Migraine: When Headaches Are The Tip Of The Neurological Iceberg

Yesterday, we asked you “What is a migraine?” and got the above-depicted, below-described spread of responses:

• Just under 46% said “a headache, but above a certain level of severity”
• Just under 23% said “a headache, but caused by a neurological disorder”
• Just over 21% said “a neurological disorder that can cause headaches”
• Just under 10% said “a headache, but with an attention-grabbing name”

So… What does the science say?

A migraine is a headache, but above a certain level of severity: True or False?

While that’s usually a very noticeable part of it… That’s only one part of it, and not a required diagnostic criterion. So, in terms of defining what a migraine is, False.

Indeed, migraine may occur without any headache, let alone a severe one, for example: Abdominal Migraine—though this is much less well-researched than the more common with-headache varieties.

Here are the defining characteristics of a migraine, with the handy mnemonic 5-4-3-2-1:

• 5 or more attacks
• 4 hours to 3 days in duration
• 2 or more of the following:
  • Unilateral (affects only one side of the head)
  • Pulsating
  • Moderate or severe pain intensity
  • Worsened by or causing avoidance of routine physical activity
• 1 or more of the following:
  • Nausea and/or vomiting
  • Sensitivity to both light and sound

Source: Cephalalgia | ICHD-II Classification: Parts 1–3: Primary, Secondary and Other

As one of our subscribers wrote:

❝I have chronic migraine, and it is NOT fun. It takes away from my enjoyment of family activities, time with friends, and even enjoying alone time. Anyone who says a migraine is just a bad headache has not had to deal with vertigo, nausea, loss of balance, photophobia, light sensitivity, or a host of other symptoms.❞

Migraine is a neurological disorder: True or False?

True! While the underlying causes aren’t known, what is known is that there are genetic and neurological factors at play.

❝Migraine is a recurrent, disabling neurological disorder. The World Health Organization ranks migraine as the most prevalent, disabling, long-term neurological condition when taking into account years lost due to disability.

Considerable progress has been made in elucidating the pathophysiological mechanisms of migraine, associated genetic factors that may influence susceptibility to the disease❞

Source: JHP | Mechanisms of migraine as a chronic evolutive condition

Migraine is just a headache with a more attention-grabbing name: True or False?

Clearly, False.

As we’ve already covered why above, we’ll just close today with a nod to an old joke amongst people with chronic illnesses in general:

“Are you just saying that because you want attention?”

“Yes… Medical attention!”

Want to learn more?

You can find a lot of resources at…

NIH | National Institute of Neurological Disorders & Stroke | Migraine

and…

The Migraine Trust ← helpfully, this one has a “Calm mode” to tone down the colorscheme of the website!

Particularly useful from the above site are its pages:

• Common migraine attack triggers
• Treatment options

Take care!

Eggs: All Things In Moderation?

We asked you for your (health-related) opinion on eggs. We specified that, for the sake of simplicity, let’s say that they are from happy healthy backyard hens who enjoy a good diet.

Apparently this one wasn’t as controversial as it might have been! We (for myth-busting purposes) try to pick something polarizing and sometimes even contentious for our Friday editions, and pick apart what science lies underneath public perceptions.

However, more than half (in fact, 60%) of the subscribers who voted in the poll voted for “Eggs are nutritionally beneficial as part of a balanced diet”, which very moderate statement is indeed pretty much the global scientific consensus.

Still, we’ve a main feature to write, so let’s look at the science, and what the other 40% had in mind:

Eggs are ruinous to health, especially cardiometabolic health: True or False?

False, per best current science, anyway!

Scientific consensus has changed over the years. We learned about cholesterol, then we learned about different types of cholesterol, and now we’ve even learned about in some instances even elevated levels of “bad” cholesterol aren’t necessarily a cause of cardiometabolic disorders so much as a symptom—especially in women.

Not to derail this main feature about eggs (rather than just cholesterol), but for those who missed it, this is actually really interesting: basically, research (pertaining to the use of statins) has found that in women, higher LDL levels aren’t anywhere near the same kind of risk factor as they are for men, and thus may mean that statins (whose main job is reducing LDL) may be much less helpful for women than for men, and more likely to cause unwanted serious side effects in women.

Check out our previous main feature about this: Statins: His & Hers?

But, for back on topic, several large studies (totalling 177,000 people in long-term studies in 50 countries) found:

❝Results from the three cohorts and from the updated meta-analysis show that moderate egg consumption (up to one egg per day) is not associated with cardiovascular disease risk overall, and is associated with potentially lower cardiovascular disease risk in Asian populations.❞

Source: Egg consumption and risk of cardiovascular disease: three large prospective US cohort studies, systematic review, and updated meta-analysis

Egg whites are healthy (protein); egg yolks are not (cholesterol): True or False?

True and False, respectively. That is to say, egg whites are healthy (protein), and egg yolks are also healthy (many nutrients).

We talked a bit already about cholesterol, so we’ll not rehash that here. As to the rest:

Eggs are one of the most nutritionally dense foods around. After all, they have everything required to allow a cluster of cells to become a whole baby chick. That’s a lot of body-building!

They’re even more nutritionally heavy-hitters if you get omega-3 enriched eggs, which means the hens were fed extra omega-3, usually in the form of flax seeds.

Also, free-range is better healthwise than others. Do bear in mind that unless they really are from your backyard, or a neighbor’s, chances are that the reality is not what the advertising depicts, though. There are industry minimum standards to be able to advertise as “free-range”, and those standards are a) quite low b) often ignored, because an occasional fine is cheaper than maintaining good conditions.

So if you can look after your own hens, or get them from somewhere that you can see for yourself how they are looked after, so much the better!

Check out the differences side-by-side, though:

Pastured vs Omega-3 vs “Conventional” Eggs: What’s the Difference?

Stallone-style 12-egg smoothies are healthy: True or False?

False, at least if taken with any regularity. One can indeed have too much of a good thing.

So, what’s the “right amount” to eat?

It may vary depending on individual factors (including age and ethnicity), but a good average, according to science, is to keep it to 3 eggs or fewer per day. There are a lot of studies, but we only have so much room here, so we’ll pick one. Its findings are representative of (and in keeping with) the many other studies we looked at, so this seems uncontroversial scientifically:

❝Intake of 1 egg/d was sufficient to increase HDL function and large-LDL particle concentration; however, intake of 2-3 eggs/d supported greater improvements in HDL function as well as increased plasma carotenoids. Overall, intake of ≤3 eggs/d favored a less atherogenic LDL particle profile, improved HDL function, and increased plasma antioxidants in young, healthy adults.❞

Source: Intake of up to 3 Eggs per Day Is Associated with Changes in HDL Function and Increased Plasma Antioxidants in Healthy, Young Adults

Enjoy!