark room, and I don't have to throw up from them, etc. But they do hurt a lot in head/face/ear/nose area. They also really impede my ability to teach 1st grade! I was at the point in May and June where I was taking sumatriptan several times a week, which you are not really supposed to do. I saw my PCP and also a neurologist. She recommended "Heal Your Headache", sooo...

I am ending month 1 of the 1-2-3 plan, and I have a few questions:

1. I have been eating a lot of chick peas and coconut milk. I stopped all coconut products midway this month, as I read that coconut is a nut and you cannot eat it on this plan. Then, I read more about it and learned that it is classified as a fruit...so I have been having a fair amount of coconut milk and using coconut oil for popcorn. Does anyone have experience with coconut triggering migraines or being ok for their migraines?

2. What about chick peas? Some sources say ok, some say not ok.

3. I also decided to cut out gluten after I had been on the diet a week and didn't think it was working super well. This week, I have eaten little bits of gluten here and there.

4. This whole month, I have still been having mostly mild headaches. I either go to bed and they go away, or I use advil and they usually get better. During the past year, NOTHING would help except sumatriptan, so I do consider this a vast improvement. I am not taking any sumatriptan nor using caffeine, and following the diet pretty consistently, except for questions above. I am in the midst of a really bad headache that started yesterday (coinciding with being a few days into my period, which is the worst time of the month for my headaches), but I am wondering if it is due to increased consumption of all three aforementioned foods this week...does anyone have advice/experience with these foods in re: migraines?

4. I also have a rx from a neurologist for topamax....I tried the smallest dose for a week but then decided to just try this diet instead. But now that I am in the midst of this headache (and don't want to take sumatriptan b/c the author is quite adamant that you go without, which I think is good for me), I am wondering if I should try both topamax as well as the diet. Does anyone have good/bad/whatever experience w/ topamax for migraines?

I feel like this question is a bit all over the place, so I am sorry about that!

posted by bookworm4125 to Health & Fitness (15 answers total)

Hi Bookworm. I don't know about the diet and those foods you mentioned are not triggers for me, but Topamax saved me from frequent, debilitating migraines like magic. I haven't had a single one since I started it a few months ago. If it has been prescribed for you, it's probably worth trying, though do be aware of the potential side effects. Also, it might be best to try one thing at a time so if something does work (and I hope it does!) you know which thing has worked and you should stick with.

FYI, staying hydrated is also key for me — once I get dehydrated I become much more susceptible to my triggers.
posted by rafaella gabriela sarsaparilla at 4:37 PM on August 11, 2015 [1 favorite]

I don't know about the diet you're following. For me avoiding gluten completely was the key. I have other triggers - hormones, barometer dropping, being dehydrated but the big one was gluten. I cannot eat a little - a very tiny amount will trigger a migraine. Not the case for other family members with migraines. Are you keeping a log? It can be very helpful to identify what works and what doesn't. And good luck!
posted by leslies at 5:40 PM on August 11, 2015

Unfortunately no kind of elimination diet has worked for me over the 30 years I have had migraines. The two things that have made a difference (but not a "cure") are hydrating almost excessively every day and daily exercise. I still get triggered by hormones, extreme humidity, stress, my shitty neck being shitty, certain smells, etc, but they don't just show up anymore without a good reason.

The thing with elimination diets is that you have to go 100% or don't even bother, and you have to stick with it for a significant period of time, like a month at least. It can be difficult to do and if it's something that makes up a big part of your diet, you can end up triggering more migraines from not getting enough calories in a day. You should be keeping a really detailed food journal, along with weather conditions and other triggers present in your life. Like, a really really detailed journal or spreadsheet, something that you might be embarrassed if someone else saw. SO DETAILED.

(i think not taking the imitrex is a terrible idea because it works! and that's all that matters when you have a migraine! but if you want to stick to this diet method and it says "no imitrex!" then i'm not going to argue you out of it)

Not sure if you've already been over this with your doctor(s), but a few other things that you might want to consider looking at are:

- your eyesight, do you need glasses, reading glasses, a new rx, etc
- do you grind your teeth at night
- do you have any hearing issues that might make you more sensitive to loud noises (like a classroom full of 1st graders!)
- do you have any strain or injuries or arthritis in your neck or shoulders
posted by poffin boffin at 6:02 PM on August 11, 2015 [2 favorites]

You need to log food. Diet made little difference to me as a migraine trigger although cutting caffeine has helped a bit I think. I went to a very stripped down allergy type diet and added things back to look for triggers but nothing stood out - I'm almost envious of people who can point to a food trigger! It's sleep and light intensity for me.

I'm on topomax and have gone from severe migraines 5-7 days a week on full painkillers just to get through the day to mild migraines 2-3x a day where a single dose of painkillers is enough. My neuro was very clear that it's an idiosyncratic medication and some people will have icky side effects (I take it at night because it makes me stupid for about 4 hours afterwards and it kills appetite) and the dose has to sometimes be adjusted, but if it works the difference is remarkable.
posted by dorothyisunderwood at 6:06 PM on August 11, 2015

I get atypical migraines, far less frequently than I used to (thankfully). The only instant cure that has ever worked for me is an IV drip of Maxeran. Non-narcotic, non-habit-forming, available orally if you're in the USA. (IV only in Canada). Knocks it right out in twenty minutes, no side effects.
posted by feckless fecal fear mongering at 6:11 PM on August 11, 2015

I would definitely second what poffin boffin said about checking out other related health issues, too, if you haven't already. I turned out to have a totally separate health condition that my neurologist spotted first and was later confirmed by other specialists that turned out to be contributing to my migraines, and getting that under control has helped as well.

I don't know if you're interested or have an iDevice, but back when I was trying to sort out triggers I started using Migraine Coach, which takes you through monitoring your migraines and documenting them, and then eliminating common triggers methodically (including dehydration, food triggers, etc.) with a sort of gamification angle. It's free for the moment as they're trying to gather more data about triggers, etc., so maybe worth helping you focus your efforts and track what's helping. I found it helpful, though stopped using it when my migraines stopped.
posted by rafaella gabriela sarsaparilla at 6:32 PM on August 11, 2015 [1 favorite]

Response by poster: Thanks everyone-- I really appreciate your detailed experiences/advice. I have been logging but stopped a bit; need to get back on it again I know. I don't have eye problems (just went to eye dr last week) and do grind my teeth but religiously wear a night guard. I have been on 20 mg celexa for the past 6 years but am very slowly and deliberately tapering to see if it may help ( also bc I am in a good place psychologically, which is tangential but anyway!). No particular noise sensitivity either though I am an introvert who hates loud noises ( Why do I teach small children? But I digress...). Hope this clarification is useful and not threadsit-y.
posted by bookworm4125 at 7:15 PM on August 11, 2015

Topamax was a godsend for me. I had really good results with the brand-name OK results with a generic and then terrible results when I switched to a different manufactured generic. So I stuck with the brand name until my insurance stopped covering it.

Are your headaches worse during the school year? It seems like if improvement headache coincided with the start of summer that would definitely be something to look into. Maybe your classroom is too hot or too stuffy etc.

I have to say this diet sounds kind of woowoo but if it's helping go with it
posted by misanthropicsarah at 7:28 PM on August 11, 2015

The 1-2-3 diet did nothing for me except make my main doctor really perturbed that it was even prescribed as a viable treatment. I ended up finding the right treatment thanks to my allergist who put me on amlodipine (a blood pressure med) as a test. It made me gain a ton of weight for the 6 months that I took it but my life long migraines have never returned. He's still delighted with himself for choosing such an effective treatment via a guess. YMMV.
posted by Hermione Granger at 7:56 PM on August 11, 2015 [1 favorite]

This doesn't address your specific questions, but I hope it might be helpful just in case. I went through a period of time where I was consistently getting mild migraines every 2-3 days. They typically involved the visual distortions, then tingling in the extremities, and then (relatively mild, not utterly debilitating) pain, especially when I sneezed or coughed.

I went to my doctor and was prepared to take a prescribed drug to manage my symptoms. She wanted to try some natural supplements first though. "Fine," I thought. "Let's get that over with so we can get to the stuff that actually works." Well, long story short, it turned out that magnesium and riboflavin cleared it up. I had very little faith that it would work, but it did. She also recommended butterbur but I ultimately didn't need it; the magnesium and riboflavin worked fine.

Apologies if this is not relevant; I just feel the need to spread the good word about this since I would have NEVER thought it would actually be effective.
posted by delight at 8:26 PM on August 11, 2015

Response by poster: Sorry, ONE more follow-up...does anyone have experience w/ slow carb/low carb helping? I have done the 4 Hour Body diet and feel like it does help my migraines...I think...there is another book that is more current than the one I cited that recommends paleo for migraines. Sorry if this 2nd follow-up is a huge no-no. Very long-time lurker, very new poster/commenter.
posted by bookworm4125 at 9:17 PM on August 11, 2015

The single best thing I've read about migraines as someone who had them probably since childhood but had no idea because I genuinely thought by auras, it meant you saw light radiating from people (!), is that migraines are multiple in cause, symptom and treatment. What works for one person doesn't for another, and might not for another person later in their life when they experience a different type of migraine. Even the medication is trial and error.

So Paleo could work for you. A better strategy is it to play the odds: what are common migraine triggers, and work on eliminating those steadily, before going to more obscure treatments
posted by dorothyisunderwood at 10:28 PM on August 11, 2015

I have a close colleague who is much better after cutting out gluten and dairy.
posted by persona au gratin at 2:42 AM on August 12, 2015

Seconding dorothyisunderwood's comments. Everything is trial and error, and things change as you age.

For me, the single biggest difference comes from eating generally healthy and getting enough sleep are helpful. And recognizing that things that wear me down (such as motor noises) increase the probability of migraines.

When you get a migraine, you might want to try taking caffeine with your painkiller, if it doesn't already include it.
posted by troytroy at 3:03 AM on August 12, 2015

I don't know whether it will do you any good to learn what somebody else's triggers are, but coconut is utterly benign for me, and so are chickpeas and wheat. My triggers include bananas (a common trigger for many people), red wine, oranges, mangoes, aged cheese (basically all cheese except cream cheese, ricotta cheese, cottage cheese, or boring American cheese), yeast extract used as a flavoring, more than small amounts of soy sauce or fish sauce, and any food that has flavor enhancers added to it, such as Doritos or canned soups. Low carbohydrate eating does not help me, although I avoid sugar for other reasons.

That book helped me mainly in pointing out that a migraine trigger can lead to a migraine the next day or even two days later. Until I read that I could never make a connection between trigger foods and my migraines, because there was no connection with foods I ate the same day. For me the headache always comes the day after eating whatever it is. It was a huge breakthrough, as the patterns in my food/headache diary became very clear with that one key fact.

I've also found that losartan, a prescription blood pressure medication, reduces my headaches by about 80%. Which medications work this way varies dramatically by the individual. If one doesn't work, try another. A nice thing about losartan is that it is very low in side effects.

If you clench your teeth at night, the right night guard can help a lot. Full-mouth night guards did me no good because I clenched my teeth right on them so I kept getting headaches from that. They also made me gag and I tended to spit them out after I fell asleep. My dentist made me an NTI dental guard that fit over just my top two teeth, preventing tooth clenching altogether. Ask your dentist about it. My dental insurance at the time covered 80% of the cost, although it paid for only 50% of the cost of a crown.
posted by artistic verisimilitude at 1:42 PM on August 12, 2015 [1 favorite]