u/Horror_Set9833 — reddlx

Medication Overuse and Migraine

Hi!

I hope this post is okay, as I'm not posting any particular recent study, but I was reading up on medication overuse and thought these studies were interesting/the results surprised me, so I'm sharing in case they might interest someone else.

To note: these articles are from the same researchers about the same patients.

I spoke with my neurologist about whether detoxing again from medication overuse was necessary before starting the next preventative treatment we'd planned for me.

On the one hand, it is standard practice here to do it at least once, and can be required by insurance before certain treatments, like botox or CGRP-meds are given, as sometimes preventative treatments are no longer necessary after detox because attack rates drop <2 days a month. On the other hand, my neurologist said that a good preventative will naturally reduce medication overuse.

So I got curious which it was and started reading a bit, and found that both statements are correct, actually.

Several studies [PMID: 15154858, 32453406] show that about 70% of people with medication overuse convert from chronic to episodic migraine after a withdrawal period, which, personally, I thought was a (positively) surprising number.

Then again, in about 75%, medication overuse ceased after starting a preventative, without being instructed for a withdrawal. [PMID: 32453406 ]

If you can see this graph ( I think it ended up at the top of the post), the drop in headache days between a group with withdrawal without a preventative (the blue line) or the group with withdrawal with preventative (purple line) at 4 months is about the same!

The orange line belongs to a group that was only started on a preventative without mentioning medication overuse at all until the sixth month, when they were told about medication overuse (if still applicable) and possible withdrawal, given the option to do so, but it wasn't necessary.

To note: there are several people in the withdrawal without preventative group that refuses to start a preventative after withdrawal, so that might play a role in that group having an increase in headaches again. [PMID: 34325483 ]

The withdrawal in these studies is defined as zero acute pain medication use except for anti-histamines. On r/migraine, I have also seen some people being instructed to restrict their intake by cutting down to 8-10 days a month instead of withdrawing completely. About that, I found this study [PMID: 29050498 ].

While both options are effective, complete withdrawal seemed more effective, with a drop in headache days by 7.2 days/ 46% in the withdrawal group and 3.6 days / 22% in the restricted intake group. Disability reduction and decrease in headache burden was greater in the withdrawal group [PMID: 30732459]

The advice/conclusion so far from the main study is that withdrawal should be 3 months without any NSAIDs/opioids/combination analgesics and 2 months without triptan, while simultaneously starting a preventative.

These are the studies:

https://pubmed.ncbi.nlm.nih.gov/15154858/

https://pubmed.ncbi.nlm.nih.gov/32453406/

https://pubmed.ncbi.nlm.nih.gov/34325483/

https://pubmed.ncbi.nlm.nih.gov/29050498/

https://pubmed.ncbi.nlm.nih.gov/30732459/

u/Horror_Set9833 — 1 day ago

▲ 15 r/plantID

Plant in my sage

Recently I planted some sage, and I did grow some sage, but also another plant.

It doesn't look like sage, it doesn't smell like sage, nor like anything else in my home.

I'm assuming there was another seed among the seeds or maybe in the soil (no birdie brought this, as it has been inside next to a window that doesn't open)

Anyone know what this is? And is this edible/a herb as well?

It's starting to develop some flower buds, and you can't see it in the picture, but it looks like the petals are going to be white.

u/Horror_Set9833 — 2 days ago

▲ 4 r/bulletjournal

Inspiration needed for extra page

Hi all!

I always code my months with my washitape, but unfortunately the washitape I used for this month was finished with one less spread than I usually have.

So I have my monthly, habits and weeklies, and then one more spread. On the right side I'm doing a dream radio (what song is in my head when I wake up), but I don't know what to do on that left page.

Normally I would do a gratitude log there, but a single page is not long enough for that for me (I used three last month and that also wasn't enough). As I also started a 'normal' journal last month, I've decided to migrate my gratitude to that one.

Which leaves me to wonder what I should do with that last page. I am thinking about a sort of reflection-theme, but not sure what to do.

I've done one memory a day spread in the past, but couldn't make that work for me.

What do you have for reflection/end of the month pages? Or fun pages, like the songs?

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u/Horror_Set9833 — 4 days ago

▲ 3 r/keto

Beach snacks/meals

Hello!

It's quite hot here this weekend, and I was planning to spend some time at the beach.

Does anyone have some good tips of food/snacks I could bring? I don't really have a good cooler, just an isolation bag/frozen elements. I feel like most keto foods (eggs, cheese, meats, yoghurt et cetera) are best cooled, and just nuts/raw veggies won't be enough.

Does anyone have some creative ideas?

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u/Horror_Set9833 — 17 days ago

▲ 21 r/plants

Variegated basil

Bought some basil at the grocery store to make pesto (but took some cuttings first), and noticed one of the cuttings seems to have some variegation.

Quite cool, never seen this in basil before!

u/Horror_Set9833 — 18 days ago

▲ 8 r/keto

Keto for migraines - is it worth it?

Hi, and sorry in advance as this may be a bit ranty.

I started doing keto at the end of april in the hope of lessening my chronic migraines.

I was really hopeful the first week because I had 2 days that week that were migraine free (which happens sometimes, but rarely, so not sure if it's a coincidence or not. Plus I also started ajovy about 3 months before starting keto so that might also have played a role). Unfortunately, that didn't hold up for the weeks after.

After 2,5 weeks of doing strict keto ( I weighed everything, stayed under 20g carbs), I developed keto rash and decided to up my carbs to 50g as the itching was keeping me up at night.

2 weeks later, as the itching and redness had gone (unfortunately the marks are still there), I decided to lower my carbs by 10g a week.

I'm currently eating about 30g, and my keto rash just returned and keeps getting worse. My migraines are no different than usual.

I'm just wondering if it's worth continuing? From what I've heard, most people notice a significant effect on their migraines within the first three weeks, and I didn't really.

I feel less bloated, and it's nice to feel like I have control/the ability to do something about my migraines instead of just waiting on meds to work when they haven't yet so far, even if this also doesn't work yet. It would also help if I knew

So, are their others here that used keto for migraines, and how long did it take to work? How effective was it?

Would it be worth trying upping my carbs a bit more for a bit longer so my body has more time to adjust? And for how long would that be?

As I know people will likely ask: I stay away from sweeteners/processed "keto" foods and eat mostly nuts/seeds/berries/fish/meat and veggies, but also some cheese and sausages; I drink at least 2L a day (but often more), and I get about 355mg of magnesium from food plus 500 from supplements, an average of 3000mg of potassium a day (which, granted, not as high as I would like it to be), and somewhere between 2000-6000mg of sodium (my scales are not precise enough to weigh salt and I am terrible at estimating it, 2000mg is the very minimum but likely a large underestimation; I did get more sodium at the start, had hardly any keto flu, and my current intake is roughly double that which I had before starting keto)

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u/Horror_Set9833 — 27 days ago

▲ 3 r/whatsthisbug

Larvae in soil of houseplants

Located in western Europe. I have some seedlings that are in soil that has been wet for awhile, saw these at the bottom of two of the pots.

What are they? Are they harmful for the plant?

They are completely white/translucent, I think I see 6 legs (but they are small and moving around a lot), about 2mm long, and have antennae.

I recently used nematodes against fungus gnats/thrips (although I haven't seen thrips in about 2 months).

Most pictures I see of fungus gnats larvae they have black heads and no antennae though.

Are they springtails? But they don't jump around a lot.

Thrips larvae? Although those are not usually in the soil/at the bottom of the pot. Something else?

u/Horror_Set9833 — 1 month ago

▲ 5 r/keto

Keto Rash

Hi Everyone!

About 2,5 weeks ago I started doing keto in the hope it would help with my chronic migraines.

Since about a day or 2 my back is itching and now I also developed bumps/welts on my back and in my armpits (after sweating more yesterday too), so I'm afraid I've developed keto rash. This also developed after I started using MCT oil, not sure if that's coincidence or if that helped it get along.

I plan to up my carbs to about 50g for a while (although I'm afraid that won't do much for my migraines).

I read other posts, and that for most people it will go away after upping their carbs or even just on their own (or after drinking dandelion tea), but online I read it can leave permanent discoloration and couldn't find too much about that.

So what are your experiences with keto rash? Did it leave discolouration, and if so, did it fade completely?

And for people who upped their carbs, were you able to go back into ketosis without the same problem or did it return?

I really want to give this a good try because the first week of this diet I had 3 headache free days (which is a lot for me) but the second week I still had a migraine every single day. So I want to figure out if this works but don't want to risk permanent marks if it doesn't...

reddit.com

u/Horror_Set9833 — 2 months ago