The Migraine World Summit: Day 3

*This post is not sponsored by the Migraine World Summit but I am a participant in the Migraine World Summit affiliate program. This means I earn a commission from any qualifying purchases of the summit made through my link. http://www.migraineworldsummit.com/?afmc=1k

Chronic migraine patients – 1-2% population

CM is reversible. 26% CM patient’s remission in 2 years.

Chronic migraine diagnostic criteria:

-        3+ months

-        15+ headache days

-        8+ migraine attacks

Risk factors for chronic migraine?

-        High frequency migraine to begin with (frequent episodic)

-        Overuse of acute meds (common trap!)

-        Anxiety/Depression

-        Life stressors

Chronic migraine attacks:

-        Longer and more severe

-        Never really goes away completely (lingering on)

-        Noise and light sensitive all of the time (not just during attack)

-        Migraine never completely turns off

Chronic migraine patients imaging: we can see areas of the brain are “hyperexcitable”. The threshold for triggering an attack becomes lower and more frequent over time.

Observe abnormalities in CM brain between attacks too but when patients go from chronic to episodic these brain changes go away.

Discussed difficulty with CM diagnosis vs high frequent episodic patients. Some patients transition in and out of CM (15 day cut off isn’t always that helpful). Similar levels of disability are found in CM patients and high frequent episodic patients.

What are the common traps of Chronic migraine?

-       Not realising they have it. Patients tend to remember the worst headaches and report those and underreport mild ones and daily “background pain”. So important to keep a headache diary in order to truly get the correct diagnosis and know how many headache free days do you have?

-        MOH – People who take pain meds for other conditions seem to be fine. It only seems to be an issue for headache patients. Days of month is important not the tablets. (Paracetamol & NSAID’s: 15 days a month, Opioids: 10 days although some people could be at risk who take 6-8.

-        Not getting a good acute response (finding an effective treatment that stops a migraine in its tracks is really important).

-        Not taking a preventative treatment (side effects, not taking it for long enough or unrealistic expectations).

-        Too much caffeine

-        Wrong diagnosis? Hemicrania continua (always one side of head) – use a completely different treatment from migraine. Low spinal fluid pressure (difficult to diagnose – woke up with a headache one day that never went away).

Help! Need more than 9 acute meds a month?!

-        Increase dose of preventative

-        Add in another preventative

-        Change preventative medication

-        Botox, topiramate, anti CGRP meds for CM.

Complimentary? Lifestyle factors are SO important too.

-        Exercise

-        Hydration

-        Eat well

-        Sleep routine (check sleep apnea)

-        Caffeine intake

-        Triggers (easy to blame yourself)

-        Natural supplements (Magnesium, B2 and CoQ10)

CM comorbidities?

-        Sleep problems

-        Anxiety

-        Depression

Doing everything right but not getting better? Is it the wrong diagnosis?

-        Sometimes it’s necessary to hospitalize people and use IV meds to break the cycle (lidocaine can be used and ketamine can be useful for people who have been overusing pain meds).

Does acute med work?

Benchmark for this – clinical trials: pain free/significant relief within 2 hours.

Take meds early! Interrupt the attack process before central sensitization occurs (1hr after attack started).

Look at the dose of your triptans and the different formulations available.

How to intervene early to prevent CM? (if you are high frequent episodic)

-        Awareness of where you are on the scale (episodic – chronic)

-        Lifestyle measures

-        Keep an eye on number of medication days

-        See a doctor!

Its much easier to treat episodic migraine than chronic migraine so important to treat and get a hold of before it progresses.

Hope for those with CM? – nothings worked

Have you got the correct diagnosis?

-        Hypnic headache (usually in older patients) alarm clock headache wakes people in sleep most night for a few hours.

-        MOH – wake up and brain needs meds again.

-        New daily persistent headache (NDPH)- underlying causes (50% of time) such as POTs.

Intractable attack that does not stop:

-        Status migraine (prior history of migraine)

-        Prolonged attack (72hrs +)

Central sensitization – the brain learns to stay in pain

Also referred to as refractory or intractable migraine.

Issues with diagnosis? Labs normal. Normal MRI. Issue with stigma with patients turning up at the emergency room or at doctor’s office because there isn’t a clear test.

How common? Research is missing on the exact numbers and occurrence rates but is usually found within the chronic migraine population.

Chronic daily migraine? Usually something else going on such as low pressure/high pressure headaches.

NDPH vs Status Migraine?

New daily persistent headache characteristics:

-        Stubborn and difficult to treat

-        Clear start of headache

-        Remember that day

-        A different type/ new headache from what they have experienced before

Low pressure headache (spontaneous type – not after surgery):

-        Like finding a needle in a haystack

-        Good idea to pull people back who haven’t got better and check for leaks.

-        Patient profile -tall, EDS, joint hyper mobility

-        Positional (worse being upright)

-        Good history taking is important

Risk factors for status migraine?

-        Chronic migraine

-        Frequent headaches

-        Treating headaches twice a week

-        Severe illness/ stressful life event

-        Obesity

-        Lower social economic status

-        Lack of access to education

-        Psychiatric comorbidities

-        GI issues – gastric shuts down during an attack

How to treat?

Dopamine receptor antagonist:

-        Infusion

-        Nerve blocks

-        Steroids can be used but not great side effects

-        DHE (IV week inpatient stay)

Acute treatment plan at home: 3 drug approach

1.     NSAID (ibuprofen): works on central sensitisation in brain

2.     Triptan (sumatriptan): works on CGRP and vasodilation

3.     Dopamine receptor antagonist (domperidone): works directly on dopamine receptor and gastric stasis.

Pain provides no benefit to those who live with chronic migraine. For the general population, pain serves a purpose. If you have no pain, you will probably die.

Migraine helps you “too much” to survive.

Pain > alert > tell body something is wrong

Chronic pain > creating networks

Not always real migraine. Probably something else going on too as brain can’t reset itself.

An example of this is seen in patients with phantom limb syndrome. Chronic pain – patient continues to feel pain in limb that’s not there after surgery.

CM- pain sometimes starts before the “trigger” itself. Pain will start before you go to do something you don’t want to do.

This is a complex problem! Multi-disciplinary – not just one drug.

Chronic pain syndromes:

-        Much higher percentage of women than men.

Research study: when they put CGRP on the dura of rats ONLY the female rats developed pain related behaviours. WOW!

How does pain change the brain?

Dynamic

FMRI: acute pain and chronic pain (CM)

Chronic migraine patients?

-        Might be dynamic aka reversible changes with patient

-        FMRI study shows permanent lesions

-        There appears to be a threshold: after a certain amount of time, the changes are not reversible.

Pain cycle?

Acute moment > there is no cycle.

Migraine:

-        Inflammation in the dura

-        Lingering attacks

-        One attack after the other

-        Psychological fear of the next attack

The fear of the next attack probably lowers the threshold for the next attack creating a big problem.

Repetition: the body learns quickly. Brain does not need much to go into attack and it becomes a vicious cycle. Sooner you stop this cycle the better.

Research in Spain: Botox

-        After 1 year of CM your response to preventative treatment is worse.

-        It takes longer to respond to treatments so you need to stick with them

-        New antibodies (CGRP) looks like people are responding a bit quicker with these

Severe chronic patients tend to be stable at around 20+ headache days and not much movement from there. Some patients seem to go in cycles. 20 attacks one month and then 3 the next. Perhaps this is their system trying to correct itself and not go into chronic.

How to break pain cycle?

A bit of everything:

-        Education

-        Choose the right medication for that patient

-        Timing of acute med

-        Avoid opioids

-        Take into account comorbidities such as mood and sleep disorders (sleep is SO important)

What about cannabis?

-        “sexy receptor”

-        Doesn’t seem to help CM patients

-        For some it helps with anxiety

CM> Chronic pain conditions tend to develop other chronic conditions. Inflammation – balance is lost in the body.

Final thoughts?

-        Make pain your friend. Don’t fight it.

-        Don’t create energy around migraine pain.

-        Get the right help and follow your instinct. If you’re not happy with Dr, find another one.

-    Chronic pain usually starts after a big life stress – explore the psychological issues – therapy etc.

The Migraine World Summit: Day 2

*This post is not sponsored by the Migraine World Summit but I am a participant in the Migraine World Summit affiliate program. This means I earn a commission from any qualifying purchases of the summit made through my link. http://www.migraineworldsummit.com/?afmc=1k

Why don’t people go to the doctor for headache/migraine?

-     Stigma (not considered a real disease)

-     Experience episodic migraine and think they are ok. Problems occur when episodic migraine isn’t treated appropriately and can escalate into frequent episodic or chronic.

Less than 50% of chronic migraine patients see a clinician.

Chronic migraine patients who have “tried everything” for example sometimes it turns out they didn’t really have CM and actually have a leak for example.

Headaches:

-        Primary (migraine, tension, cluster, trigeminal)

-        Secondary (due to another condition)

What condition is migraine mistaken for?

-Sinus headaches

-vestibular issues

On average patients will see 3-5 different specialists before they see a headache specialist.

Central sensitization and the issue for chronic migraine patients being on high alert all of the time and not just during an attack Problem with patient and how they are able to interact with the environment.

Head pressure can present as a migraine. Leaks in spinal fluid (spontaneous intercranial hypotension -SIH).

Symptom profile: (usually feel worse when upright, symptoms get worse throughout the day, nausea, vision problems).

Patient profile: (Tall & lean, hypermobile, mixed connective tissue disorders are often a comorbidity).

MOH > Secondary headache disorder and is often superimposed on primary headache disorders such as migraine.

Underdiagnosis is as much of a problem as misdiagnosis.

Discussed research using computers to find groups of migraine patients and explore trends in mass data. Larger amygdala found in patients with chronic migraine compared with non – headache participants. Link between big amygdala and high catastrophisation scoring. Episodic migraine patients have a mix of high and low catasrophisation scores. Higher scores a pre marker for those who go from episodic to chronic migraine perhaps?

Causes?

Head injury:

-        A fall (most frequent in youth and elderly)

-        Flying object

-        Car accident

-        Sports

Head injury symptoms:

-        Headache

-        Nausea

-        Vision changes

-        Sleep distrubances

-        Difficulty with attention

-        Memory problems

-        Cognitive difficulties

-        Fatigue

-        More severe cases may include; weakness, numbness & tingling

What next?

-        Neuro exam

-        Look at any weakness

-        Sensory deficits

-        Eye exam

-        MRI/CAT scan

What is concussion? Movement of the brain in the skull, a jolt.

Migraineurs are more likely to have symptoms after a concussion compared with non-headache patients. It is important to focus on what is new symptom wise. Is there a different symptom you don’t usually experience or a new type of pain?

Most people are fine after concussion.

There is the acute phase (3 months post-concussion).

Persistent/chronic (still experiencing symptoms 3+ months after).

Refractory (continued symptoms over time)

The Migraine World Summit :Day 1

I hope you find these summary notes from this years Migraine World Summit useful. There are not notes on every talk but a good selection from each day. If you would like to go back and watch any of the talks from this summit you can get the all access pass here http://www.migraineworldsummit.com/?afmc=1k

*This post is not sponsored by the Migraine World Summit but I am a participant in the Migraine World Summit affiliate program. This means I earn a commission from any qualifying purchases of the summit made through my link.

Alicia Torborg is the Executive director for the Association of Migraine disorders.

Jon Summer is a board member for the American Migraine foundation.

Shirley Kessel is the Executive director for Miles for Migraine

Attacks are so varied even for the individual. Some start behind the eye whereas some might start at the back of the head. Jon discussed how stress was likely to have triggered off his chronic migraine. The less you fight it- it gets better.

Stress the difference between seeing a neurologist and a headache specialist.

How do you manage your attacks and what meds do you take?

Alicia: Exercise is helpful for her (walking). She takes over the counter meds for attacks (Excedrin migraine) and tries to stay hydrated. For prevention she is on an anti CGRP, Botox and an antidepressant.

Jon: He doesn’t take much for acute attacks as nothing much works but he will take over the counter meds (Tylenol and 800mg ibuprofen). Get out of bed as quickly as you can after an attack. As soon as you feel able get up and get going again. Appreciates he is very lucky that he is able to exercise. For prevention he is currently taking a break from preventative pharmaceutical drugs. He finds mindfulness and paying the guitar have been really helpful for him and he has also been drinking celery juice.

Shirley: Exercise is key and the best preventative she has tried (walking). She sticks to a routine “lives life like a baby”. Get up at the same time, eat at the same time, go to bed at the same time etc. For prevention she is on an anti CGRP, Botox and an antidepressant. She also does exercise, yoga and meditation for migraine prevention.

Living life VS Managing your health?

Alicia: Say YES to everything when feeling good.

Jon: It took a few years for family and friends to understand but he mostly says yes now too.

Shirley: Live like a baby and stick to a schedule. Says no to lots of things.

Migraine causes anxiety & depression. They seem to come hand in hand with chronic migraine unfortunately.

Experience of migraine in the workplace?

Alicia: For years in the corporate world she hid her migraine and was too afraid to tell anyone. Her husband had to bring her in a couch for her office so she could lie down in the dark when she got attacks. She changed roles and is now able to work from home as an executive director for a migraine non-profit.

Jon: Had to stop working due to migraine (“too much, too fast”). He stressed the importance of opening up to your employer and explaining to them what migraine is and how it impacts you.

Shirley: She is able to work from home which helps.

Family & Migraine?

All three of them have children with migraine. Try not to let migraine be the focal point. Difficulties with other family members not understanding the extent of migraine especially when its chronic. Fears for children who are episodic that it might progress to chronic migraine.

Biggest success and failure in managing migraine?

Alicia: Success - her career. Failure - the side effects of meds

Jon: Success – Finding likeminded people who understand. It’s important to be able to poke fun at migraine and the challenges it brings.

Shirley: Success – her biggest success is hope and having a positive outlook. The belief that tomorrow will be better. Failure – totally giving in and letting her mind go down the rabbit hole and catastrophising.

Don’t fight it. Find new hobbies and adventures. You’re the boss!

Cluster headache is often referred to as “suicide headaches”.

They are a cluster of specific attacks. Typically, the attacks last between 45 mins to 3 hours and you might have a few of these attacks per day. The attacks come in cluster cycles which could be 6 weeks or 3 months long for example. Typically, you will only be symptomatic during a cycle.

What are the non-headache symptoms?

-        One sided

-        Eye droops

-        Eye tears

-        Sinus drain

-        Start behind eye/temple

-        Can move down into the jaw area.

You can have cluster headache AND migraine but people who have both can usually easily distinguish between the two.

*Attacks last the same time. This blew my mind! So, if someone has a cluster attack that lasts for 57 mins… all of their attacks will last for 57 mins.

Diagnosis?

Diagnosis can be very difficult. Often misdiagnosed with migraine and patients frequently see between 6 -8 different doctors before being diagnosed with cluster headache.

Very hard to diagnose because of the nature of the cycles. A doctor might prescribe a medication for a sinus infection for example. Patient takes this medication and symptoms improve only because the cycle then ends. Because the symptoms stop and start depending on cycles often the wrong medication and diagnosis is given as the patient seemingly seems to improve.

40% misdiagnosed thinking it’s a dental issue and often go on to have dental work and procedures when it’s actually cluster headache.

Cluster headache profile?

8:1 male to female was the ratio that was used for years. Now believe it’s probably somewhere closer to 2-3:1. For years women were misdiagnosed and told they didn’t have cluster and it was migraine.

Age – typically starts mid to late twenties. Paediatric cases of cluster in patients as young as 4 years old. Incredibly difficult to diagnose. Some people grow out of it with age but sadly lots of people don’t. Cases of patients in their nighties in care homes still suffering with cluster attacks.

Usually with a cluster attack, when it’s over its completely done. There isn’t usually lingering pain like that is seen in some migraine patients or other headache disorders.

Episodic VS Chronic

Episodic cluster: 80% of cluster patients. Tend to have 1-2 short cycles a year (spring and autumn season cycles for example) lasting for around 6 weeks or so.

Chronic cluster: no cycles. Experience cluster attacks 12 months of the year. Usually once chronic, people stay in chronic cluster.

Treatment options?

-       New anti CGRP drug Emgality has been approved for cluster headaches.

-      Oxygen therapy. Been used for years and can be extremely effective for many. High flow oxygen. No side effects. Unfortunately, there are many access issues.

-        Devices – ElectroCore/gammaCore

What are the key advocacy issues?

-       Oxygen through Medicare.

-     Educating medical professionals about what cluster headache is and how to spot it in order to correctly diagnose.

-      Educate the migraine community to avoid further misdiagnosis between the two headache disorders.

Clusterbusters have trained suicide helpline operators to help with how they should be handing calls from those who have cluster headaches. For example, saying something like “oh my mum gets migraines, so I know exactly how you feel” could be the worst thing you could say to someone struggling with cluster attacks.

Things will get better. There is more research being done and more treatment options available for cluster headache than ever before. Keep making it one more day.

♥These are a few of my favourite things ♥

I wanted to start a little blog series where I share my favourite things with you every so often. This will be everything from migraine/health related products, to what shows I have been loving, food faves and any other random bits and bobs I have been obsessed with.

Recumbent exercise bike

Since we are only allowed out for one walk a day at the moment, I thought it would be a great time to try and get back into using the bike at home. The recumbent bike was suggested to me by my cardiologist to help with POTs, by building up my leg muscles. I like to sit back in a comfy chair and watch Netflix whilst I pedal.

I find that because my body is not fighting gravity and its fairly low impact, that it doesn’t seem to trigger my head off in the same way most exercise does. I have the Mira Fit bike but there are lots of different models you can choose from online. Try and get one which is fairly heavy so it doesn’t move around too much when you pedal. The Mira Fit one has a little display panel showing you your speed, distance, time, calories burned etc.

Native deodrant (aluminium free)

I’ve been looking for a new deodorant for a while as I wanted to switch to one which was aluminium free. I’ve tried a few different ones in the past but never found them very good and always ended up going back to my trusty dove roll on.

I saw a few “influencers” (bleugh I still hate that word) talking about Native online and ordered some to try. They aren’t cheap and unfortunately I had to pay extra customs charges but the deodorant is incredible. It’s a creamy stick and feels lovely to apply. It’s aluminium and paraben free and you can choose from so many different scents. I’m currently loving the coconut and vanilla scent. At the end of the day I still smell of coconut! If you want to try it for yourself, you can get a free mini deodorant with your first order using this link https://refer.nativecos.com/x/sjLI1G

Sh**ged Married Annoyed  (podcast)

I’m wayyyy late to the party on this one but it’s amazing when you find a great podcast and have about a year’s worth of episodes to binge on. It’s by Chris and Rosie Ramsey and is a hilarious chat between husband and wife about day to day life, relationships and their grievances. To anyone who already listens and has a clue what I’m on about... everytime I hear the babagabagababaga I always go babagabagababaGANOUSH. You’re welcome.

Lotus biscoff spread

I’m not sure if I’m sad or relieved that I didn’t discover this pot of joy sooner. I’ve loved the lotus biscoff biscuits for years but for some reason never tried the spread. Wow. It’s delicious! I haven’t found anything I particularly love to eat it with yet (suggestions welcome). I like it best straight off the spoon! Big thanks to my friend Sarah for showing me how it’s done.

Faith in Nature: Dragon fruit body wash

This stuff smells incredible! I don’t think I’ve ever rationed myself with a shower gel before but I’ve been trying so hard not to use this all up but finally it’s gone. It lathers up well like most shower gels to be honest but the scent is SO fresh. I can’t wait to try the shampoo and conditioner next! It contains no SLS or parabens and is vegan and cruelty free.

What are you loving at the moment? ♥

The Migraine Life is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com and amazon.co.uk.

How I keep my headache/migraine diary

I have kept a headache/migraine diary since my very first neurology appointment in 2015. It’s one of the best things I have done and has provided both me and my doctors with in-depth information about my migraines and how they have developed and changed over time.

I have tried numerous apps, such as Migraine Buddy but personally I prefer to track them myself, using good old-fashioned pen and paper. I would say the most important thing, is to do a headache diary that works for you. If you find the apps useful and you use them daily then great. If not, I hope my own way of doing a headache diary might give you some ideas of how you could layout yours.

Essentially, each day I record two numbers. A pain score (an average of the day) and an activity score. I score my pain out of 10 and my activity on a 1-5 scale.

The key with recording these numbers is to be consistent. My scale is slightly skewed because I always record my pain quite low (for example, migraine is at about a 6 and I never record much higher than a 7/8). It doesn’t matter how you do it, as long as when you record a 6 for example it’s consistently a “6” the next time you record it. You will start to recognise what level of pain you are at on YOUR scale. This can also be extremely helpful for opening up lines of communication with your loved ones. They will start to understand what different pain and activity scores mean for you and what you're able to do/not do, depending on the level of disability associated with that score.

My biggest tip though is to give yourself room for there to be a noticeable difference. For example, I’m functional at a 5 but not at a 6. It’s very tight on my scale.  It would be a lot easier if my migraine was (7-9) for example.

So, each day, along with recording my pain and activity. I also make a note of any medication I have taken (not daily meds) and I mark an X if I had a migraine attack (usually obviously from pain recording and medication). If you have pain free days, it might be useful to note these down with a tick symbol instead of an X for example, or you can just count up any "0" days in your pain column.

Anyone else dreaming of a 0 pain day right now?

Moving on...

I record this is in a super simple way in my bullet journal. It’s clear to see across the month how my head is doing and how many migraines I have had. It’s also really easy to keep track of how many painkiller days I’m on. Before I started recording it like this, I used to just use the notes in my phone. I would record the two numbers and a short note of the day.

“Monday: 5.2. Short walk this morning. Didn’t feel good when got back. Rested in afternoon”

Every few months I will put my headache diary numbers into an excel spreadsheet for my master headache diary. From here I can easily compare my migraines across different months and even years. It allows me to create simple but effective tables for my neurology appointments that show all the key information such as;

- total number of headache days

- total number of Migraine days

- average pain for month

- average activity for month

- total number of painkiller days

Make sure you clearly explain to your doctor how your headache diary works and what the numbers mean for you. Your 5 might be another patients 8. 

If you are someone who doesn’t see the point in keeping a migraine diary because “it’s bad everyday” please please reconsider. There is likely to be some variation with your activity levels, even if your pain score stays pretty consistent. Its such useful information to have and often when you reflect back over a longer period you realise oh it’s not actually been a dreadful month, just a really bad week. Many migraine treatments also require you to have kept a headache diary to see whether or not you’re eligible for a particular treatment.

If you have any questions or would like help setting up a headache/migraine diary that works for you please don’t hesitate to send me a message and I will be happy to help.

Dolovent: The 3 in 1 supplement for migraine #AD

I’ve tried several migraine supplements before but have always found it difficult to find the recommended doses. Combining all the key ingredients together can mean you end up taking so many different tablets. So, when Nouveau health first told me about Dolovent™, I was excited to try a supplement for migraine that contained all the key ingredients in one easy to take capsule.

What’s in Dolovent?

Dolovent™ contains three supplements that are known to help with migraine along with many other useful vitamins and minerals.

The three key players are;

Magnesium (magnesium oxide)- 600mg (per daily dose) 

Riboflavin (vitamin B2) - 400mg (per daily dose)

Coenzyme Q10 (CoQ10) - 150mg (per daily dose)

Recommended daily dose is 2 capsules, twice a day.

What does the research say?

There are randomised clinical trials to support the efficacy of magnesium, riboflavin and CoQ10 in migraine patients.

Magnesium:

• Magnesium has been shown to be lower during migraine attacks and often deficient in migraine patients. (Ramadan et al 1989, Trauinger et al 2002.
• Magnesium at 600mg works as a migraine preventative. Significantly decreasing migraine days and medication taken. (Peikert et al 1996).

Riboflavin (vitamin B2):

• Schoenen et al 1998 found that 59% of migraine patients who took 400mg riboflavin daily for 3 months reported a 50%+ reduction in migraine attacks.

CoQ10:

• Rozen et al 2002 found that CoQ10 does work as a preventative treatment but it could take a few months to really see a big improvement and reduction in migraine attacks.
• Migraine frequency was reduced by 13% after 1 month of use compared to 55% after 3 months of taking CoQ10.

Dolovent™ Clinical Study:

Gaul et al 2015, did a randomised, placebo controlled, double blind and multi-centre trial on 130 migraineurs and found that Dolovent™, containing all three of these supplements resulted in a reduction in migraine days. Although this result was not statistically significant, participants in the supplement group reported lower pain and they also had a reduced score in the Headache impact test (HIT). This test is often used by doctors to assess the burden of disease migraine has on an individual.

Why should I take supplements for migraine?

                                                        

Migraine is a chronic neurological illness which currently has no cure. In order to manage migraine as best as possible there are both preventative and acute options that can be used.

Managing migraine is often far more complex than simply taking a preventative medicine. It requires lifestyle adjustments (sleep, exercise, diet & stress management).

Supplements are a great place to start if you are looking to try a more “natural” preventative treatment. Or perhaps you already take a migraine prophylaxis and have made lots of lifestyle adjustments and are still struggling to manage your migraines. Then why not give supplements a go?

Where can I buy it?

You can buy Dolovent™ direct from Nouveau Health’s website. They cost £36.88 for 120 capsules (1 months’ supply). Nouveau Health have kindly given me the discount code TML10 for you to use which will get you 10% off your order. If you purchase 3 bottles you will gain free shipping.

Are there any side effects?

If you have ever taken Riboflavin before you will know that it can cause your urine to turn a fluorescent yellow colour. Don’t be alarmed, this is totally normal.

If you haven’t taken magnesium before, or know that your stomach can be sensitive to it then I personally recommend you start slowly and build up to the 4 capsules a day to try and reduce the risk of an upset stomach. I gradually built up to 4 capsules a day over the course of a few weeks.

Please check with your doctor for possible interactions with other medications or if you have any other concerns before taking Dolovent™.