Top Migraine Myths From Dr. Thomas Berk, headache specialist at NYU Langone Medical Center
While doctors and researchers continue to learn and discover more about migraine, and advocates continue to spread the word, there are still many widely-held myths about this chronic disease. At a minimum, these myths can be harmful or demoralizing to the patients in their search for the best treatment and care. Even worse, they can also foster widespread misunderstanding and perpetuate false information about the disease. To help put these myths to rest, we called on Dr. Thomas Berk from NYU’s Langone Medical Center to dispel the top 10 migraine myths.
- Migraine is just a headache. A migraine is a type of headache, but when someone truly has one, the pain they’re experiencing can be substantially more severe. Migraine is a neurological disease with functional and sometimes structural changes that occur in the brain. Furthermore, it is a polysymptomatic disease with headache as only one, and not even a necessary feature, of migraine. Migraine is often associated with nausea, sensitivity to light, sound and odor, difficulty concentrating or thinking clearly, vertigo, and neurological problems such as visual disturbances, numbness, speech and language impairment, or weakness.
- All headaches are migraine. While the word “headache” may sound like a catch-all umbrella term, there are many different types of headaches. There’s an international classification framework for headache disorders that doctors can use to measure headache pain, and the American Migraine Foundation created their own guide to help people with migraine determine exactly what type of headache they could be experiencing. Migraine is distinct from headaches because of its duration, severity and accompanying symptoms.
- Migraine is my fault. At the end of the day, the sole perpetrator to blame for migraine is genetics—no one is at fault when a migraine attack strikes. Stress, anxiety and depression may seem like triggers that are under your control, but it’s nearly impossible to manage all the factors that contribute to those feelings, and many triggers cannot be avoided.
- The more headache medicine I take, the more control I will have over my migraine. Unfortunately, taking more medication to treat individual attacks likely won’t help a migraine: it might actually make it worse. Some people living with migraine complain of “rebound headaches,” but the medical term for that phenomenon is Medication Overuse Headache. Taking a lot of medication to treat an acute migraine attack could lead to more frequent and more severe migraine attacks in the future, which are often more difficult to treat.
- There is nothing you can do for migraine if you’re pregnant. While some medications used to treat migraine may be unavailable to pregnant women due their harmful effects on the mother or developing fetus, there are plenty of safe alternatives. The best way to prepare for managing migraine and pregnancy is to talk to your neurologist or headache specialist about your options and design a treatment plan. It may be more complicated than it was before you were pregnant, but it can certainly be done.
- Caffeine is the cause of my migraine: Not always the culprit, caffeine is found in some of the most effective headache medications. For many patients, a caffeinated drink like coffee or soda helps alleviate head pain. The key to making caffeine work for you is to use it only when needed to avoid daily headaches or caffeine overuse headaches.
- There is a diet plan that will cure migraine. There are some foods generally thought to trigger migraine or at least lower the migraine threshold, including alcohol, gluten, monosodium glutamate and histamine containing foods, chocolate and cheese. Some patients try to eliminate any potential food triggers from their diet, but the list of potential migraine trigger foods is extensive, and avoiding all of them may be unhealthy. There is no silver bullet diet because every patient’s body processes food differently. The best thing people with migraine can do is to know their own triggers and avoid them during high-risk periods.
- All supplements that prevent migraine are safe and effective. There is some evidence that certain supplements/nutraceuticals may be safe and effective in reducing the frequency of migraine. Riboflavin (Vitamin B2) Coenzyme Q10, and magnesium may be effective. Ask any doctor or headache specialist and they will tell you whether and how to best integrate supplements into your treatment regimen.
- You must have an aura for it to be a migraine. Absolutely not true. Migraine can occur with or without aura. Whether or not a person experiences the aura phase of migraine makes a difference when it comes to navigating treatment options, so make sure you’re keeping track of whether or not you experience any symptoms of aura in your headache diary. Aura is also different from the premonitory or prodromal symptoms that many patients experience before migraine. See “The Aura Phase” and “The Postdrome Phase” for a list of aura and prodromal symptoms.
- No medication will ever treat my migraine. As headache doctors, we understand that some days it may feel like nothing can touch the migraine pain. You’ve tried everything, and now your only option is to “wait it out”. It can be a helpless feeling. Remember that you are on a journey, along with your doctor or headache specialist, to find the treatment regime that will work for you. We haven’t found a cure for migraine yet, but we have many effective treatment options and are well on our way to discovering new and even more effective treatment options.
The wealth of migraine myths spans well past the ten listed above. To help tune out the noise of the internet, stick to credible websites, and make sure to consult your doctor if you have questions. For more information about migraine, visit the American Migraine Foundation’s resource library.