Patient's Query
Hello, Doctor,
I am 28 year old and have had migraines with aura since my teens, but lately they are worsening. I am getting 8 to 10 attacks per month, despite using sumatriptan 100 mg as abortive. MRI brain was normal, but magnetic resonance angiography (MRA) showed a slight narrowing of the posterior cerebral artery (PCA). My vitamin D is 12 ng/mL, and my iron is low at 23 mcg/dL.
Could nutrient deficiencies be triggering this?
Should I start a preventive like Topiramate or a CGRP inhibitor?
Kindly help.
Thank you.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
Your headache can be caused by vitamin D and iron deficiencies. Your low iron can reduce oxygen delivery to the brain, and low vitamin D is linked to higher migraine risk in some studies. However, given that you are having eight to ten migraine days per month, preventive therapy is reasonable in addition to correcting deficiencies.
Topiramate (an antiepileptic medication) is an established preventive option, though it can cause side effects like tingling, cognitive slowing, or weight loss. Calcitonin gene-related peptide (CGRP) monoclonal antibodies (Erenumab, Fremanezumab, Galcanezumab) are newer, generally well-tolerated monthly or quarterly injections that can significantly reduce migraine days. Your neurologist can help decide based on your health profile, potential side effects, and insurance coverage.
While preventive treatment is being started, continue avoiding such as,
Known triggers.
Maintain regular sleep.
Stay hydrated.
Ensure balanced nutrition.
With both nutrient correction and preventive therapy, your migraine burden should improve significantly.
I hope this information helps you.
Feel free to ask further queries.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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