Dioscorea Villosa: Hormones, Arthritis, & Skin

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On A Wild Yam Chase?

We recently came across a supplement blend that had wild yam extract as a minor ingredient. Our plucky (and usually very knowledgable) researcher had never heard of its use before, so she set about doing her thing. This is what she found…

What health claims are made?

Wild yam extract (Dioscorea villosa) is traditionally sold and used for:

  • Balancing hormones
  • Combating arthritis
  • Anti-aging effects for the skin

Does it balance hormones?

First, as a quick catch-up, we’ll drop a previous article of ours for your convenience:

What Does “Balance Your Hormones” Even Mean?

We couldn’t find almost any studies into wild yam extract’s hormone-balancing effects, but we did find one study, and:

❝Symptom scores showed a minor effect of both placebo and active treatment on diurnal flushing number and severity and total non-flushing symptom scores, and on nocturnal sweating after placebo, but no statistical difference between placebo and active creams.

This study suggests that short-term treatment with topical wild yam extract in women suffering from menopausal symptoms is free of side-effects, but appears to have little effect on menopausal symptoms❞

…which is a very thorough, polite, sciencey way of saying “wow, this does so many different kinds of nothing”

Source: Effects of wild yam extract on menopausal symptoms, lipids and sex hormones in healthy menopausal women

On the one hand, this was a small study (n=23). On the other hand, it was also literally the only study we could find.

Does it combat arthritis?

Maybe! We again didn’t find much research into this but we did find two in vitro studies that suggests that diosgenin (which can be derived from wild yam extract) helps:

And we also found a rodent study that found that wild yam extract specifically helped against “acetic acid-induced writhing and formalin-induced pain“, and put that down to anti-inflammatory properties:

Read: Bioassay-guided evaluation of Dioscorea villosa – an acute and subchronic toxicity, antinociceptive and anti-inflammatory approach

So, none of these studies tell us much about whether it would be helpful for humans—with or without arthritis, and hopefully without “acetic acid-induced writhing and formalin-induced pain”.

However, they do suggest that it would be reasonable to test in humans next.

You might prefer:

Does it keep skin young?

Again, research is thin on the ground, but we did find some! A study with wild-yam-derived diosgenin found that it didn’t make anything worse, and otherwise performed a similar role to vitamin A:

Read: Novel effects of diosgenin on skin aging

That was on rats with breast cancer though, so its applicability to healthy humans may be tenuous (while in contrast, simply getting vitamin A instead is a known deal).

Summary

  • Does it balance hormones? It probably does little to nothing in this regard
  • Does it combat arthritis? It probably has anti-inflammatory effects, but we know of no studies in humans. There are much more well-established anti-inflammatories out there.
  • Does it keep the skin young? We know that it performs a role similar to vitamin A for rats with breast cancer, and didn’t make anything worse for them. That’s the extent of what we know.

Where can I get some?

In the unlikely event that the above research review has inspired you with an urge to buy wild yam extract, here is an example product for your convenience.

Some final words…

If you are surprised that we’re really not making any effort to persuade you of its merits, please know that (outside of the clearly-marked sponsor section, which helps us keep the lights on, so please do visit those) we have no interest in selling you anything. We’re genuinely just here to inform 🙂

If you are wondering why we ran this article at all if the supplement has negligible merits, it’s because science is science, knowledge is knowledge, and knowing that something has negligible merit can be good knowledge to have!

Also, running articles like this from time to time helps you to know that when we do sing the praises of something, it’s with good reason

Take care!

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  • What you need to know about PCOS

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    In 2008, microbiologist Sasha Ottey saw her OB-GYN because she had missed some periods. The doctor ran blood tests and gave her an ultrasound, diagnosing her with polycystic ovary syndrome (PCOS). She also told her not to worry, referred her to an endocrinologist (a doctor who specializes in hormones), and told her to come back when she wanted to get pregnant. 

    “I found [that] quite dismissive because that was my reason for presenting to her,” Ottey tells PGN. “I felt that she was missing an opportunity to educate me on PCOS, and that was just not an accurate message: Missing periods can lead to other serious, life-threatening health conditions.” 

    During the consultation with the endocrinologist, Ottey was told to lose weight and come back in six months. “Again, I felt dismissed and left up to my own devices to understand this condition and how to manage it,” she says. 

    Following that experience, Ottey began researching and found that thousands of people around the world had similar experiences with their PCOS diagnoses, which led her to start and lead the advocacy and support organization PCOS Challenge

    PCOS is the most common hormonal condition affecting people with ovaries of reproductive age. In the United States, one in 10 women of childbearing age have the condition, which affects the endocrine and reproductive systems and is a common cause of infertility. Yet, the condition is significantly underdiagnosed—especially among people of color—and under-researched

    Read on to find out more about PCOS, what symptoms to look out for, what treatments are available, and useful resources. 

    What is PCOS, and what are its most common symptoms? 

    PCOS is a chronic hormonal condition that affects how the ovaries work. A hormonal imbalance causes people with PCOS to have too much testosterone, the male sex hormone, which can make their periods irregular and cause hirsutism (extra hair), explains Dr. Melanie Cree, associate professor at the University of Colorado School of Medicine and director of the Multi-Disciplinary PCOS clinic at Children’s Hospital Colorado. 

    This means that people can have excess facial or body hair or experience hair loss. 

    PCOS also impacts the relationship between insulin—the hormone released when we eat—and testosterone. 

    “In women with PCOS, it seems like their ovaries are sensitive to insulin, and so when their ovaries see insulin, [they] make extra testosterone,” Cree adds. “So things that affect insulin levels [like sugary drinks] can affect testosterone levels.”

    Other common symptoms associated with PCOS include:

    • Acne
    • Thinning hair
    • Skin tags or excess skin in the armpits or neck 
    • Ovaries with many cysts
    • Infertility
    • Anxiety, depression, and other mental health conditions
    • Sleep apnea, a condition where breathing stops and restarts while sleeping

    What causes PCOS?

    The cause is still unknown, but researchers have found that the condition is genetic and can be inherited. Experts have found that exposure to harmful chemicals like PFAs, which can be present in drinking water, and BPA, commonly used in plastics, can also increase the risk for PCOS

    Studies have shown that “BPA can change how the endocrine system develops in a developing fetus … and that women with PCOS tend to also have more BPA in their bodies,” adds Dr. Felice Gersh, an OB-GYN and founder and director of the Integrative Medical Group of Irvine, which treats patients with PCOS. 

    How is PCOS diagnosed?

    PCOS is diagnosed through a physical exam; a conversation with your health care provider about your symptoms and medical history; a blood test to measure your hormone levels; and, in some cases, an ultrasound to see your ovaries. 

    PCOS is what’s known as a “diagnosis of exclusion,” Ottey says, meaning that the provider must rule out other conditions, such as thyroid disease, before diagnosing it. 

    Why isn’t more known about PCOS?

    Research on PCOS has been scarce, underfunded, and narrowly focused. Research on the condition has largely focused on the reproductive system, Ottey says, even though it also affects many aspects of a person’s life, including their mental health, appearance, metabolism, and weight. 

    “There is the point of getting pregnant, and the struggle to get pregnant for so many people,” Ottey adds. “[And] once that happens, [the condition] also impacts your ability to carry a healthy pregnancy, to have healthy babies. But outside of that, your metabolic health is at risk from having PCOS, your mental health is at risk, [and] overall health and quality of life, they’re all impacted by PCOS.” 

    People with PCOS are more likely to develop other serious health issues, like high blood pressure, heart problems, high cholesterol, uterine cancer, and diabetes. Cree says that teenagers with PCOS and obesity have “an 18-fold higher risk of type 2 diabetes” in their teens and that teenagers who get type 2 diabetes are starting to die in their late 20s and early 30s. 

    What are some treatments for PCOS?

    There is still no single medication approved by the Food and Drug Administration specifically for PCOS, though advocacy groups like PCOS Challenge are working with the agency to incorporate patient experiences and testimonials into a possible future treatment. Treatment depends on what symptoms you experience and what your main concerns are.

    For now, treatment options include the following:

    • Birth control: Your provider may prescribe birth control pills to lower testosterone levels and regulate your menstrual cycle. 
    • Lifestyle changes: Because testosterone can affect insulin levels, Cree explains that regardless of a patient’s weight, a diet with lower simple carbohydrates (such as candy, sugar, sweets, juices, sodas, and coffee drinks) is recommended.

      “When you have a large amount of sugar like that, especially as a liquid, it gets into your bloodstream very quickly,” adds Cree. “And so you then release a ton of insulin that goes to the ovary, and you make a bunch of testosterone.” 


      More exercise is also recommended for both weight loss and weight maintenance, Cree says: “Food changes and better activity work directly to lower insulin, to lower testosterone.”


    • Metformin: Even though it’s a medication for type 2 diabetes, it’s used in patients with PCOS because it can reduce insulin levels, and as a result, lower testosterone levels. 

    What should I keep in mind if I have (or think I may have) PCOS?

    If your periods are irregular or you have acne, facial hair, or hair loss, tell your provider—it could be a sign that you have PCOS or another condition. And ask questions.

    “I call periods a vital sign for women, if you’re not taking hormones,” Cree says. “Our bodies are really smart: Periods are to get pregnant, and if our body senses that we’re not healthy enough to get pregnant, then we don’t have periods. That means we’ve got to figure out why.” 

    Once you’re diagnosed, Ottey recommends that you “don’t go through extremes, yo-yo dieting, or trying to achieve massive weight loss—it only rebounds.” 

    She adds that “when you get this diagnosis, [there’s] a lot that might feel like it’s being taken away from you: ‘Don’t do this. Don’t eat this. Don’t do that.’ But what I want everyone to think of is what brings you joy, and do more of that and incorporate a lot of healthy activities into your life.” 

    Resources for PCOS patients:

    For more information, talk to your health care provider.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • Eat More, Live Well – by Dr. Megan Rossi

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    Often, eating healthily can feel restrictive. Don’t eat this, skip that, eliminate the other. Where is the joy?

    Dr. Megan Rossi brings a scientific angle on positive dieting, that is to say, looking at what to add, rather than what to subtract. Now, the idea isn’t to have sugar-laden chocolate cake with berries on top and call it a net positive because of the berries, though. Rather, Dr. Rossi lays out how to include as many diverse vegetables and fruits as possible, with tasty recipes so that we’re too busy with those to crave junk food.

    Speaking of recipes, there are 80, and they are easy to follow. She describes them as “plant-based”, and by this what she really means is “plant-centric” or such; she does include the use of some animal products.

    This is important to note, because general convention is to use “plant-based” to mean functionally vegan, but being about the food rather than the ideology; a relevant distinction in both society and science. In the case of this book, it’s neither, but it is very healthy.

    Bottom line: if you’d like to introduce more healthy diversity to your diet, rather than eating the same three fruits and five vegetables, but you’re not sure how, this book will get you where you need to be.

    Click here to check out Eat More, Live Well, and diversify your diet!

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  • Cost of living: if you can’t afford as much fresh produce, are canned veggies or frozen fruit just as good?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The cost of living crisis is affecting how we spend our money. For many people, this means tightening the budget on the weekly supermarket shop.

    One victim may be fresh fruit and vegetables. Data from the Australian Bureau of Statistics (ABS) suggests Australians were consuming fewer fruit and vegetables in 2022–23 than the year before.

    The cost of living is likely compounding a problem that exists already – on the whole, Australians don’t eat enough fruit and vegetables. Australian dietary guidelines recommend people aged nine and older should consume two serves of fruit and five serves of vegetables each day for optimal health. But in 2022 the ABS reported only 4% of Australians met the recommendations for both fruit and vegetable consumption.

    Fruit and vegetables are crucial for a healthy, balanced diet, providing a range of vitamins and minerals as well as fibre.

    If you can’t afford as much fresh produce at the moment, there are other ways to ensure you still get the benefits of these food groups. You might even be able to increase your intake of fruit and vegetables.

    New Africa/Shutterstock

    Frozen

    Fresh produce is often touted as being the most nutritious (think of the old adage “fresh is best”). But this is not necessarily true.

    Nutrients can decline in transit from the paddock to your kitchen, and while the produce is stored in your fridge. Frozen vegetables may actually be higher in some nutrients such as vitamin C and E as they are snap frozen very close to the time of harvest. Variations in transport and storage can affect this slightly.

    Minerals such as calcium, iron and magnesium stay at similar levels in frozen produce compared to fresh.

    Another advantage to frozen vegetables and fruit is the potential to reduce food waste, as you can use only what you need at the time.

    A close up of frozen vegetables (peas, carrot and corn).
    Freezing preserves the nutritional quality of vegetables and increases their shelf life. Tohid Hashemkhani/Pexels

    As well as buying frozen fruit and vegetables from the supermarket, you can freeze produce yourself at home if you have an oversupply from the garden, or when produce may be cheaper.

    A quick blanching prior to freezing can improve the safety and quality of the produce. This is when food is briefly submerged in boiling water or steamed for a short time.

    Frozen vegetables won’t be suitable for salads but can be eaten roasted or steamed and used for soups, stews, casseroles, curries, pies and quiches. Frozen fruits can be added to breakfast dishes (with cereal or youghurt) or used in cooking for fruit pies and cakes, for example.

    Canned

    Canned vegetables and fruit similarly often offer a cheaper alternative to fresh produce. They’re also very convenient to have on hand. The canning process is the preservation technique, so there’s no need to add any additional preservatives, including salt.

    Due to the cooking process, levels of heat-sensitive nutrients such as vitamin C will decline a little compared to fresh produce. When you’re using canned vegetables in a hot dish, you can add them later in the cooking process to reduce the amount of nutrient loss.

    To minimise waste, you can freeze the portion you don’t need.

    Fermented

    A jar of red peppers in oil.
    Fermented vegetables are another good option. Angela Khebou/Unsplash

    Fermentation has recently come into fashion, but it’s actually one of the oldest food processing and preservation techniques.

    Fermentation largely retains the vitamins and minerals in fresh vegetables. But fermentation may also enhance the food’s nutritional profile by creating new nutrients and allowing existing ones to be absorbed more easily.

    Further, fermented foods contain probiotics, which are beneficial for our gut microbiome.

    5 other tips to get your fresh fix

    Although alternatives to fresh such as canned or frozen fruit and vegetables are good substitutes, if you’re looking to get more fresh produce into your diet on a tight budget, here are some things you can do.

    1. Buy in season

    Based on supply and demand principles, buying local seasonal vegetables and fruit will always be cheaper than those that are imported out of season from other countries.

    2. Don’t shun the ugly fruit and vegetables

    Most supermarkets now sell “ugly” fruit and vegetables, that are not physically perfect in some way. This does not affect the levels of nutrients in them at all, or their taste.

    A mother and daughter preparing food in the kitchen.
    Buying fruit and vegetables during the right season will be cheaper. August de Richelieu/Pexels

    3. Reduce waste

    On average, an Australian household throws out A$2,000–$2,500 worth of food every year. Fruit, vegetables and bagged salad are the three of the top five foods thrown out in our homes. So properly managing fresh produce could help you save money (and benefit the environment).

    To minimise waste, plan your meals and shopping ahead of time. And if you don’t think you’re going to get to eat the fruit and vegetables you have before they go off, freeze them.

    4. Swap and share

    There are many websites and apps which offer the opportunity to swap or even pick up free fresh produce if people have more than they need. Some local councils are also encouraging swaps on their websites, so dig around and see what you can find in your local area.

    5. Gardening

    Regardless of how small your garden is you can always plant produce in pots. Herbs, rocket, cherry tomatoes, chillies and strawberries all grow well. In the long run, these will offset some of your cost on fresh produce.

    Plus, when you have put the effort in to grow your own produce, you are less likely to waste it.

    Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Wholesome Threesome Protein Soup

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This soup has two protein– and fiber-rich pseudo-grains, one real wholegrain, and nutrient-dense cashews for yet even more protein, and all of the above are full of many great vitamins and minerals. All in all, a well-balanced and highly-nutritious light meal!

    You will need

    • ⅓ cup quinoa
    • ⅓ cup green lentils
    • ⅓ cup wholegrain rice
    • 5 cups low-sodium vegetable stock (ideally you made this yourself from offcuts of vegetables, but failing that, low-sodium stock cubes can be bought in most large supermarkets)
    • ¼ cup cashews
    • 1 tbsp dried thyme
    • 1 tbsp black pepper, coarse ground
    • ½ tsp MSG or 1 tsp low-sodium salt

    Optional topping:

    • ⅓ cup pine nuts
    • ⅓ cup finely chopped fresh mint leaves
    • 2 tbsp coconut oil

    Method

    (we suggest you read everything at least once before doing anything)

    1) Rinse the quinoa, lentils, and rice.

    2) Boil 4 cups of the stock and add the grains and seasonings (MSG/salt, pepper, thyme); simmer for about 25 minutes.

    3) Blend the cashews with the other cup of vegetable stock, until smooth. Add the cashew mixture to the soup, stirring it in, and allow to simmer for another 5 minutes.

    4) Heat the coconut oil in a skillet and add the pine nuts, stirring until they are golden brown.

    5) Serve the soup into bowls, adding the mint and pine nuts to each.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • Resveratrol & Healthy Aging

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    Resveratrol & Healthy Aging

    Resveratrol is the compound found in red grapes, and thus in red wine, that have resulted in red wine being sometimes touted as a heart-healthy drink.

    However, at the levels contained in red wine, you’d need to drink 100–1000 glasses of wine per day (depending on the wine) to get the dose of resveratrol that was associated with heart health benefits in mouse studies.

    Which also means: if you are not a mouse, you might need to drink even more than that!

    Further reading: can we drink to good health?

    Resveratrol supplementation

    Happily, resveratrol supplements exist. But what does resveratrol do?

    It lowers blood pressure:

    Effect of resveratrol on blood pressure: a meta-analysis of randomized controlled trials

    It improves blood lipid levels:

    Consumption of resveratrol decreases oxidized LDL and ApoB in patients undergoing primary prevention of cardiovascular disease: a triple-blind, 6-month follow-up, placebo-controlled, randomized trial

    It improves insulin sensitivity:

    Resveratrol retards progression of diabetic nephropathy through modulations of oxidative stress, proinflammatory cytokines, and AMP-activated protein kinase

    It has neuroprotective effects too:

    Resveratrol promotes clearance of Alzheimer’s disease amyloid-beta peptides

    Is it safe?

    For most people, it is generally recognized as safe. However, if you are on blood-thinners or otherwise have a bleeding disorder, you might want to skip it:

    Antiplatelet activity of synthetic and natural resveratrol in red wine

    You also might want to check with your pharmacist/doctor, if you’re on blood pressure meds, anxiety meds, or immunosuppressants, as it can increase the amount of these drugs that will then stay in your system:

    Resveratrol modulates drug- and carcinogen-metabolizing enzymes in a healthy volunteer study

    And as ever, of course, if unsure just check with your pharmacist/doctor, to be on the safe side.

    Where to get it?

    We don’t sell it, but here’s an example product on Amazon for your convenience

    Enjoy!

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  • What happens in my brain when I get a migraine? And what medications can I use to treat it?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Migraine is many things, but one thing it’s not is “just a headache”.

    “Migraine” comes from the Greek word “hemicrania”, referring to the common experience of migraine being predominantly one-sided.

    Some people experience an “aura” preceding the headache phase – usually a visual or sensory experience that evolves over five to 60 minutes. Auras can also involve other domains such as language, smell and limb function.

    Migraine is a disease with a huge personal and societal impact. Most people cannot function at their usual level during a migraine, and anticipation of the next attack can affect productivity, relationships and a person’s mental health.

    Francisco Gonzelez/Unsplash

    What’s happening in my brain?

    The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply:

    The earliest phase is called the prodrome. This is associated with activation of a part of the brain called the hypothalamus which is thought to contribute to many symptoms such as nausea, changes in appetite and blurred vision.

    The hypothalamus is shown here in red. Blamb/Shutterstock

    Next is the aura phase, when a wave of neurochemical changes occur across the surface of the brain (the cortex) at a rate of 3–4 millimetres per minute. This explains how usually a person’s aura progresses over time. People often experience sensory disturbances such as flashes of light or tingling in their face or hands.

    In the headache phase, the trigeminal nerve system is activated. This gives sensation to one side of the face, head and upper neck, leading to release of proteins such as CGRP (calcitonin gene-related peptide). This causes inflammation and dilation of blood vessels, which is the basis for the severe throbbing pain associated with the headache.

    Finally, the postdromal phase occurs after the headache resolves and commonly involves changes in mood and energy.

    What can you do about the acute attack?

    A useful way to conceive of migraine treatment is to compare putting out campfires with bushfires. Medications are much more successful when applied at the earliest opportunity (the campfire). When the attack is fully evolved (into a bushfire), medications have a much more modest effect.

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    Aspirin

    For people with mild migraine, non-specific anti-inflammatory medications such as high-dose aspirin, or standard dose non-steroidal medications (NSAIDS) can be very helpful. Their effectiveness is often enhanced with the use of an anti-nausea medication.

    Triptans

    For moderate to severe attacks, the mainstay of treatment is a class of medications called “triptans”. These act by reducing blood vessel dilation and reducing the release of inflammatory chemicals.

    Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action.

    The choice of a triptan depends on many factors including whether nausea and vomiting is prominent (consider a dissolving wafer or an injection) or patient tolerability (consider choosing one with a slower onset and offset of action).

    As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke.

    Nurse takes blood pressure
    Triptans should be used cautiously in patients with heart disease. CDC/Unsplash

    Gepants

    Some medications that block or modulate the release of CGRP, which are used for migraine prevention (which we’ll discuss in more detail below), also have evidence of benefit in treating the acute attack. This class of medication is known as the “gepants”.

    Gepants come in the form of injectable proteins (monoclonal antibodies, used for migraine prevention) or as oral medication (for example, rimegepant) for the acute attack when a person has not responded adequately to previous trials of several triptans or is intolerant of them.

    They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke.

    Ditans

    Another class of medication, the “ditans” (for example, lasmiditan) have been approved overseas for the acute treatment of migraine. Ditans work through changing a form of serotonin receptor involved in the brain chemical changes associated with the acute attack.

    However, neither the gepants nor the ditans are available through the Pharmaceutical Benefits Scheme (PBS) for the acute attack, so users must pay out-of-pocket, at a cost of approximately A$300 for eight wafers.

    What about preventing migraines?

    The first step is to see if lifestyle changes can reduce migraine frequency. This can include improving sleep habits, routine meal schedules, regular exercise, limiting caffeine intake and avoiding triggers such as stress or alcohol.

    Despite these efforts, many people continue to have frequent migraines that can’t be managed by acute therapies alone. The choice of when to start preventive treatment varies for each person and how inclined they are to taking regular medication. Those who suffer disabling symptoms or experience more than a few migraines a month benefit the most from starting preventives.

    Pharmacy assistant serves customer
    Some people will take medicines to prevent migraines. Tbel Abuseridze/Unsplash

    Almost all migraine preventives have existing roles in treating other medical conditions, and the physician would commonly recommend drugs that can also help manage any pre-existing conditions. First-line preventives include:

    • tablets that lower blood pressure (candesartan, metoprolol, propranolol)
    • antidepressants (amitriptyline, venlafaxine)
    • anticonvulsants (sodium valproate, topiramate).

    Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone.

    For all migraine preventives, a key principle is starting at a low dose and increasing gradually. This approach makes them more tolerable and it’s often several weeks or months until an effective dose (usually 2- to 3-times the starting dose) is reached.

    It is rare for noticeable benefits to be seen immediately, but with time these drugs typically reduce migraine frequency by 50% or more.


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    ‘Nothing works for me!’

    In people who didn’t see any effect of (or couldn’t tolerate) first-line preventives, new medications have been available on the PBS since 2020. These medications block the action of CGRP.

    The most common PBS-listed anti-CGRP medications are injectable proteins called monoclonal antibodies (for example, galcanezumab and fremanezumab), and are self-administered by monthly injections.

    These drugs have quickly become a game-changer for those with intractable migraines. The convenience of these injectables contrast with botulinum toxin injections (also effective and PBS-listed for chronic migraine) which must be administered by a trained specialist.

    Up to half of adolescents and one-third of young adults are needle-phobic. If this includes you, tablet-form CGRP antagonists for migraine prevention are hopefully not far away.

    Data over the past five years suggest anti-CGRP medications are safe, effective and at least as well tolerated as traditional preventives.

    Nonetheless, these are used only after a number of cheaper and more readily available first-line treatments (all which have decades of safety data) have failed, and this also a criterion for their use under the PBS.

    Mark Slee, Associate Professor, Clinical Academic Neurologist, Flinders University and Anthony Khoo, Lecturer, Flinders University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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