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Metabolic Theories of Migraine Pathogenesis

“Increasingly, researchers are beginning to look at migraine as a solution rather than a problem; that the symptoms of migraine are the result of the body’s attempt to restore homeostasis following disruption of metabolic systems involving diet, sleep, exercise, and adaption to changes in weather and temperature. This new knowledge can inform approaches to therapy that focus on preventing future attacks and improving results with abortive treatments.”

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So, funny you should mention that. You know this is a pet theory of mine. I’ve been hesitant to jinx myself but I’ve been back on the diabetes drug metformin for about a month - to treat my insulin resistant PCOS. I have also been taking a ketosis supplement. I’ve noticed MAV has been really quiet the last week or so. Today was maybe a 95% day.

(Still managed to not lose any weight damnit.)

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That is what I’ve been saying all along.

Only it’s not a solution, it’s an undesirable state when the brains algorithm to reimpose homeostasis (aka ‘learning’) is pushed too far.

It will be interesting to see if this produces improved medication but imho this will still be treating a symptom rather than a cause.

For MAV you are still imho dealing with a vestibular system that’s been thrown out of kilter and the brain is simply struggling to deal with that.

you are talking inner ear homeostasis which is totally different. the article is on systemic homeostasis.

Till date there is no scientific correlation between migraine meds helping vestibular compensation in any way whatsoever.

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No I’m not. I’m talking about homeostasis of the vestibular system.

But yes, problems with the ear (not just inner) can cause that as signals (and response to stimuli) will diverge from the brains expectation causing loss of homeostasis and thus stress on the brain.

Migraine is just the point at which the brain goes into crisis and cannot deal with the overwhelming issue.

Again completely different than the article.

Not at all

you are talking endolymphatic hydrops. Do you have any other ear disorder which will cause false signals ?

No I’m not just talking about hydrops

If you want to focus on ears there are:

  • PLF
  • Hydrops (both menieres and secondary)
  • Neck injury (causing alterbaric variations)
  • ETD (ditto)

There are probably more:

  • external Chemical/physiological influences yet to be identified
    • eg diabetes which causes a drop in the stability of response (inner ear balance maintenance has yet to be fully understood so we have yet to learn the full implications of some other conditions and it’s effect on the ear)
    • significant Blood pressure fluctuations.

Who knows …

The article is on general migraine. It is not possible that all migraineurs have an ear disorder. So migraine exists in the absense of ear disorders. And whatever causes that migraine can also cause vestibular migraine.

Yes it’s talking about what it takes to get into migraine state.

Something is pushing the brain into migraine in the first place (well you might say it’s doing it to itself as part of its reaction)

I am agreeing with the article and giving my opinion on how that works for vestibular conditions.

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a person takes an anesthetic spray via nose and dizziness stops. There is a video by Dr.Texido where he did a live demonstration. All the ear disorders you mentioned the anesthetic spray would have done zilch. BTW the anesthetic spray works equally well for non-vestibular migraine as well.

Great, so why isn’t that prescribed for MAV and why doesn’t that eliminate it?

it is used an abortive med and it works well for acute episodes. Dizzy cook she uses an eye drops as a similar abortive as well.

Aborting is not enough. You’ve got to determine and treat the root cause.

ohh aborting a migraine is better than living the full course for 48 hours…been there a zillion times

Of course it helps. That’s obvious. But gosh let’s stop this obsession with one element of the problem.

Medicine needs to find the root causes of migraine, and not only find treatments to dampen them (as those treatments will likely have broader effects)

There are forums with 360K people with chronic migraine. If we want a root cause we got to get in line.

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For sure.

@GetBetter and @turnitaround

You two goobers arguing etiology again and missing the forest for the trees. I just said I’ve been having better MAV control on a diabetes drug than with any of the other prophylactics I’ve tried (topirimate, amitryptiline, venlafaxine, nitroglycerin, propranolol). Side effects are digestive issues but they are doable and nothing compared to psychotropics. To do their work, which was partial at best and carried a heavy toll in side effects, both ami and venlafaxine had to destroy my metabolism. Topirimate gave me permanent nerve damage and wrecked my cognition for months after I got off it. Propranolol resulted in disabling brachycardia while screwing up my blood pressure - insane for a beta blocker. With metformin I’m clear headed a lot of the time and even less photosensitive. If that isn’t a metabolic smoking gun, what more do you need?

The article is talking about systemic inflammation in the endocrine system which goes back to our autoimmune discussion. It also goes a long way towards explaining why so many MAVericks have co-morbid PCOS, endometriosis, fibromyalgia and/or MS. I’ve always said there was something wrong with me at a cellular level. This research corroborates that thought both in the discussion of pro inflammatory cytokines and a faulty mitochondrial function. And it talks about migraine like a fever - an attempt to regain homeostasis after potentially weeks of build up - which describes chronic MAV perfectly given there is always a disordered metabolic background.

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