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Coincidence, or?

Hi everyone,

I wonder if anyone can shed some light for me.
I’ve been doing really well with MAV lately so much so I have been going back to the gym able to weight train and push myself a little to my limits. All until yesterday when a band of symptoms came flooding back!!
Ear fluid feeling, true migraine, dizziness, facial tightness… one interesting thing I did yesterday was have a amalgam filling in my tooth! At 3pm!
All these symptoms started after this around 9pm! Could it be that? Or the fact I am due to have Botox in 3 weeks and its wearing out?

I haven’t had a true migraine like this for months now! Is it too close to be coincidental?


I absolutely do think there is a link. I used not to be able to go on my haunches. I had a relapse from lifting boxes. I believe @Young_Lee also had a relapse after a gym session recently.

It’s worth noting Dr. S recommends only light exercise to sufferers.

I’ve got back to the gym very recently. However I’m very careful not to strain so weight lifting is OUT! I’m doing indoor rowing which is obviously lighter weight exercise.

I think weight lifting or anything which increases head pressure is a big no-no.

I’ve said it before but the number of personal trainers and amateur weight lifters on this board seems disproportionately large.

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Hi James,

Indeed there is! I have been working up slowly over the last few months in the gym and im sure to give myself time before and after working out. I guess because Ive been working out for the last 7 weeks and haven’t seen an increase in symptoms that would be the last thing I’d thought had brought on the symptoms. I was particularly worried they may have manifested because of the filling I had a few hours earlier. And that because I am back working out I may have broken down the Botox a little sooner and it is not longer effective.

Im going to rest up today and see if I can shake it off :relieved:

I guess the best thing you can do is experiment and find your limits, then try to keep within them.

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I often have symptoms after the dentist, so much so that I dread going there now. I think there is a lot of stimuli at the dentists, lights, having to go back in the chair, the noise and drilling , it is quite an assault and our brains just object. I need a filling replaced and I’m being chicken and avoiding it at present.


Really? Interesting! I searched on this site about dentist and I was so worried I had caused it by going there. I had an injection and the drilling was vibrating my brain so much I kept having to stop! But the symptoms came a little later in the evening and are still here this morning! Im praying its short lived! :expressionless:

There was an interesting discussion on the role of exercise in migraine at the recent Migraine World Summit. If I understood correctly, chronic exercise can have a preventative effect against migraine by increasing the threshold but, conversely, acute exercise can trigger migraine attacks.

They think the trigger effect might be due to increased lactate in the brain following intense exercise, so advise against anything too strenuous. Personally, I always find myself at least slightly dizzy/giddy the day after a weights workout.

The following paper reviews this association:
Amin et al. The association between migraine and physical exercise. J Headache Pain 2018 Sep 10;19(1):83. doi: 10.1186/s10194-018-0902-y.

But that’s not a paper about MAV? I don’t think there’s any proof that vertigo or dizziness is ‘a migraine’. Whilst migraines can clearly cause you to feel dizzy, I don’t believe MAVers are suffering from 24/7 migraines, even though their often dizziness is. So something additional is surely going on? Just an opinion …

We use the term ‘migraine’ too loosely imho.

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Thank you for the info!!

I will have a read of that! :relieved:
I suppose it could be a culmination of things, hopefully it wont last :crossed_fingers::crossed_fingers:

My understanding is that:
(1) in migraine, the trigeminovascular system is activated;
(2) in the MAV/VM subtype of migraine, one part of this system in particular is the problem, i.e. the trigeminocervical complex, as this communicates with parts of the brainstem involved in processing vestibular signals - hence the dizziness/vertigo;
and (3) with chronic migraine, this is happening 24/7.

I might have some of that wrong,but I remember Dr S telling me that the problem was in the part of the brainstem connecting with the vestibular system. He said this is why MAV patients get so much fatigue - as their brain is constantly using extra energy to actively correct balance whereas normally this is done automatically by the brainstem.

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Dr S. could not explain the aetiology to you, neither can my doctor (he’s a professor at a teaching hospital and admits he can’t), the science isn’t there yet.

Massive assumption right there. Why would MAV be a subtype of migraine? Also possible is that migraine is a symptom of MAV.

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Yeah, there seems to be a lot more unknown about the condition than known. Some interesting theories, though…

Coincidence? I don’t much believe in coincidence when it comes to medical matters. After all where would diabetics be if the man who was first brave enough to taste urine and find it sweet had thought ‘coincidence’, and walked away to get on with his life?

Probably IMHO several things going on here. Could be your dentist uses Lidocaine for your treatment. That can react with certain drugs and can cause dizziness anyway. As @sputnik2 says a dentist’s surgery is positively crowded with possible triggers, that tilting chair, bright lights, unfamiliar smells to name but three. Then, triggers are cumulative so you added in a good session at the gym. I used to tell ‘my’ Him Indoors’ my balance capability was restricted daily to strict limits. I always envisage a tiny pot of powder, some people count spoons. Everything one does uses up a portion of whatever til the pot’s empty and you collapse. You’ve done so well, others could be envious. Be careful not to bring about a total relapse by overexertion. Helen

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No I did not say that at all. I was actually linking the relapse to the gym.

I’m personally convinced that in many cases MAV involves the inner ear and ICP increases can cause problems with an effected inner ear. That’s absolutely the case in my case, and possibly others.

Reclining back in the dentists chair may also have had an impact, sure.

But I think we should recognise that there’s possibly a strong physiological, not just neurological element to MAV.

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So you didn’t. My mistake it was @sputnik2!!

I must admit on this occasion I’d say it’s probably cumulative, and the gym trip just pushed it over the edge. However I think gym work far too strenuous for recovering MAVers. I even found Tai Chi totally impossible. I was advised to walk outside daily by everybody medical, except my GP (who is MAV `clueless’) but looking back I think I have probably held myself back by walking too far when feeling 24/7 dizzy, extremely light sensitive and feeling rough. For a long time I thought it would hurrying things up but looking back now I think it did the opposite. I think it’s possible to over-walk. Helen

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I don’t think it’s as simple as cumulative triggers. Why don’t ‘regular migraine’ sufferers get the same symptoms?

No, imho there is some physiological element that is compromising the vestibular system and this leads to the brain struggling to deal with exposure to things it would normally brush off.

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Which symptoms? Do you mean dizziness? Some regular migraine sufferers get dizziness during acute attacks. I‘ve one friend who gets light sensitivity badly during attacks and regularly in everyday life. We used to work together and she would always ask me to load her photocopier with paper to avoid her looking at the glare coming off the pristine sheets of A4. And she used to get a migraine after a trip to the dentist.

I’ve no real idea what causes my ‘vertigo attacks’ but it does seem too much of a coincidence they are just like two friends classic migraine attacks except more of my symptoms have lingered on between attacks constantly since 2014 and I haven’t the true migraine headache. So I am perfectly happy to treat my attacks as if they are a ‘migraine variant balance disorder’. The same drugs are used for prevention in both so I don’t see them as dissimilar. The Migraine Diet seems to stop the dizziness for some people. It would be great if research one day provides answers and it could well mean some physiological element being involved but until then I just go with the flow. Helen


Hi Helen

Yes, indeed I have had some enviable few weeks! I guess, I have been taking advantage of feeling relatively normal and doing all the things I miss! I really didn’t think my gym session was any more strenuous that usual and I felt fine afterwards… Seeing your post about the delay in symptoms would of course account for it but I am reluctant to blame exercise fully. Like you say, a culmination of triggers may have occured and I was just too sensitive :persevere:

Today has been difficult… almost felt like I had forgotten how rotten MAV was! Im optimistic I will be able to recover again. :crossed_fingers:

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Funny - just looked at drug interactions with Lidocaine and Ami - Online it states that 2% of Ami is removed from the body by Lidocaine. Plus this was 3.30pm so I wouldn’t have thought there would have been that much in my system at that moment?

I think you are fairly accurate when it comes to what the current literature states. The migraine protocol works and stick to that and many have gotten to 100% using just that. Right now science says Migraine, let’s roll with it. If they change the tone we can adapt until then migraine is the best we got and i don’t think it is a far shot.

i have seen Dr.Hain multiple times and correspond regularly over email, i think he is on the same page as Dr.S when it comes to MAV.