Everything you need to know about migraine prevention

As we head into the hottest month of the year, we chatted with NoVA experts in the field to find out how to avoid recurring headaches this August.

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The last month of summer is a time for adjustment. From youngsters starting school to the air becoming even more humid, the environment around us is changing, which can have both positive and negative effects on our well-being. 

This time of change can affect our brains, too, especially in the case of migraines, according to neurologist Tracy V. Fulton M.D. of Integrated Neurology Services, a practice with locations throughout Northern Virginia, including Reston, Falls Church, Alexandria and Lorton.

Migraines are no ordinary headache, in that they have a wide array of painful symptoms, ranging from nausea to acute sensitivity to sound, smell and light. While they differ for each individual, migraines are the third-most prevalent illness in the world, affecting about 12% of the U.S. population, according to the Migraine Research Foundation

Researchers throughout the globe are constantly untangling the cause, as well as finding more effective treatments for migraines. In July, an issue of The New England Journal of Medicine released results from its large-scale trial of a drug called Rimegepant, which “may be effective in acute migraine treatment.” 

Plus, here in NoVA, some individuals are taking a different approach to studying the illness, including Margaret Slavin, Ph.D., who is an associate professor of nutrition and food studies at George Mason University.  

“We’ve looked at dietary intake of the vitamins magnesium and riboflavin in the U.S. population and have found that diets high in those nutrients are associated with a lower risk of migraines,” says Slavin.  

While plenty of research shows supplements with these two ingredients are effective, Slavin and her team are attempting to look at how people’s food intake differs on days with headache symptoms and days without. 

There is currently no cure for these recurring headaches and the research will continue. Yet, until a resolution is found, Dr. Fulton shares everything you need to know about who gets migraines, how to prevent them and exactly how to cope, below. 

Why is it that some people get migraines more frequently than others?
Well, it is more common in women than men and tends to have its onset when people are in their young 20s. And while there’s probably a little bit of a genetic component, it is highly environmental, too. There are a couple of different genes that work together, and then an environmental trigger typically causes it. So, sometimes a few people in a family can have it and other times there is just one individual who happens to suffer from migraines.

Talk to me about what exactly causes recurring headaches and how people can avoid getting them.
Everybody’s trigger is going to be personal. Some common triggers are changes in sleep patterns, including not having enough and also changing a sleep schedule, any drops in blood sugar, environmental changes in the weather … and then stress is probably the number one cause. For some women, the drop in estrogen when they are on their period can be a trigger, too.

Many people say there are different foods that can be triggers, as well, like red wine or monosodium glutamate (MSG), but honestly, I wouldn’t say there’s one food that triggers migraines for people. The list online is pretty much all food, but if you see a trend then I would recommend decreasing frequency with that specific product or item. 

It’s essential to have a regular sleep schedule, keep an eye on your blood sugar and try healthy ways to cope with stress, whether that’s exercise or having good social support. If you’re interested in non-grade perspective medicine, studies show magnesium and riboflavin are helpful.

What do you recommend for treatment?
There are two types of treatment. There’s prevention medicine and then there’s rescue medicine. If rescue medicine like the over-the-counter medicine, like ibuprofen, isn’t cutting it, then you can see a neurologist or internal medicine doctor to get a prescription medication. The largest family is the triptin family, those are probably the most popular. I would recommend prevention medicine for anyone who has more than four migraines a month, and that’s because if you use too much rescue medicine, that can lead to medication overuse headache

For people who have more than four migraines a month—say you have 15 headaches a month and eight of those reach migraine criteria—then you would be eligible for Botox. It is shown to decrease migraines. It’s a series of injections done every three months and in the first round, about 40% of people get relief and in the second round another 20%, then another 10% at the third.

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