“We have loads of people who say, I was fine, and then I got divorced, or made redundant, and my hair fell out,” says Professor Anthony Bewley, a psychodermatology specialist at the British Association of Dermatologists. The important thing is to have this range of options, and not to give up.” Hair loss My impression of that is it’s pretty much nonsense. And there’s mixed evidence for taking the herb feverfew as a preventive. “There’s some weaker evidence for something called coenzyme Q10. “There’s a small, very well-done study which showed modest preventive effects,” says Goadsby. If you want to go DIY, it could be worth trying a vitamin B2 (riboflavin) supplement. He recommends checking in with the Migraine Trust (of which he’s a trustee) for the latest developments.Ī more invasive option, botulinum toxin – Botox – is sometimes prescribed for chronic migraine (more than 15 days of headaches a month) if three other preventive treatments haven’t worked. “You can go on and function, do your work.” Two more types – also working with the CGRP pathway – are in the pipeline: a preventive in tablet form and a treatment to take once an attack has started. “They’re effective and incredibly well tolerated,” says Goadsby. These work to prevent attacks and are self-injected either monthly or every few months. Already available are CGRP monoclonal antibodies. Goadsby’s life’s work has been developing a new class of medicines called calcitonin gene-related peptides (CGRP), which block molecules involved in causing attacks. “About a third will find that it doesn’t make any difference, or they’ll get some intolerable side-effect.” Luckily there are six to try, in tablet form or as a nasal spray. “About two out of three people will find significant relief within about two hours of taking them,” says Goadsby. Once you’ve exhausted taking aspirin, paracetamol or ibuprofen as soon as you think an attack is imminent, talk to your GP about triptans – a well-established group of medications. There aren’t any specific stress-management techniques for migraine – finding the best treatment is trial and error. “Consider for a moment what life would be like if you couldn’t focus on things – everything would seem more stressful, not because it is, but because the brain has already started the migraine attack.” The important thing is to have a range of treatment options, and not to give up An attack can start hours or days before the pain arrives, bringing problems with concentration, mood change, fatigue, light sensitivity or neck discomfort. Migraines can cause a fair bit of stress themselves. People have the highs and lows of life, and you don’t want to have a boring life just as a way of getting rid of migraines.” “Patients often say that it’s Saturday morning or when they have the pressure of work and then the letdown – and the problem is that we can’t stay stressed all the time. But they often come just after a stressful period rather than in the thick of it. While genetics and monthly hormonal changes in women play their part, many people say that stress can bring on or exacerbate their migraines.
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