Finding the source of migraines (and fifty useless migraine drugs)

My favorite n=1 experimenter, Seth Roberts, wrote about how someone managed to greatly reduce her migraines by avoiding certain household chemicals.
Sarah MacDonald (pseudonym) started getting migraine headaches the summer before she started college. During her first year of college, she was in a car accident and hit her head. Her migraines got much worse. More than once a week, she had to stay in bed all day, in darkness and silence, not eating anything. She tried pain killers. None worked. "They spread out the pain," she said. "They made me totally stupid." The only relief was sleep. The summer after her freshman year (2004), she stopped getting her period. In November, she saw a doctor near her university (Mount Allison, in New Brunswick). Blood tests showed that her prolactin was way off. The likely cause, said the doctors, was a tumor on the pituitary. But CAT scans and MRIs found nothing. The tumor must be small, her doctors said. It would grow and become visible. She waited for this to happen. Her doctors kept ordering new scans, looking for the tumor. Eventually she had two CAT scans and five MRIs. None found a tumor. During the year of waiting, she tried about fifty different drugs. None helped. I'm getting desperate, she told her doctors. "You need to give the medicine more time to work," they said. It was almost a requirement of treatment that she start taking birth control pills. Over the same year that she tried fifty drugs for her migraines, she tried thirteen different birth control pills, hoping to find one that was tolerable and made  her migraines better. She never did. None of them made her migraines worse, but some caused nausea.
In January 2006, unhappy with lack of progress, she stopped taking all medicines, including birth control pills. Her migraines didn't change. In April 2006, she moved to a new apartment. Because she didn't have a roommate, she had total control of her living space. She had been reading about environmental causes of migraines. She was especially impressed with Annie Bond's story. Bond lives in upstate New York. In the 1980s, after the restaurant where she worked had a gas leak and her apartment building was fumigated. Bond started having all sorts of health problems. They turned out to be due to chemicals in household products. Perhaps the conjunction of gas leak and fumigation made her hypersensitive. Bond's story, plus other stories Sarah found on the Internet, suggested that three sorts of chemicals were dangerous: 1. Sodium lauryl sulfate (a foaming agent). 2. Methyl and ethyl parraben (preservatives). 3. Artificial fragrances. Sarah purged her apartment of anything that contained them or similar chemicals: bodywash, makeup, shower cleaner, laundry detergent, all cleaning products, deodorant, anything that went on her body. She decided there were five household products she couldn't live without: moisturizer, deodorant, laundry detergent, dish soap, and toothpaste. She got new versions of them at a health food store. This helped a lot. "That summer [2006] I missed only four days of work," she said. "It was miraculous and totally shocking." In the summer, she didn't have exams, which were stressful. Maybe the decrease in migraines had been due to less stress. When school resumed in the fall, however, her migraines continued to be relatively rare, about two per month. The elimination had really helped. During the 2006-7 school year, she had a roommate. They fought about cleaning. Her roommate liked the lemon scent of Mr. Clean. But something in Mr. Clean caused trouble. "If she cleaned the bathroom, I'd have a migraine the next day," said Sarah. Because the time between exposure and the resulting migraine was short, she was able to figure out which chemicals caused migraines. Over the school year, she introduced, one by one, dozens of cleaning products, usually ones her roommate wanted. She figured out that artificial fragrances were bad, as she had guessed, but that sodium lauryl sulfate and the parrabens were okay so long as she did not have direct contact with them. If her roommate used her own dish soap, laundry detergent, toothpaste, and body care products (shampoo, soap, moisturizer), Sarah was fine. After graduation, she moved to Kentville, Nova Scotia. She had to move her medical records, too, so she brought them to a general practitioner. He looked at them. "We'll need to have MRIs done," he said. I'm done with that, Sarah told him. It didn't go over well. Because of  her GP's insistence -- she was still getting two migraines/month -- she saw another round of specialists: endocrinologist, gynecologist, ear nose and throat doctor, neurologist. The endocrinologist said, "There's a lot of scare stuff on the Internet. It's hard to pick out the good science. Most of it is placebo effect. You just think it works." He said this after Sarah had been immensely helped by "stuff on the Internet" and not helped by dozens of drugs. The (male) gynecologist insisted she take birth control pills. "You're being an idiot about this," he said. "You're 23 and you don't want to have kids."  Sarah refused. The estrogen in birth control pills can make migraines worse, she said -- and she was seeing him because she had migraines. They argued so loudly the office manager could hear them. The gynecologist gave her a birth control prescription anyway, which she ignored. The neurologist did a 45-minute physical. When he was done, he said, "Yes, you've got migraines. Have a good life," and left the room. In 2008, her oldest brother, an acupuncturist, told her she should have a cleanse to get the toxins from the drugs out of her system. She decided to see a naturopathic doctor. (Naturopathic doctors are closer to conventional doctors than other naturopaths.)  She saw Dr. Susan Ritcey, of Hawthorn Naturopathic Clinic, who specializes in migraines. Dr. Ritcey did something the conventional doctors had never done: study Sarah's tracking records. Sarah had recorded her periods, migraines, chemical exposures, and other things for several years. The doctor noticed there was a fixed period between the timing of Sarah's remaining migraines and the start of Sarah's periods, which she interpreted it to mean Sarah's progesterone levels were low. A saliva test confirmed this. (Conventional doctors, in Sarah's experience, never did saliva tests, although they were covered by her insurance. Researchers have used them to measure sex hormones, such as testosterone.) Dr. Ritcey prescribed a topical cream of wild yam to increase progesterone. Sarah applied it daily for three weeks before her period for three months. Her progesterone level became normal -- and her migraines less frequent. By now, they were almost gone -- less than one per month. She found that several triggers around the same time were required to produce one. Triggers included a drop in air pressure, exposure to cleaning chemicals (e.g., at school), and perhaps fluorescent lights. Everyone understands that conventional doctors can't always help. What's striking about Sarah's story is how easily she did better. Sarah's conventional doctors had gone to medical school, passed a licensing exam, trained as residents, and accumulated years of clinical experience. The research behind their recommendations cost billions of dollars (developing fifty useless drugs, for example). Sarah was an undergrad cognitive science major. Her research was free. Her conventional doctors would have discouraged her from seeing a naturopath. The American Cancer Society says that "available scientific evidence does not support claims that naturopathic medicine can cure cancer or any other disease." Yet her naturopathic doctor greatly helped her, while her conventional doctors arguably harmed her. The year she took their advice was a year she made no progress -- a year of excruciating and frequent migraines and fifty useless drugs.


  1. Just one part I don’t get; why couldn’t her docs prescribe a diaphragm? They’re silicone, no latex, and no hormones–there are plenty of women who use them because they can’t deal w/ b/c pills.

    Allergies are a bitch to figure out; my husband has had to do something similar to Sarah to get his food allergies under control, and he finally did. His doctors weren’t hostile, just unable to be much help.

    1. I don’t think it was so much about her having kids, as much as them trying to use some of the (side) effects of BC to help with her migraines.  Though why the need to point out the doc is male is beyond me.

    2. I’m not a doctor, but to me it seems the reasoning behind the ‘take the pill’ advice might have more to do with hormone levels than getting pregnant.
      The naturopath came to the same conclusion when s/he told her to use a topical cream to increase her progesterone* levels. The common birth control pill** elevates your progesterone too (besides increasing your oestrogens). 


      1. Birth control pills do NOT elevate progesterone; they are synthetic progestins that do not duplicate all of endogenous progesterone’s effects–they’re great at preventing birth, but crappy at preventing migraines, etc.  Often, the progestins in BC’s make migraines worse…and very often, proper progesterone levels (with supplementation if necessary) will decrease migraine frequency and severity. 

        Of course, you still need to avoid known triggers as well.

    3. Because it wasn’t about contraception.  They wanted to put her on the pill because they thought the hormones would help her.  Notice that natural progesterone did help balance her out; but often the artificial hormones in the contraceptive pill make migraine worse.  My migraines started around the same time as I was put on the pill in my teens.

    4. Because they weren’t prescribing it for birth control purposes, they were prescribing it because they were trying to treat a hormone imbalance.  It’s not uncommon.

  2. I have an interesting anecdote. My mother, who never had much more than the occasional ice cream brainfreeze, suddenly started getting severe headaches. She suffered from constant day and night migraines that would only ease up slightly for a period of about 4 years. She had gone through many tests for tumors and taken many different medications with no relief. She even tried accupuncture and a couple other alternative treatments.

     Just when she was about to give up, she was diagnosed with lung cancer. (she was not a smoker, and we still aren’t sure if there was a cause of the cancer). 
    She had surgery to have half of one lung removed and when she woke up after the surgery the headaches had completely gone. She survived the surgery and has now gone about 1 1/2 years without recurrence. All scans are showing up clear. Which is great, but the real unexplained miracle is how the headaches just disappeared. It’s really weird in a good way. I feel like someone should have looked into this a bit more for those people in similar situations. But her doctor she had been seeing about the headaches just seemed to happy agree that it was strange but unexplainable.

    1. Interesting – I had started getting stabbing pains behind my ear about two years ago. Frequent enough to be a bother, but not enough to really investigate. One day I realized – pain from a node on my neck on the left side. Pain from teeth (they felt tight) on the left side. Sharp pain behind the ear on the left side. Always the left side – and there are facial nerves connecting all of these spots. I finally saw my GP about it, who referred me to an ENT.

      I went in for some scans, and they discovered the node on my neck was actually a very small tumor – an epimucodermoid. However, it was growing right next to a nerve and irritating it, causing pain spikes all along it – I actually ended up on vicodin before the surgery, not afterwards! Once the tumor was removed, and the pains – all of them – shut off like a switch, and have never recurred.

      Or as this article suggests, I could have gone online, taken some herbal remedies, had some acupuncture – and died of an undiagnosed cancer.

      I’m not saying avoid natural remedies completely – after all, at some point they worked in some fashion for someone, or we wouldn’t still use them. However, don’t make them your first line of defense – you don’t know what’s in them, why or if they work, and how they’re going to interact with your body, other medications, or each other.

      1. cool. yeah it was mostly shooting facial pains in my mom that would move around from day to day.. I think they also removed a small tumor in a gland or something.. I don’t really understand how the nervous system is connected, but I wonder now if it was something like your situation.
         I really am skeptical of these cleanses and such. I am also skeptical of drug companies pushing drugs with all kinds of side effects for ailments we didn’t know we had, but sometimes science actually has some answers. 

      2.  >Once the tumor was removed, and the pains – all of them – shut off like a switch, and have never recurred.
        ALWAYS happy when I read of someone miraculously escaping terrible pain. You are very fortunate.

    2. Some lung cancers are really weird, there are effects called ‘paraneoplastic syndromes’ where the cancerous tissue starts producing hormones and peptides identical to other body cells or have similar action. Steroids, adrenalin etc can all be produced and have bizzare manifestations (think men lactating etc). It’s a fascinating phenomenon.

  3. Yes, shall we have a long multipage article for the MILLIONS AND MILLIONS of people who are helped every day by modern medicine?

    Great, this will ensure I have more long discussions with my mother-in-law about natural remedies (you know, those things that we don’t know what’s in them, why they do what they do, what they interact with, and are completely unregulated – but hey, they’re *natural*).

    1. “…natural remedies (you know, those things that we don’t know what’s in
      them, why they do what they do, what they interact with, and are
      completely unregulated – but hey, they’re *natural*).”

      You mean like St. John’s Wort, which has been studied intensively in other countries but is pooh-pooh’d here in favor of prescription anti-depressants, which we really don’t understand at all, but are regulated? That kind of natural remedy?

    2. Of course conventional medicine helps people every day; and there are some things that natural medicine can’t help with.  A good example for both of these is emergency situations.  The point is that they’re both useful but in different ways. In this case, natural medicine worked.  In other cases, conventional.  It’s not an either-or situation.  There’s nothing in this article that suggests that conventional medicine is completely useless, I don’t understand why you’re assuming this implication.

    3. Yes, feel free to post about the successes of modern medicine and I’ll post about the failures. Then you can post about the failures of alternative medicine and I’ll post about the successes. Let’s put all the relevant evidence on the table so people can judge for themselves and find a cure for whatever ails them.

      Isn’t finding what works the most important thing? Or are you more concerned with ideological loyalty?

    4. Cut me a break, I had debilitating migraines for years. Always thought they were simple headaches. When I finally discussed this with a doctor friend, he diagnosed the problem and prescribed Imitrex. Guess what, now when I take imitrex [actually a generic] it goes away. There are even newer orthodox drugs but imitrex worked for me so I stick with it. I have friends who have bought this Nautropathic stuff and they go from cure to cure, magnets, accupuncture,    etc. There simply is no substitute for science.

      1. So, you’re saying that anecdotes are data as long as they’re your anecdotes?

  4. Sigh.  Anecdotal evidence being used to attack conventional science = major fail.  While I’m very glad ‘Sarah’ found some relief from her migraines, she’s far from a typical patient.  Those 50 drugs are not ‘useless’, they didn’t work for Sarah.  Her doctors tried them in all likelyhood because they’ve been shown to work for patients with migraines in the past.   This piece was obviously written by someone with an axe to grind against conventional medicine.  N=1 is not science, it is narrative.  Personally, I’m a big fan of alternative medicines, and have had overall good results.  But, as my Dr. in S. Korea used to say (had a western MD + a 4 year doctorate in accupuncture & oriental medicine): “You get a cold, come see me.  You get a car wreck, go to the ER.  You get cancer, go to your Dr for chemo & surgery, AND you come see me.” And as my spiritual teacher used to say “The best time to cure your cancer energetically is BEFORE in manifests in your body.”

  5. The “developing 50 useless drugs” parenthetical is BS.  They were useless to her but they certainly aren’t useless.

  6. The article doesn’t propose one cure, but lists multiple steps the woman took to remove triggers from her life. I have a similar list, products with fragrances are on it as well.

  7. Calling “bullshit” on her carefully documented experience is pretty much the same ignorant reaction most of her doctors had. 

    Doctors, with all their training, really just play the odds – which is successful most of the time, as would be expected. This makes sense because they see many patients – most are helped, some are not.

    Patients who don’t benefit from the “playing the odds” strategy are basically on their own. If your cytochrome P450 enzymes are not within the normal range of metabolism of the general population, you will have different effects and side effects from the drugs doctors like to drop into unsuspecting bodies. This is just one possible example of an outlier attribute of a patient – there are of course lots and lots. Modern medicine, with doctors playing the odds and maximizing # of patients they can see in an hour to boost the bottom line, simply cannot deal with outliers.

    Dropping a quantity of a biologically reactive drug into a system as complex as the human body is without knowing how it would affect that individual body could be seen as deeply irresponsible, yet doctors do it every day, all day. As a society we accept such risks, and the occasional casualties.

    Yet you have this strong reaction to a frustrated and long suffering patient doing something as harmless as avoiding a few chemicals and getting good results? Why the intense bias?

    1. If you *can* identify and avoid specific triggers, fine – that’s called an allergy, and we deal with them much the same way. The intense objection to this article is now it portrays all of medicine as “useless” because it didn’t work in this one outlier case – but nevermind the millions of people it does work for. It paints the doctors as incompetent and uncaring – personally, I’ve only ever met a single doctor who I *wouldn’t* describe as deeply caring, and if “x” works for 99.99% of cases – you try that. She was in the 0.01% – well, sorry – medicine is not going to be able to get that specific. You do not get your own Dr. House and team (oh, how doctors *hate* that show).

      “Dropping a quantity of a biologically reactive drug into a system as complex as the human body is without knowing how it would affect that individual body could be seen as deeply irresponsible, yet doctors do it every day, all day. ”

      Except for doctors, those chemicals have been rigorously studied and analyzed, the effects are known, the interactions are known, the epidemiology is known. But lots of people will go and read on the internet that echinacea worked for this random person, or take a vitamin designed by a teacher, and who knows what – if anything – that stuff will do to you.

      I’ll take the stuff with decades of research and studies behind it, with firm “this does this because of this”, rather than “oh, apply pressure here and your spirit will flow differently”.

      THAT is where the “bullshit” comes in.

      1. Why do you insist on dismissing her taking an active role in her own healing process by equating her with fringe beliefs (echinasia, chriropractors) that were never even mentioned in this article? Mainstream medicine has plenty to learn, that’s why it changes so quickly, and its quite probable that the revolution in human communication that the internet has enabled in only the last few years will have a HUGE effect on medicine’s development.

        Its easy to call other people wrong when you have nothing to lose. But something tells me you’d open your mind very quickly if you had a condition that traditional medicine isn’t able to deal with very well, like migranes or lyme disease to name only two.

        1. Oh, I have nothing to lose and have never had a condition that medicine didn’t deal with well? I dealt with choking at most meals for over a dozen years that couldn’t be diagnosed – motility scans came up with nothing, no physical signs, etc. I choked for hours, heck, I choked through my prom night. Does that count for you, or do I still have “nothing to lose”?

          Ultimately I *did* find a cure when my mom ran into a similar issue, and a drug she was on stopped it – prilosec. I started taking it and it likewise turned that off like a switch. If I go off it for a couple days, I start choking again.

          The difference is that with science and a medical approach, I can at least understand the reasoning here. The choking was caused by esophegeal damage, which was in turn caused by excessive acid production. However, since it manifested as choking, I and the doctors were looking for a solution in the neck region – not the stomach.

          That doesn’t mean the doctors were uncaring, incompetent, or the drugs and things we tried before were useless! It just means that in a complex system we didn’t manage to identify it immediately. Now I know exactly what caused it and how to address it – I’m not guessing at things I read online.

          Had I self diagnosed (and let’s assume I discovered the acidity link) I could have done things like drink more milk and manage my acid balance indirectly – or I can fix the root cause and reduce the production of acid. Self diagnosis would have led me to change your diet to partially address a problem. Medical diagnosis fixed the underlying problem.

          1. You realize you just claimed that you’ve had a condition that traditional medicine couldn’t deal with, and as proof cited a condition that traditional medicine cured, right?

          2. Taking PPI’s for the rest of your life is not a cure – that’s a bandaid.

            A bandaid with long term side effects, like impaired calcium and iron absorption.

            Have you explored any other ways of addressing the root cause other than dependence on a powerful synthetic drug? I’m not saying you will find one, but you might, and your long term outcome would benefit

          3. Actually, a naturopathic doctor would go even further, and investigate why you are producing excess stomach acid, and try to correct that imbalance.  Currently, you are artificially suppressing the imbalance with medication.  This is not enough for some people, who cannot tolerate drug side effects, are worried about long term health risks, or simply can’t or don’t want to pay for long term drug therapy.

        2. Well, I have had migraines for years now, and I have always been skeptical about the promises of alternative “medicine”.  I had to be very patient(no pun intended) while my doctors tried various  things.  Along the way I found I had sleep apnea- which, while treating it did not help the migraines, I was glad that I didn’t skip some steps and go straight to some reiki nonsense.  Since I was willing to work with my doctors- who respect a flexible and intelligent patient, and respond in kind- we were able to discover my Meniere’s disease, which is the cause of the migraines.  Now I am treating that and finding improvement.  It’s in our nature, I suppose, to rely on superficial or magical thinking.  We’re all guilty of it- myself included.  But it’s generally worth it to lean on the science that is rational and established.  My guess would be that the lady in the article had a particular problem that has nothing to do with the magic vs. science debate: her doctors were jerks.  Caveat emptor.

      2. The decades of research and studies funded by the companies that need to make money on this stuff. How trustworthy is that?

      3. ”   ‘we’ deal with them much the same way “.  So, you are an md then?  btw-you do know there any number of western pharma drugs that have had double blind placebo studies done for specific conditions/symptoms that are then successfully used for off label for other symptoms/conditions.  And, you also know that there are any number of the again FDA approved drugs with their attendant phase approvals, that had initially been considered purely homeopathic, such as Coartem used to treat the often intractable disease, malaria that was developed from Chinese wormwood.

        I am not saying that the above scenario doesn’t sound like the plot of Todd Hayne’s, “Safe”, just that when “science” does not serve you well, some find relief in other modalities.

        For example, I find marijuana cures my sense of unfounded superiority and its symptoms of snarkiness.  Now if they could just find a synthetic and patentable version of THC and a bajillion spent on pharma funded studies, FDA approval, marketing and advertising, my insurance would cover it.

      4. Actually not called an allergy, it’s called a trigger.  An allergy generally refers to an IgE response.  IgE/allergic response is not one of the many theories suspected in how migraines work. 

        1. Yes! Thank you for this.

          The difference between an allergy (immunological, and can kill) and an intolerance (not immunological, can’t kill, can make you very unhappy) is not well understood.

          My son has some allergies, and a boatload of intolerances. Thankfully he can tolerate most scents, and we’ve only reached the point we’re at now with the guidance of his paediatric allergist and a consulting dietitian who has extensive xp in the field of food intolerances. The work done initially by Feingold into salicylates affecting behaviour after aspirin became widely used was greatly expanded on by a PhD candidate Anne Swain at the Royal Prince Alfred Hospital in Sydney in the 1980s. Included in this research is work on the role that frangrance can play in individuals who are prone to intolerances.

          Her research has now been expanded to the point where the RPAH has a diet that is often referred to as the RPAH Elimination Diet, or FAILSAFE, and it is low in salicylates, amines, glutamates, and free from most additives, natural OR artificial. In my son’s case, he’s also free from egg, nuts, dairy, gluten and soy. The downside: I spend most of my life cooking for him. The benefits? He’s no longer in chronic pain, covered in eczema, scratching, throwing tantrums, hyperactive, teary, angry, aggressive, and he sleeps now.

          As there are no tests for intolerance, all of the work we’ve done has had to be anecdotal. Anecdotal isn’t the devil in itself, but in the wrong hands you end up with BS like “eating apricot kernels will cure your cancer”.

          Just my 2 cents.

      5. For me, you just nailed the issue on the head.  You do NOT get your own team of doctors to look into your issue, so if conventional medicine isn’t working, it is up to you to try other things.  There is a lot of BS behind “natural” remedies, but our medical system sometimes makes giving quality care difficult however you slice it.

      6. “I’ve only ever met a single doctor who I *wouldn’t* describe as deeply
        caring, and if “x” works for 99.99% of cases – you try that.”

        Wow, you are intensely lucky. Also, probably male. Most of the doctors I’ve met (lots of pediatricians, family doctors, gynecologists, and OBs) were too busy to give ten minutes, much less to ‘deeply care’.

        “But lots of people will go and read on the internet that echinacea
        worked for this random person, or take a vitamin designed by a teacher,
        and who knows what – if anything – that stuff will do to you.”

        Which isn’t relevant, since that’s not what happened here.

        “I’ll take the stuff with decades of research and studies behind it, with
        firm “this does this because of this”, rather than “oh, apply pressure
        here and your spirit will flow differently”.”

        Umm… RTFA? She did take the stuff with decades of research, so why are you complaining? Should she have just stayed sick? If so, why?

        “THAT is where the “bullshit” comes in. “

        The bullshit comes in when you realize that your anecdotal experiences with physicians are just as unlikely as her anecdotal experiences.

        To everyone who is calling BS on her fairly scientific trigger study:

        I’d like to note that what she did was rather scientific. She
        proposed a hypothesis, formulated testing, and came to conclusions over
        time. This is something that her physicians should have done from the
        beginning, because many, many migraine sufferers have ‘triggers’. This
        isn’t exactly news, and every physician should both know this and be willing to do something more than write a prescription.

        Personally, I went through several (civilian) physicians who just wanted to write me a
        prescription that knocked me out for a day whenever I got a migraine. (I changed physicians so frequently, not because I was
        dissatisfied with them, but because we’re military and kept moving.)
        Finally, we settled down and got a new doc, who refused to write a full
        scrip. He gave me a partial and told me to start charting my days. We
        eventually figured out that I get light-induced migraines and rarely
        have to take any meds.

        Tl;dr: What, exactly, is wrong with studying your habits to find a trigger? Is it that she didn’t wait for a physician to propose the idea?

      7. Yes these drugs have been tested rigorously – and sometimes dangerous effects become known about them years later.  It’s not infallible.  They are also ‘pushed’ (and one of those doctors did ‘push’ the contraceptive pill on that woman) by powerful pharmaceutical corporations that sometimes downplay side effects, because they are enormously profitable.  They downplay herbal remedies because they can’t patent them.  Yes, herbal remedies in most cases have not been tested in the same way, but because they have been used for millenia in some cases (especially Chinese medicine) there is perhaps greater confidence in their efficacy. 
        Again, I say it’s not an either-or situation.  For some things, conventional medicine works brilliantly.  For other things, complementary medicine is best.  That’s why it’s called complementary.

    2. Good response, I was about to say much the same thing, though less eloquently.

      But I don’t understand why the mods deleted the post you’re responding to? It was a bit condescending in the way it claimed this article was worthless, but was pretty representative of the prevailing point of view that patients should be passive and submit to the all encompassing authority of doctors.

      Anyway, I think the way the internet lets people suffering from an illness share information much more efficiently than the traditional medical journals is quite a force. Of course you need to filter out all the hypocondriacs and wingnuts, but when you’re suffering from a disease that the medical orthodoxy can’t comprehend, that’s a small price to pay.

  8. I’m glad she figured out a relatively simple solution to her particular problem. I agree with the take an active role in your health care points not so much with the modern medicine is useless bits.

  9. I am as skeptical of homeopathy, natural medicine etc as anyone else, heck I live in Santa Cruz, the hippie haven of the Bay Area… I am well exposed to all the feel good pseudo science baloney.. you can’t go more than a few blocks in some parts of town without running into a store that sells crystals, natural medicine, buddha statues and psychic readings. What I am less skeptical of is an individuals ability to deduce what worsens or improves their own afflictions. I myself suffer from HS (hidranenitis suppurotiva) and have had it since I was 16, and I can tell you this.. my doctors didn’t know what it was, dermatologist didn’t know what it was.. but they all prescribed me tons of anti-biotics and accutaine. That stuff was the worst, I gave up taking it after 3 years because the side effects just made my affliction worse. Fast forward 20 years and I find a support group for sufferers of my affliction. I am able to self-diagnose and begin a regimen of taking 2 specific supplements of turmeric and flax oil daily and my affliction is 90% better. It’s like night and day if I skip taking it, my affliction worsens. Pay attention to yourself and do what works, and also go to the doctor routinely, just don’t expect them to support your insights.

    1. Is there some reason you chose to discuss your affliction as if everyone else knew what it is? Not that it’s necessary to get your point, but you go into a lot of detail, yet fail to actually explain what the problem is (hidranentitis suppurotiva is gibberish to everyone else). Yes, I googled it :)

  10. well townandgownie,maybe you don`t get migraines?I do,I`m nearly 60,have had migraines for more years than I care to remember and taken just as many useless drugs to prevent//remove the migraine.They don`t work.Above article stands true for me! Find what triggers your migraines and avoid! My main trigger,drop in air pressure,the only one I can`t avoid.My bad luck eh? But I can avoid the chocolate,coffee and perfumes with vanilla………keep taking the tablets,if they work for you!

    1. You are the first person I have read-talked to that has problems with vanilla!  I DO TOO!  I take migraines–BUT AT THE TIME they were so bad I had a special needs grandson living with me, I had to keep one eye open all the time and was in a terrible marriage.  NOW the grand lives with Mom, I am divorced, watch my diet, what I clean with, being around dust (my house or other houses), keeping mold at bay,  being out doors on high pollen days,  not drinking soda from cans and most of all being around perfume!  The air pressure is one thing that we can’t control but can still trigger my migraines.  It took me several years to figure out most of this stuff.  Thankfully I had a doctor that worked with me, suggesting that I keep a diary of migraines.  STRESS CAN CAUSE MIGRAINES!!! Most often the cluster types.  It took many tries to find a med that worked, EVEN to the point that I tried SEVERAL FORMS of a med.  For me, the IMTREX NASAL spray worked where the pill or shot did not!   BUT Finally I am living MY life.  I rarely take meds for the migraines, because I control my environment! 

  11. There’s a difference between various “holistic” or “natural” fields of medicine. Homeopathy, for instance, is 100% pure bullshit. But chiropractic, while it has some dubious origin myths, is extremely valuable; it saved me from excruciating pain that my regular doctor had absolutely nothing for — just some dope. The dope didn’t work. And naturopathy is likewise not BS — it is science-based.

    There is only one thing on this earth that gives me the migraine headache — microwave popcorn. One whiff and I am immobilized for two hours, not just with migraine but uncontrollable trembling and a metallic taste in my mouth — it’s like being hit with a nerve toxin.

    1. I should add that what was most frustrating about my experiences with “real” doctors, over and over, is that they really didn’t seem to care. They had the prescription typed into the system before I was even finished telling them what was going on. I was reminded of the saying “when all you have is a hammer, every problem looks like a nail”. I even had doctors read back the exact opposite of what I had just told them to me “oh, I thought you said the pain was getting better”. It’s as if they themselves have no faith that the stuff they do has any value or even effect, unless there’s a reason to cut it. Very frustrating.

  12. Can someone explain the difference in receiving progesterone from a yam spread as opposed to from birth control pills? It seems like the same treatment the other doctors were proscribing in a slightly different delivery system.

    1. Birth control pills contain progestin, the creams contain progesterone*. Progestin is not a naturally-occurring substance, and it has been claimed that progestin is not tolerated as well by the body.

      * The creams that say Wild Yam do NOT contain progesterone – they only have progesterone if they say on the packaging that they have it. Wild yam contains diosgenin, which can be converted into progesterone in the lab, using lots of chemicals that your body doesn’t have.

      1. Yes, some of those “Wild Yam” creams are bogus.  You want one that actually contains progesterone, such as Progest by Emerita.

    2. Yams are FROM A NATURAL SOURCE!!! They are not classified as medication.  Sometimes people have a reaction to the fillers that go into medication!  I know that my daughter has SEVERE problems with Gluten, which is used in meds and most products.  She has to be very careful about what she eats.  BUT no Gluten===means NO PAIN for her.  She found that out, not a doctor, she heard of the diet, researched it and followed it for a few weeks. FOUND OUT IT WORKED…her stomach pain disappeared. To make it better she is off her stomach meds and has lost weight!!!!

    3. Lower, localized dosage.  If you are trying to avoid problem side effects due to the progesterone in other parts of the body, a cream can be a better choice.  Doesn’t make a difference if it is from yam or a synthetic source, though I understand the yam products are often less expensive for people who don’t have insurance to cover it.

  13. I’ve had recurrent migraines for almost 20 years now, and I usually always side with western medicine, but that seems to be one of the chronic conditions my family and I have had trouble getting effective treatment for or even a good ( or any ) explanation of why we were getting them.

    I’ve since ( about 5 or 6 years ago ) ditched all the medications I was being prescribed since they were either making them worse or more frequent or the side effects were just too extreme. The last thing I was taking was an anti- epilepsy medication ( topamax I think ) which helped slightly but made me feel like I had no idea of what the hell I was doing most of the time.

    Thankfully I only have about 1 a month ( as apposed to 2 – 4 a week ) now that seems to be hormonally triggered, and I’ve found staying out of bright light and away from strong smells seems to keep me migraine free. Go figure.

  14. When I was a pre-teen, my best friends mother and sister worked as perfume samplers in a department store. This of course meant my friend would get tons of free little test samples of various colognes. And I occasionaly was given ones he had duplicates of. One such sample was Nautica. I remember talking a direct sniff of the cologne, and suddenly getting one of the worse migraines I have ever had. I was incapacitated with pain. I got in bed, and woke up 17 hours later.

  15. I’ve had migraines since I was seven years old.  You can by this fact alone eliminate hormones.  I didn’t menstruate for another seven years.  I have been prescribed any number of drugs.  The only one that actually stopped the pain dead on was Fiorinal.  It is also highly addictive and I am an addict, a clean addict.  That wasn’t very nice.

    Every migraine sufferer is different, every one of us.  We all have different triggers.  Doctors are not always helpful in the main because not all doctors are current on their medical journals.  We won’t discuss those who believe migraines are imaginary.  One told me it was all in my head, I said “No shit, Sherlock” and I never saw him again.

    I know my triggers.  Chocolate is the worst and quickest for me.  You can’t know how badly I miss chocolate or how much I resent that nearly every goodie on earth has chocolate in it.  Red wine is a hard trigger, nearly instant.  So are sparkling wines.  No chocolate-dipped strawberries and champagne on a romantic night for me either.  Stress is a trigger, hard stress mind you.  I take St. John’s Wort and Valerian Root which is helpful. 

    The biggest and worst for me is bright light, sunlight.  I have light blue-green eyes.  I have to wear sunglasses outdoors always and a cap to keep sunlight from coming in from above.  I don’t give a crap how silly I may look, it’s better than a migraine.  So is root canal.  I kid you not.  I envy Bono those ugly glasses sometimes.

    If I pop a migraine these days I take two Excedrin migraine and sleep for four hours in a very dark room.  That’s not really compatible with a fast paced life so I don’t have a fast paced life. 

    Migraine sufferers sometimes become their own best researchers.  There’s no freaking cure because nobody knows exactly how to stop the damn things once they’ve begun.  I knew someone who had to be taken to hospital for a shot of percodan directly into her throat muscles and she said they really didn’t help, they just left her unable to cry for the pain.  Which looks good to someone looking in.

    Migraines do not make you stupid or irrational.  The pain can do that, mind you.  I have been convinced since I was a child that someday I would die during a migraine, the pain is that bad.  Keep in mind I have also been in a car accident that broke bones all over my face and that pain wasn’t as bad.  I have laid in bed sweating literal sheets of sweat, soaking through the sheets and blankets, staggering out of bed only to vomit again.  When the pain finally breaks that’s a kind of nirvana and at times I would have done anything to get there.

    So, the b.s. flows and some in the media have decided “Aha, that’s what’s wrong with Michelle Bachman.”  No, the problem isn’t migraines.  The problem is that she’s stupid.  An entirely unrelated matter.

    1. I think you have your pharmaceuticals mixed up as I doubt anyone other than an addict with bad aim ever got a shot of Percodan into their throat muscles. Percodan is the brand name for an orally-administered pressed pill containing aspirin and oxycodone. Neither pressed pills nor oxycodone and aspirin are ever given IM into the throat. You probably mean one of the something-caines (e.g., lidocaine, procaine).

  16. Seems to me that the takeaway isn’t that “modern medicine and drugs are useless” but “don’t waste your time with doctors who don’t listen to you.”

  17. I kept wondering while reading the story what kind of medical insurance she has. Most HMOs will fight you tooth and nail to give you MRIs or CT scans, let alone try tons of drug regimens.
    Glad she’s seemed to have found a healthy and natural way to attenuate the problem somewhat!

  18. Yay for “Sarah”. This reads like an ad for the Hawthorn Naturopathic Clinic. I don’t have a problem with non-conventional treatments, I just get annoyed at the idea that something being “natural” makes it better. 

  19. Modern medicine is a function of curing diseases ~statistically~. A therapy, to be approved, and realistically, to be taught to doctors; must demonstrate statistically significant efficacy relative to placebo effect. It needs to help MORE than placebo–that’s it. It doesn’t need to help EVERYONE. There are those for whom the medically approved treatment does not work. That does not make the therapy worthless, except anecdotally. Similarly, there are those for whom rubbing a cheese grater on their head is an effective therapy–I mean this seriously, not as placebo adjunct. That doesn’t make it wrong (for that patient), it just means it doesn’t work as an effective therapy for the population. 

    Read this story as a success for a small sample (n = 1). Not as a failure for modern medicine in general.

  20. I can sympathize.  Barometric change is one possible trigger, but fragrances, particularly several different strong ones in together or in quick succession is one strong trigger for me.  I avoid places selling scented candles and the area near perfume counters in stores as much as I can.  The detergent aisle in the grocery is nearly as bad.

    And, yes, I haven’t had any migraine medication that helped at all either.  But I haven’t tried 50 different kinds.  (The fun part of taking any medication is reading the side effects.  ‘Headache’ is one of the most common… even for medications that are supposed to stop/prevent it!)

    Yes, drug trials are useful scientific means of determining a drug’s effectiveness… for a random set of individuals.  However, some medications show enough statistical effectiveness to warrant their approval for use without working for a majority of the patients.  The simple fact of the matter is that we are not yet to the point where we can assign people to phenotypes in a fine enough table to determine what will work most effectively. Which is why we have to try the different drugs to figure out what works for different individuals… and why we get anecdotes like this one about cases where next to nothing works except for the patient’s own research and personal discovery.


  21. why doctors would push birth-control pills — which are known to cause headaches — to someone with migraines is beyond me.  i have them myself, but must take the pill because if i don’t, i have nodular acne.  not little breakouts… severe sub-dermal nodes of it.  and that’s after having done accutane.

    anyway — my triggers include stress, extremes of heat/light… but SMELLS, oh ye gods, smells are rough.  strong, sharp, chemical smells, especially the ones like in mens’ colognes, are almost guaranteed to set me off.  on my worst days i wish that i were allowed to carry a baseball bat and a license to hit anyone in the head who comes close to me smelling as thought they’ve bathed in it just so i could feel some justice… but alas, this is the real world…

  22. What I take from this is that she found a doctor who listened to her, kept useful records of events, and had a methodology for removing triggers.  It was a naturapathic doctor, so what?  If any of her other doctors had taken a similar approach of reviewing the data and taking her experience with her own body into account, then maybe one of them would have helped her.

    bravo to her for managing her own health and finding the people and resources to achieve a better life.

    1. “What I take from this is that she found a doctor who listened to her,
      kept useful records of events, and had a methodology for removing

      No, she did those things on her own. However, I absolutely agree that they are all things that every single previous physician should have done, instead of reaching for their pads.

  23. How the heck did she try 50 migraine drugs and 13 birth control pills in one year and find out that they were useless?  That’s a new birth control pill every single cycle and one migraine drug a week – definitely not enough time to find out if it was affecting the frequency of her once-weekly migraines.  I guess if they didn’t permanently eradicate all migraines in one dose they got dumped in the useless bucket?

  24. The human body is a massively complex system – probably the most complex system of any we’ve studied. If you’re able to manage it with self-diagnostics or with natural remedies, I’m quite thankful. But please don’t disregard the incredible progress we’ve made in treatment of human disease and suffering. For most people, most of the time, it works.

    I’d simply like to close with an apology, as on reflection little I’ve posted here has been useful or expansive – if anything, it has added vitriol without substance, and that was the last thing I wanted to do when I started.

  25. So she has anecdotal evidence of how she conquered a condition that is anecdotal in the diagnosis of its symptoms? I can’t wait until I can tell someone else this story I heard that proves medical science is out to kill us all.

  26. speaking from personal experience, at least some migraines are bacterial infections of the upper sinus, where the body uses its traditional weapons of inflammation and muscle spasms but only ends up making everything worse because it’s inside your skull.

    I spent most of my life suffering from migraines– the kind where you need to go lie down in a dark room and try not to breathe too hard because doing anything makes pain spike through your skull, all the while feeling incredibly nauseous, and having everything too bright and too loud and too smelly, sort of an out-of-control sensory amplification. and coughing and puking, too.

    doctors would tell me nothing was wrong that they could see, saying random nonsense that it must be that I was eating the wrong foods or having too much salt or that I was otherwise doing something to induce it.

    I could feel them coming on– there would be this kind of twinging / buzzing in my skull, back between my eyes.
    and nothing would stop them once they started; I just had to suffer through it for 10+hours until it faded.

    then about 8 years ago I accidentally discovered that fresh garlic cooked in olive oil made the migraine stop and go away– note that is has to be fresh garlic, since apparently the whatever helpful fat-soluable compounds that are in there get damaged by freezing or roasting or drying (powder/flakes).
    then a little while later I found that using a netti pot would also do the trick, if one modifies the procedure a bit by leaning forward and letting the water saturate the upper sinus. (warning: when it drains back down, it’s gonna make you cough like crazy.)

    so now I don’t have migraines anymore.
    at worse, when i feel a twinge, I just cook something with fresh garlic or wash out my upper sinus, and then it stops.

    I see a lot of patterns with other people’s reports of symptoms which seem to indicate that my specific problem is also a more generally experienced one– anything which induces the upper sinus to drain or otherwise flush out will help (exercise, hot peppers, etc.); anything which causes the sinus to swell or encourage baterial growth will make things worse (eating too much salt, skipping one’s normal caffiene intake, etc.).

    I suspect that the bacteria responsible for the problems are my own symbiotics and assume this for others as well, so using antibiotics would just make things worse– one has to be one’s own bacterial wrangler or they just run amuck. :)

    for people who’ve never had migraines, I cannot explain how absolutely fantastic it is to be able to make the pain just go away, which is only bested by preventing it from happening in the first place.

    1. Technically speaking that’s a sinus headache not a migraine. Once the inflammation/irritation gets to a certain level, the symptoms are pretty much the same. I used to get those as a teenager, but it took until my 20’s to realize I needed anti allergy medicine, not pain relievers.

    2. Very cool.  Just to complicate matters, I would like to point out that garlic is also an antifungal, and there’s been some studies that implicate fungus in chronic sinus infections.  If it was a fungal infection, that would explain why medicinal antibiotics did no good.  Also garlic has some vascular effects, and one of the theories of how migraines happen is through some sort of vascular dysregulation.  Regardless, very happy your head feels better. 

  27. Don’t birth control pills raise progesterone? So the advice she was unwilling to accept from her male doctors she was willing to accept from her female Naturopathic doctor. This narrative implies that the birth control pills didn’t work originally because she was still exposed to the chemical factors.  After the chemical factors were removed, she didn’t take that into account when she responded to the new GP’s suggestion to go on the pill, and refused to take the BC pills.

    What we have here is a failure to communicate on both sides. On the other hand, doctors are being paid to communicate, so more fault to them.

    1. The article stated that the patient objected to birth control pills because of the extra estrogen, not the progesterone.  Also, the progesterone in birth control pills is chemically different than that found in the human body, so it would not be the same substance at all.

  28. My migraine situation is similar and managed by 1 migraine drug and a pain killer. About 75 % of the times that I can feel a migraine starting one or two small 10 mg wafers of Maxalt a Rizatriptan ( 5-HT1 agonist) abort my migraine. Maxalt is not perfect and sometimes a dark room and Fiorinal (analgesic) are the best route, anyway, 2 useful drugs provide migraine management for me and many others.   

  29. I’m a pharmacist, and have dispensed bioidentical hormones for decades; I suggest that EVERY woman who gets migraines, particularly if they occur in the 2 weeks before your period or during perimenopause, should get their progesterone checked.  Low progesterone decreases your “headache threshold”, making it easier to have a migraine; most women, if their progesterone levels are adequate, will have fewer or no migraines.   Most doctors, unfortunately, are unaware of this link between progesterone and migraines*, but if they test and see your progesterone is low, they may be willing to supplement it. 

    By “progesterone”, I do NOT mean birth control pills, or Provera.  Those are progestins, not progesterone.  Progesterone is chemically identical to the hormone you make in your body; the others are not.  BC’s and Provera tend to make migraines worse, not better (because they do some, but not all, of progesterone’s jobs…and also send a strong signal to to the body to make less of your own progesterone).  Progesterone is available in non-prescription creams like Progest–but those are rather weak, and migraine sufferers often need larger doses.  By prescription, you could use Prometrium, or get a custom progesterone cream from a compounding pharmacy (that’s what I do).  I feel creams are preferable as their onset of action is quite rapid (within an hour) and the dose is easier to adjust.

    Other symptoms of low progesterone may include anxiety, depression, emotional outbursts, mood
    swings, irritability, and insomnia.  If you only have such symptoms (or
    they get worse) during the 14 days prior to menses, get your
    progesterone checked.  If it gets REALLY low, you’ll have irregular
    periods, as your progesterone cycle is what controls the timing of your
    periods.  Progesterone also drops rapidly during times of stress.  Long
    term, being low on progesterone can increase your chances of
    miscarriage, decrease fertility, and increase chances of cell-overgrowth
    disorders such as fibroids, cysts, and cancer…which can eventually
    lead to a hysterectomy, down the road.

    PMS, post-partum depression, and perimenopause symptoms are also often caused by low progesterone, and can be relieved by progesterone supplementation (cream or Prometrium).

    Note that you need progesterone, you should not take any of the non-progesterone progestins (eg: BC’s), since they will interfere with (compete and block) the function of the real progesterone.

    *(Doctors are unaware of the link because there are few studies on it in the US…because no large drug company can patent progesterone and make billions on it, so they’re not going to bother doing a great big expensive study to publish in the literature, either….but many prescribers who are familiar with the use of bioidentical hormones are aware of the frequent migraine-progesterone connection.) 

  30. I don’t have migraines – but I do live with chronic pain :o/  Finding what works for you (if anything) is time consuming and often times frustrating.

  31. Interesting that the majority of migraine sufferers are women, and there seems to be a causal link with progesterone levels.
    But I’m male, and have suffered from migraines for decades. Wonder what that says about my progesterone?

    In the past there were triggers such as certain foods; then 6 years ago I suffered a heart attack and after angioplasty my migraines went into a long, 5 year eclipse. It was wonderful. Then this year, they came back — with an entirely different trigger. Now I can predict the weather with my pain, because changes in air pressure cause them. Bizarre.

    And I used to eschew drugs just because they never really seemed to work – until I found sumatripan, which stops the migraine in its tracks within a half hour. I praise big pharma for bringing me a miracle drug… and if the profits from keeping old men’s penises erect are what funded it, well, that’s now fine with me.

    1. One prescriber I work with does use progesterone to prevent migraines in men…but in comparatively tiny doses.  Might be worth a try, with supervision…

  32. I had migraines for 15 years and part of the solution WAS removing these items from my life and when they are reintroduced…..I relapse into a migraine where I need to be hospitalized. I certainly don’t believe western medicine should be completely discredited but for MOST health issues eastern medicine has a greater effect and less horrible side effects. I’ve only almost died 10 times and have suffered immensely from life threatening genetic health issues for my entire life. What would I know? I ASSUREDLY do not think ONE cure is best for all. That’s a given, right? How do we act like there is ONE ANSWER?! That makes no sense from an intellectual point of view.

  33. You folks who are reading this article as “alternative medicine versus Science” have got it completely backwards. Sarah very scientifically, through experimentation and trial and error figured out what caused her migraines and how to fix it. She used the internet to research, yes, and was appropriately critical of her sources, sifting good information from bad or irrelevant information.  The one doctor who helped her out at the end looked at her data, formulated a theory, and suggested a solution, which worked.    

    By contrast the prior doctors — effectively little better than cargo cultists — read uncritically from their catalog of “if you want A outcome, then do B”, and threw their hands up when she didn’t magically get better and the planes didn’t come with shiny trade beads.  Actual data ?  Irrelevant.  Don’t fit our curve ?  Out the door with you.

  34.  @Antinous, just because something is an anectdote, does not mean it is anectdotal evidence, which has a specific meaning in this context.  Patients taking part in a study often give self-reports in the form of anectdotes.  This is in contrast to narative reports that are given in the *abscence* of controlled scientific conditions, which makes the data very suspect & highly unreliable.  It is a very common logical error to overgeneralize anectdotal evidence which may be true and/or verifiable to reach conclusions that are not supported by statistically based scientific evidence.  For example, my grandmother didn’t have grey hair until she was in her 80s.  She washed her hair every saturday with vinegar.  She claims this is the reason.  This is anectdotal evidence.  Following 100 people over time who do this rinse every week produces statistically based evidence that can be used to draw conclusions about the sampled population in general. 

  35. I have a chronic (daily) migraine that I manage with: Botox every three months, a low dosage of Nortriptyline every day, Imitrix as needed, AND (I think most importantly) a strong control of my triggers.
    Most of my triggers are fragrance-based. A scented candle or strong-smelling cleaner will have me out for the count. I have to wear a hat outside, always, because for some reason direct sunlight on my head kills me, as does bright light in my eyes. Some people can smell perfume all day but chocolate or wine will do it; those things don’t affect me at all.

    I discovered my triggers with guidance from my neurologist and the internet. It took a while to figure out the correct combination of medicines, too. The ones we tried and discarded were not useless; they work for other people. When I can’t avoid the triggers–and it’s impossible to avoid all of them all the time–the medicines keep it from being disastrous.

    I’m glad Sarah figured out a method that worked for her… But this piece seems to be saying that traditional medicine doesn’t work for anyone’s migraines, and that’s just not true.

    1. Nowhere did this article say traditional medicine doesn’t work for anyone’s migraines.  It simply related one patient’s experience with trying to deal with a complex medical problem with traditional doctors, and their failure to help.  It is my experience also that “traditional” doctors are  not very useful when dealing with complex medical problems, although they are very good at simple, obvious things like broken bones.  I worked through 8 or 9 different doctors before I found one who was willing to take the time to solve my medical puzzle.  Not coincidentally, he is an MD who integrates alternative medical information and treatment with what he learned in traditional medical school.  

  36. Ugh, I have a history of migraines and had my GYN specifically and carefully help me find a BCP that didn’t make them worse (non-estrogen pills) and my internist had me read a neurologist’s book (David Buchholz’s “Heal Your Headache” – he specializes in migraines) on migraine treatment to find my triggers and figure out what do to. Later, I went on methylin for ADHD and my migraines pretty much went away. Just because some doctors are jerks doesn’t mean you should dismiss all the actual evidence and data and go to unproven or disproven methods. That’s like going to a couple bad restaurants and saying you’ll never eat out of the house again.

  37. icrow, I agree: this is a story about how science (looking at data, getting ideas, testing those ideas) worked. Sarah was a good scientist. The conventional doctors were not.

  38. I treat my doctor with the same attitude I treat my mechanic, plumber, electrician, etc.  They’re paid professionals, but they’re not infallible.  If I tell my mechanic I want my brakes replaced, that’s what he’ll do.  A good one will come back and tell me that my brakes needed to be replaced because I have a wheel alignment problem and weren’t wearing properly.  But I can’t depend on that. 

    It seems as though in this story, Sarah’s medical team never really invested any time or effort into curing her affliction.  They were primarily concerned with which medications to prescribe that stood the best chance at helping her.  It wasn’t until the doctor actually took a second, looked at Sarah’s own research and made a connection that they were able to suss out a treatment for her. 

    So for the same reason you can call a painter to fix the spot on the wall but it won’t stop the leak from the dripping pipe, you as an individual have to be responsible for knowing, documenting and keeping track of your body and how it responds to different things so that you can present your medical professionals with a better idea of your condition.  And if they aren’t interested, ditch them and keep going till you find someone who is. 

    For the record, I used to have a job printing the clinical trials forms on NCR paper and sending them all over the world.  I saw what kind of Data they were looking to collect.  Lots and lots of it were subjective. 

    1. >It seems as though in this story, Sarah’s medical team never really invested any >time or effort into curing her affliction.
      This seems to happen somewhat often, unfortunately. I’ve had something similar happen to myself (though not involving migraines), one med upon another med etc. A few years into it, I realized that the problems were the medications. I had been incorrectly proscribe done med, and experienced side effects from it (though the Dr. didn’t label them as such), for which I was given another Med etc… I went in with one problem, and ‘magically’ picked up about 3 others during the course of my ‘treatment’. Sometimes Drs. just aren’t really using their brains.

  39. “In 2008, her oldest brother, an acupuncturist, told her she should have a
    cleanse to get the toxins from the drugs out of her system.”

    Hoho!  I was with her up to there.  Toxins, eh?  One ticket for the Woo train, please.

  40. I spent the first 30 years of my life experiencing crippling headaches four or five days a week. As soon as I eliminated the artificial fragrances from cleaning products, household chemicals, makeup, shampoos and other people’s perfume from my life? Gone. Now I never have a headache unless I’m stuck in a small space with someone wearing perfume. When that happens, I have a blinding headache for three days that doesn’t respond to painkillers. Better living through fewer chemicals. Also, applying wild yam cream does work to knock out PMS headaches… and it was suggested to me by my gynecologist, so it’s hardly fringe science.

  41. My anecdotal story: like Sarah, I suffered terrible headaches in high school, and the doctors suspected a pituitary tumor. It turns out… it was a pituitary tumor. Post-surgery, no more headaches. Three cheers for modern medicine!

  42. Are BB commenters significantly more likely to be migraine sufferers?!  I too get wicked migraines.  The triptans just made me feel like my heart was trying to bust out of my chest ala “Alien”.  Ketoprofen worked well but removed a layer of stomach lining.  I now do Fiorinal and caffeine with quite a bit of success.

    BUT, found that a shot of Mastica liqueur (from a refined tree resin only found on the Greek island of Chios) got rid of both migraine and its nausea.  Now, if the FDA would only approve it for import to the US.  Maybe Joshua could get his mom to get this done a little faster : D

    1. Chios! Hey, that’s where part of my family is from. Never heard of this stuff. Is it related to that MAstic stuff the Ottomans and their unfortunate subjects used to like to chew?

      1. Sorry so late if you read this.  YES! it is, and I even read that one Ottoman sltinate who ordered the murder of all people on Chios, said everyone except the Mastic farmers…I like that stuff, and harvesting it is a secret.  (or at least I read on its wiki anyway).

  43. I’m glad that “Sarah” did finally figure out what her migraine triggers are, and now knows to avoid them.  But they didn’t cause her migraines because they were “dangerous chemicals.”  They caused her migraines simply because they are her migraine triggers. (OK, circular argument. Sorry.  I’ll say instead: These things caused her migraines because she happens to be sensitive to them.)I get migraines too — One of my triggers is black pepper (weird, I know).  Another is strong fragrances.  But that doesn’t make black pepper or fragrances evil. They just happen to trigger my migraines, so I avoid them.Now, PEOPLE who apply excessive fragrance and then hop onto a crowded bus with trapped migraine sufferers…. THEY might be evil. ;-)- KB

  44. There were two different styles of differential diagnosis at play.  One was her conventional doctors, probably doing their work in isolation from each other, seeing their patient a few times but not really immersed in her life.  Doing their best with the information available. 

    And then there was her.  She was performing a differential diagnosis on herself, based on a hunch, guided by a naturopath, and eventually she came up with the right answers.  

    The key is that she did this for herself, which is what modern medicine should really be embracing: how to get the patient to think rationally and do as much for themselves as they can.  

    I wouldn’t bag on doctors about this.  It’s unfortunate, sure, but they cannot solve all things.  And neither can an individual.  People have to work together and not be so ready to point the finger of doom.  It takes a village to make an accurate differential diagnosis.

  45. What I love about a lot of homeopatic/naturopathic medicine is that the cures often take several months and require extreme discipline. Since most people can’t avoid say, all wheat products for 6 months, they blame themselves rather than the cure for not working.

    That’s not to say that some eastern medicines don’t work, but a lot of them don’t hold up to even a casual double blind test.

    Speaking of double-blind tests. Has anyone ever carried out their own? I would think creating a placebo for most things isn’t all that difficult and even self-administering it by pre-making 3 months of doses in identical bottles and replacing one with a placebo seems totally doable.

    1. I’ve never done a proper double-blind test on the matter, but have personally experienced a very powerful placebo that left me quite respectful of the effect.  When I was in my early teens I had regular petite mal seizures about three times a day on average.  When I first spoke to my doctor about it, it was misdiagnosed and he prescribed something for a condition involving the epiglottis.  For the entire month that I took that pill, I did not have a single seizure.  As soon as it was gone, they came back.  When they were later correctly diagnosed as seizures due to a brain tumor, the drugs that are actually meant to control seizures had no noticeable effect.

  46. First and foremost, I’m glad that Sarah found relief.  That’s all that matters in the end.  Given that, the story illustrates several limitations in our understanding of the human body and in the medical system in this country:

    1.  The human body is extremely complex and not well understood.  In absence of understanding the cause of the problem, the best approach is to choose the treatment that is most likely (been shown to work in a statistically significant number of people).  This is the same reason why the first thing I tell my grandma when she calls me up with a computer question is to reboot.  It’s not because I think that the lack of rebooting is the problem, it’s just that it has been shown to work in a large number of cases.

    2.  The complexity of the human body is further exacerbated by the fact that often the doctor can not directly observe the symptoms, instead having to rely on an untrained persons interpreting and describing phenomena they don’t understand.  The rise of the internet and things like WebMD mean it’s very easy for people to develop pre-conceived notions and bias about what is wrong with them. Sarah sounds like a sane, rational person, but it’s often hard to tell that within the short time doctors have with patients.

    3.  There are not enough doctors to go around.  I have yet to meet a doctor that’s said: “Gee, I really wish there were more sick people because I just can’t seem to keep myself busy.”  With a limited resource, it becomes a simple numbers game.  If a doctor can see 10 patients and help 8 or 9 of them, they have done more collective good than the doctor who has taken a whole day to understand a single patient’s rare condition.  It may not seem fair to you if you’re the one with the rare condition, but then again, it probably wouldn’t seem fair to the dude with the broken arm suffering in the waiting room while the doctor spends the whole day with you.

    4.  All those doctor visits and medications, while not ultimately solving the problem, gave Sarah the base on which to build her diagnosis.  I’m not convinced from the anecdote above that if Sarah had gone straight to the naturopathic doctor first that he or she would have immediately diagnosed and cured her problem.  It’s clear from looking at the varied symptoms listed by migraine sufferers in the responses to this story that there’s no ‘typical’ migraine.  She could have just as easily lucked out by going to a conventional doctor that had more experience with migraines and this could be an anecdote supporting conventional medicine.

    I don’t know enough of the specifics of the interactions Sarah had with the doctors whom she feels failed her, so I’ll refrain from passing judgement on them.  I do feel like our medical system is not optimized for solving rare or complex conditions; it’s optimized for keeping the herd healthy.  And we could even do a better job of that.

    Ultimately you got to do what works best for you.  For me, my first stop is going to be conventional medicine.  

  47. I’m extremely allergic to many, many things… it manifests in injury to my skin (itching, cracking, bleeding, painful sores and boils).  I unfortunately passed this on (and have a direct record of 3 generations before me.  After I spoke with my daughters dermatologist about my intuition that it might be tied to diet, he said “just keep records and start eliminating”… that’s when we discovered the threshold.  You’re fine at some perfect level of stuff around you.. say 20.  at 80 you’re a bloody mess.  Pollen gives you something like +10 to +50, wheat gives you +70, milk +20, fragrances can range from +5 to +100 at an indoor event (I’ll get constricted airways). So it comes down to managing the load and knowing where you are at…  Every other doctor before him just gave us a cream and said it would clear up… now we’re like ninjas with the food we eat (although she’s better at noticing the dreaded ‘Modified Food Starch’).  I sympathize with the subject of the story… keep at it.  Doctors are people who studied a lot. Some like a quick symptomatic fix and some are scientists… just keep digging. I loved how the “hippy pseudoscience guy” (as some might call him) had the rigorous approach.

  48. Interesting comments. As a Quantified Self member (that’s how I found out about this article,, I think we should look at this anecdote the following way:

    Conventional medicine is certainly useful, and running trials on large cohorts to study the effects of drugs on a large sample of the population can ensure the safety of a drug, and help determine its interactions and side effects.

    The problem is that due to genetic differences among patients, there are always people who won’t respond to the treatment in the expected way, hence a drug may be successful in 90% of the cases, and have no benefit in the other 10%. And this is where self-tracking comes in – when you’re in the 10% and conventional medicine didn’t help.

    A sample of one means that whatever solution you find probably won’t apply to anyone else (except perhaps some people in your online support group), but it also means you’re doing a form of personalized medicine. If it’s placebo, but still works, you don’t really care. Fuzzy conditions such as pain, as other commenters have said, are deeply subjective, and if conventional medicine hasn’t isolated an underlying problem that cause the symptom, yet you manage to cure the symptom by eating 5 lbs. of strawberries a day, that’s an effective cure for you.

  49. Sounds like Sarah probably spent hundreds of hours on researching and tracking her migraines. That’s not “easily” doing better than the doctors. It’s simply not feasible for doctors to spend that much time on every migraine patient. If alternative treatments are to do better, they need to take no more than an hour for diagnosis.

    1.  “Sounds like Sarah probably spent hundreds of hours on researching and
      tracking her migraines. That’s not “easily” doing better than the
      doctors. It’s simply not feasible for doctors to spend that much time on
      every migraine patient. If alternative treatments are to do better,
      they need to take no more than an hour for diagnosis.”

      That’s just silly. No one has suggested that the physician follow her around and track her themselves. Obviously, all the physician had to do was explain how to chart to Sarah and then review the records when she brought them back. In the short-term, it is more time-consuming than handing a prescription to a migraine patient, but in the long-term, it is both hugely better for the patient and physician alike.

    2. I’ve had seven primary physicians in the last decade due to various machinations by my HMO. Some of them have been amazingly adept at figuring things out in fifteen minutes and some of them have been amazingly focused on getting the boxes checked off on their Model of Care and moving on to the next patient. Skill and intelligence vary considerably in the medical profession.

      1. Skill and intelligence vary considerably in *any* field.  And the fact that you’ve had to see seven doctors in the last decade is more a failure of the medical system.  The deck is stacked against doctors: the human body is complex and every case is different, they aren’t given enough time to effectively do their jobs, and they’re constantly under pressure from higher up to treat more patients or do less tests to save money.  Sounds like you should be doing something to change the system rather than blaming it on the doctors themselves.

        1. I’m not blaming doctors; I’m just pointing out that if one of them doesn’t seem to be doing much to help you, get a new one. In my case, the local health group fired one doctor (whom I had seen once) for idiocy, and the next one that I chose figured out the reason for my life-long health problems after asking me a couple of questions.

        2. “Skill and intelligence vary considerably in *any* field.  And the fact
          that you’ve had to see seven doctors in the last decade is more a
          failure of the medical system.”

          He wasn’t complaining about the number of physicians. He was countering your personal experiences with his own.

          “The deck is stacked against doctors: the
          human body is complex and every case is different, they aren’t given
          enough time to effectively do their jobs…”

          Charting and reviewing said charts by my physician took less time than constant check-ups to get new prescriptions from previous physicians. Not to mention, of course, the time taken to treat the problems I would have had if I’d been forced into decades of pain management via medication. So try again.

          “…and they’re constantly under
          pressure from higher up to treat more patients or do less tests to save

          Exactly. Instead of ordering a dozen useless tests, they could have sent her home with a simple chart and actually figured out her problem, as well as we can right now.

          “Sounds like you should be doing something to change the system
          rather than blaming it on the doctors themselves.”

          In reality, it should be the physicians themselves who are changing the system.

  50.  the underlying point isn’t that conventional medicine isn’t beneficial- even miraculous ;) but that all science is arrogant;  about new findings done outside of the institution of science, regardless of method or results. you can’t argue with results in medicine-it’s the name of the game.  people blindly following in any faith (and it is a faith) are doomed to ignorance of innovation and progress-onto war if need be. the very notion of progress is change, expect it, embrace it’s possibility.  leave arrogance in faith to fools and politicians.

  51. Was she vaccinated? Maybe the vaccines were causing her migraines! Or maybe it was the radiation from her cellphone! Or maybe the polarity of her drinking water wasn’t properly aligned! Quacks will happily blame anything for your symptoms as long as they can sell you something. Sarah was lucky and smart to have found her causes.

    Clinical trials show that Wild Yam does literally nothing for female hormonal issues. Yes, her “naturopath” was nice to her (which helps with a lot of things! No doubt about that) but she wasted her money and time: Sarah’s successes were her own (charting, doing experiments to find triggers) and all that naturopath gave her was a needlessly expensive skin cream.

    I wish bb were not complicit in the death industry of quackery.

  52. I register skepticism about this article.
    ND’s aren’t “closer to conventional doctors than naturopaths,” they have no real medical training. The likelihood of this one running any sort of competent lab test is unlikely. One big hint that they’re not f’n doctors is that they don’t yet have the right to write prescriptions. This bit in the article stands out like a sore thumb.
    The fact that like many nutters, our protagonist now has environmental sensitivities to everything under the sun (a combination exposure to fluorescents, air pressure changes, and chem exposure is now needed to set her off). What was initially reasonable (an environmental sensitivity) has now become something off the deep end.
    The fact that 2 out of some 4 or 5 doctors had horrendous interactions with her – and among homeopathic circles, these are the stereotypes of doctors, which rings a suspicious bell. I’ve never known docs to have screaming matches – and I have an actual chronic illness, that results in my seeing more docs/year than most people see per decade. I’ve worked in ER’s as a patient liaison, I’ve seen doctors negotiation with patients who refused to have chemo for advancing cancers because of naturopathic BS, and *they* didn’t descend to screaming at their patients, much less scream about birth control. It’s one of the biggest no-no’s in medicine possible.
    Somehow, this patient managed out of a single round of doctor visits to find *2* homeopathy stereotypes? If it stood alone, I’d say shit happens, but in context, I call bullshit.
    The saliva test thing is bullshit. Saliva tests are useful in endocrinology because unlike blood tests they discriminate between free steroidal hormones and bound steroidal hormones. They’re problematic in that they *only* measure free hormone levels. A saliva test in the absence of a blood test only gives you a partial quantity. Surprise, low progesterone! [Oral progesterone testing was advanced by chemists; no one’s actually profiled medically useful free progesterone levels in saliva yet, to the best of my knowledge.] 
    Lastly, conventional medicine is based on experimentation and data. There is no valid “alternative” or “complement” to the process of “experiment to see if it works; if yes, keep it, if not, chuck it.” Sara’s story doesn’t even touch alternative medicine (until we get to our ND quack).
    As others have said, I’m now awaiting our multi-page paean to conventional medicine, the constantly unsung (when not being scorned) savior of millions. Though it does lack the feel-good factor of a little herb, don’t it?

    1. “I’m now awaiting our multi-page paean to conventional medicine” – Most reasonable people understand the enormous benefit to human health conveyed by conventional medicine. That is not the story of interest, and to me this comment sounds a bit buttsore.

      What interests me about Sarah’s story, as others have pointed out, was the role she was able to take in seeking relief from a complex and debilitating condition. She relied on conventional medicine, and it failed her, for many reasons already articulated here – she’s an outlier, the differential diagnoses required more attention and time than most doctors can give, etc. 

      If you understand science and medicine you also understand that medicine doesn’t help everyone – that is simply a fact. Most migraine drugs, as someone pointed out upthread, help most people a little bit some of the time. Most antidepressants have an even more dismal success rate, barely better than placebo in many cases – yet they are a multi-billion dollar industry.

      In the face of the conflicting interests we encounter as patients – the interest of the drug company to earn profits, the interest of the insurance company to do the same, the varied interests of the doctors we see, only a part is in our own interest as patients. We can uncritically submit to the authority of the professionals, and maybe that works out fine for us.

      But when it doesn’t, again as someone has pointed out upthread – are we to shut up, go home and remain sick? Or are we to take responsibility and participation in our own health? I certainly prefer this approach – I’m not interested in living as a victim, and if I am unfortunate enough to suffer from an ailment that medicine isn’t helping with, it is my responsibility to seek a solution to the best of my ability.

      Science teaches that our understanding must be able to continuously evolve – in the context of a single life this evolution is based on the experiences and reactions of a sample of one. The information gained from large scale double blind studies can certainly point in useful directions – but again, when they don’t, what are we as suffering individuals to do? We do our best. Sometimes this means not subjecting our bodies to continued unnecessary and painful medical interventions in the name of blind obedience to a dogmatic view of “medical science”.

      You are of course free to disbelieve the report of Sarah; for myself as a migraine sufferer who is not helped by any of the pharmaceutical interventions I’ve tried, but who is helped by avoiding certain triggers, her account rings true. 

      If more people took the attention and care for their own health that Sarah did, a great many problems would be solved with the state of medicine today. Even if you believe that her relief is mostly placebo effect, I say don’t underestimate the power of placebo. It is to be respected. If that makes you uncomfortable I suggest you look at that discomfort more closely.

      Ultimately we are all responsible for ourselves; ultimately we all need help from others who have knowledge and expertise we don’t. To live well we must be able to find the balance.

    2. I’ve both seen and been yelled at by physicians. One physician yelled at me because I drank a breakfast shake the morning of a test that he neglected to tell me to fast for, which messed up the results (I retook the test the next day, boohoo, it wasn’t like it was a big deal to reschedule), and a different one yelled at me when I asked for my alternatives to having a gallbladder removal. Mind, I wasn’t a natural nutter; I just didn’t have insurance at the time or six grand and needed an alternative while I saved up the money for surgery.

      My next physician gave me a list of foods to watch out for and I spent the next six months figuring out what I could no longer eat, with a few painful interludes. Five years later, I still have my gallbladder and no problems, with just a few dietary restrictions. (I can’t eat many fried foods, which is really better for me, anyway, lol.)

      Again, taking ten minutes to speak with me was way less time than scheduling surgery and the aftercare so why is this bad, again?

      Last, conventional medicine is based on a prescription pad, not on experimentation and data. If those things were important, more than two out of over a dozen physicians would have spoken up and said ‘Let’s find your trigger for migraines and gallstones.’ rather than ‘Let’s give you harmful medications and surgery that you can’t afford.’.

      No matter how much you wish it were otherwise, actually treating individual patients is not conventional and is, therefore, the alternative.

  53. Fixing my migraines was all about careful observation. The really interesting part for me was that there was another level below my direct triggers–getting gluten-free and supplementing magnesium defanged ALL of my triggers–even chocolate. Bizarrely, getting gluten-free without the magnesium blunted a lot of triggers, but turned previously-safe corn into a fierce trigger.

    Nobody is as interested in your health as you are. Some mysteries take immense amounts of work to track down–your HMO won’t pay for it–it’s just you, your notes, and the internet.

  54. An anecdote with no supporting information. Did the neurologist really say “have a good life”.Honestly, the doctors in this story are recycled stereotypes.
    Who on earth tries 50 medications for migraines? It takes months to gauge if one treatment is effective or not.  There’s so much to this story that doesn’t add up and seems to be a sales pitch for yam cream.
    When you work up a patient with a headache then a detailed history of triggers and stresses are fundamental to gain an understanding. The focus during the history will be on common causes such as menstration/pill related headaches but if sinister causes have been excluded then there is a big onus on the patient to help identify triggers and avoid them. It’s not like house where they break into your apparent and run mass spectrometry on your toothpaste.Most headaches are idiopathic but are clearly linked to stress and can only be made worse by obsessiveness about the headache. What’s the best way to manage a headache that has no obvious organic cause and all tests have shown to be fruitless? Repeat visits to the doctor, looking for a cure,  is unlikely to be help anyone (but a periodic checkup to ensure that headache hasn’t changed in character is important).This is just common sense.How can boing boing run stories about science and dangers of anti-vax and offer this damaging tripe with no critical analysis.BTW It’s not ‘conventional medicine’, it’s just ‘medicine’.

  55. Male gynecologist? So? My gynecologist certainly is not the friendliest woman around, and I’d readily describe her as “dismissive.” When I asked her about birth control methods as an alternative to hormonal ones, she was pretty hedgy and basically told me what tons of women have heard: you’re young, take BC, see you next year.

    I don’t like my family doctor either. But it never occurred to me that his somewhat crap bedside manner was because he was an unfeeling man. I figured it was because he’s not a terribly good doctor.

    That reminds me. I need to get some new medical professionals in my life.

    1. The difference between you and I is that you look at these two doctors and draw the conclusion that the doctors are at fault.  I look at your story and I see a common denominator, you, and it makes me wonder what kind of a patient you are.  This isn’t Starbucks where you spit out your order and it comes out at the end of the counter.  This is a complex interaction between two people, often with no easy solution.  Both people in the interaction bear the responsibility for the outcomes.  

      The best thing for you is probably to find a new doctor.  I’m sure your existing doctors won’t be crushed by you leaving, because despite what you may think, they really do want to see you get better and be healthy even if it isn’t with them.  Nobody becomes a doctor just because it sounded like a good idea some Sunday afternoon, the road is too long and hard for that.

      1. “I look at your story and I see a common denominator, you, and it makes me wonder what kind of a patient you are.”

        It’s two doctors, but that’s a fair observation. Naturally, this is my own account, but I don’t feel I am confrontational with my doctors. My boyfriend is extremely aggressive when it comes to making me go to the doctor with the smallest medical problem, and I tend to wait things out, for the reason that I don’t like taking up time better spent on other people’s more pressing concerns.

        I agree with you that doctor/patient relationship is indeed an interaction between both parties. That is exactly my problem, though. My issue here is that my doctors show very little interest in interacting. They do not take a few extra minutes (literally … I’m in and out of offices usually in under five minutes) to explain their decisions or provide information. 

        I don’t need explanations because I mistrust their expertise or training. I need their explanations because it makes *me* a more informed patient, and so better equipped to make observations and provide useful information for them to make future diagnoses. I try under my own power to ask intelligent questions, but this can be difficult since I’m not medically trained, and sometimes it does feel like a test.

        The last time I asked about a different kind of hormonal birth control, my doctor switched me to a different brand (didn’t explain how it was different, and when I asked, he said just to try it). When it didn’t do anything for me, he switched me back to the old one. It was the clinic where I buy them who told me there was such a thing as a low dose option to try.

        “This isn’t Starbucks where you spit out your order and it comes out at the end of the counter.”

        Again, 100% agree. But that’s how my doctor acts.

        I appreciate that my doctor has to play the odds … medical diagnosis is an elimination process. But I think he should be OK with the possibility that the process can take more than one visit sometimes. When I ask *him* for *his* assessment for when I should follow up if something doesn’t clear up, he acts like I’m questioning his orders. Dude, I’m trying to get your opinion now so I don’t rush back here in a panic a day later complaining my meds aren’t working.

        And that all said, I do like my pharmacist.

      2.  “This isn’t Starbucks where you spit out your order and it comes out at
        the end of the counter.”

        I agree, and that’s why I believe that physicians should stop treating medicine as though it is.

        This is a complex interaction between two
        people, often with no easy solution.  Both people in the interaction
        bear the responsibility for the outcomes.

        But mainly the physician does, because they set the tone for the entire relationship. If their idea of medicine is to send in a nurse to speak with the patient and report back, a quick no-speaking exam to say that you actually saw the patient, then sending a scrip, if needed, back with the nurse to ‘explain’ everything, then they are clearly at fault. The only responsibility the patient bears in that scenario is for not firing the physician.

        I eventually did fire the physician (who was ‘shocked and upset’ with me), but I had to drive 1.5 hours to the next OB, because people in small towns have very few choices.

        Nobody becomes a doctor just because it sounded like a good idea some
        Sunday afternoon, the road is too long and hard for that.”

        And no one stops being a physician when they burn out, either. The road there was too long and too hard for that.

    2. Ironically, I avoided military docs for years under the impression that they were grizzled, uncaring, and dismissive. Then I finally found a great physician who is anything but those things – and was the first physician to mention that a thing existed called a ‘trigger’ for migraines and maybe we should find mine instead of taking all of these migraine meds and hey, while you’re saving up for your gallbladder surgery here’s a list of foods to avoid – and he’s a retired military physician. Seriously, I ♥ him so much.

  56. I have controlled my migraines with magnesium supplements.  Once I get the aura, I dump two crushed magnesium pills under my tongue and wait for it to turn to slush.  Then I take a mouthful of water and rinse it down.  20 minutes later, the aura is gone and so is the headache.  Yes, magnesium aborts classic migraine. I am hesitant to recommend this to people because I am not a doctor.  A friend was getting what sounded to me like classic migraine from his description, so I told him about this cure.  It didn’t work for him as he was not getting migraines, but petite mal seizures.  I am not a doctor, so I don’t prescribe anymore.  But for a migraine sufferer who has tried everything, this certainly cannot hurt.

  57. The only lesson here is that root cause of migraines can be different for everyone. Mine are weather related, and if it wasn’t for topomax – long live modern meds – I wouldn’t be able survive. 

  58. If any gynecologist told me I was “being an idiot” at any time, he would have to worry about finding a way to alleviate severe pain from my foot in his ass. Why any woman would go to a male gynecologist is beyond me. Like going to a mechanic who’s never owned a car.

    Oh, and in some states, (like Oregon) Naturopathic docs DO have the right to write some prescriptions. 

  59. A name who should likely be mentioned is Theron Randolph.   He was an MD who many here will likely regard as woo, but he had some sound ideas.  He would spend a lot of time listening to patients, recording their history, chemical exposure and diet.  At the time, (30’s and 40’s) that was very unconventional. He was the founder of clinical ecology, what’s now called environmental medicine.  I mentioned the point about allergy above, it used to be medical dogma that there were no food or chemical sensitivities, there were only allergies. If you didn’t have an IgE reaction to a substance, it wasn’t an allergy, therefore not a real problem. 

    He went (in my mind) overboard in overdiagnosing people as having a food addiction to common foods.  But he was just about  the only one (back in the 30’s and 40’s) suggesting eliminating triggers like cleaning products, or trying to drop certain foods out of your diet to see if you feel better. It’s likely rare when this is miraculously helpful, but some folks get a lot of benefit.  He also occasionally ate lion meat as one of the non-typical meats to avoid food addictions, which would likely not win you many friends these days.

    Some folks with migraines are seriously helped by imitrex or one of the others meds, I really suggest those get tried if you’re having problems and haven’t tried them.

    One point in the story, is that the headaches became significantly worse after the car accident.  This is very common, and suggests that there may be musculoskeletal injuries involved. I treat this daily in my practice as a chiropractor.  For headaches, usually what I do is based on Janet Travell’s work, another quack like me, though she was an MD.  Migraines are generally harder to treat than post MVA headaches, but a good percentage improve with care.   If you’re one of the one’s who associate us with woo, find a decent physical therapist who does myofascial work or possibly a massage therapist. 

    Some people do have bad luck with doctors, and yes, the stories here sound believeable.  I’ve heard worse from credible patients.  The vast majority of MD’s are helpful, and if you can’t deal with yours, try a different doctor before you ditch all of conventional medicine. 

  60. Many people are sensitive to perfumes, fragrances, and chemicals, so Sarah’s story is not hard to believe.  It’s also not hard to believe that her conventional doctors failed to listen to her.  Now, this is not an argument for alternative medicine, but in my experience with migraines, all my doctors have ever wanted to do was alleviate the symptoms, not find and cure the underlying cause. It’s important to find a doctor who wants to work with you rather than argue with you.

    Luckily, I stumbled on the cure for the majority of migraines when I was diagnosed with celiac disease.  I’ve gone from several headaches a week to an average of one or two a month, and I don’t need to take any meds except the occasional advil.  Not a cure for everyone, obviously, but if you have migraines that don’t respond to conventional treatment, you may want to research or ask your doc about celiac/gluten intolerance, as it can frequently cause migraines and other neurological symptoms in addition to stomach problems and other issues.

  61. Sounds to me like her migraines may be triggered by the stress of being exposed to the things that she’s convinced will trigger her migraines.

    I understand that migraines definitely have triggers, and that many diseases have complex and often unknown causes, but I also understand from direct personal experience that the process of self-diagnosis, especially when trying to find a diet or other environmental exposure trigger for a symptom, is rife with pitfalls; difficulty in establishing a cause/effect relationship (sure, the symptom reduced/went away, but did the change in diet cause it?), confirmation bias, and the general difficulty in trying to diagnose problems from the inside of the body that’s having the problems.

    I’m glad she’s found relief, and I just hope she hasn’t found enough ’causes’ to avoid that she’s unable to live a happy life.

    1. You seemed to be suggesting she needed a good placebo, and that’s what she found.  She initially had a lot of faith in the conventional approach.  If she’d had more faith in the internet or naturopaths, she would have gone there first.  She did not research or identify triggers until after she washed out of the med approach.  If placebo works for her, why wouldn’t one of the fifty meds or the bcp forumulations worked? I do honestly think it’s nice you’re concerned for her happiness.

      1. I’m not really suggesting all she needed was a good placebo; it’s possible that the migraines reduced in severity/frequency for reasons entirely unrelated to what she was doing, which reinforced her belief that she’d found the cause, which reduced her stress, helping to resolve the problem because the migraines were partially stress-triggered. Or maybe it was just random. Or maybe one of the things she found solved the problem and the others were just red herrings.

        Or maybe she’s exactly right and her migraines are triggered by fourteen dozen common household substances. I don’t know. Neither do you, and neither does she. All I’m saying is it’s a hugely complex problem and it’s really easy to come to bad conclusions because of subjectivity.

        I spent a year breaking out in hives all over, every day. The doctor said, basically, “yeah, this happens sometimes, nobody really knows why. Take some antihistamines to treat the symptoms and it’ll probably go away eventually, or not”. I decided instead to figure out what was wrong and fix it. I spent most of that year driving myself insane, trying to figure out what the cause was. I tried to be as scientific as possible; I kept lists, I eliminated things, I did more of things. I found a lot of stuff that seemed to have an effect and pointed towards one cause; I developed a grand theory and determined a plan of treatment and undertook it, and it didn’t do a damn bit of good; in retrospect, I have to admit that pretty much all of the evidence I had were just random fluctuations in severity. Eventually they went away.

        Troubleshooting is hard when you’re inside the problem.

        1. Your experience sounds very frustrating, I’m glad it resolved.

          There is a big difference between saying “the stress of what you’ve convinced your problem is could be causing your problem” and “I don’t know what is causing your problem”.  The first is uncomfortably close to blaming the patient for the problem.  Which I feel is usually unhelpful.  Yes, stress is a real thing,  but you can sometimes account for it, and treat it appropriately, with either medicine, or exercise or cognitive therapy.  It is likely more than one of the “50 meds” tried was one that reduces stress, or the effects of stress.

          While your personal experience suggests her approach was 100% ineffective for your problem, consider that if we had a pool of 100 BobDoleDoppelgangers with similar symptoms, it is possible it could have helped some.  You may have done everything right, but your presumed hypothesis that you were dealing with a environmental trigger/allergen may have been incorrect.  And yes, we don’t have a smoking gun to say what exactly was going on with Sarah. 

          If you don’t mind my asking, how many Bob Dole Doppelgangers are there out there?  If you all have the same genotype, you guys could be more helpful than twin studies. 

  62. Hi, 

    I realize that I’m pretty late to the game here on this one but I just wanted to leave a note saying, wow. The ridiculous argument of evidence based medicine vs “if stab myself and it hurts then I shouldn’t do that” aside I wanted to say I’ve had a similar journey in my life.

    I’m a 30 year old male who’s had migraines since birth. Only within the last 10 years have I found how to handle them properly, mostly because they have been getting steadily worse and something had to been done. I’ve seen MANY doctors about my migraines and my experience with a neurologist is the same as the story above. He walked in, open a big cupboard full of pills and said “pick one” then he left the room. What an ass clown. I have documented what triggers my headaches as well as severities and how to fix them. Some of the solutions are pills some are not. In either case many many people were consulted, some naturopaths some GPs some other sufferers. I won’t slag the medical system or the doctors cause I know they work hard but I will say this, I saw over 27 different GPs until I found one that was actually interested in taking a profile and DEDUCING what the triggers were. The problem isn’t that doctors don’t care, they do care or else they wouldn’t have become doctors. The disconnect between dr’s and patients is time, influx of new patients, drug pushing companies, moms bringing their shit kids in with a shit nose, and other facets. Don’t blame the doctors, but more importantly doctors, DO NOT belittle the personal experience and knowledge of your patients. The patients are the authority on events that happen to them, instead of talking listen. I beg you. 

    And you idiots arguing above about ND vs MD. Shut up, listen, learn. 

    Triggers : Severity : Solution
    Pressure system change : 3-7 : Advil Liquid Gel, Yoga
    Alcohol : 9 : Avoid Alcohol, once started, no solution. While drinking take a triptan (Zomig,Relpax,Imitrex)
    Disodium Inosinate : 7-9 : Avoid
    Disodium EDTA : 10 : Avoid
    Maltodextrin : 6 : Avoid
    Perfumes : 9 : Avoid girlfriends
    Artificial Sweeteners : 7 : Avoid
    Intense Physical Exercise : 10 : Drink water, breathe deeply thru mouth, ALWAYS cover up, helps increase sweat. If I sweat I won’t trigger, if I don’t sweat I trigger. Yes, I can exercise HARD and not sweat. 
    Slight Dehydration : 5 : Drink water, sugar, salt, lemon (yuck)
    Moderate Dehydration : 7 : Drink water, sugar, salt, lemon (yuck) take a triptan

  63. A disclaimer: I’m a practicing neurologist.

    Triggers are tremendously helpful in diagnosing migraines. No doubt. Most headache specialists have people keep headache diaries to identify them. One of the first triggers a physician should ask about are periods. I’m surprised that was missed. And normalizing a woman’s estrogen and progesterone levels can be an very effective treatment. But progesterone-only birth control pills would have done that, just as well as the yams. And if yams helped, I don’t understand why the birth control pills didn’t, back when she was taking them prior to 2006.

    Also, I didn’t hear that anyone ever figured out why she lost her period – or if it came back – which is a pretty big deal, medically. Also, having been on fifty different drugs is insane. I’ve seen a lot of patients with refractory migraines, and I’ve never seen a list longer than ten. There are four or five different classes that can help, and it makes sense to try one or two in each class – but that’s it. I know that the post isn’t designed to give all the details of her medical history, but to this physician, the story sounds incomplete.

    And as for the naturopathy vs. medicine debate, I’m not clear on what naturopathic treatment she received. Someone listened to her, found a hormonal irregularity and identified some triggers, and treated her with a supplement and a change in her habits. Sounds like standard allopathic medicine to me. It’s a shame it took so long for her to get that attention.  

  64. Wait… she tried 13 types of birth control, over the course of a year?! BC effects a woman’s cycle, which is usually about 28 days. Not only is it crazy to try so many different hormones in such a short time, there is no way you could see if they work. It takes at least a month or two to get any positive effects from this type of hormone therapy. Also, 50 drugs in a year is equally crazy, and I agree with the doctors that there is no way she took them long enough to know if they worked.

    It’s great that this person found what works for her, but I work in the natural products industry and know several people who have not used any of the chemicals she avoids for years or even decades and still have regular migraines. I don’t think the placebo effect should be discounted in this instance.

    I’m a huge fan of natural products and not a big fan of prescription meds, but I don’t think this one story proves anything about what works for migraines.

    1. The thing about “what works for migraines” is that it is different for different people – what works for Sarah is only likely to help a subset of other migraine sufferers, possibly a very small subset.

      For me green tea must be avoided at all costs – guaranteed migraine if I have it. for other people, not so much.

  65. 50 “migraine medications”  in one year?
    13 birth control pills in one year?

    You have got to be kidding me.
    Not one doctor suggesting she keep a trigger diary? Not one doctor suggesting she clean her environment and eliminate certain “known trigger” foods? Not one doctor trying progesterone pills instead of estrogen pills?
    You have got to be kidding me.

    Now, a team of doctors trying to find and  treat a tumor with specific therapies (and therefore not being too focused on the migraines specifically) – THAT I can buy.

    Either this woman was surrounded by the most incompetent boobs in the medical industry or she’s exaggerating her story out of the bounds of credulity. I’ve had migraines all my life. Last I checked, there’s only 3 specific compounds unique to migraine pain mitigation. Everything else is generalized pain relievers or off-label prophylactics (usually tricyclic anti-depressants)

    This whole story does not at all fit together.  

  66. Oh and the one thing that finally lessened my migraines?

    Discovering I had both types of herpes IN MY SPINAL FLUID. I take daily anti-virals and my migraines went down to one every three months or so. Which Imitrex treats just fine. I do not recommend asking your doctor to search for spinal herpes as it takes a lumbar puncture during a flare-up to find it. On the other hand, if you end up in the hospital with meningitis it’d be a good idea to suggest looking for it.

    So you see, conventional medicine sure helped me. Every day that I take my valacyclovir I thank modern medicine for my pain-free existence (and no more hospital visits)

  67. 133 comments? Medical anecdotes draw lots of attention.

    Would a broader discussion of systemic failings of our medical and scientific institutions draw the same number of comments?

  68. I bet two of those 50 useless drugs are working for me right now. Why is that noteworthy? It is nearly dangerous to broadly call them “useless.” They didn’t work FOR HER but I bet they work for many. 

  69. Being written as a story, I can completely understand “about 50” drugs.  Recall may not be as good, especially someone who is in pain.  It could have been 25, it could have been 45.  It also didn’t say that it was 50 specific migraine medications.  I’d say after a few years of suffering like this, she knew what it was ‘supposed’ to feel like, and if the medications made her feel worse, then ya, I’d quite the drug too…probably AFTER talking to the doctor. 
    Also note in the article, the word “tolerable”.  She was trying to find something “tolerable” to take.  To me, that would indicate that the medications that she was taking were causing side effects (like the first painkiller) that she didn’t want.  

    Personally, I’m in the camp that we take too many drugs for to many things that can be more simply fixed.  A change in diet is a ‘natural’ cure, as is eliminating triggers (for migraines or otherwise).

  70. Coventional medicine is certainly useful, but since it is set up for profit, you must be proactive, which is how I read the above article (though it does appear there is some exaggeration). Here are my own personal anecdotes, some I went straight to the doctor for and some I thought were not serious enough for that, so I tried a few simple things first. It is not an either/or problem, it is about the fact that doctors are not neccessarily paid to heal you. If you want that, you must be your own advocate.

    Problem: constant sweaty armpits.
    Dermatologist solution: Drysol (heavy duty antipersperant, applied to underarms and sleep in tight shirt with saran wrap…yuck.) He said it was probably nerves.
    My solution: I tried Drysol and hated it. I eventually found that doing yoga address the underlying problems with my “nerves” and it went away.

    Problem: restless legs
    Conventional solution: they have a drug for that
    My solution: I happened to realize that I didn’t get it if I was consisitent with taking a multivitamin. That worked for years. When I got pregnant it would sometimes occur even with prenatals. Magnesium seems to help. Doing some research to try and figure out what it was in the vitamins led to information on how calcium/magnesium balance affects contraction versus relaxation of muscles…

    Problem: mouth ulcers
    GP solution: “meh, some people get them, we don’t know why, nothing you can do do about it”
    My solutuion: after internet research, I discovered there are different things (as with migraine triggers) for different people that lead to them. For me, it seems to be acidity in food, but the solution is taking one caplet of L-lysine a day. That took me from almost always having at least one ulcer, to almost never having any. If I don’t take it, they come back within a day or two. If I take the hard pill versus the powdery caplet I still get them.

    Problem: horrible daily headaches
    GP Solution: just stress, take some Naprosen (like I hadn’t tried that)
    My solution: I did some research online and discovered myofascial pain, cervical headaches, and other possible causes. Went to a chiropractor and hated that. Did some more research, saw a PA at the GP office and said I think it’s related to my neck. He said “I doubt it, but here’s a referral to a head and neck pain clinic”. Correcting postural problems, physical therapy, subtle exercises, relaxation exercises–all this worked and gave me the tools to keep it in check to this day. Had I gone back to the GP just complaining that Naprosen didn’t work maybe they’d have given me a pain killer or a muscle relaxant.

    Problem: crazy horrible itching head to toe
    Conventional Solution: emergency room, where they gave me a shot for allergy and said it was probably something I ate.
    My solution: same as above. DUH! But, I later figured out it was a prescription medicine for mentrual cramps that I became allergic to because it happened a month later when I took it again…and never sense.

    Obviously, there are some issues that you go straight to the doctor for, do not pass go. But there are many complicated things that require logic, trial-and-error and TIME to figure out. It is everyone’s right to choose whether they want to invest that time…or just take a pill.

    1. Have you looked at salicylates as a factor? A lot of the symptoms you’re describing are associated with salicylate intolerance. And you’ve mentioned “acidic” foods which people commonly use as a label for things like strawberries and tomatoes which are on the extreme end of the spectrum for salicylate levels. (Tomatoes also contain glutamates.)

  71. I wonder if she was ever prescribed small amounts of ketamine. It sounds odd, but one of my best friends suffers from awful migraines and ketamine has been the only thing that’s helped. She’s been through all the MRIs and CAT scans allowable by her insurance and the doctors can’t find anything. Ketamine was a last resort, but it’s been insanely effective.

  72. So, wait. The “conventional” doctor suggests she take birth control, and she gets in a screaming match. The “natural” doctor suggests she has low progesterone, and take a “natural” remedy, and it’s a miracle cure. Except, birth control also contains progesterone, and doesn’t always contain estrogen, and would have done the exact same thing.

    So I guess the moral of the story is that conventional medicine fails when you refuse to take it? Do we need our hospitals to wrap their trade in superstitious nonsense to get people to go along with their diagnosis? Maybe buy out a gift shop from Sedona and redecorate the waiting rooms?

    1. “The “conventional” doctor suggests she take birth control, and she gets in a screaming match. The “natural” doctor suggests she has low progesterone, and take a “natural” remedy, and it’s a miracle cure”

      “Over the same year that she tried fifty drugs for her migraines, she tried thirteen different birth control pills, hoping to find one that was tolerable and made  her migraines better. She never did. None of them made her migraines worse, but some caused nausea.”

      She did try birth control pills – they did not help her

      Your sarcasm and mockery don’t serve your point when you are not even reading the article – they just show your lazy bias.

      “So I guess the moral of the story is that conventional medicine fails when you refuse to take it?”

      It failed her, apparently. Pretending this story applies to all cases of conventional medicine use and then mocking that statement is weak. Classic unscientific straw man weak tea. 

      This is not about naturopathic versus allopathic medicine – it is about personal responsibility for one’s own health and finding what works, in the face of mindless and lazy prejudice such as that being demonstrated in some of the more dismissive comments here..

  73. As the son of a family physician, I have some of my own anecdotal observations from years of dinner table discussions. First, doctors are victims of their own PR. Spend years convincing people of your infallibility and they tend to get mad and disappointed when you don’t really have a good answer for them. Some doctors tend to believe their own PR also. Those should be avoided.

    Second, doctors condition people to expect a cure for every problem because they have become dispensing machines for the most part. Describe symptoms, receive prescription. In and out in 10 minutes. Works fine in many cases because many problems are simple. But some are not and the insurance model does not allow for extensive histories and stabs-in-the-dark diagnoses for complicated problems. 

    Finally, human bodies are complex, as has been noted above several times. What works for me may not work for you because everyone has different chemistry. It doesn’t necessarily mean that you received inadequate care because you weren’t cured on the first try. Sometimes symptoms mask other symptoms. Sometimes patients make stuff up. Sometimes they just want attention. Sometimes the doctor is really thinking about his golf game. Reality is never as straightforward as we would like.

  74. I really appreciate this article on Boing-Boing.  It reminds me that I need to research my own migraine triggers more thoroughly (Air pressure, scents, chocolate, wine, MSG, but nothing consistent).  It gives me some hope that if I put some effort into it I might find a common theme that could lead my doctor into finding a solution.

    The right thing to do based on this article and accompanying comments is try to do your own research AND enlist the aid and expertise of doctors AND perhaps try the natural way too.  When you’re in that much pain, you want to put any and all resources to work on the problem at the same time.

    Next thing I want to read up on, all triggers aside, are they any closer to a cure?

    1. You could look into the RPAH Elimination Diet. It’s not terribly well-known outside of Australia where it has been developed based on Feingold’s research from the 60s. It makes tracking down and diagnosing food/environmental intolerances as scientific as possible when there are no scientific tests available for these intolerances. Note: there are a bunch of people who do this diet who also subscribe to a huge amount of woo. Try to ignore that if you can.

      Side note: if you can find a consultant dietitian who has experience in this stuff, you have faster success in tracking down your triggers.

  75. If any gynecologist told me I was “being an idiot” at any time, he would
    have to worry about finding a way to alleviate severe pain from my foot
    in his ass.

    And then what do you do if they’re the only OB/GYN in town?

    Why any woman would go to a male gynecologist is beyond me.

    Gender has nothing to do with compassion or good care.

    I know; I was surprised, too!


    Like going to a mechanic who’s never owned a car.

    Ironically, my mechanic does not own a car. He’s a great mechanic, however.

  76. Medicine is based on science, but the practice of medicine is also an art, and not all doctors are equally good at it. To state the obvious, that doesn’t invalidate the science, any more than bad painters invalidate the chemistry that goes into making their paints.

    From the point of view of scientific research, Sarah, the anecdotal case, was hampered by only studying one narrow question (why she got migraines), and only having one subject to experiment on (herself). What she had going for her was a background in science and logical thinking, which stood her in good stead. She went after the problem in a logical way. She learned all she could, kept detailed records, and removed and reintroduced variables in an orderly fashion.

    Science isn’t a product that you ship or an orthodoxy you embrace on faith alone. Science is a way of examining the world around us, and accumulating a body of tested results. There’s nothing unscientific about deciding that your doctors aren’t practicing medicine terribly well. I did the same thing myself, many years ago, with an equally hard-to-diagnose condition.. For the record, during that long and vexing process I lost patience with alternative medicine a lot sooner than I lost patience with mainstream medicine.

    Naturopathy had squat to do with sorting out Sarah’s migraines. Sarah did 95% of the work herself. All Dr. Ritcey did was spot the correlation between migraines and menstrual periods. Arguably, looking for patterns is something all of Sarah’s previous doctors should have done. Perhaps some of them would have done so if, at the beginning of the diagnostic process, they’d had the benefit of all that detailed tracking data Sarah had compiled by the end of the process.

    Dr. Ritcey is a trained physician. That’s why she knows about things like regular fluctuations in hormone levels before and after menstruation. Scientific medicine, not naturopathy, taught her that. Scientific medicine also provided the tests that revealed Sarah’s low progesterone levels. If her wild yam cream contains progesterone, thank science for that knowledge as well. As for using creamed wild yam rather than a standardized pharmaceutical preparation for the delivery device, that’s just exotic packaging.

    Seth Roberts thinks this is a story about naturopathy delivering superior results. He is mistaken. What the story itself tells us is that Sarah’s diagnosis and treatment owed almost nothing to naturopathy.

  77. After thirty years of having migraines quite frequently I developed a heart problem which, in turn, led to me having a series of strokes. Migraines stopped. Completely. Neurologist said this is by no means rare, and that we have no idea why it happens. I don’t really recommend it as a cure for migraines, but…

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