Lower Risk of Breast Cancer for Women With Migraine

Finally, some good news for migraineurs. Women with migraine had a 30 percent lower risk of breast cancer than those without, according to a recently released study. Hormonal changes, which commonly trigger migraine, are a potential link.

In particular, migraine history appeared to reduce the risk of the most common subtypes of breast cancer: those that are estrogen-receptor and/or progesterone-receptor positive. Such tumors have estrogen and/or progesterone receptors, or docking sites, on the surface of their cells, which makes them more responsive to hormone-blocking drugs than tumors that lack such receptors.

The biological mechanism behind the association between migraines and breast cancer is not fully known, but Li and colleagues suspect that it has to do with fluctuations in levels of circulating hormones.

Study: Chronic Migraine is Disabling and Severely Affects the Ability to Lead a Productive Life

The National Headache Foundation‘s American Migraine Prevalence & Prevention Study data have been reanalyzed to reveal just how debilitating chronic migraine is. Chronic migraineurs have migraine episodes at least 15 days a month and most have pain every day. Approximately one million people -– mostly women -– have chronic migraine.

Key findings of the study, from a NHF press release:

Chronic migraine remains a largely under-diagnosed and under-treated medical condition.

While the vast majority of individuals with chronic migraine (87.6%) had sought care from a healthcare professional, just 20.2% of those with chronic migraine received a diagnosis of chronic migraine, chronic daily headache or transformed migraine. Another nearly 14% were told that they had rebound headache or medication overuse headache.

Migraine-specific acute treatments were used by 31.6% of respondents with chronic migraine. Almost half (48%) of the individuals with chronic migraine were satisfied with their acute therapies. A third of those with chronic migraine (33.3%) were currently using preventive medications.

Although most individuals with chronic migraine sought medical care for this disorder, the majority did not receive specific acute or preventive medications.

One in five chronic migraine sufferers cannot work due to the severity of their condition.

Over a 3-month period, 8.2% of the chronic migraineurs missed at least 5 days of work and school. Further, slightly more than a third (33.8%) of these sufferers reported at least 5 days of significant reduction in productivity during the same time frame.

Chronic migraine severely impacts one’s ability to lead a productive life.

More than half of those with chronic migraine (57.4%) missed at least 5 days of household work, and 58.1% reported a reduction in productivity in household work for at least 5 days within the last three months.

Chronic migraineurs also reported missing out on at least 5 days of family activities within the three month period.

“With one in five chronic migraine sufferers not being able to work due to the severity of their condition, the human and economic costs to these patients, their families and their employers are staggering,” said Suzanne E. Simons, Executive Director, National Headache Foundation. “This report shows there is much work to be done to help them get the proper diagnosis and treatment they need to be able to lead productive lives.”

Migraine Linked to Blood Clots in Veins

People with migraine may be more likely to develop blood clots in their veins than those without, according to a study published today. Called venous thrombosis or thromboembolism, the blood clots can lead to strokes. Researchers speculate this is why people with migraine have a greater risk of stroke.

Studies of stroke and migraine implicate only people who have visual auras with their migraines. I wonder what migraine types the blood clot study participants had.

From Science Daily:

Of the [574] participants, 111 people had migraine. A total of 21 people with migraine also had one or more instances of venous thrombosis, or 19 percent. In comparison, 35 people without migraine had the condition, or 8 percent.

Researchers do not know why migraine and venous thrombosis are linked. One theory is that the blood of people with migraine may be more prone to clotting.

The study also found that people with migraine are not more likely to have hardening or narrowing of the arteries, which is contrary to a current theory.

Headache Only One of Migraine’s Many Symptoms

More than half of people with migraine experience nausea, neck pain, or sensitivity to lights, sounds or smells during a migraine, yet few doctors regularly ask about symptoms other than headache. These findings, from a National Headache Foundation survey, include only a partial list of possible migraine symptoms.

Migraine Goes Beyond Head Pain
(National Headache Foundation press release)

Chicago, IL – August 13, 2008 – Migraine sufferers often experience a series of associated symptoms in addition to migraine head pain, according to a recent survey conducted by the National Headache Foundation (NHF). Survey results reveal that more than 50% of respondents said they frequently or always experience symptoms such as nausea, neck pain, or sensitivity to lights, sounds or smells when suffering from a migraine. Additionally, 78% of respondents said their healthcare professional does not regularly inquire about associated symptoms experienced beyond actual migraine head pain.

“It is extremely important for headache sufferers to talk with their healthcare professionals about symptoms occurring in conjunction with pain,” said Dr. Roger Cady, Vice President and Board member of NHF. “Diagnosis of migraine is based in part on associated symptoms or characteristics such as nausea, vomiting or sensitivity to lights but communication about the entire migraine experience aids your medical provider with proper diagnosis, understanding you, and your specific treatment needs.”

Of those respondents experiencing nausea or vomiting along with their migraine head pain, many reported having to delay taking migraine medication or taking additional medication to manage their nausea. Others said they alternate an injectable form of migraine medication instead of swallowing a pill.

In order to manage migraine head pain and associated symptoms, the majority of survey respondents said they try to maintain a regular sleep schedule, eat balanced meals and reduce stress.

Additional NHF survey results:

  • 78% of survey respondents reported missing work due to migraine pain and/or its associated symptoms.
  • 84% said they frequently or always experience throbbing pain on one-side of their head with their migraine.
  • When asked to rate their migraine pain on a scale of 1-10 with 10 being unbearable, 56% of respondents said their migraine pain is typically between a 7 and 8.

NHF’s tips for dealing with migraine head pain and associated symptoms:

  • Get help. Discuss the associated symptoms of your migraine with your healthcare provider. S/he can help you determine your treatment options.
  • If you experience nausea or vomiting as associated symptoms of your migraine, talk with your healthcare provider about other forms of your medication such as injections, nasal sprays or tablets that do not require drinking water to take them.
  • Avoid identifiable migraine triggers and practice a healthy lifestyle.
  • Track your migraines. Write down when your migraines occur. Bring your results to your healthcare professional to review. A free downloadable headache diary is available at www.headaches.org.

Welcome, Neurology Now Readers

Neurology Now, the American Academy of Neurology‘s patient-focused magazine, featured The Daily Headache in its August issue. Look for it at your next doctor’s appointment or, even better, subscribe to the free magazine. Each issue is informative and spotlights patients’ experiences.

If you found out about The Daily Headache from the article, thanks for stopping by! Get to know the blog by reading some favorite posts and visiting the online support group and forum. Check back regularly for new posts or subscribe to our feed or emails.

This week at Free My Brain from Migraine Pain

Posts this week over at Free My Brain From Migraine Pain range over a variety of topics:

  • Being Prepared to see the Doctor: It takes two to tango in a doctor-patient partnership. I draw on some great resources to prepare for my long-awaited headache specialist appointment.
  • Exercise and Migraine Prevention: Take Two: New research indicates no proof of a connection between exercise and migraine prevention. It may not be proven, but there are still lots of reasons to think exercise is good for migraineurs. Some discussion of why, with some personal anecdotes thrown in.
  • Believing in Ghosts: Okay, I don’t really believe in ghosts, but sometimes when a Migraine takes me by surprise it reminds me of my nightmares.  I can’t explain – read it and you’ll understand!
  • God Grant Me the Serenity to Accept the Migraines I Cannot Change: How I use spirituality to help me through Migraines.

Megan Oltman, a migraine management coach, has volunteered to keep The Daily Headache running while I’m on vacation. Be sure to check out her blog, Free My Brain From Migraine Pain for more thoughts, tips and techniques on managing life with migraine. -Kerrie

Is One of Your Medications a Placebo?

Almost half of doctors use placebos to treat patients, but only 4% are up front with patients about it, according to an American Medical Association article. Having doctors admit that they dance around the truth to get patients to agree to a medication they don’t know is a fake is troubling. It also poses ethical questions about patient-provider relationships. But…

Placebos have an important role in medical treatment. I’d be thrilled if one did the trick for me. Telling the patient that they’re getting a placebo undermines the placebo effect, thus negating the potential benefit. I wouldn’t want to know if my doctor prescribed a placebo for me — at least not at first. However, I also expect my doctors to be honest with me.

The phrases physicians used were:

  • “[It is] a substance that may help and will not hurt. “34%
  • “This may help you, but I’m not sure how it works.” 33%
  • “It is medication.” 19%
  • “It is medicine with no specific effect.” 9%
  • “It is a placebo.” 4%

The article Doctors Use Placebos But Don’t Tell Patients describes the study and the American Medical Association’s response to it.

National Headache Awareness Week: Get a Head S.T.A.R.T. on Your Headaches

In recognition of the 15th annual National Headache Awareness Week, the National Headache Foundation (NHF) is announcing a series of events across the country in order to educate the public about types of headache and their impact on daily living, as well as stressing the importance of seeking an accurate diagnosis and appropriate treatments. This year’s National Headache Awareness Week takes place June 1-7, 2008. Nearly 21 million people were reached last year through this successful annual campaign.

“One of our primary goals during National Headache Awareness Week is to gain recognition of headache pain as a real and legitimate condition,” said Dr. Seymour Diamond, Executive Chairman of the National Headache Foundation. “Over 45 million Americans get chronic, recurring headaches. Of this number, nearly 30 million have migraine headaches.”

Activities taking place across the country this week include headache screenings, educational seminars led by expert physicians, menstrual migraine awareness events and a 5-part podcast series focusing on women’s headache issues, a radio news release and the launch of a non-profit NHF channel on YouTube.

This year, the NHF is encouraging sufferers to “Get a Head S.T.A.R.T. on Your Headaches,” offering five easy-to-remember strategies for effective headache management and treatment:

  • Seek diagnosis — Obtaining the correct diagnosis for your headache is the first step toward effective treatment.
  • Triggers — Identify and track your triggers (e.g., foods, stress, hormonal and weather changes) by keeping a headache diary and share this information with your healthcare provider.
  • Advocate — Be an advocate. Be informed. Be a participant in your headache care.
  • Resources — Utilize the National Headache Foundation as a resource. Visit www.headaches.org for the latest information about headache causes and treatments, or call 1-888-NHF-5552.
  • Treatment — Successful treatment may include medications and lifestyle changes. Work with your healthcare provider to find the right plan for you.

For the first time, this year’s campaign is drawing specific attention to menstrual migraines by designating Wednesday, June 4th as National Menstrual Migraine Awareness Day. In support of Menstrual Migraine Awareness Day efforts, the NHF will also be releasing new survey data from a recent poll of its website respondents suffering from menstrual migraine.

Additionally, the NHF is hosting a five-part podcast series specifically addressing women’s headache issues including Hormones & Headache, Contraception & Headaches, Pregnancy & Headache, Menopause & Headaches and Menstrual Migraine. Podcasts and expert questions and answers are available through links on the National Headache Awareness Week page.

This post is adapted from a National Headache Foundation press release. -Kerrie

Migraine Abortives (Triptans) & Serotonin Syndrome

Migraine abortive drugs called triptans can cause the potentially serious serotonin syndrome in rare cases, according to a study in the May 15 issue of the New England Journal of Medicine. Serotonin syndrome is a known risk when combining antidepressants and triptans. The new study shows that triptans alone can cause serotonin syndrome.

Serotonin syndrome is most likely to happen when you first start taking the medication. It is very rare and, even if it does happen, the remedy is to stop taking the medication. According to Migraine Medications May Cause ‘Serotonin Syndrome’ in the Washington Post:

The average age for someone experiencing serotonin syndrome associated only with triptan therapy was 39.9 years, and the most common symptoms included tremor, stiffness, palpitations, high blood pressure and agitation, according to the study.

Five people required hospitalization, and two cases were classified as “life-threatening.” Four of the 11 cases cleared up within an hour of treatment.

“It’s very rare and not likely to happen,” said Soldin of serotonin syndrome. “And, you just need to stop taking the drugs when it does happen. If you’re taking these medications and you have strange muscular, mental or hyperactivity symptoms, contact your doctor.”

Not sure if you’re taking a triptan? The seven available are:

  • Imitrex or Imigran (sumatriptan)
  • Maxalt (rizatriptan)
  • Amerge or Naramig (naratriptan)
  • Zomig (zolmitriptan)
  • Relpax (eletriptan)
  • Axert or Almogran (almotriptan)
  • Frova or Migard (frovatriptan

Read more about serotonin syndrome in these posts:

Botox Doesn’t Relieve Migraines & Tension-Type Headaches?

A review of all available data on treating migraines and tension-type headaches with Botox indicates it is no better than a placebo, according to a US News & World Report article. The findings are included in guidelines for using Botox published in today’s issue of the journal Neurology.

Botox Works on Muscle Disorders But Not Migraines

[B]otulinum toxin has become an effective treatment for numerous movement disorders associated with excessive muscle contraction.

The new guidelines approve its use for treating cervical dystonia, a condition of involuntary head tilt or neck movement; involuntary facial contractions, involuntary eye closure, focal limb dystonias (such as writer’s cramp), essential tremor and some spastic bladder disorders. The drug is injected directly into affected muscles.

[non-contiguous paragraphs]

The finding that botulinum toxin probably does not help relieve migraine or chronic tension headaches surprised the researchers.

“Based on currently available data, botulinum toxin injections should not be offered to patients with episodic migraine and chronic tension-type headaches,” pain guidelines author Dr. Markus Naumann, head of the Department of Neurology at Augsburg Hospital in Germany, said in a prepared statement. “It is no better than placebo injections for these types of headache.”

I haven’t even found the abstract yet. I’ll let you know as soon as I learn more about this surprising report. If you know anything about it, please leave a comment below.