Patient's Query
Hello doctor,
I am a 29‑year‑old female who has had migraines since my teenage years. Aura, throbbing headache, vomiting, often worse around my cycle. MRI scan of the brain was normal. I tried triptans, but the side effects make me feel spaced out.
I heard about monthly CGRP injections; are they safe for young women? My vitamin B12 level is 210 pg/mL, and my ferritin level is 18 ng/mL. Can deficiencies make migraines worse? Do hormonal contraceptives trigger migraines, or can they help regulate them?
Kindly help.
Thank you.
Hello,
Welcome to icliniq.com.
I read your query and understood your concern.
Vitamin B12 and ferritin deficiencies can absolutely contribute to worsening migraines. Your vitamin B12 level is considered low by many experts, and your ferritin is quite low. Both deficiencies are well-known contributors to fatigue, brain fog, and a lower threshold for migraine attacks.
Correcting these is a crucial first step. I strongly suggest discussing a supplementation plan with your doctor. This intervention alone may not eliminate migraines, but it can help your body function better and potentially reduce the frequency or intensity of attacks.
For many women with menstrual‑related migraines, a drop in estrogen just before the period is a major trigger. In some cases, using continuous or extended‑cycle hormonal birth control can effectively regulate hormones and prevent those attacks.
There is an important caveat. For women who experience migraine with aura, there is a small but increased risk of ischemic stroke when using combined hormonal contraceptives. Because of your aura, you should avoid estrogen‑containing pills, patches, or rings. Safer options to discuss with your doctor include progestin‑only methods or non‑hormonal alternatives.
Treatment with CGRP (calcitonin gene‑related peptide) monoclonal antibodies has been revolutionary for many migraine sufferers. They are specifically designed to target the CGRP pathway, a key player in migraine pain. Regarding safety, young women are generally considered safe and well-tolerated.
They are not hormonal and do not affect fertility. Deciding to start one involves weighing the significant potential benefits, such as reducing migraine days, against the costs and the requirement for monthly injections.
I hope that this answers your query.
Kindly follow up if you have more doubts.
Thank you.
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Answered byDr. Kanishka Sharma
Medically reviewed byiCliniq medical review team
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