Could sugar be triggering a chain-reaction that leads to early puberty – and migraine – in some girls?
A recent study took a look at various stages of puberty in girls and its relationship to migraine. The bottom line is that girls who enter puberty early may have a higher risk of migraine.
Puberty is a complex change, and it happens in stages. In girls, the change includes breast development, the menstrual cycle, and changes in hair growth, for example. Each change is related to different chemical messages that are sent throughout the body.
The University of Cincinnati College of Medicine hosted this particular study, which was presented last week at the American Headache Society 61st Annual Scientific Meeting in Philadelphia. Generally speaking, breast development and menstrual periods began earlier in girls who developed migraine.
Although we often think about the menstrual cycle and its relationship to migraine (and the connection is very clear in some women), there may be other changes that trigger migraine in the first place. As the doctor who presented the finding explained (note – pubarche refers to first growth of pubic hair, thelarche to first breast growth, and menarche to periods):
At each of these stages, different hormones are starting to appear in girls. During pubarche, testosterone and androgens are present, and during thelarche, there is the very first exposure to estrogen. Menarche is when a more mature hormonal pattern emerges. Our study implies that the very first exposure to estrogen could be the starting point for migraine in some adolescent girls.
Early breast development may happen even at the age of 6 or 7, and is not necessarily a sign of early puberty. Variations are normal, and not necessarily a sign of a problem. However, the study results have led doctors to ask the question – if certain stages of early puberty increase the risk of migraine (as seems to be the case), is early puberty itself the cause somehow? Or is something causing both?
Interestingly enough, there has been a lot of interest in the connection between early puberty, obesity, and sugar. There does seem to be a connection between early puberty and obesity (as the researchers in the above study also mentioned). But even without the obesity, too much sugar may also cause early puberty.
This combined with the current interest in the sugar-migraine connection does raise some suspicious questions. Might refined sugar not only increase your changes of migraine attacks – might it also cause migraine to start at an earlier age?
Take for example this study on girls and sugary drinks. Even if obesity was taken out of the equation, the sugary drinks were still linked to early onset of puberty.
Again, early signs of puberty are no reason to panic. However, these studies are causing us to think again about why and when migraine begins in some girls, and how “normal” refined sugar should be in our diets.
For many years, one of the resources that we have provided has been the Migraine Barometer. We will no longer have them available – but there are two left! Read on…
The Migraine Barometer was especially for those who suffered from weather related migraine. It is a high precision barometer (designed for marine use), and it kept track of a history of barometric pressure. In fact, it could even warn you of sudden pressure changes.
This was invaluable for two reasons. 1) It helped many of us confirm what type of pressure changes we are sensitive to. 2) It gave us a “warning”, sometimes allowing us to step the migraine attack before it started.
There are two barometers left, and so we are selling them at the same price as always (US$215.99 + shipping), but only to the first two people who contact me. I’m sorry, we can only ship to the USA or Canada.
Please only contact me if you’re ready to buy, so that you don’t waste the time of people who could really benefit from this barometer. Please do explain that you’re contacting me to purchase a Migraine Barometer.
Once I confirm that you were one of the two “winners”, I’ll email you the information so you can purchase.
I’m sorry that this resource will no longer be available, because it was a help to a lot of people (including me!). I’m hopeful that we may be able to find a good quality replacement, but most of the barometers that are available today do not have the precision or features for medical use.
It’s news, but it mostly isn’t news. A new study published in the journal Headache confirms again that there’s a link between colic in babies and migraine.
Let’s take a quick look at the study, and then talk about how to apply the information.
The study, published last month, set out to investigate if parents with migraine were more likely to have babies with colic. Colic, as you may know, is defined as prolonged and intense crying/fussiness, and it tends to peak in the second month before decreasing in the 3rd or 4th month (read more about colic here).
The study confirmed that mothers with migraine are more likely to have colicky babies. And if migraine was chronic, it was even more likely.
Unlike some information we’ve seen before, there was no link between fathers with migraine, only mothers.
(On the other hands, although the link between mothers with anxiety and colicky babies was weak, a father with anxiety or depression was more likely to have a colicky baby).
As the study of this link continues, there are two important applications.
You don’t hear about it too often – but yes, men have issues with migraine and hormones too.
Of course many women have a very clear, definite connection between their migraine attacks and their menstrual cycles. Although it’s not quite the same for men, there is growing evidence that there is an important hormonal connection.
First, some basic information. In popular culture, we often talk about “male” and “female” hormones. Estrogen, for example, is associated with women. But although estrogen levels tend to be higher in women, men have estrogen too – and it’s an important part of their biology as men.
Studies have been done on levels of “female” hormones in men, and even how this may relate to migraine. For example, a study in the journal Neurology investigated the estrogen (estradiol) / androgen (e.g. testosterone) ratio in men with migraine, finding that androgen levels were low compared to estrogen in men with migraine (see Female sex hormones in men with migraine).
A new study, published in Neurology International, focused on testosterone levels in men with migraine compared to the general population. Generally speaking, men with migraine did indeed have significantly lower testosterone levels. A large number of these had levels lower than the normal laboratory range.
Immediate questions arise – does migraine lead to low testosterone levels, or do low levels lead to migraine? Either way, there is growing interest in testosterone supplementation for men with migraine.
What are common symptoms of low testosterone? Well, erectile dysfunction is an obvious one – a condition that has links to migraine, especially for men in their 30s.
Other symptoms include:
Lower sex drive
Depression (strongly linked to migraine)
Increased body fat
There are good ways to increase testosterone naturally, which may help fight migraine – or the effects of migraine! Here are some quick suggestions, with links at the bottom of this article to read with more information.
Be more active. This is not necessarily 6 days a week at the gym. Just start moving more. There are plenty of great tips out there – for migraine patients, I do recommend increasing your activity gradually, but steadily. Weight training is especially helpful.
Watch out for processed foods, especially refined sugars and flours. There are various reasons why these foods can cause testosterone problems.
Prioritize sleep. It may seem like a catch-22, if low testosterone makes it harder for you to sleep. Don’t be stressed if you can’t get to sleep when you want to – but do make sleep a priority in your life. Again, there are lots of great tips out there.
Eat healthy fats and proteins. You will do this differently depending on your lifestyle, but think avocados, fish, butter, eggs, chia seeds, steaks, coconut oil, and nuts.
Get outside in the sun.You need that vitamin D. If you’re outside for 30 minutes every day but still have low levels, consider a supplement.
Researchers aren’t sure what the connection is between migraine and testosterone in men. In this recent study, evidence was collected which suggests that testosterone, as a “neuroprotective agent”, may help fight migraine and related symptoms – which means that raising your levels may indeed decrease your migraine attacks.
And one more surprise – this may even be true for women. Granted, most women aren’t looking for huge testosterone increases. But a small therapeutic increase may help women fight migraine as well, as the researchers note.
Earlier this month in the USA, the FDA approved Emgality (galcanezumab) for use with episodic cluster headache. This is a big step for CGRP inhibitors, which have shown promise for treating both migraine and cluster (for example, see this article about Ajovy).
As the official Emgality site states:
For adults with episodic cluster headache: Emgality can help reduce the number of weekly cluster headache attacks that occur during a cycle
It is good news that cluster patients have something else to try – and we hope that Emgality will help some. But much more needs to be done to help cluster headaches. Sadly, this is only a small step toward better treatment.
A study out of Denmark, published last month in the journal Headache, is raising serious concerns about the link between migraine and certain pregnancy risks. How can mothers with migraine give their babies the best possible opportunities for good health?
In the study, researchers used population registries and identified 22,841 women with migraine who became pregnant, compared with 228,324 pregnancies where there was no migraine. They then identified several areas of increased risk for the women with migraine, including:
pregnancy?associated hypertension disorders
low birth weight
There was also a higher risk of several complications after birth, such as febrile seizures.
The most concerning issue was that the increased risk seemed to be there whether or not migraine was treated – suggesting to the researchers that it was migraine disease itself that increased the risks in pregnancy, not the treatment or lack of treatment.
Although there are some weaknesses with this study, it does seem to confirm other studies that also indicate risks in pregnancy due to migraine. It’s difficult to tell exactly how medications come into play, but the researchers seem to think that medications are not explaining the risk.
At first, this may sound like information that you can’t use. After all – if there’s no improvement with treatment or without treatment, who cares? But several things need to be kept in mind.
This study only found some associations with migraine, and further study will be needed to confirm. This is not to say that treatment is will not help you and your baby during pregnancy.
Anytime there is an indication of increased risk, what can you do? You can decrease your risk in other areas. If there is a risk of hypertension, there are ways to lower your risk.
Just because there is an increased risk does not mean it’s a high risk. This is very important to remember – the risk from migraine is still low.
Pay attention to your own symptoms and talk to your doctor about them. A registry based study like this one relies a lot on minimal information collected after the fact. There are a lot of issues that may cause headaches, migraine, and changes in your symptoms. It’s not “just normal” in pregnancy.
A new study casts some light on Botox (onabotulinumtoxinA) treatment and how side effects change over time. If you’re using Botox to treat chronic migraine, or if you’re considering it, take the time to look at this study.
This study comes out of the USA and was published this month in Drug Safety: The Official Journal of the International Society of Pharmacovigilance. It compiles about two years of information from what was called the COMPEL study – The Chronic migraine OnabotulinuMtoxinA Prolonged Efficacy open-Label Study. Although “long term” was only about 2 years, the study does provide valuable insights into the side effects of Botox.
Before we get to the specific side effects, it’s worth noting that the study does confirm the general safety of Botox treatment. Although many patients withdrew from the study for various reasons (such as simply not staying in contact or not following the study protocols), only 3.5% withdrew specifically because of “adverse events” or side effects.
Only a small percentage of those were “serious adverse events”, and the researchers believe that only 1 patient (716 started the study) had a serious adverse event actually related to the Botox treatment – and that was a rash. Of course, there are always patients who respond poorly to medication (or even to food!), so this is a pretty good record.
But Botox is not completely free and clear, because there were reported side effects. First, let’s look at the common ones. Then stay tuned for a very important clarification.
Here are the most common side effects. None of these were common – in other words, you’d be unlikely to find even one patient in 10 with the most common side effect.
Eyelid ptosis (droopy eyelid)
General stiffness or weakness
Pain at injection site
Headache and/or migraine symptoms
Facial paresis (muscle weakness)
Now if you’ve experienced any of these side effects, there may be some good news for you. The side effects did tend to lessen with repeated treatments.
In this study, treatments were given every 12 weeks. The neck pain was the worst after the first cycle – it decreased significantly after that. Headache and migraine symptoms were the worst during the first two cycles (migraine symptoms actually increased during the second cycle), and then significantly decreased. Droopy eyelid decreased significantly in the second cycle, and then almost disappeared.
Generally speaking, side effects decreased after the third cycle. By the fourth treatment, side effects were drastically decreased.
Now if treatment isn’t helping at all, you’re not likely to stick with it for four treatments. Remember, at every 12 weeks, that’s about 11 months. However, if you find that Botox is helping after you’ve tried it two or three times, you might be encouraged to know that the side effects should be far less at treatment 4 (or even 3) and beyond.
It will be interesting to see even longer term studies in the future. But at this point, this study confirms what other studies have shown us. Side effects are minimal, and tend to be even fewer as the months pass.
Once again a very eclectic list makes up the articles that were most popular to guests here at Headache and Migraine News. Both symptoms and treatments are highlighted this month. Here are the links, with a little introduction to get you started. The most popular article of the month is first.
New Approaches to “Aggressive” Migraine Treatment Migraine symptoms are sometimes “endured” for months or years without serious focus on treatment. Many people are being told that migraine is “normal” and that they just have to “put up with it”…
Eye Drops for Migraine revisited – a low-cost treatment? A few years ago we talked about a possible “$5” treatment for migraine – Timolol eye drops. Since then the price may have increased slightly, but researchers are still interested in the possibility that such an inexpensive treatment may work well for many migraine patients…
Fighting Stress as an Adolescent Although you should never accept the “it’s just stress” diagnosis of migraine or headache, it’s clear that there is a link between the two. Minimizing the negative effects of stress can certainly have a positive effect on your life…
Recently TED-ed posted a little introduction to some of the complexities of pain. Take the time to watch it below. It’s critical that we start thinking about these things, so that we don’t over-simplify either our condition or our treatment.
The video is just 5 minutes long.
The mysterious science of pain - Joshua W. Pate - YouTube