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I stumbled across this book The Migraine Miracle by neurologist Josh Turknettyears ago. I had tried all sorts of stuff prior to that: meds, chiropractic, acupuncture, massage, etc without success. I finally tried the diet from the Heal Your Headache the 123 program and found it reduced my migraines but I had a daily headache. Once I started limiting my carbs to 100-150 grams/day, my migraines AND headaches were gone within a week. The diet worked great until I had my son and he wants lots of carbs and it was really challenging to eat so low carb. I then stumbled across the topic of digestive enzymes and how they can help digest food better and decided to try them. Poof! They help break down carbs and I feel like I have my life back. I just have to take a broad spectrum digestive enzyme before every meal and snack. I still can’t go too crazy on carbs, but at least I am back to being virtually migraine and headache free.
But my 5 yr old son also gets migraines and we just started working with a naturopath and she suspects SIBO (gut problems) and said I may likely have similar issues. That may be why I don’t tolerate carbs. For me, it is clearly linked to foods and digestion.
So my right shoulder and neck also tighten up a lot when I get a migraine or am pre-migraine. I went on a low carb diet based on this book, The Migraine Miracle, and not only did it help reduce my migraines, but my neck and shoulder pain disappeared as well. I realized that the muscle issues are just a symptom of the migraine, and aren’t the cause of the migraine. I suspect it involves inflammation. Another headache book called Heal Your Headache describes how headache diets (typically low histamine/low tyramine) help reduce overall chronic pain issues and the author said many of his patients with fibromyalgia have found a reduction in overall pain by doing the diet, when they originally did the diet to combat migraines.
Migraine Miracle: A Sugar-Free, Gluten-Free Ancestral Diet to Reduce Inflammation and Relieve Your Headaches for Good https://www.amazon.com/dp/1608828751/ref=cm_sw_r_cp_api_glt_i_S2DT0BWMN43QKYCRGZ71
You might try taking a look at Josh Turnkett's book "Migraine Miracle" https://www.amazon.com/Migraine-Miracle-Sugar-Free-Gluten-Free-Inflammation/dp/1608828751/ He argues that the keto diet can be used to help decrease or eliminate migraines. I highly recommend the book even to people who aren't on or considering keto - the other material in his book about the stages of a migraine, the different triggers or risk factors for a migraine, and all the pain and preventative treatment medications were extremely helpful and informative to me.
Glad to see you're having some success!
Not a migraineur but my wife is. She suffers from chronic migraine and has some level of headache pain 24/7, with it developing into attacks ~3 times a week. This has been like this for years - it's been rough, as I'm sure I don't have to tell you.
It sounds like you are already well down the path of using the best techniques that the medical world has come up with to tackle migraines. Good luck with this! I've pretty much given up on looking online for medical advice (which I realize is not what you were asking for) - it seems for every form of medication available there are a thousand stories of it working miracles, and a thousand stories of it doing nothing at all. If you find something that works, awesome. My wife tried topimax and botox, and we think they were marginally helpful, but the difference was small enough it was hard to say. As a result she still continued to pop her triptans like candy. This past new years / christmas holiday was particularly bad, and it really made us go back to the drawing board and reexamine our migraine approach, as it was clear that life this way is just not sustainable. I'm sure you know the feeling. We were considering aimovig and that class of new drugs, but in our research stumbled upon this book The Migraine Miracle by Josh Turknett. The author is a neurologist who allegedly suffers with migraines himself, and he lays out the case that migraines have their root causes in our diet, and argues that longterm use of abortive medications like triptans cause rebound headaches. Believe me, I know that the idea that just eating differently and going off meds sounds too good to be true (and I really do dislike the book's title - such a lofty promise to print on the front cover), and honestly I'm not sure his method works quite as well as he claims, but I still HIGHLY recommend reading this book and following it up with his blog posts. I also highly recommend making your loved ones read the book - I learned more about the science of migraines and what it's like to suffer from them than I have from any other one source.
For the past 3 months my wife has been on the diet and has gone off all medication, including triptans and NSAIDs. She's improving, slowly but surely - her attacks are less violent and shorter, and slightly less frequent. She still suffers from more or less constant head pain on some level, which we (& Turknett) believe is the rebound headaches, and we expect to see that disappear after six months of being medication-free.
I'm not saying this book will cure you - for us, the jury is still out on whether it's actually the 'miracle' it promises, but there's not doubt we've seen some improvement by following its recommendations. Clearly there are people who respond very well to botox, topimax, the occasional triptan use, and other medicines. We are envious! This book has been absolute paradigm shift for us, and has sent us down a treatment path that so far has been at least as effective as the medication we've been on, and promises to deliver much more. It's not a quick fix and it's definitely not easy, but if you're not making progress with the expensive medications then I HIGHLY recommend reading the book and seeing what you think of it.
I highly recommend reading The Migraine Miracle or checking out the My Migraine Miracle website. Dr. Turknett talks about keto diets, but it's more than just that. If you aren't dealing with other issues (rebound headaches, medication overuse, etc), it won't help. I just read the book and am part of a group on Facebook, and there's been many people who've had success with this.