Phase 1: “DETOX“
“The road to hell is paved with good intentions”
One of the tragic ironies of migraine care in the past several decades is that the well intentioned efforts of those in the health care community (myself included) have created a massive and growing epidemic of chronic headaches.
Our medicines have turned what should be a transient and episodic condition to one that is chronic and lifelong (note that if you’re a maker of migraine medicines, this is very good for your bottom line…).
The introduction of Sumatriptan in 1993, the most effective migraine remedy ever made, should have dealt a mighty blow to the beast.
A drug so effective should’ve put headache specialists like myself out of business.
Yet, rates of chronic migraine have only risen.
With the best of intentions, we in the health care community implored migraineurs to keep their abortive medications with them, so that they could take them “at the first sign of a headache.”
What we failed to appreciate was how devastating a strategy this was over the long term, that we were trading a short term fix for a lifetime of misery.
So why didn’t Sumatriptan (or any other migraine relief medication, for that matter) spell the end for the beast?
Because it actually made the beast stronger.
Cut to my clinic today, where roughly 8 in 10 new patients I see are in rebound. I cannot overstate the scale of this problem.
In fact, in over ten years of practice, I can’t recall a single migraine patient who met the criteria for phase 1 who wasn’t in rebound.
Why is this so important?
Because until rebound headaches are broken, nothing will work.
Repeat: until rebound headaches are broken, nothing will work.
In fact, a migraine that no longer responds to migraine-specific treatments (like sumatriptan, etc.) is one of the signature features of rebound headaches.
So, for Phase 1, breaking rebound is top priority.
Doing what it takes to get there requires courage, no doubt. Because doing what it takes is not easy. It’s both the most difficult and most important step you’ll ever take.
But the decision here is a simple one. Either continue on the current path, the one that’s led you to and will keep you having chronic headaches, or choose to walk a different one.
The upside here is tremendous.
I’ve seen many a patient who’d been in rebound for DECADES, who’d accepted that chronic headaches were as much a part of them as the color of their eyes.
And I’ve seen those same people with tears in those eyes after seeing those headaches vanish.
Since 99.99…% of the patients I see in Phase 1 are in rebound, which is the direct result of drug-induced damage, Phase 1 is all about…DETOX. A detox for your brain, and a vital first step.
What follows is the guide to moving past Phase 1, along with specific links for each topic.
PHASE 1: Highest Priority Behaviors
Reduce medication consumption. For more on getting out of rebound headaches, click on the resources listed below. Be sure to download the Frequently Asked Questions about rebound headaches (if you’ve been on addictive headache medications like opiates or butalbital, then consult with your prescribing physician on how to best taper off of them). Finding alternative strategies for dealing with and eliminating a migraine is also of central importance.
1. 7 Warning Signs You’re Having Rebound Headaches
2. How To End A Rebound Headache
3. Frequently Asked Questions About Rebound Headaches
4. 11 Drug-Free Ways To End A Migraine
Eliminate mismatch foods and behaviors. The cornerstone of the Migraine Miracle plan is to reclaim the diet and lifestyle that’s appropriate for human beings, as migraines are provoked when we eat foods and engage in behaviors out of sync with our biology. They occur when there’s a mismatch between the food our body expects us to eat, and the food with ACTUALLY eat (this is why hunter gatherer humans don’t get them).
Highest priority for elimination are processed foods, especially those with wheat and added sugar. When in phase 1, you are walking the thinnest of lines, hovering so close to the headache threshold that virtually anything can send you across.
For this reason, those in phase 1 should ease their way into this, ESPECIALLY if you’ve been eating a higher carb diet with processed foods.
How To Eat Your Way To Migraine Freedom
Migraine As The Hypothalamic Distress Signal
Seek Stability. Migraines are often provoked by changes in diet and lifestyle (weather fronts, staying up late, etc.). And so maintaining stable eating and lifestyle patterns is essential to their prevention. This is doubly important when in rebound.
Maintain blood sugar stability. Eliminating the wild swings in daily blood sugar triggered by high carb foods is one of the key components of lowering your vulnerability to migraine, and of starving the beast of fuel. If you are easing your way into this and reducing daily carbohydrates gradually, still avoid eating high carb foods in isolation.
Articles: The Spark and the Fuel
Minimize stress hormones. For a typical modern human, stress – in this case psychological (rather than physical) stress – may account for more physiologic upheaval than anything else. The typical human today has far more adrenaline circulating through their blood day to day than our pre-civilized ancestors did, despite the fact that our world is much less dangerous!
The thoughts running through our heads, through the triggering of stress hormones, CAN have tremendous power over our biology/physiology. And this roller coaster of stress hormones is immensely damaging for the migraineur.
But, it doesn’t have to be this way! Cutting the connection between thoughts and your stress response can pay huge dividends in moving you forward along the freedom timeline, not to mention long term health and happiness. So many folks overlook this piece – don’t let that be you!
Article: The Power of Thought
Book: The Untethered Soul, by Michael Singer
Apps: Headspace, Calm (effective and easy ways to get started)
PHASE 1: Other Strategies to Consider
Join Migrai-Neverland so you can take the Beast Slayer Training Academy that covers all these strategies plus more for how to break rebound. Learn more here.
Intermittent Fasting. Like nutritional ketosis, intermittent fasting is gaining increasing acceptance as another component of a healthy lifestyle.
Also like nutritional ketosis, it appears to be a potentially powerful weapon against cancer, degenerative brain disorders, and aging. I do it essentially every day (I found eliminating breakfast to be particularly helpful), as do many of our members, especially as a means of ending a migraine attack.
1. How To End A Rebound Headache
2. The Beginner’s Guide to Intermittent Fasting, by James Clear
FOUNDATIONS, aka “Migraine 101”
The following are a list of articles covering topics that aren’t necessarily specific to a particular phase on the Timeline of Migraine Freedom, but that I think constitutes the core knowledge base that every migraine sufferer should possess.
- What Are Migraines? (a 3-part series)
- How To Trigger A Migraine (a 2-part series)
- Frequently Asked Questions About Migraine